Community attitudes and Indigenous Health Disparities: Evidence from Australia’s Voice Referendum
Melbourne Institute Working Paper No. 08/24
Date: June 2024
Author(s):
Abstract
Objectives: Community attitudes influence health outcomes especially for racially diverse and minority groups exposed to the detrimental effects of racism and discrimination. Using the results from Australia’s national referendum to establish an Aboriginal and Torres Strait Islander Voice to Parliament (‘the Voice’) as a proxy for attitudes to Indigenous peoples, this study examined health outcomes for Indigenous and non-Indigenous Australians according to levels of opposition to the Voice.
Methods: The regional share of votes against the Voice was linked to 2021 data from the Household, Income and Labour Dynamics in Australia survey, a large, national probability sample (n∽17,000) of Australian adults. Adjusting for regional-level confounders, we used logistic regression analyses to predict health outcomes, healthcare use, and risk-taking behaviours among Indigenous and non-Indigenous Australians for different levels (quartiles) of opposition to the Voice.
Findings: Greater opposition to the Voice was associated with widening Indigenous disparities in health, healthcare use, and health behaviours. Indigenous people living in regions with the highest opposition to the Voice (top quartile: ≥72% community voting ‘No’) were more likely to report fair/poor health [OR 2.36 (95%CI 1.50-3.72)] and poor mental health [OR 2.30 (95%CI 1.50-3.52)], were less likely to have visited any healthcare provider [OR 0.52 (95%CI 0.36-0.76)], and were more likely to smoke [OR 4.54 (95%CI 2.94-7.03)] or engage in risky drinking [OR 2.68 (95%CI 1.61-4.45)] relative to non-Indigenous Australians. Widening health disparities with higher opposition to the Voice was driven by increased prevalence of poor health outcomes among Indigenous Australians.
Interpretation: Aboriginal and Torres Strait Islander people living in communities with greater opposition to the Voice experience poorer health relative to non-Indigenous Australians, which may be in part due to less healthcare access and increased risk-taking behaviours. Health and social policy should consider how broader societal level conditions shape Indigenous health disparities in Australia.
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