Editorial

Abstract

This special issue of Contemporary Nurse is focused on how nurses are helping to close the gap in Indigenous Australian health outcomes. The gap represents the accumulated, appalling statistics that compares the state of Aboriginal and Torres Strait Islander peoples' health and life expectancy to the health and longevity of all other Australians. Close the Gap is a concerted and directed campaign with many signatories including Government, organisations and agencies to reduce the level of disadvantage among Aboriginal and Torres Strait Islander peoples. The Council of Australian Governments (COAG) and Close the Gap identifi ed key areas that require immediate funding and action - health, healthy homes, education, early childhood, safe communities, economic participation and governance and leadership.Early deaths of Aboriginal and Torres Strait Islander people is linked to the long-term result of policies of removal of children, removal from land and culture, and loss of language and lore. In addition, these issues are compounded by chronic illness, including diabetes, cardiac and lung diseases (due in no small part to changes in lifestyle); poor nutrition and poor access to high quality food; poor mental health, alcohol and substance abuse; and increased rates of incarceration and suicide. Furthermore, poor access to services, lack of infrastructure, and poverty continue despite changing government policies and increased funding for health, housing, education and infrastructure. While there have been some small improvements in longevity as well as improved maternal and infant mortality and morbidity rates (AIHW National Perinatal Statistics Unit, 2009), there is still a long way to go. Armstrong (2004) echoed the critical view of a number of experts in Aboriginal and Torres Strait Islander health when she wrote that if the previous policies and strategies had worked, Aboriginal people should be the healthiest in the world. It is time for action rather than more words and numbers.While nurses and midwives have made some advances towards closing the gap in Aboriginal and Torres Strait Islander health as described in the articles included in this special edition, there are signifi cant steps nurses and midwives must yet take in order to start to begin to make a real contribution to closing the gap. Some of those steps are personal while others are the responsibility of the nursing and midwifery professions. I have outlined some of these in this foreword.On a personal level, nurses and midwives really need to understand that the statistics about the health of Aboriginal and Torres Strait Islander people represent real people. To understand each statistic as a person, a child, mother, brother, father, grannie, sister, niece or nephew, helps to make them more than just numbers. Each neo-natal statistic is a newborn baby who died - a death that often could be prevented if the required interventions were provided early enough. Each premature adult death is a mother or father with a family and perhaps little baby grandchildren. Each of these people has friends and family and lives within a community to which they contribute and where they are loved and respected. Furthermore, it is important to recognise that domestic violence fi gures actually represent families in distress - damaged families where the kids see, hear and feel the abuse of living in a violent and dysfunctional family.Likewise it follows that the fi gures surrounding mental illness and Aboriginal and Torres Strait Islander people represents real lives disrupted or destroyed with pain, suffering and anguish with a sickening propensity to end in suicide. The same is the case for people living with alcohol and substance abuse, chronic disease, poor living conditions, poor education, lower socioeconomic status, higher representation in prisons and in child protection. As we are told over and over, Aboriginal and Torres Strait Islander peoples are signifi cantly disadvantaged on every measurable level within our Australian society. …