The gap in mortality rates between Aboriginal and non-indigenous Australians is growing wider, underlining the greatest failure of the nation's health system, a major conference has heard.
Seventy-one per cent of indigenous people die before they reach 65, compared with just over one fifth of other Australians, the Australian Institute of Health and Welfare (AIHW) conference in Canberra heard on Tuesday.
Life expectancy for Aborigines is at least 17 years lower than for non-indigenous Australians.
They are 12 times more likely than non-indigenous people to have diabetes, four times more likely to have a respiratory disease and three times more likely to die from injury.
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Indigenous Australians are twice as likely to be obese as their non-indigenous counterparts, and almost half of Aboriginal people smoke tobacco.
Aboriginal women are four times as likely to fall pregnant during their teenage years, with one in five giving birth before they turn 20.
Rates of sexually transmitted infections (STIs) chlamydia and gonorrhoea have skyrocketed among indigenous people, the conference was told.
Between 1994-2000, rates of chlamydia for indigenous people leapt 179 per cent, while the incidence of gonorrhoea jumped by almost two thirds.
But despite the great disparities, the nation spent just 17 cents more per person on indigenous health than on non-indigenous Australians.
While the death rate for the Aboriginal population has fallen, that for non-indigenous people has declined more quickly.
"Although there have been improvements in the mortality rates of indigenous Australians in recent years, available data suggests that the relative gap in overall mortality rates between indigenous and non-indigenous Australians is widening," the AIHW Australia's Health 2008 report said.
Former health minister Dr Neal Blewett, the architect of anti-smoking and HIV AIDS campaigns during the 1980s, said the statistics presented on Tuesday merely scratched the surface of the "litany of shame" in indigenous health.
"We should be grateful to the institute for once again bringing to our attention in such a powerful and uncompromising fashion, the greatest failure of the Australian health system," he told the conference.
Aboriginal leader, Associate Professor Ted Wilkes, said it was part of indigenous culture not to discourage girls of child-bearing age from giving birth.
"We need to have some systems in place to deal with that," he told the conference.
Suicide was a major concern, and it was vital indigenous parents pass on positive health messages and habits to their children.
"The situation for Aboriginal people is that we are born into a world where it's normal to accept that poverty, being on the dole and doing what our parents have done to survive (are) normal behaviour."
Hospitals needed to introduce more culturally aware treatment because many indigenous people were intimidated by the system.
"Some of our mob are frightened of dying in hospital," Prof Wilkes said.
He urged health authorities and the federal government to allow indigenous people to play the leading role in lifting themselves out of poverty.
"We have a right to self-determine our pathway out of poverty," he said.
The Australian Institute of Health and Welfare (AIHW) conference, held in Canberra, Australia, received mixed messages on Tuesday about the health of Australians. While average life expectancy is 81.4 years, second only to Japan's 82.2, and rates of cancer, heart disease and stroke are dropping, incidence of obesity, alcohol-related diseases, and sexually transmitted infections are on the increase.

The AIHW report highlighted the increasing gap between Australia's Indigenous population and the rest of the nation. Australian Aborigines and Torres Strait Islanders have a life expectancy around 17 years lower than the general populace, and in at least four states 71% of Aboriginals who died were under 65-years old, compared with 21% for the rest of the population. Indigenous Australians are reported to have higher rates of obesity, diabetes, respiratory illness, teenage pregnancy and sexually transmitted infections. People living in rural and regional areas were also found to have lower life expectancies and higher illness rates than their suburban and metropolitan counterparts.

While obesity is a growing concern in Australia, AIHW director Penny Allbon expressed skepticism over a recent report from the Baker IDI Heart and Diabetes Institute that claimed that Australia had overtaken the United States as the "fattest" nation in the world, with "over four million adult Australians ... currently obese". Allben commented that the institute's sample from 100 locations across the country may not be representative of the whole population. "At the moment the ABS Australian Bureau of Statistics is out there measuring height and weight in a population-based survey, so we don't know the results," Dr Allbon said. "We were just a bit concerned that the statistics that came out about us being the fattest in the world is not based on a population survey." AIHW reported the number of Australians being obese as closer to 2.5 million, with 7.4 million being overweight.

Between 1997 and 2005, the number of general practitioners in Australia has dropped 9%, although in regional areas there has been an increase of 15%.

Based on the report, the AIHW has recommended that Australians consider lifestyle change, such as healthier eating and more exercise, to alleviate the pressure on Australia's public health system. "In rank order, the greatest improvements can be achieved through reductions in tobacco smoking, high blood pressure, overweight/obesity, physical inactivity, high blood cholesterol and excessive alcohol consumption," according to Dr. Allbon.