Research in context
Evidence before this study
Adolescence is now understood as a developmental stage in which investments in health bring a triple dividend of reduced death and disability during these years, healthier trajectories across the life-course, and the best possible start for the next generation. Many Indigenous communities have a large burden of disease, high rates of premature mortality, and poor health in early childhood. Yet there has been no comprehensive account of the health of Indigenous adolescents in Australia or in other countries. We had previously systematically reviewed health-related literature including all studies of individual health outcomes and risks for Indigenous adolescents in Australia over a 15-year period. The methodological quality of each study was graded and the focus mapped against the burden of disease reporting framework. We identified 360 publications that focused predominantly on sexually transmitted infections, oral health, and substance use, a mismatch with modelled burden of disease where mental health and injury were prominent. A simple synthesis of the published literature would therefore be unlikely to provide an adequate profile of health. We did an updated search in English on July 1, 2017, with PubMed using the broad search terms “(Aborigin* OR Indigenous)” AND “(youth OR young OR adol*)”. We did not identify a published health profile of Indigenous adolescents in any setting.
Added value of this study
This study provides the first comprehensive profile of Indigenous adolescent health in Australia. Priority areas of health need (spanning health outcomes, health risks, and sociocultural determinants) were identified to inform policy. The reported indicators provide a baseline for monitoring of progress and a framework for setting policy and service delivery priorities. Identified data gaps inform a research agenda. Although the focus of the study is Indigenous adolescents in Australia, the findings and approach used might inform the development of relevant Indigenous adolescent health policies in other countries that share similar health profiles.
Implications of all the available evidence
The health profile of Indigenous adolescents differs markedly from that of non-Indigenous Australian adolescents, with high rates of communicable, nutritional, and reproductive diseases; non-communicable diseases; and injuries. Policies and programmes designed for the broader Australian population might be inadequate to address the health needs of Indigenous adolescents. The early onset of health risks, high adolescent birth rates, and heavy disease burden suggest that without a priority focus on adolescents, Australia will not redress Indigenous health inequalities.