Geographic variation

Figure 3 shows the rate of Indigenous-specific health checks by 5 different geographic classifications—state/territory, remoteness area, Primary Health Network (PHN), Indigenous Regions (IREG) and Statistical Areas Level 3 (SA3). See Box 2 for information about the reporting of geographic data.

Box 2: Geographic reporting

Geographic region types

The geographic areas presented in this report relate to one another as depicted below:

A diagram showing the different geographic area types in this report, and how they interrelate with one another. Statistical Areas Level 3 (SA3s) and Indigenous Regions (IREGs) fit within states and territories.

Notes:

Postcode data

This analysis is based on the postcode of the patient’s given mailing address. As a result, the data may not reflect where the person actually lived—particularly for people who use PO Boxes. This is likely to impact some areas more than others, and will also have a generally greater impact on the SA3 data than on the larger geographic classifications. See Box 5 in Data sources and notes for information on areas most likely to be affected.

Metropolitan classification

To distinguish different geographic regions based on their level of urban development, certain bar charts in Figures 3 and 15 depict areas as:

  • Metropolitan where at least 80% of the total estimated resident population lived in Major Urban centres at 30 June 2016 (cities with 100,000 residents or more, according to the ABS’ Section of State boundaries)
  • Non-metropolitan where at least 80% of the total estimated resident population lived outside of Major Urban centres at 30 June 2016
  • Combination where between 20% and 80% (exclusive) of the total estimated resident population lived in Major Urban centres at 30 June 2016.

In 2019–20:

  • Across states and territories, Queensland had the highest rate of Indigenous-specific health checks (with 35% of the Aboriginal and Torres Strait Islander population receiving an Indigenous health check), followed by the Northern Territory (34%). Victoria had the lowest rate (15%).
  • Across PHNs, the rate of Indigenous-specific health checks ranged from 5% (in Northern Sydney) to 39% (in Western Queensland).

Figure 3: Indigenous-specific health check rates by geography and telehealth status, 2018–19 and 2019–20

Maps and bar graphs showing the number and rate of Indigenous-specific health checks (per cent of Indigenous population) by state and territory, remoteness, PHN, Indigenous Region, and SA3, by telehealth status (face-to-face, telehealth and total).

In 2018–19, across states and territories, Queensland had the highest rate of Indigenous-specific health checks (with 35.2% of the Indigenous population receiving an Indigenous-specific health check), followed by the Northern Territory (33.5%). Victoria had the lowest rate (14.7%). Refer to tables ‘HC03’ to ‘HC07’ in data tables.

Across the 5 remoteness areas, the rate of Indigenous-specific health checks in 2019–20 was generally higher in more remote areas—increasing from 24% in Major cities to 34% in Outer regional and Remote areas. Very remote areas were the exception to this general pattern, with a rate of 27%. This may be partly due to the use of mailing address to derive these rates—in particular, where a person lives in a Very remote area, but has mail delivered to a PO Box in a less remote location, the health check will be counted in the less remote location. Another explanatory factor would be the availability of GPs in more remote areas (RACGP 2020).

Across Indigenous Regions, the rate of Indigenous-specific health checks was highest in Alice Springs (55%) and lowest in Melbourne (10%) (Figure 3). Note that the rate in Alice Springs is likely to be inflated, since many residents of Central Australia use PO Boxes located in Alice Springs for receiving mail. This means some of the health checks counted in Alice Springs probably belong to residents of Apatula (IREG).

Across SA3s, the rate of Indigenous-specific health checks ranged from 3% to 56% in 2019–20 (Figure 3; analysis relates to 328 areas for which rates could be reported).

On average, the rate of Indigenous-specific health checks was higher in SA3s with larger Indigenous populations. For example, the rate of health checks, when averaged across the SA3s in 2019–20, was:

  • 16% in SA3s with fewer than 1,000 Indigenous Australians (114 SA3s)
  • 26% in SA3s with between 1,000 and 4,999 Indigenous Australians (173 SA3s)
  • 33% in SA3s with 5,000 or more Indigenous Australians (41 SA3s).

In 2019–20, about 7 in 10 SA3s (69%, or 226 areas) had a rate below the national average (that is, a rate lower than 27.9%). This is because SA3s with larger populations—which tended to have higher rates of health checks—contribute more to the national rate than the smaller SA3s.

Change between 2018–19 and 2019–20

Most states and territories saw a drop in rates of Indigenous-specific health checks between 2018­–19 and 2019–20. In Victoria, which experienced a second COVID-19 outbreak and resulting lockdown, the proportion of the Indigenous population who received an Indigenous-specific health check fell from 16.1% in 2018­–19 to 14.7% in 2019–20. This was the largest decrease in relative terms among the states and territories (down almost 9%). Conversely, Tasmania and New South Wales saw increased rates of Indigenous-specific health checks over the same period—Tasmania’s rate increasing from 13.1% to 15.4% (up 17% in relative terms) (Figure 4).

Figure 4: Change in Indigenous-specific health check rates by geography, 2018–19 and 2019–20

Column graphs showing the rate of Indigenous-specific health checks in different states/territories and remoteness areas, for years, 2018–19 and 2019–20 – as well as telehealth status (face-to-face, telehealth and total). Most states and territories saw a drop in rates of Indigenous-specific health checks between 2018–19 and 2019–20. Victoria had the largest relative decrease in the rate of health checks—16.1% in 2018–19 to 14.7% in 2019–20. PHNs, Indigenous Regions, and SA3s are coloured by ‘Metropolitan status’, which just distinguishes areas by how much of the population lived in Major Urban areas (cities of 100,000 or more) in 2016.

Refer to tables ‘HC03’ and ‘HC05’ in data tables.

Among remoteness areas in 2018–19, Remote Australia had the highest annual rate of Indigenous-specific health checks, with 38.2% of the Indigenous population having received a health check that year. In 2019–20, however, only 34.3% of the Indigenous population received a health check (down over 10% in relative terms). Rates also dropped among Outer regional and Very remote Indigenous populations (down 6% and 5% respectively, in relative terms).

Populations living in Major cities and Inner regional areas, however, both saw rates of Indigenous-specific health checks stay about the same across the 2 financial years (Figure 4). This was partly because the use of telehealth health checks was highest in Major cities and Inner regional areas—despite falls in face-to-face health check rates in all remoteness areas between 2018–19 and 2019–20 (Figure 4). Figure 5 shows that around 5% of patients living in Major cities and Inner regional areas had Indigenous-specific health checks delivered via telehealth (claimed as MBS Items 92004, 92011, 92016 or 92023), compared with 2–3% of patients living in more remote areas.

Figure 5: Proportion of health check patients who used telehealth by remoteness, 2019–20

Column graph showing the proportion of Indigenous-specific health check patients in 2019–20 who received at least 1 health check via telehealth, by Remoteness Area. In 2019–20, 4% of Indigenous-specific health checks patients in Australia had a least 1 health check via telehealth. Those in Major cities (5%) and Inner regional areas (5%) were more likely to have at least 1 health check via telehealth, compared to those living in Outer Regional (3%), Remote (3%) and Very Remote areas (2%). Refer to table ‘HC05’ in data tables.