title: Gaps in Indigenous disadvantage not closing: a census cohort study of social determinants of health in Australia, Canada, and New Zealand from 1981-2006.
abstract: BACKGROUND
  Australia, Canada, and New Zealand are all developed nations that are home to Indigenous populations which have historically faced poorer outcomes than their non-Indigenous counterparts on a range of health, social, and economic measures. The past several decades have seen major efforts made to close gaps in health and social determinants of health for Indigenous persons. We ask whether relative progress toward these goals has been achieved.
  
  
  METHODS
  We used census data for each country to compare outcomes for the cohort aged 25-29 years at each census year 1981-2006 in the domains of education, employment, and income.
  
  
  RESULTS
  The percentage-point gaps between Indigenous and non-Indigenous persons holding a bachelor degree or higher qualification ranged from 6.6% (New Zealand) to 10.9% (Canada) in 1981, and grew wider over the period to range from 19.5% (New Zealand) to 25.2% (Australia) in 2006. The unemployment rate gap ranged from 5.4% (Canada) to 16.9% (Australia) in 1981, and fluctuated over the period to range from 6.6% (Canada) to 11.0% (Australia) in 2006. Median Indigenous income as a proportion of non-Indigenous median income (whereby parity = 100%) ranged from 77.2% (New Zealand) to 45.2% (Australia) in 1981, and improved slightly over the period to range from 80.9% (Canada) to 54.4% (Australia) in 2006.
  
  
  CONCLUSIONS
  Australia, Canada, and New Zealand represent nations with some of the highest levels of human development in the world. Relative to their non-Indigenous populations, their Indigenous populations were almost as disadvantaged in 2006 as they were in 1981 in the employment and income domains, and more disadvantaged in the education domain. New approaches for closing gaps in social determinants of health are required if progress on achieving equity is to improve.
authors.affiliation: Telethon Institute for Child Health Research, The University of Western Australia, PO Box 855 West, Perth, WA 6872, Australia. francism@ichr.uwa.edu.au.
authors.forename: Francis
authors.initials: F
authors.lastname: Mitrou
authors.forename: Martin
authors.initials: M
authors.lastname: Cooke
authors.forename: David
authors.initials: D
authors.lastname: Lawrence
authors.forename: David
authors.initials: D
authors.lastname: Povah
authors.forename: Elena
authors.initials: E
authors.lastname: Mobilia
authors.forename: Eric
authors.initials: E
authors.lastname: Guimond
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Zubrick
mesh_terms: D000328:Adult; D001315:Australia; D002170:Canada; D019352:Censuses; D015331:Cohort Studies; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D009520:New Zealand; D044382:Population Groups; D064890:Social Determinants of Health; D012959:Socioeconomic Factors; D014478:Unemployment