147 The Australia Institute, Polling – Bushfire Crisis and Concern about Climate Change (Report, January 2020) 5. 148 Poverty and poor living conditions contribute to high rates of cardiovascular disease for Aboriginal and Torres Strait Islander Peoples (18% for remote regions), with 94% of cases of Acute Rheumatic Fever, and 92% of cases of Rhematic Heart Disease involving Aboriginal and Torres Strait Islander Peoples. Kidney disease and renal failure in 2011-2015 for Aboriginal and Torres Strait Islander Peoples was 6.8 times the rate of other people, with 18.6 times the rate in the NT, and 12.7 times the rate in WA. Aboriginal and Torres Strait Islander Peoples also have 3 times the rate of blindness than other people, and trachoma, caused by poor living conditions and over-crowding, was at 4% in identified Aboriginal communities in 2017. Australia is the only developed country with trachoma. Diabetes impacts 13% of Aboriginal and Torres Strait Islander Peoples, with a death rate of 5.2 times that of other people. Cancer accounted for 9% of the disease burden for Aboriginal and Torres Strait Islander Peoples, and chronic respiratory disease is the third leading cause of death among Aboriginal and Torres Strait Islander Peoples, with Aboriginal and Torres Strait Islanders babies 4.5 times more likely to die than other babies. See, Australian Indigenous Health InfoNet, Summary of Aboriginal and Torres Strait Islander health status 2017 (Report, 2018) 10-21. 149 In 2016, an inquest was launched following 13 child deaths in the Kimberley in less than four years, including five children aged between ten and 13. The Coroner recommended a greater focus on self-determination, consultation, cultural education, increased and paid Aboriginal employment in service delivery, increased mental health services, recreational facilities and educational engagement, language learning, together with education on preventing, increased support for Foetal Alcohol Syndrome Disorder and the provision of alcohol rehabilitation with an emphasis on selfdetermination. See, State Coroner, Record of Investigation into Death: Inquest into the deaths of thirteen children and young persons in the Kimberley Region of West Australia (Report, 2017). 150 Ibid 268. 151 Ibid 334-336. 152 Ibid 295-297. 153 Ibid, 372. In a 2019 inquest into five deaths by suicide at Casuarina Prison, in which three of the deceased persons were Aboriginal or Torres Strait Islander Peoples, the Coroner made a series of recommendations on the need to improve mental health support and reduce the risk of suicide in the prison. See, State Coroner, Record of Investigation into Death: deaths of five persons incarcerated at Casuarina Prison (Report, 2019) 128–129 [666]. The Coroner also acknowledged that it is important that the cultural needs of Aboriginal and Torres Strait Islander prisoners are recognised, and that Aboriginal and Torres Strait Islander prisoners are supported by networks of Aboriginal and Torres Strait Islander Elders and support workers. See, State Coroner, Record of Investigation into Death: deaths of five persons incarcerated at Casuarina Prison (Report, 2019) 65-66 [317]-[322]. 154 State Coroner (n 149) 332. 155 Australian Bureau of Statistics, National Health Survey: First Results, 2017-18 (Catalogue No 4364.0.55.001, 12 December 2018). 156 Commission on Ending Childhood Obesity, World Health Organisation, Report of the Commission on Ending Childhood Obesity (Report, 2016). Thank you to Professor Louise Baur for reviewing this section. 157 See, Human Rights Council of Australia, Oral Statement by Cristyn Davies to United Nations Human Rights Council, 41st session, agenda item 8 (24 June 2019). 158 Culturally safe healthcare refers to care that 1) respects human rights of self-determination and bodily autonomy 2) ensures health professionals are trained in culturally safe gender affirming care; 3) that therapeutic agents are subsidised and accessible; and 3) that provides a culturally safe informed consent model practiced across communitybased services and in general practice. National frameworks and up-to-date guidelines for healthcare must be developed in partnership with community. In addition, Australia must (1) implement the Australian modification and implementation of the ICD-11 (ensuring that all diagnostic coding of ‘Gender Incongruence’ are within a newly established Sexual Health chapter and that all gender related coding is removed from the existing Mental Illness chapter), and (2) establish a review of the Medicare Benefits Schedule, which allows public funding to be directed towards particular healthcare services, to ensure the health system does not discriminate against people on the grounds of their gender identity and sex characteristics. See, Cristyn Davies et al, ‘Australians of diverse sexual orientations and gender identities’, (2020) Culture, Diversity and Health in Australia: Towards Culturally Safe Health Care; Michelle Telfer et al., Australian Standards of Care and Treatment Guidelines for Trans and Gender Diverse Children and Adolescents (Report version 1.1, Melbourne Royal Children’s Hospital, 2018); Editorial, ‘Gender-affirming care needed for transgender children’ (2018) 391 (10140) The Lancet 2576; E Coleman et al, ‘Standards of Care for the Health of Transsexual, Transgender, and Gender-Nonconforming People, Version 7’ (2012) 13(4) International Journal of Transgenderism 165-232; Cheung et al ‘Position statement on the hormonal management of adult transgender and gender diverse individuals’ (2019) 211(3) Medical Journal of Australia 127. Thank you to Associate Professor Michelle Telfer and Professor S. Rachel Skinner for reviewing this section. 159 The Human Rights Commission states “climate change threatens the enjoyment of all human rights, including the rights to health, water, food, housing, self-determination, and life itself. Climate change is man-made. It is a result of policy choices that breach the affirmative obligations of States to respect, protect and fulfil human rights”: ‘Human Rights and Climate Change’, Office of the High Commissioner, United Nations Human Rights (Fact Sheet, October 2018), The Paris Agreement preamble states “Parties should, when taking action to address climate change, respect, promote and consider their respective obligations on human rights, the right to health, the rights of indigenous peoples, local communities, migrants, children, persons with disabilities and people in vulnerable situations and the right to development, as well as gender equality, empowerment of women and intergenerational equity." 160 Quarterly Updates of Australia’s National Greenhouse Gas Inventory in ‘Publications and Resources’, Department of Agriculture, Water and the Environment (Web Page, September 2019). 161 The Climate Action Tracker is an independent scientific analysis that tracks government climate action and measures it against the globally agreed Paris Agreement. Its December 2019 update has rated Australia’s 2030 target as “insufficient” and is at the less stringent end of what would be a fair share of the global effort. See, ‘Australia’, Climate Action Tracker (Web Page, 2 December 2019). 33