Health and wellbeing

Increasing physical activity (PA) can reduce the risk of developing a range of non-communicable diseases and illness as well as improving physical fitness and enhancing cognitive, psychological, and social development. ^{43, 44, 45}

Sport—particularly team-based sport—can provide outcomes including improved resilience and mental health, positive role models, social connectedness, and a higher likelihood of meeting PA guidelines and continuing PA long term. ^{43, 45, 46, 47, 62}

Many First Nations people and communities have a strong connection to sport. Some of Australia's most popular sport role models, such as Patty Mills, Ashleigh Barty, Adam Goodes, and Cathy Freeman are also proud Aboriginal and Torres Strait Islander people.

The Australian Institute of Health and Welfare (AIHW) ‘Physical activity across the life stages report’ highlighted that First Nations children aged 5-17 were more likely to meet the physical activity guideline for moderate-to-vigorous activity (MVPA) than children in the broader population. ⁴⁸

The Footprints in Time longitudinal study of Indigenous children also found that children in the study who live in areas of high, moderate, or extreme isolation were more physically active, and more likely to be able to ride a bicycle or swim unassisted at younger ages than children living in areas of low isolation (i.e., urban areas). However, those in urban areas were more likely to participate in organised sports and dance, with older children and boys having higher participation rates in these activities. ⁴⁵

Determinants of health

While acknowledging the strengths, resilience, and impact of First Nations people in sport, many also experience a greater and avoidable health gap compared with the rest of the population. ^{49, 50, 61}

Social determinants of health, include access to education, employment, income, appropriate health services, and secure housing. These factors play a significant role in population health and wellbeing. ⁵⁰

For First Nations peoples, the impacts of colonisation such as the introduction of infectious and chronic diseases and social/physical dislocation (loss of connection to family, community, and land) have contributed significantly to negative health outcomes when compared to the broader population. ^{50, 51, 52}

Data from the Australian Institute of Health and Welfare (AIHW) indicates that First Nations individuals experience a burden of disease that is 2.3 times the rate of the wider Australian community, although the absolute gap narrowed between 2003 and 2018. ⁴⁹

The Australian Bureau of Statistics (ABS) ‘National Aboriginal and Torres Strait Islander Health Survey’ provides data on long-term health conditions, disability, lifestyle factors, physical harm, and use of health services. Some key findings include: ⁵³

• 46% of people had at least one chronic condition, up from 40% in 2012–13.
• 17% of people two years and over had anxiety and 13% had depression.
• 37% of children 2–14 years were overweight/obese, up from 30% in 2012–13.
• 71% of people aged 15 years and over were overweight or obese — almost 29% were overweight and more than 43% were obese.
• 89% of people aged 15 years and over did not meet the physical activity guidelines for their age.
• More than 22% of people aged 15 years and over had done no physical activity at all in the last week.

Impact of physical inactivity

Physical inactivity has a significant impact on the likelihood of developing many diseases including type 2 diabetes, bowel cancer, dementia, coronary heart disease and stroke, as well as uterine and breast cancer in females. ⁴³

In 2018, physical inactivity accounted for 2.4% of the total disease burden among First Nations people. These estimates reflect the percentage of disease burden that could be avoided if all First Nations people met the Australian physical activity guidelines, including: ⁵⁴

• 24% of the total disease burden due to type 2 diabetes
• 21% of coronary heart disease burden
• 16% of uterine cancer burden
• 15% due to bowel cancer
• 13% of stroke burden
• 12% of dementia burden
• 5% of breast cancer

Health benefits of sport

Available evidence supports a positive impact of sport participation on the health and wellbeing of First Nations people. ^{55, 56, 57, 58, 61}

• 'Footprints in Time: A longitudinal study of Indigenous children' that began in 2008 found that for children in the study participation in organised sport or dance was related to better social and emotional wellbeing. This relationship remained clear even after controlling for age, sex, general health, television watching, psychological distress, the number of major life events experienced by the family in the past year, and the relative disadvantage of the area. ⁴⁵
• The 'What Works for Aboriginal and Torres Strait Islander Men?' systematic review identified interventions, programs, and activities that are successful in improving the wellbeing of First Nations men. It found that playing sport, especially group or team sports, contributed to social and community connection, and having a sense of belonging and identity. ⁴⁷
• The study, 'Factors Associated with Thoughts of Self-Harm or Suicide among Aboriginal and Torres Strait Islander People Presenting to Urban Primary Care' found that participating in sport or community activities was associated with decreased thoughts of self-harm or suicide. The authors suggest this reflects the cultural strength of these communities, and the social connectivity and cultural affirmation attained through community sporting activities. ⁵⁹
• A 2015 evaluation of a sport and active recreation program in an Indigenous Men's Shed confirmed the importance of sport and active recreation programs in enhancing the social connectedness, health and wellbeing of an Indigenous community. ⁶²
• Analysis of the 2012 Mission Australia Youth Survey (MAYS) found that among First Nations youth aged 15–19 years those who participated in sport were 3.5 times more likely to report good general health and 1.6 times more likely to have no serious mental illness. ⁶⁰
• The ‘After the Siren’ report investigated First Nations participation in Australian rules football at a grass-roots level, and the associated individual and community level outcomes. Some key health and wellbeing findings included:¹²
  • Those playing AFL were twice as likely to rate their health as excellent, as those playing no sport.
  • 56% of children who participated in football were assessed as being in excellent health compared to 48% of those who had not participated in any organised sport.
  • Children who played football were 6 percentage points less likely to be assessed as having learning difficulties due to health issues.
  • Mental health was estimated to be higher among adults who participate in organised sport, after controlling for an extensive range of other factors.
  • Adults who played football in the previous 12 months reported higher life satisfaction than people who did not participate in sport.
  • Adults who played football reported more frequent social contact and were more likely to feel they had support outside their immediate household [an important determinant of positive mental and social wellbeing].

Resources and reading