Aboriginal and Torres Strait Islander People

AIHW Emergency department care (ref 1):

In 2024-2025 there were about 92,000 presentations to the Emergency Department of public hospitals with asthma. (ref 1)*

Specifically 91,480 presentations with asthma were recorded across complexity level A, B and C, of which:
– about 46,000 (50%) were admitted (including admission in the emergency department, admission to another hospital ward, including a short stay unit, or admission to hospital-in-the-home)
– about 45,000 (50%) were not admitted
– 1.5% were triaged as resuscitations
– 39% were triaged as emergencies
– 47% were triaged as urgent
– 12% were triaged as semi-urgent
– <1% were triaged as non-urgent

*ED presentations included all types of visits, including Emergency presentation but also Return planned visit (e.g for Follow-up treatment, test results etc), pre-arranged admission and dead on arrival (without resuscitation attempt) (see https://meteor.aihw.gov.au/content/684942)

Note: This data differs from AIHW asthma webpage which lists ED due to asthma (asthma as the principal diagnosis)

Note: the number of admissions here is different from the hospitalisation number provided through the AIHW “Admitted Patient Care”. Admitted patient care provides a count of hospitalisations with asthma as principal diagnosis (i.e. main reason for hospitalisation)

AIHW Asthma webpage (ref 2):

In 2024-25, there were:

• 60,300 ED presentations with asthma as the principal diagnosis
• ED rate was about 220 presentation per 100,000 population, slightly higher in females than males (245 vs 220 per 100,000)
• Age standardised ED rate in 2024-25 was 234 per 100,000, about the same level as in 2020-21 during the COVID pandemic, and the lowest since 2020-21 (highest was in 2022-23 at 272 per 100,000) – see figures below
• boys aged 0-14 had an ED rate 1.5 times as high as that of girls the same age (boys were 1.5 times as likely to visit an ED for asthma)
• ED rates (age standardised) are higher for people living in Remote and Very remote areas compared to people living in Major cities (535 and 140 per 100,000 population, respectively), and for people living in areas of most disadvantage compared to people living in areas of least disadvantage (320 and 64 per 100,000 population, respectively).
• First Nations: 6,200 ED presentations with asthma as principal diagnosis among First Nations people, a rate of 590 per 100,000 population (720 vs 460 per 100,000 in females vs males), which after adjusting for age, is 2.7 times higher than for other Australians

Fig 3 from AIHW: ED rates with asthma as principal diagnosis, by age and sex (ref 2)

ED rate (age standardised) trends from 2018-19 to 2024-25 (ref 2):

Asthma hospitalisations 2023 – 2024 (AIHW)
In 2023 – 2024, there were 31,994 hospitalisations with asthma as principal diagnosis.(ref 1)
This is very small increase compared to the previous year (31,107 hospitalisations in 2022-2023), a substantial increase compared to years affected by COVID-19 restrictions (e.g. about 25,500 in 2021-22) but remains below pre-pandemic level (about 37,000 in 2018-19).(ref 2)

Children under 15 accounted for 43% of all asthma hospitalisations.(ref 1)

In 2023-2024, 90% of asthma hospitalisations were potentially preventable.(ref1, 3)

*PPH: Potentially Preventable Hospitalisations (hospitalisations for asthma in people 4 years and over).

According to AIHW asthma webpage (ref 4), in 2023-24 there were:

• 32,000 hospitalisations with a principal diagnosis of asthma, representing 0.3% of all hospitalisations in Australia, and 119 hospitalisations per 100,000 population. Children 0-14 yo made up 43% of these hospitalisations (about 13,600 admissions)
• 65% of asthma hospitalisations were overnight stays, with an average length of 2.6 days
• the median age for asthma hospitalisations was 23
• When counting asthma hospitalisations as principal or additional diagnosis (any diagnosis), there were about 47,200 hospitalisations (0.4% of all hospitalisations)
• First Nations: 2,3000 hospitalisations due to asthma in First nations people, a rate of 220 per 100,000, which after adjustement for age, was 1.8 times higher than non-Indigenous Australians

Hospitalisation rates (ref 4):

• 119 per 100,000 (all ages, principal diagnosis)
• Highest among children aged 5-9 (around 405 per 100,000)
• boys aged 0–4, 5–9, and 10–14 had higher rates of hospitalisation than girls of the same age. For example, boys aged 0–4 were 1.8 times as likely as girls of the same age to be admitted to hospital

In 2023-2024, there were 28,778 potentially preventable hospitalisations (PPH) due to asthma. (ref 1).

This is similar to the year before with 28,238 PPH in 2022-2023, compared to 22,985 in 2021-2022 (a year with pandemic measures), and 32,558 in 2018-2019 before the COVID pandemic. (ref 2)

Note: Asthma PPH are all hospitalisations with asthma as principal diagnosis in people aged 4 and over.

Asthma PPH by jurisdiction (2023-24)

Asthma PPH rate (per 1,000 people) by Indigenous status and state or territory of residence, 2023-2024 (ref 3)

(c) Includes other territories, overseas residents and unknown state of residence.

The National Aboriginal and Torres Strait Islander Health Survey for the financial year 2022-2023  reported:
• 16.6% has asthma, up from 15.7% in 2018-2019 (note that the difference between 2018-2019 and 2022-2023 was not statistically significant)
• Asthma was the second most prevalent selected chronic condition after mental and behavioural conditions
• By remoteness: 18.2% of people living in non-remote areas had asthma, compared to 8.1% of people living in remote areas (the difference was statistically significant)
• Around two in four people (49%) had one or more selected chronic conditions in 2022–2023, up from 46% in 2018–2019.
• 29% of people aged 15 years and over smoked daily (excluding e-cigarettes or vaping devices), down from 37% in 2018–2019.

In 2023, there were 474 deaths with asthma as underlying cause in Australia, including 325 females and 149 males (see table below) (ref 1):
* Women over 75 are the most at risk, with 43% of asthma deaths in this age group in 2023 (Ref 2,3)
* Asthma deaths were nearly identical to last year, with a return to pre-pandemic level after seeing a reduction in 2021 due to pandemic measures resulting in fewer respiratory infections (ref 3)
* However, over the last 35 years, asthma deaths have halved, from 964 deaths in 1989 (ref 3)

The age-standardised death rate in 2023 was 1.4 deaths per 100,000 people (1.7 for females and 1.0 for males) which remains similar to before the pandemic. (ref 1)

Asthma deaths by state/territory and sex 2023 (ref 1)

NAC infographic (ref 2)

According the AIHW Asthma webpage updated on 17 Feb 2026:(ref 4)

480 people died from asthma (underlying cause) in 2023, with a death rate (not adjusted for age) of 1.8 deaths per 100,000 population.

Mortality rates:

• increased with age (highest in people 75+ at 13.2 per 100,000)
• was higher in females vs males, with a difference more pronounced in people 75+
• changed little over time
• was 3.4 times higher in First Nations people after adjusting for age (31 deaths in 2023, crude rate 3 per 100,000)

Provides the most up-to-date information available on the targets and indicators in the National Agreement on Closing the Gap (the Agreement).

Not asthma-specific

The Overview of Aboriginal and Torres Strait Islander health status 2023 (Overview) aims to provide a comprehensive outline of the current health status of Aboriginal and Torres Strait Islander people.
This includes: information about the social and cultural context , social determinants, the structure of the population, and measures of population health including births, deaths and hospitalisations, cultural indicators including language, selected health conditions (incl. asthma) and risk/protective factors.
Information is provided for states and territories, Indigenous Regions and remoteness, and for demographics such as sex and age, when the information is available and appropriate.

Age-standardised asthma hospitalisation rate in 2021-2022 in First Nations people vs other Australians, by jurisdictions:
– for Aboriginal and Torres Strait Islander people: 1.6 per 1,000 in NSW; 1.3 in VIC; 2.1 in QLD; 2.2 in WA; 2.0 in SA; 0.7 in TAS; 2.1 in ACT; 3.4 in NT, Nationally 2.0 per 1,000 (Table 10A.71)
– for other Australians (incl when indigenous status is not stated): 0.8 per 1,000 in NSW; 0.9 in VIC; 1.1 in QLD; 0.5 in WA; 1.0 in SA; 1.3 in TAS; 0.6 in ACT; 0.2 in NT, Nationally 0.9 per 1,000 (Table 10A.71)

AIHW has a website specifically for Aboriginal and Torres Strait Islander people, providing statistics by geographical areas, including:
– A Closing the Gap dashboard: access regional statistics related to the 17 socioeconomic targets
– Regional Overview Dashboard: data down to the LGA level, including socioeconomic and health data (including asthma prevalence based on Census 2021)
– Service map: search for health and medical services available for each region

AIHW report providing summary of epidemiological data in First Nations peoples with asthma (prevalence, risk factors, quality of life, burden of disease, mortality, hospitalisations, ED). This report provides a nice summary and a single reference.

Prevalence (2018-2019 National Aboriginal and Torres Strait Islander Health survey (NATSIHS):
– Around 128,000 First Nations people reported having asthma (16%), down from 18% in 2012-13, making asthma the third most prevalent long-term condition reported in 2018-19.
– higher in females (18%) compared to males (13%)
– increased with age, from 12% in children aged 0–14 to 26% in those aged 55 and over
– 1.6 times as high for boys compared with girls (aged 0–14) (14% and 8.6%, respectively)
– 2.1 times as high for females compared with males aged 55 and over (34% and 16%, respectively)
– 1.6 times higher in First Nations people compared to non-Indigenous Australians after adjusting for age structure (18% and 11% age-standardised prevalence respectively)
– Prevalence decreased with increasing remoteness: 19% in Major Cities, 12% in Remote areas and 7% in Very remote areas
– Prevalence by states: 25% in ACT, 23% in SA, 22% in TAS, 19% in NSW, 18% in VIC, 14% in QLD, 13% in WA, 6% in NT

Hospitalisation rates (2021-2022):
– 1,800 hospitalisations with asthma as principal diagnosis in 2021-22 (Covid pandemic year), an hospitalisation rate of 200 per 100,000; a decrease by 30% compared to 2018-19 (non Covid-pandemic year; 290 per 100,000)
– highest for females aged 45–54 (469 per 100,000) and higher for females overall compared to males (250 vs 155 per 100,000)
– 1.8 times higher for boys compared to girls aged 0-14 (318 vs 173 per 100,000)
– 2.1 times higher in First Nations people compared to non-Indigenous Australians after adjusting for age structure (205 vs 100 per 100,000, age-adjusted)

Emergency Departments visits (2021-2022 Non-admitted Patient Emergency Department Care database):
– 5,400 ED presentations for asthma in 2021-22 (605 per 100,000 population, decreased by 14% compared to 700 per 100,000 in 2018-19)
– Highest for females 35-44 (1,063 per 100,000) then females 45-54 (1,014 per 100,000) then boys 0-14 (883 per 100,000)
– 1.6 times higher in boys vs gilrs aged 0-14 (883 vs 558 per 100,000)
– 1.4 times higher in females vs males overall (about 710 vs 500 per 100,000)
– 2.6 times higher in First Nations people compared to non-Indigenous Australians after adjusting for age structure (about 600 vs 230 per 100,000; age-standardised)

Mortality (2017-2021):
– 65 deaths over the 5 years, corresponding to a mortality rate of 1.7 deaths per 100,000 population (decreasing from 2.1 per 100,000 in 2015-2019)
– Mortality rate increases with age and is 1.6 times higher in females
– Mortality rates adjusted for age structure are 1.9 times higher in First Nations people compared to non-Indigenous Australians

Burden of Disease (Australian Burden of Disease Study 2018):
– 7th leading cause of disease burden in First Nations people, contributing 3.4% to the total burden
– Burden of asthma is greater in females (4.3%) compared to males (2.5%)
– 4th leading cause of non-fatal disease burden (5.7% of total non-fatal burden)

Risk factors for First Nations people with asthma compared to those without asthma (2018–2019 NATSIHS):
– Similar likelihood to be a current daily smoker (43% vs 40%)
– More likely to be insufficiently active (93% vs 87%)
– 1.3 times more likely to live with obesity (55% vs 43%)

Quality of life (2018–2019 NATSIHS) for adult First nations people with asthma compared to those without asthma:
– 2.5 times more likely to have poor health (18% vs 7.2%)
– 1.5 times more likely to experience high or very high levels of psychological distress (42% vs 28%)
– 62% had at least one other chronic condition – the top 3 comorbidities were arthritis (51%), mental and behavioural conditions (46%), and back problems (37%)

Asthma Management in First Nations people with asthma (2018–2019 NATSIHS):
– 56% reported using asthma medication within the last 2 weeks
– 32% had a written asthma action plan (32% of those in non-remote areas vs 27% of those in remote areas)

Over the 5-year period 2017-2021 (including years of COVID-pandemic measures), there were:
– 65 deaths due to asthma in First Nations people, corresponding to a mortality rate of 1.7 deaths per 100,000 population (decreasing from 2.1 per 100,000 in 2015-19)
– Mortality rate increases with age and is 1.6 times higher in females
– After adjusting for age, First Nations people were 1.9 times more likely to die due to asthma compared to non-Indigenous Australians

In 2021-2022, a year affected by Covid-129 pandemic measures, there were:
– 1,800 hospitalisations with asthma as principal diagnosis in First Nations people, an hospitalisation rate of 200 per 100,000 population; a decrease by 30% compared to 2018-2019 (non Covid-pandemic year; 290 per 100,000)
– highest asthma hospitalisation rates for females aged 45–54 (469 per 100,000) and higher for females overall compared to males (250 vs 155 per 100,000)
– 1.8 times higher asthma hospitalisation rates for boys compared to girls aged 0-14 (318 vs 173 per 100,000)
– 2.1 times higher hospitalisation rates in First Nations people compared to non-Indigenous Australians after adjusting for age structure (205 vs 100 per 100,000, age-standardised)

In 2018, almost two-thirds (64%) of the fatal burden among Aboriginal and Torres Strait Islander (First Nations) people was classified as avoidable (preventable), compared to 54% in non-Indigenous Australians.
There were:
– 486 AYLL (avoidable years of life lost) (1.2 AYLL per 1,000 population) due to asthma in females under 75
– 303 AYLL (0.7 per 1,000) due to asthma in males under 75
– 789 AYLL (1.0 per 1,000) due to asthma in persons under 75
You can find further details (e.g. the stats per age group) in the data download on the AIHW website.

In 2018-2019, among Aboriginal and Torres Strait Islander people with asthma that had symptoms in the last 12 months:
– 31.6% had an Asthma Action Plan
– 56.1% had used medications in the last 2 weeks

The age-standardised mortality rate due to asthma among Aboriginal and Torres Strait Islander people was 2.5 times as high as among other Australians in 2015-2019 (3.7 compared with 1.5 per 100,000 population over the 2015-2019 period). By gender, it was 2.7 vs 1.1 per 1,000 (2.5 times higher) in males, and 4.4 vs 1.8 per 1,000 (2.4 times higher) in females.
Note: the deaths were reported in NSW, QLD, WA, SA and NT only as these jurisdictions had adequate levels of Indigenous identification in mortality data.

Between 2017 and 2019, Aboriginal and Torres Strait Islander people were 80% more likelly to be hospitalised for asthma than other Australians, with an age standardised asthma hospitalisation rate of 2.7 per 1,000 people, and an asthma hospitalisation rate ratio of 1.8 (rate difference 1.2 per 1,000) compared to non-Indigenous Australians.
Specifically, the age standardised asthma hospitalisation rates and rate ratios were:
– for males: 1.9 hospitalisations per 1,000 population (rate ratio 1.4 so 40% higher compared to non-Indigenous Australians)
– for females: 3.5 hospitalisations per 1,000 population (rate ratio 2.2 so 120% higher compared to non-Indigenous Australians)

By age groups, the asthma hospitalisation rates for 2017-2019 were:
– under 1 yo: 0.3 per 1,000 (vs 0.2 per 1,000 in non-Indigenous, rate ratio 1.7) – 70% higher
– 1-4 yo: 7.1 per 1,000 (vs 6.2 per 1,000 in non-Indigenous, rate ratio 1.2) – 20% higher
– 5-14 yo: 3.0 per 1,000 (vs 2.8 per 1,000 in non-Indigenous, rate ratio 1.2) – 10% higher
– 15-24 yo: 1.6 per 1,000 (vs 0.9 per 1,000 in non-Indigenous, rate ratio 1.8) – 80% higher
– 25-34: 2.1 per 1,000 (vs 0.7 per 1,000 in non-Indigenous, rate ratio 3.1) – 310% higher
– 35-44 yo: 2.9 per 1,000 (vs 0.9 per 1,000 in non-Indigenous, rate ratio 3.1) – 310% higher
– 45-54 yo: 3.1 per 1,000 (vs 1.0 per 1,000 in non-Indigenous, rate ratio 3.1) – 310% higher
– 55-64 yo: 2.6 per 1,000 (vs 1.0 per 1,000 in non-Indigenous, rate ratio 2.5) – 250% higher
– 65 and over: 2.2 per 1,000 (vs 1.5 per 1,000 in non-Indigenous, rate ratio 1.5) – 150% higher

This internal data report discussed prevalence, mortality, burden of disease, gap, remoteness, risk factors, demographic considerations, in relation to:
– Aboriginal and Torres Strait Islander Health (in general)
– asthma
– respiratory conditions

Provides comprehensive epidemiological information, as well as key facts.

Report: https://asthmafoundation.sharepoint.com/:w:/s/RPA/EZVD72ep5AZPpgs1RXRvDu4BTuP0TRYeYGIIfyT7wh94Gw?e=ZN7RMn

Summary Presentation: https://asthmafoundation.sharepoint.com/:w:/s/RPA/EZVD72ep5AZPpgs1RXRvDu4BTuP0TRYeYGIIfyT7wh94Gw?e=ZN7RMn

These resources are for internal use only, please do not distribute the report and presentation externally.

The prevalence of asthma was about twice as high for Aboriginal and Torres Strait Islander people living in non-remote areas (17%) compared with those living in remote areas (9%) in 2018-19.

The age-standardised mortality rate due to asthma among Aboriginal and Torres Strait Islander people was 2.2 times as high as among other Australians in 2014-2018 (3.4 compared with 1.5 per 100,000 population).

In 2012–13, 18% of Aboriginal and Torres Strait Islander Australians had asthma (an estimated 111,900 people), with a higher rate among females (20%) compared with males (15%).
The prevalence of asthma was almost twice as high among Indigenous Australians compared with non-Indigenous Australians (a rate ratio of 1.9) after adjusting for difference in age structure.

Based on the National Aboriginal and Torres Strait Islander Survey 2018-2019

15.7% Indigenous Australians reported having asthma in 2018-2019: 13.4% of males and 15.7% of females (ref 1)

An estimated 128,000 Aboriginal and Torres Strait Islander people had asthma in 2018-2019 (16%), with a higher rate among females (18%) compared with males (13%). The prevalence of asthma among Indigenous Australians was was 1.6 times as high as non-Indigenous Australians after adjusting for difference in age structure, and the difference is more marked for older adults. (ref 4)

Asthma was the third most prevalent chronic condition in Aboriginal and Torres Strait Islander people. (ref 3)

Asthma was the most commonly self-reported long-term respiratory condition in 2018-2019 in Aboriginal and Torres Strait Islander people. (ref 1)

Prevalence by age groups: 11.5% of 0-14 yo; 13.8% of 15-24 yo; 15% of 25-34 yo; 17% of 35-44 yo; 20.8% of 45-54 yo; 25.8% of 55+ yo reported having asthma (ref 1 or ref 2)

Prevalence by jurisdictions: 18.6% in NSW; 18.0% in VIC; 13.7% in QLD; 12.6% in WA; 22.7% in SA; 21.9% in TAS; 25.3% in ACT; and 6.2% in NT (ref 2). Note: these statistics are also available stratified by remote/non-remote status in Table D1.04.20

According to the Australian Burden of Disease Study 2018, asthma was, in First Nations people: (ref 1)
– 7th leading cause of disease burden in First Nations people, contributing 3.4% to the total burden (crude rate, NOT age-standardised)
– Burden of asthma was greater in females (4.3%) compared to males (2.5%)
– 4th leading cause of non-fatal disease burden (5.7% of total non-fatal burden)

Comment: Note important variation between age-standardised (below) and crude (above) burden of disease ranking for First Nations people, due to the differences in age structure between First Nations (younger population) and non-Indigenous Australians.

Key findings from the Australian Burden of Disease Study (ABDS) 2018 also include:
– Asthma ranked 11th in 2018 as leading specific cause of total burden (age-standardised, fatal and non-fatal burden) in First Nations people, compared to 17th in 2003 and 13th in 2011, an increase of 36.4% compared to 2003. (ref 2,3)
– In Aboriginal and Torres Strait Islander children aged 5-14 years old, asthma was the third leading cause of total burden of disease in 2018, contributing 8.7% to the total burden.(ref 4)
– the aged-standardised DALY (disability-adjusted life years) rate for asthma was 11.4 DALY per 1,000 people in 2018 compared to 8.3 in 2003 (ref 2)
– Asthma was the leading cause of respiratory disease burden among Aboriginal and Torres Strait Islander people aged under 45 in 2018 (contributing 80% of respiratory burden).(ref 4)
– Respiratory diseases contributed to 7% of total burden (DALY) in 2018 for both indigenous and non-indigenous Australians (ref 2)
– the gap in (all-cause) total burden has narrowed between indigenous and non-indigenous Australian between 2003 and 2018, with 49% of the burden of disease in indigenous Australian being preventable in 2018 (ref 2)
– gap: the contribution of asthma to total burden of disease in 2018 was 2.2 times higher for Aboriginal and Torres Strait Islander people compared to other Australians, with a difference of 6.3 years lost to premature death or living with an illness or injury. (ref 4)
– gap: asthma contributed 1.6% to the burden of disease difference between Aboriginal and Torres Strait Islander people and other Australian in males, and 4.1% in females in 2018. (ref 4)
– the risk factors contributing to the most (all-cause) burden of disease in 2018 were tobacco use (12%), alcohol use (10%), overweight (9.7%), illicit drug use (6.9%) and dietary factors (6.2%) (ref 2)

Indigenous Australians have higher asthma mortality rates compared to non-Indigenous Australians, after adjusting for differences in age structure. Between 2011 to 2015, the mortality rate for asthma among Indigenous Australians was 2.8 per 100,000 population, twice that of non-Indigenous Australians (1.4 per 100,000), based on the five jurisdictions with adequate Indigenous identification (NSW, Qld, NT, WA and SA).