How do an Aboriginal community and an international Indigenous community experience and respond to health as a social justice issue?
Compare the health experiences and self-determination strategies of an Aboriginal community and an international Indigenous community
A worked answer comparing Indigenous health for the HSC Aboriginal Studies Comparative Study. Uses Aboriginal community-controlled health organisations and Maori health models to compare the legacy of colonisation, the Close the Gap movement, and self-determination in health.
Reviewed by: AI editorial process; not yet individually human-reviewed
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What this dot point is asking
NESA wants you to compare how an Aboriginal or Torres Strait Islander community and an international Indigenous community experience health, and how each pursues self-determination over its own health care. Health is one of the six Comparative Study topics, and this dot point models the kind of integrated, evidence-based comparison that earns marks in the 45-mark Part 2 of the HSC examination. The example below uses an Aboriginal community and the Maori of Aotearoa New Zealand, but the structure transfers to any pairing.
The answer
Health as a social justice issue
For Indigenous peoples worldwide, health gaps are not natural but the measurable result of colonisation, dispossession and the loss of land, culture and self-governance. Comparing health therefore means comparing the social determinants, the policy responses, and above all the self-determination strategies communities use to take control of their own wellbeing. The right to the highest attainable standard of health, and the right to maintain traditional medicines, are affirmed in the United Nations Declaration on the Rights of Indigenous Peoples 2007.
The shared legacy of colonisation
Both Aboriginal peoples in Australia and Maori in Aotearoa New Zealand carry a comparable legacy. Dispossession, introduced disease, and the disruption of kinship and Country produced large gaps in life expectancy, chronic disease and infant mortality relative to non-Indigenous populations. Recent data puts the Aboriginal life-expectancy gap at approximately 8 years (ABS, 2020-2022 experimental life tables) and the Maori gap at approximately 7 years relative to non-Maori (Stats NZ, 2017-2019 period life tables) - a strikingly similar scale despite very different national health systems. In both societies, mainstream health systems were designed without Indigenous involvement and often failed to provide culturally safe care, deterring people from seeking treatment. This shared pattern is your first comparison point.
Self-determination as the key response
The decisive comparison is how each community has reclaimed control. In Australia, the Aboriginal community-controlled health organisation model treats health holistically, linking physical, social, emotional and cultural wellbeing, and is governed by the communities it serves. In Aotearoa, the Treaty of Waitangi (1840) underpins Maori claims to health equity, and kaupapa Maori health services reflect a parallel push for Indigenous control. New Zealand went further institutionally in July 2022, establishing Te Aka Whai Ora (the Maori Health Authority) to co-govern national health policy - though the incoming government disestablished it from 30 June 2024, folding its functions back into Health New Zealand (Te Whatu Ora). Comparing these models shows two communities reaching similar conclusions about WHO should run Indigenous health care, even where the institutional form proves politically unstable.
Policy frameworks and targets
Both countries have national frameworks you can compare. In Australia, the National Agreement on Closing the Gap (2020) sets health targets and, crucially, was negotiated with the Coalition of Aboriginal and Torres Strait Islander Peak Organisations, embedding shared decision-making as one of its four Priority Reforms. The Close the Gap campaign, led by Aboriginal and Torres Strait Islander health leaders, pushes for rights-based equality in health. In Aotearoa, successive Maori health strategies have pursued equity through partnership grounded in the Treaty, with mixed institutional durability, as the rise and 2024 disestablishment of Te Aka Whai Ora shows. Comparing the design of these frameworks, and how genuinely each shares power, is strong analysis.
Outcomes and ongoing gaps
A balanced comparison acknowledges that gaps persist in both contexts despite progress. Productivity Commission reporting shows several Closing the Gap health targets are not on track in Australia, while Maori health inequities also endure - and the 2024 disestablishment of Te Aka Whai Ora shows that even a dedicated national institution can be reversed by a change of government. The point for the HSC is not to declare one community better off, but to compare how structural factors, policy design and the degree of self-determination shape outcomes in each.
Structuring the comparison
Write integrated paragraphs. For each criterion - the legacy of colonisation, the community-controlled response, the national framework, and outcomes - move between both communities so the comparison is explicit. Support every point with specific, dated evidence and frame both peoples as agents reclaiming control of their health.
Examples in context
Example 1. Central Australian Aboriginal Congress. An ACCHO based in Alice Springs delivering primary health care, women's health, social and emotional wellbeing and remote outreach services, governed by the Aboriginal community it serves - illustrating the ACCHO model in a specific, nameable community rather than "Aboriginal people generally".
Example 2. Te Aka Whai Ora (Maori Health Authority), 2022-2024. Established in July 2022 under the Pae Ora (Healthy Futures) Act to give Maori a dedicated, co-governing role in national health policy, then disestablished from 30 June 2024 when the incoming government folded its functions back into Health New Zealand - a case study in both the ambition and the political fragility of institutionalised Indigenous self-determination.
Try this
Q1. Outline ONE Aboriginal initiative that addresses health issues. [3 marks]
- Cue. Name an ACCHO (for example Congress); state it is community-governed, culturally safe and targets specific local health priorities.
Q2. Compare the national health policy frameworks of Australia and Aotearoa New Zealand. [6 marks]
- Cue. Closing the Gap (2020, negotiated with peak organisations) versus Treaty of Waitangi based policy (Te Aka Whai Ora, 2022-2024); compare how genuinely each shares power.
Q3. Compare the health experiences and self-determination strategies of an Aboriginal community and an international Indigenous community. [8 marks]
- Cue. Shared colonial legacy and similar life-expectancy gaps; community-controlled response (ACCHOs/kaupapa Maori); national frameworks and their durability; a calibrated judgement on what has worked best.
Exam-style practice questions
Practice questions written in the style of NESA exam questions on this dot point, with worked answer explainers. The year tag is the paper they imitate, not the source.
2021 HSC3 marksOutline ONE government program or strategy that aims to address the health needs of Aboriginal peoples.Show worked answer →
For 3 marks, name one program and outline its main features and aim.
Closing the Gap is an Australian government strategy that aims to reduce disadvantage and improve life outcomes for Aboriginal and Torres Strait Islander peoples. In health it specifically targets equality in health status and life expectancy between Aboriginal peoples and non-Indigenous Australians.
Outline its features: it sets measurable national targets (for example reducing the life-expectancy gap and child mortality), reports progress annually, and under the 2020 National Agreement commits governments to partnership with Aboriginal community-controlled organisations. Markers reward a named program plus its aim and key features rather than a one-line mention.
2022 HSC3 marksOutline ONE Aboriginal initiative that addresses health issues.Show worked answer →
For 3 marks, name one Aboriginal-led initiative and outline what it does and how it addresses health.
A strong choice is an Aboriginal Community Controlled Health Organisation (ACCHO), such as the Central Australian Aboriginal Congress. It is a community-run organisation that delivers clinics and services to its community, including women's health, social and emotional wellbeing, and remote health services.
Outline its features: it is Aboriginal-owned and governed (an expression of self-determination), provides holistic and culturally safe care delivered by Aboriginal staff, and targets priority issues such as diabetes, heart disease, mental health and substance use. Because it is community-controlled, it improves trust and access where mainstream services often fail. Markers reward a named initiative with its features and health focus.
2021 HSC12 marksExplain how socioeconomic status of Aboriginal and other Indigenous peoples affects their health outcomes. In your response, refer to ONE Australian Aboriginal community and ONE other Indigenous community.Show worked answer →
For 12 marks, explain the relationship between socioeconomic status and health, sustained across two communities.
- The relationship
- Lower socioeconomic status is strongly associated with poorer health. Low income limits access to doctors, medication and ambulance services; poor education and health literacy affect lifestyle and ability to navigate care; overcrowded housing spreads illness; and these factors interact to drive chronic disease and a lower life expectancy. The effects are physical, mental and emotional.
- Australian Aboriginal community
- Use ABS evidence that Aboriginal life expectancy is below the non-Aboriginal population, and a community example (such as a remote community served by an ACCHO) where income, housing and education shape health outcomes.
- International Indigenous community
- Maori in Aotearoa New Zealand show similar patterns - long-standing health disparities driven by colonial history, income and access to care.
Conclude that socioeconomic status is a key determinant of Indigenous health in both contexts, and that community-controlled services and self-determination help mitigate it. Markers reward detailed reference to both communities and integrated concepts.
2022 HSC12 marksAssess the health status of Aboriginal and other Indigenous peoples. In your response, refer to both an Australian Aboriginal community and an international Indigenous community.Show worked answer →
For 12 marks, the verb "assess" requires a judgement about the state of Indigenous health, compared across two communities.
- Judgement
- Indigenous health status remains significantly poorer than that of non-Indigenous populations in both countries, but is improving where communities lead their own services.
- Australian Aboriginal community
- Use evidence such as the life-expectancy gap, higher rates of chronic disease and the slow progress of Closing the Gap targets. Show how a community-controlled organisation (for example the Central Australian Aboriginal Congress) improves access and culturally safe care.
- International Indigenous community
- Compare with Maori, who experience persistent disparities rooted in colonisation but benefit from Maori health providers and Treaty-based policy.
- Sustain the comparison
- Note shared causes (colonisation, socioeconomic disadvantage, access barriers) and shared solutions (self-determination and community control).
Conclude with a clear assessment: health status is poor but not static, with self-determined health models the strongest driver of improvement. Markers reward a judgement integrated with both communities.
Practice questions
Original practice questions graded from foundation to exam level, each with a full worked solution. Try them before revealing the solution.
foundation3 marksIdentify the international Indigenous community used in this comparison, and name ONE feature of its self-determination approach to health.Show worked solution →
Community (1 mark). Maori, the Indigenous people of Aotearoa New Zealand.
Feature (2 marks). Kaupapa Maori health services - providers designed and governed according to Maori cultural values, delivering holistic, culturally safe care (an equivalent model to Aboriginal community-controlled health organisations).
Marking spine: correct community named (1), an accurate, specific self-determination feature named (2). A vague answer such as "Maori have their own health system" with no named model loses a mark.
foundation4 marksOutline TWO features of an Aboriginal Community Controlled Health Organisation (ACCHO).Show worked solution →
Any two of: (1) Aboriginal-owned and governed, an expression of self-determination rather than a government-run clinic; (2) delivers holistic, culturally safe care covering physical, social and emotional wellbeing, not just physical illness; (3) staffed substantially by Aboriginal health workers, improving trust and access; (4) targets priority local health issues such as chronic disease, maternal health or substance use.
Marking spine: 2 marks per accurate, distinct feature (4 total). Naming the same feature twice in different words earns marks once.
core5 marksA described dataset (illustrative, ExamExplained) shows the life-expectancy gap between Indigenous and non-Indigenous populations: approximately 8 years in Australia (ABS, 2020-2022) and approximately 7 years in Aotearoa New Zealand (Stats NZ, 2017-2019). Describe the pattern and explain what it suggests about the two health systems.Show worked solution →
Describe the pattern (2 marks). Both Aboriginal Australians and Maori in Aotearoa New Zealand experience a significant, broadly similar life-expectancy gap relative to their countries' non-Indigenous populations - approximately 8 years in Australia and approximately 7 years in Aotearoa, a difference of only around 1 year between the two contexts.
Explain the significance (3 marks). The similarity in scale, despite different colonial histories, health systems and government structures, suggests the gap is driven by a shared underlying cause rather than country-specific policy failure alone: the structural legacy of colonisation and socioeconomic disadvantage affecting both peoples. It also suggests that neither country's mainstream health system, on its own, has closed the gap, reinforcing why community-controlled and Treaty-based self-determination models are argued to be the more effective long-term response in both contexts.
Marking spine: accurate reading with both figures and the small gap-between-gaps noted (2), a reasoned explanation linking the pattern to a shared structural cause and to the case for self-determination (3). A reading with no figures, or a explanation that blames culture, cannot reach full marks. Figures are illustrative ExamExplained figures modelled on ABS and Stats NZ life-table data; treat as approximate.
core6 marksCompare ONE national health policy framework in Australia with ONE in Aotearoa New Zealand, focusing on how each shares power with Indigenous peoples.Show worked solution →
A 6-mark "compare" needs both frameworks named and an explicit comparison of how power is (or is not) shared, not two separate descriptions.
Australia - the National Agreement on Closing the Gap (2020) (about 3 marks). This agreement sets measurable national health targets and, crucially, was negotiated directly with the Coalition of Aboriginal and Torres Strait Islander Peak Organisations, formally embedding shared decision-making (one of its four Priority Reforms) rather than being government-designed and imposed.
Aotearoa New Zealand - Treaty-based Maori health policy (about 3 marks). Maori health strategy is grounded in the Treaty of Waitangi (1840), which is used to argue for partnership and Maori authority over Maori health. This principle was given a dedicated institutional form when Te Aka Whai Ora (the Maori Health Authority) was established in July 2022 to co-govern health policy alongside Health New Zealand, though it was disestablished by the government from 30 June 2024, showing that even a strong legal foundation like the Treaty does not guarantee a lasting dedicated institution.
Marking spine: both frameworks correctly named with a feature (2 marks each, 4 total), an explicit comparative statement on how genuinely each shares power, including the Te Aka Whai Ora disestablishment as a limit (2). Describing the two frameworks with no comparative link caps at mid-band.
core6 marksExplain how community-controlled health organisations represent self-determination in BOTH the Aboriginal Australian and Maori contexts.Show worked solution →
- Definition of self-determination in health (1 mark)
- Self-determination means the community itself designs, governs and delivers its own services, rather than having health care designed for it by an external, non-Indigenous authority.
- Aboriginal Australian context (about 2-3 marks)
- ACCHOs such as the Central Australian Aboriginal Congress are owned and governed by the Aboriginal communities they serve, employ Aboriginal staff, and deliver holistic care (physical, social, emotional and cultural wellbeing) shaped by community priorities - the first such service was established at Redfern in 1971, and the sector is now represented nationally by NACCHO.
- Maori context (about 2-3 marks)
- Kaupapa Maori health providers are similarly governed according to Maori cultural values and, since 1840, Treaty of Waitangi principles have been used to argue for Maori authority over Maori health, a claim given (temporary) institutional form through Te Aka Whai Ora from 2022 to 2024.
Marking spine: accurate definition (1), both contexts explained with a named model and a feature showing community control (2-3 each). An answer describing only benefits without explaining HOW the model expresses self-determination stays mid-band.
exam8 marksCompare the health experiences and self-determination strategies of an Aboriginal community and an international Indigenous community.Show worked solution →
An 8-mark "compare" needs sustained, integrated comparison across shared criteria (legacy, response, framework, outcome), not two separate accounts.
Band 6 PLAN.
Thesis: Aboriginal Australians and Maori in Aotearoa New Zealand share a comparable legacy of colonisation-driven health disadvantage, and both have responded chiefly through self-determined, community-controlled health models, though national policy frameworks in both countries have shown that genuine power-sharing is harder to sustain than to legislate.
Point 1 - shared colonial legacy. Both peoples experienced dispossession and exclusion from mainstream health system design, producing a comparable life-expectancy gap: approximately 8 years for Aboriginal Australians (ABS, 2020-2022) and approximately 7 years for Maori (Stats NZ, 2017-2019).
Point 2 - the community-controlled response. Australia's ACCHO sector, beginning at Redfern in 1971 and now represented nationally by NACCHO, and Aotearoa's kaupapa Maori health providers, both deliver holistic, culturally safe care governed by the community itself - the clearest point of convergence between the two contexts.
Point 3 - national frameworks and the limits of power-sharing. Australia's National Agreement on Closing the Gap (2020) formally embeds shared decision-making with Aboriginal and Torres Strait Islander peak organisations, while Aotearoa's Treaty of Waitangi (1840) underpinned the creation of a dedicated Maori Health Authority, Te Aka Whai Ora, in July 2022 - which the government then disestablished from 30 June 2024. This shows both countries have moved toward institutionalising Indigenous authority over health, but that such institutions can be politically reversible.
Judgement: on balance, the strongest, most consistent driver of improved health outcomes in both contexts is direct community control of service delivery (ACCHOs, kaupapa Maori providers), which has proven more durable than government-created institutions that depend on the policy of the government of the day.
Marker's note: markers reward genuine COMPARISON (not parallel description), at least three criteria compared (legacy, community-controlled response, national framework), current dated evidence for both communities, and a calibrated final judgement. Writing "Community A does X, Community B does Y" with no explicit comparative link caps at mid-band regardless of factual accuracy.