Working together: A collective impact approach to achieve the priority reforms underpinning Closing the Gap targets

Australia's Closing the Gap (CtG) targets represent the social, cultural and environmental determinants of First Nations' health. If these determinants are not considered when monitoring health system effectiveness, there is a risk of failing to account for up to 81% of the health gap between First Nations’ and non-Indigenous Australians. Yet Australia is failing to meet the CtG targets; of the 15 targets for which national data are available, 11 are improving but only four are currently on track. The cost of the gap in recurrent health expenditure is estimated at $4.4 billion annually. The CtG targets are themselves influenced by political determinants; represented by four priority reform areas recently agreed upon by Australian governments and the First Nations Coalition of Peaks. These aim to shift power to community for decision making and data sovereignty, build community organisation capacity, while also improving the cultural safety and responsiveness of government organisations to improve the health of Indigenous peoples.