Indigenous peoples’ health after Australia’s No vote

In a national referendum in October 2023 Australians voted against recognising Aboriginal and Torres Strait Islander peoples constitutionally and creating an Indigenous federal advisory body—the Voice to Parliament.1 Leaders of over 125 health organisations had supported the proposals to help improve health outcomes among these peoples.2 Aboriginal and Torres Strait Islander peoples experience stark health and social inequities,3 including living on average 10 years less than non-Indigenous Australians3 and having rates of rheumatic fever and rheumatic heart disease greater than in other high income countries.4

A constitutional voice would have increased autonomy. When Aboriginal and Torres Strait Islander Australians have more say over their own affairs, access to health services and outcomes improve567: the National Aboriginal Community Controlled Health Organisation’s services provide high quality healthcare to most communities. During the covid-19 pandemic, community leadership and self-determination were key to a successful response.8

A constitutional voice would also have increased political stability for the long term strategies needed to tackle health inequity. Aboriginal and Torres Strait Islander peoples constitute just 3% of the population,2 and political will to act in their interests is inconsistent. Governments have …