Understanding the factors shaping Healthy Life Expectancy (HALE) in Indigenous Australians: A Scoping Review

Background Aboriginal and Torres Strait Islander peoples in Australia experience substantial inequities in life expectancy (LE) and Healthy Life Expectancy (HALE) compared with non-Indigenous Australians. These disparities are shaped by complex, interrelated physical, mental, socio-economic, and regional determinants across the life course. This scoping review aims to examine these factors and their influence on HALE among Indigenous Australians, identifying key patterns, gaps, and implications for public health policy and research. Methods A scoping review was conducted following the PRISMA-ScR framework. We systematically searched seven academic databases (MEDLINE, Scopus, Web of Science, ScienceDirect, PsycINFO, CINAHL and the Social Science). We also searched relevant grey literature sources published between January 2015 and April 2025. The inclusion criteria focused on Aboriginal and Torres Strait Islander peoples in Australia and reported HALE, LE, physical, mental, socioeconomic or regional factors relevant to years lived in good health. Data were charted using a standardized extraction framework to capture study characteristics and key findings across these domains. Results Twenty-two studies were (11 peer-reviewed studies and 11 government reports) included in this review. Evidence consistently showed that chronic disease burden, multimorbidity, and limited access to preventive care were associated with reduced HALE among Aboriginal and Torres Strait Islander peoples. Mental health conditions, including psychological distress and depression, contributed substantially to years lived in poor health and influenced health behaviours and service engagement. Socio-economic disadvantage particularly in remote communities with constrained health system capacity, further compounded HALE disparities among Aboriginal and Torres Strait Islander peoples. Conclusion The review identified physical, mental, socio-economic, and regional conditions relevant to HALE among Aboriginal and Torres Strait Islander peoples. Nationally comparable HALE estimates, disaggregated by age and region, are needed to identify and monitor inequalities in years lived in good health.