The Voice referendum is about making practical progress for First Nations Australians with a focus on health, education, jobs and housing. It makes sense in the country of the “fair go” that all Australians are given the very best chance in life.

No one in Australia should have worse health because of the circumstances of their birth and yet First Nations Australians experience preventable disease and early death.

When talking about the gap, the figure that often comes up is the eight-year difference in life expectancy between Indigenous and non-Indigenous Australians.

But that single figure does little to tell the full story of the stark divide in health and wellbeing, especially for First Nations People in our most rural and remote communities.

Take rheumatic heart disease - a debilitating and often fatal condition that damages heart valves, lining and muscle that can lead to heart failure.

It begins as a common strep A infection that when left untreated leads to acute rheumatic fever, the precursor to rheumatic heart disease. The disease has been eliminated in non-Indigenous Australians for decades, and yet about six First Nations people die from the disease every month.

It is a disease of bone-grinding poverty, the result of overcrowding, a lack of access to hot water and running showers, and inadequate healthcare.

More than 7000 Aboriginal and Torres Strait Islander people live with acute rheumatic fever or rheumatic heart disease, with the rate of far higher for those living in rural and remote communities.

There is no cure, it can only be treated with regular injections of penicillin. It is a preventable disease that we have been unable to prevent. For First Nations Australians living in rural and remote communities, rheumatic heart disease is a part of life, but it doesn't have to be.

What is clear is that we need a new approach. Despite the best of intentions and millions of dollars of investment in rural health, what we have been doing has not worked.

The best way to find out what you should do is to ask those who will be affected by your decisions.

It is what health professionals do all the time, in the pharmacy dispensary, at the bedside, and in clinic rooms. That is what the Voice is about, asking for advice, and listening for better results.

This opinion piece was published in The Courier Mail on Thursday, 7 September 2023.