A majority of Australians "no" to an Indigenous Voice to Parliament. But if we dig deeper into the data from the 2023 referendum, there is more to learn, especially about the health of Indigenous Australians living in communities with strong opposition to the Voice. It is a picture both striking and urgent.

In research in we show for the first time that Indigenous Australians living in regions more strongly opposed to the Voice had poorer health. When we mapped community-level opposition to the Voice to Australians' health, we found Indigenous Australians were more likely than non-Indigenous Australians to report poorer general and mental health. But Indigenous Australians were less likely to access health care.

These inequalities were larger in areas with higher opposition to the Voice. Our results likely reflect underlying negative attitudes towards Indigenous Australians and fewer culturally sensitive options for accessing health care in some regions. Both impact Indigenous Australians' health in numerous ways.

What we did and what we found We started with the national map of voting patterns to identify regions with the highest level of opposition to the Voice (defined in this study as regions of Australia where more than 72% of voted "no"). Next, we compared regions with high versus lower levels of opposition to the Voice with Australians' health. We did this using a 2021 , which included information on self-reported general health, mental health, and use of health care i.