Drink and drug driving education in the Northern Territory: a qualitative study illustrating issues of access and inequity

OBJECTIVE

In the Northern Territory, people who commit drink driving offences are required to undertake an approved course or treatment to be eligible for a driver's licence, however, course uptake is low. We investigated barriers to program uptake.

METHODS

We conducted semi-structured interviews with 24 program attendees, course providers and government stakeholders. We used a framework analysis.

RESULTS

Program coverage in remote areas was limited, leading to inequitable access. The course cost affected uptake and exacerbated existing financial hardship. There were mixed views among government stakeholders on the program. While some held a view that offenders should 'pay the price', some also saw the user-pays model and high program cost as a clear barrier to accessibility.

CONCLUSIONS

The data from this study demonstrate how the current delivery model for drink and drug driving education increases inequities for those in regional and remote areas, and Aboriginal and Torres Strait Islander people.

IMPLICATIONS FOR PUBLIC HEALTH

Moving away from the current user-pays model to a subsidised or free model may facilitate greater access. Online delivery may increase accessibility; however, consultation is required to ensure the program is delivered equitably with consideration of language, literacy, cultural factors and access to technology.

A socioecological discourse of care or an economistic discourse: which fits better with transition?

OBJECTIVE

To analyse a 'socioecological' health promotion discourse and its relationship to orthodox 'economistic' discourse in Australia.

METHOD

In research on health promotion addressing equity and environmental sustainability, we identified a socioecological discourse, based on an ethic of care for people and ecosystems. Using Foucault's concept of discourse as a regime that produces and legitimises certain kinds of knowledge, and ecofeminist historical analysis, we analysed this discourse and its relationship to economism.

RESULTS

The socioecological discourse takes social and ecological wellbeing as primary values, while economism takes production and trade of goods and services, measured by money, as primary. Following British invasion, property-owning white men in Australia had the right to control and profit from land, trade, and the work of women and subordinate peoples. A knowledge regime using money as a primary measure reflects this history. In contrast, a First Nations' primary value expressed in the study was 'look after the land and the children'. Conclusion and implications for public health: Public health often attempts to express value through economism, using monetary measures. However, socioecological discourse, expressed for example through direct measures of social and ecological wellbeing, appears more fit for purpose in promoting a fair and sustainable society.