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Fatima Y, Liu Y, Cleary A, Dean J, Smith V, King S, Solomon S. Connecting the health of country with the health of people: Application of "caring for country" in improving the social and emotional well-being of Indigenous people in Australia and New Zealand. THE LANCET REGIONAL HEALTH: WESTERN PACIFIC 2022; 31:100648. [PMCID: PMC9700301 DOI: 10.1016/j.lanwpc.2022.100648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 10/03/2022] [Accepted: 11/02/2022] [Indexed: 11/27/2022]
Abstract
Emerging evidence from the western literature suggests an increasing focus on applying nature-based interventions for mental health improvements. However, in Indigenous communities, caring for country has always been central to the Indigenous way of life. Knowing that nature-based interventions effectively improve mental health outcomes, this review collated evidence on the application of caring for country in improving social and emotional well-being (SEWB) of Indigenous peoples in Australia and New Zealand. Three studies from Australia and one from New Zealand, explored the role of country or whenua (land) in the lives of Indigenous people. Participation in caring-for country activities was associated with lower levels of psychological distress and strengthened guardianship relationship with country, which positively affected SEWB. This systematic review offers preliminary evidence on the role of caring for country activities in improving the SEWB of Indigenous peoples and highlights the need for strengths-based approaches to improve the SEWB of Indigenous peoples. Funding None.
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Affiliation(s)
- Yaqoot Fatima
- Institute for Social Science Research, The University of Queensland, Indooroopilly, Queensland, Australia,ARC Centre of Excellence for Children and Families over the Life Course (The Life Course Centre), The University of Queensland, Indooroopilly, Queensland, Australia,Murtupuni Centre for Rural and Remote Health, James Cook University, Queensland, Australia,Corresponding author. Institute for Social Science Research, University of Queensland, Indooroopilly, Queensland, Australia.
| | - Yongbo Liu
- Institute for Social Science Research, The University of Queensland, Indooroopilly, Queensland, Australia,ARC Centre of Excellence for Children and Families over the Life Course (The Life Course Centre), The University of Queensland, Indooroopilly, Queensland, Australia
| | - Anne Cleary
- Institute for Social Science Research, The University of Queensland, Indooroopilly, Queensland, Australia
| | - Julie Dean
- Institute for Social Science Research, The University of Queensland, Indooroopilly, Queensland, Australia
| | - Valance Smith
- Auckland University of Technology, Auckland, New Zealand
| | - Stephanie King
- Murtupuni Centre for Rural and Remote Health, James Cook University, Queensland, Australia
| | - Shaun Solomon
- Murtupuni Centre for Rural and Remote Health, James Cook University, Queensland, Australia
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Oswald TK, Langmaid GR. Considering ecological determinants of youth mental health in the era of COVID-19 and the Anthropocene: A call to action from young public health professionals. Health Promot J Austr 2021; 33:324-328. [PMID: 34855274 PMCID: PMC9015409 DOI: 10.1002/hpja.560] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 11/08/2021] [Accepted: 11/21/2021] [Indexed: 11/30/2022] Open
Abstract
In 2019, young Australians reported that two of their top concerns were ‘climate change and the environment’ and ‘mental health’. The events of 2020/2021, such as the ongoing climate emergency, the Australian bushfires, and the COVID‐19 pandemic, reflect the human‐induced environmental issues young people are most worried about and have also exacerbated the mental health issues which they already reported to be at a crisis point back in 2019. Given experiences of mental illness in adolescence are associated with poorer mental health across the lifespan, it is becoming increasingly important to address ecological determinants of youth mental health in the Anthropocene. However, despite the inclusion of ecological determinants of health in seminal health promotion frameworks, health promotion has been described as ‘ecologically blind’, emphasising social determinants of health at the expense of ecological determinants of health. A socio‐ecological model, which equally considers upstream social and ecological factors, should be applied to youth mental health issues. Using the Ottawa Charter for Health Promotion, we demonstrate how the ecological determinants of health may be incorporated into health promotion approaches targeting youth mental health. We also call for the health promotion sector to consider a number of actions to work towards achieving a transition to ecological determinants of health being at the forefront of health promotion activities. This commentary, written by young public health professionals, hopes to build on the momentum garnered by youth activists around the world and bring attention to the importance of ecological determinants of health for youth mental health promotion in the era of COVID‐19 and the Anthropocene.
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Affiliation(s)
- Tassia K Oswald
- School of Public Health, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Georgia R Langmaid
- School of Health & Social Development, Deakin University, Burwood, Victoria, Australia
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Dudgeon P, Bray A, D'costa B, Walker R. Decolonising Psychology: Validating Social and Emotional Wellbeing. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12294] [Citation(s) in RCA: 95] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Pat Dudgeon
- The School of Indigenous Studies, University of Western Australia,
| | - Abigail Bray
- The School of Indigenous Studies, University of Western Australia,
| | | | - Roz Walker
- Telethon Kids Institute, University of Western Australia,
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Langmaid G, Patrick R, Kingsley J, Lawson J. Applying the Mandala of Health in the Anthropocene. Health Promot J Austr 2020; 32 Suppl 2:8-21. [PMID: 33067906 PMCID: PMC8596827 DOI: 10.1002/hpja.434] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 10/03/2020] [Accepted: 10/13/2020] [Indexed: 01/21/2023] Open
Abstract
Issue addressed The Anthropocene is a new era in which human activity has been the dominant influence on climate and the environment. The negative impact humans have on the earth's systems pose significant threats to human health. Health promotion is a discipline well placed to respond to planetary health challenges of the Anthropocene. The overarching aim of this paper is to describe the elements of 21st century socio‐ecological health and apply them in a revised socio‐ecological framework for health promotion. Methods A qualitative description study design was employed to explore the significance of ecological and cultural determinants of health and review models in contemporary health promotion to inform the development of a revised Mandala of Health. Purposeful sampling was used to recruit ten experts from across Australia including academics and practitioners working at the nexus of health promotion, environmental management and sustainability. Data were analysed thematically, using deductive and inductive methods. Results A revised Mandala of Health could address existing gaps in health promotion theory and practice. Ecological and cultural determinants of health were considered essential components of health promotion that is often lacking in socio‐ecological frameworks. Indigenous Knowledge Systems were considered immensely important when addressing ecological and cultural determinants of health. Conclusions A revised Mandala of Health could encourage development of contemporary health models, assisting health promotion to evolve with the health and environmental issues of the Anthropocene. This study highlights the need for more theoretical development and empirical research regarding ecological and cultural determinants of health in a health promotion context. So what? In the context of the Anthropocene, this study highlights the potential gaps in health promotion theory and practice in terms of the natural environment and health and emphasises the need of a paradigm shift to embed ecological and cultural determinants with other determinants of health.
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Affiliation(s)
- Georgia Langmaid
- School of Health & Social DevelopmentDeakin UniversityBurwoodVic.Australia
| | - Rebecca Patrick
- School of Health & Social DevelopmentDeakin UniversityBurwoodVic.Australia
| | - Jonathan Kingsley
- Centre of Urban TransitionSwinburne University of TechnologySwinburne Place West, HawthornVic.Australia
| | - Justin Lawson
- School of Health & Social DevelopmentDeakin UniversityBurwoodVic.Australia
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Asmoro CP, Hariyati RTS, Wahyudi AS. Why We Have to Develop Instruments of Our Caring Measurement Based on an Indonesian Perspective. JURNAL NERS 2020. [DOI: 10.20473/jn.v14i3.17216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction: Caring is the core or focus in nursing as a form of professional nursing practice. The current caring instrument is an original instrument that measures the attitudes or behavior of nurses, has not paid attention to the administrative and environmental aspects of the hospital. The use of an instrument that does not yet contain certain characteristics gives rise to improper measurement results. The purpose of this study was to explain the importance of developing caring measurement instruments with an Indonesian perspective.Methods: Systematic reviews were carried out from database articles on ScienceDirect, Scopus, Google Scholar, SpringerLink, Wiley online, Proquest, and EBSCOhost. Criteria for articles were articles published in the last 10 years, national and international research locations, and in Indonesian and English. 15 references were obtained from 2100 references that met the predetermined criteria. The development of a caring behavior instrument based on an Indonesian perspective does not yet exist.Results: The results found that development on the basis of linguistics, cultural adjustment, and according to the prevalence of disease in a country because the epidemiology of the disease differs on the climate region.Conclusion: Specific caring instruments in an Indonesian perspective is expected that the research results will be more accurate.
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Abstract
Strong female governance has always been central to one of the world’s oldest existing culturally diverse, harmonious, sustainable, and democratic societies. Aboriginal and Torres Strait Islander women’s governance of a country twice the size of Europe is based on complex laws which regulate relationships to country, family, community, culture and spirituality. These laws are passed down through generations and describe kinship systems which encompass sophisticated relations to the more-than-human. This article explores Indigenous kinship as an expression of relationality, culturally specific and complex Indigenous knowledge systems which are founded on a connection to the land. Although Indigenous Australian women’s kinships have been disrupted through dispossession from the lands they belong to, the forced removal of their children across generations, and the destruction of their culture, community and kinship networks, the survival of Indigenous women’s knowledge systems have supported the restoration of Indigenous relationality. The strengthening of Indigenous women’s kinship is explored as a source of social and emotional wellbeing and an emerging politics of environmental reproductive justice.
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Schultz R, Abbott T, Yamaguchi J, Cairney S. Indigenous land management as primary health care: qualitative analysis from the Interplay research project in remote Australia. BMC Health Serv Res 2018; 18:960. [PMID: 30541540 PMCID: PMC6291963 DOI: 10.1186/s12913-018-3764-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 11/23/2018] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND For Indigenous Australians, health transcends the absence of disease, and includes the health and wellbeing of their community and Country: their whole physical, cultural and spiritual environment. Stronger relationships with Country and greater involvement in cultural practices enhance the wellbeing of Indigenous Australians, and those in more remote regions have greater access to their Country and higher levels of wellbeing. However this does not translate into improvements in clinical indicators, and Indigenous Australians in more remote regions suffer higher levels of morbidity and mortality than Indigenous people in non-remote areas, and other Australians. The Interplay research project aimed to explore how Indigenous Australians in remote regions experience high levels of wellbeing despite poor health statistics, and how services could more effectively enhance both health and wellbeing. METHODS Indigenous Australians in remote regions, together with researchers and government representatives developed a wellbeing framework, comprising government and community priorities: education, employment and health, and community, culture and empowerment respectively. To explore these priorities Indigenous community researchers recruited participants from diverse Indigenous organizations, including Indigenous land management, art, business development, education, employment, health and municipal services. Fourteen focus groups and seven interviews, involving 75 Indigenous and ten non-Indigenous service providers and users were conducted. These were recorded, transcribed and analyzed, using thematic analysis, based on the wellbeing framework. RESULTS Research participants highlighted Indigenous land management as a source of wellbeing, through strengthened identity and empowerment, access to traditional food sources, enjoyable physical activity, and escape from communities where high levels of alcohol are consumed. Participants described how collaboration and partnerships between services, and recognition of Indigenous languages could enhance wellbeing, while competition between services undermines wellbeing. Indigenous land management programs work across different sectors and promote collaboration between services, serving as a source of comprehensive primary health care. CONCLUSIONS Developing primary health care to reflect distinctive health needs of Indigenous Australians will enhance their health and wellbeing, which includes their communities and Country. Indigenous land management consolidates aspects of comprehensive primary health care, providing both clinical benefits and wellbeing, and can provide a focus for service collaboration.
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Affiliation(s)
- Rosalie Schultz
- Centre for Remote Health, Flinders University, PO Box 4066, Alice Springs, NT 0871 Australia
| | - Tammy Abbott
- Ninti One Ltd, PO Box 3971, Alice Springs, Australia
| | - Jessica Yamaguchi
- Information and Evaluation Branch, Department of the Prime Minister and Cabinet, PO Box 6500, Canberra, ACT 2600 Australia
| | - Sheree Cairney
- Centre for Remote Health, Flinders University, PO Box 4066, Alice Springs, NT 0871 Australia
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Associations between Participation in a Ranger Program and Health and Wellbeing Outcomes among Aboriginal and Torres Strait Islander People in Central Australia: A Proof of Concept Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15071478. [PMID: 30002356 PMCID: PMC6068952 DOI: 10.3390/ijerph15071478] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 07/09/2018] [Accepted: 07/10/2018] [Indexed: 11/17/2022]
Abstract
Culture can be viewed as an integral part of Aboriginal and Torres Strait Islander health and wellbeing. This study explores the association between caring for country, through participation in a Ranger program, and wellbeing. We analyzed cross-sectional data collected in Central Australia in 2017, comparing health and wellbeing (life satisfaction, general health, psychological wellbeing and family wellbeing) among Aboriginal and Torres Strait Islander peoples employed as Rangers (n = 43) versus not employed as Rangers (n = 160). We tested if any differences in outcomes were explained by differences in key demographic or health factors. Ranger participation was significantly associated with very high life satisfaction (PR = 1.69, 95% CI: 1.29, 2.20) and high family wellbeing (PR = 1.47, 95% CI: 1.13, 1.90); associations remained significant after individual adjustment for education, income, employment, health risk factors and health conditions. The magnitude and direction of associations were similar for very good general health, but results were not significant. We did not identify an association between Ranger participation and psychological wellbeing. While based on a small sample, these findings support the assertion that participation in the Ranger program is associated with positive health and wellbeing outcomes. This supports the continuation of cultural participation and practice through the Ranger program and has implications for funding, program and policy development.
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Cairney S, Abbott T, Quinn S, Yamaguchi J, Wilson B, Wakerman J. Interplay wellbeing framework: a collaborative methodology 'bringing together stories and numbers' to quantify Aboriginal cultural values in remote Australia. Int J Equity Health 2017; 16:68. [PMID: 28468656 PMCID: PMC5415825 DOI: 10.1186/s12939-017-0563-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 04/20/2017] [Indexed: 11/17/2022] Open
Abstract
Background Wellbeing has been difficult to understand, measure and strengthen for Aboriginal people in remote Australia. Part of the challenge has been genuinely involving community members and incorporating their values and priorities into assessment and policy. Taking a ‘shared space’ collaborative approach between remote Aboriginal communities, governments and scientists, we merged Aboriginal knowledge with western science – by bringing together stories and numbers. This research aims to statistically validate the holistic Interplay Wellbeing Framework and Survey that bring together Aboriginal-identified priorities of culture, empowerment and community with government priorities including education, employment and health. Method Quantitative survey data were collected from a cohort of 842 Aboriginal people aged 15-34 years, recruited from four different Aboriginal communities in remote Australia. Aboriginal community researchers designed and administered the survey. Results Structural equation modeling showed good fit statistics (χ/df = 2.69, CFI = 0.95 and RMSEA = 0.045) confirming the holistic nature of the Interplay Wellbeing Framework. The strongest direct impacts on wellbeing were ‘social and emotional wellbeing’ (r = 0.23; p < 0.001), ‘English literacy and numeracy’ (r = 0.15; p < 0.001), ‘Aboriginal literacy’ (r = 0.14; p < 0.001), ‘substances’ (lack thereof; r = 0.13; p = 0.003), ‘work’ (r = 0.12; p = 0.02) and ‘community’ (r = 0.08; p = 0.05). Correlation analyses suggested cultural factors have indirect impacts on wellbeing, such as through Aboriginal literacy. All cultural variables correlated highly with each other, and with empowerment and community. Empowerment also correlated highly with all education and work variables. ‘Substances’ (lack thereof) was linked with positive outcomes across culture, education and work. Specific interrelationships will be explored in detail separately. Conclusion The Interplay Wellbeing Framework and Survey were statistically validated as a collaborative approach to assessing wellbeing that is inclusive of other cultural worldviews, values and practices. New community-derived social and cultural indicators were established, contributing valuable insight to psychometric assessment across cultures. These analyses confirm that culture, empowerment and community play key roles in the interplay with education, employment and health, as part of a holistic and quantifiable system of wellbeing. This research supports the holistic concept of wellbeing confirming that everything is interrelated and needs to be considered at the ‘whole of system’ level in policy approaches.
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Affiliation(s)
- Sheree Cairney
- Centre for Remote Health, a Joint Centre of Flinders University and Charles Darwin University, Alice Springs, NT, Australia. .,Ninti One Limited and the Cooperative Research Centre for Remote Economic Participation (CRC-REP), Alice Springs, NT, Australia. .,Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.
| | - Tammy Abbott
- Ninti One Limited and the Cooperative Research Centre for Remote Economic Participation (CRC-REP), Alice Springs, NT, Australia
| | | | - Jessica Yamaguchi
- Policy, Analysis and Evaluation Division, Australian Government Department of the Prime Minister and Cabinet, Canberra, ACT, Australia
| | - Byron Wilson
- Ninti One Limited and the Cooperative Research Centre for Remote Economic Participation (CRC-REP), Alice Springs, NT, Australia.,Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - John Wakerman
- Centre for Remote Health, a Joint Centre of Flinders University and Charles Darwin University, Alice Springs, NT, Australia
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Jongen CS, McCalman J, Bainbridge RG. The Implementation and Evaluation of Health Promotion Services and Programs to Improve Cultural Competency: A Systematic Scoping Review. Front Public Health 2017; 5:24. [PMID: 28289677 PMCID: PMC5327788 DOI: 10.3389/fpubh.2017.00024] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 02/08/2017] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Cultural competency is a multifaceted intervention approach, which needs to be implemented at various levels of health-care systems to improve quality of care for culturally and ethnically diverse populations. One level of health care where cultural competency is required is in the provision of health promotion services and programs targeted to diverse patient groups who experience health-care and health inequalities. To inform the implementation and evaluation of health promotion programs and services to improve cultural competency, research must assess both intervention strategies and intervention outcomes. METHODS This scoping review was completed as part of a larger systematic literature search conducted on evaluations of cultural competence interventions in health care in Canada, the United States, Australia, and New Zealand. Seventeen peer-reviewed databases, 13 websites and clearinghouses, and 11 literature reviews were searched. Overall, 64 studies on cultural competency interventions were found, with 22 being health promotion programs and services. A process of thematic analysis was utilized to identify key intervention strategies and outcomes reported in the literature. RESULTS The review identified three overarching strategies utilized in health promotion services and programs to improve cultural competency: community-focused strategies, culturally focused strategies, and language-focused strategies. Studies took different approaches to delivering culturally competent health interventions, with the majority incorporating multiple strategies from each overarching category. There were various intermediate health-care and health outcomes reported across the included studies. Most commonly reported were positive reports of patient satisfaction, patient/participant service access, and program/study retention rates. The health outcome results indicate positive potential of health promotion services and programs to improve cultural competency to impact cardiovascular disease and mental health outcomes. However, due to measurement and study quality issues, it is difficult to determine the extent of the impacts. DISCUSSION Examined together, these intervention strategies and outcomes provide a framework that can be used by service providers and researchers in the implementation and evaluation of health promotion services and programs to improve cultural competency. While there is evidence indicating the effectiveness of such health promotion interventions in improving intermediate and health outcomes, further attention is needed to issues of measurement and study quality.
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Affiliation(s)
- Crystal Sky Jongen
- School of Human Health and Social Sciences, Central Queensland University, Cairns, QLD, Australia
| | - Janya McCalman
- School of Human Health and Social Sciences, Central Queensland University, Cairns, QLD, Australia
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Campbell D. Economies through Application of Nonmedical Primary-Preventative Health: Lessons from the Healthy Country Healthy People Experience of Australia's Aboriginal People. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:400. [PMID: 27482574 PMCID: PMC4847062 DOI: 10.3390/ijerph13040400] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 03/24/2016] [Indexed: 12/02/2022]
Abstract
The World Health Organization reports noncommunicable disease as a global pandemic. While national and international health research/policy bodies, such as the World Health Organization and the Australian Institute of Health and Welfare, emphasize the importance of preventative health, there is a continuing distortion in the allocation of resources to curative health as a result of government failure. Government failure is, in part, the result of a political response to individual preference for certainty in receiving treatment for specific health conditions, rather than the uncertainty of population-based preventative intervention. This has led to a failure to engage with those primary causative factors affecting chronic disease, namely the psychosocial stressors, in which the socioeconomic determinants are an important component. Such causal factors are open to manipulation through government policies and joint government-government, government-private cooperation through application of nonmedical primary-preventative health policies. The health benefits of Aboriginal people in traditional land management, or caring-for-country, in remote to very remote Australia, is used to exemplify the social benefits of nonmedical primary-preventative health intervention. Such practices form part of the "healthy country, health people" concept that is traditionally relied upon by Indigenous peoples. Possible health and wider private good and public good social benefits are shown to occur across multiple disciplines and jurisdictions with the possibility of substantial economies. General principles in the application of nonmedical primary-preventative health activities are developed through consideration of the experience of Afboriginal people participation in traditional caring-for-country.
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Parkes MW. Pacific connections for health, ecosystems and society: new approaches to the land-water-health nexus. REVIEWS ON ENVIRONMENTAL HEALTH 2016; 31:125-130. [PMID: 26953704 DOI: 10.1515/reveh-2015-0067] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Accepted: 11/16/2015] [Indexed: 06/05/2023]
Abstract
Renewed effort to understand the social-ecological context of health is drawing attention to the dynamics of land and water resources and their combined influence on the determinants of health. A new area of research, education and policy is emerging that focuses on the land-water-health nexus: this orientation is applicable from small wetlands through to large-scale watersheds or river basins, and draws attention to the benefits of combined land and water governance, as well as the interrelated implications for health, ecological and societal concerns. Informed by research precedents, imperatives and collaborations emerging in Canada and parts of Oceania, this review profiles three integrative, applied approaches that are bringing attention to the importance the land-water-health nexus within the Pacific Basin: wetlands and watersheds as intersectoral settings to address land-water-health dynamics; tools to integrate health, ecological and societal dynamics at the land-water-health nexus; and indigenous leadership that is linking health and well-being with land and water governance. Emphasis is given to key characteristics of a new generation of inquiry and action at the land-water-health nexus, as well as capacity-building, practice and policy opportunities to address converging environmental, social and health objectives linked to the management and governance of land and water resources.
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Green D, Minchin L. Living on climate-changed country: indigenous health, well-being and climate change in remote Australian communities. ECOHEALTH 2014; 11:263-272. [PMID: 24419665 DOI: 10.1007/s10393-013-0892-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Revised: 11/21/2013] [Accepted: 12/07/2013] [Indexed: 06/03/2023]
Abstract
Closing the gap between the health and well-being status of Indigenous people living in remote areas of northern Australia and non-Indigenous Australians has long been a major target of federal health policy. With climate projections suggesting large increases in hot spells in desert regions and more extremes in rainfall in other areas of the north, direct and indirect impacts resulting from these changes are likely to further entrench this health and well-being disparity. This paper argues that it is time to explicitly draw on Indigenous definitions of health, which directly address the need to connect individual and community health to the health of their country, in order to develop effective climate adaptation and health strategies. We detail how current health policies overlook this 'missing' dimension of Indigenous connection to country, and why that is likely to be detrimental to the health and well-being of people living in remote communities in a climate-changed future.
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Affiliation(s)
- Donna Green
- Climate Change Research Centre, University of New South Wales, Kensington, NSW, 2052, Australia,
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Browne J, D'Amico E, Thorpe S, Mitchell C. Feltman: evaluating the acceptability of a diabetes education tool for Aboriginal health workers. Aust J Prim Health 2014; 20:319-22. [DOI: 10.1071/py14040] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Accepted: 06/11/2014] [Indexed: 11/23/2022]
Abstract
There is an urgent need to address the lack of Aboriginal-specific diabetes prevention and management resources. Following consultation with Victorian Aboriginal health workers, the Victorian Aboriginal Community Controlled Health Organisation and Diabetes Australia – Victoria developed ‘Feltman’, a life-sized felt body showing the main organs involved in the digestion and metabolism of food, and the main parts of the body affected by diabetes. Feltman was distributed to all Victorian Aboriginal Community Controlled Health Organisations and an additional 32 Victorian organisations. In total, 276 people from 57 organisations were trained to use Feltman. An online evaluation survey was developed and sent to all people who were trained to use Feltman in Victoria. Sixty-six people completed the survey. All respondents agreed Feltman was an appropriate tool for the Aboriginal community, 89% of health workers felt more confident in their ability to discuss diabetes with their community but would like further training to maintain skills and confidence and 70% of workers had used Feltman with the community. Qualitative feedback noted its strength as a highly visual resource that was popular with the Aboriginal community. Workers reported that Feltman was a highly acceptable diabetes education resource, which they believed had increased knowledge and improved the management of diabetes among clients.
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Economic rationality in choosing between short-term bad-health choices and longer-term good-health choices. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:5971-88. [PMID: 24217181 PMCID: PMC3863881 DOI: 10.3390/ijerph10115971] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2013] [Revised: 10/31/2013] [Accepted: 11/01/2013] [Indexed: 11/16/2022]
Abstract
Non-contagious, chronic disease has been identified as a global health risk. Poor lifestyle choices, such as smoking, alcohol, drug and solvent abuse, physical inactivity, and unhealthy diet have been identified as important factors affecting the increasing incidence of chronic disease. The following focuses on the circumstance affecting the lifestyle or behavioral choices of Aboriginal and Torres Strait Islander peoples in remote-/very remote Australia. Poor behavioral choices are the result of endogenous characteristics that are influenced by a range of stressful exogenous variables making up the psychosocial determinants including social disenfranchisement, cultural loss, insurmountable tasks, the loss of volitional control and resource constraints. It is shown that poor behavioral choices can be economically rational; especially under highly stressful conditions. Stressful circumstances erode individual capacity to commit to long-term positive health alternatives such as self-investment in education. Policies directed at removing the impediments and providing incentives to behaviors involving better health choices can lead to reductions in smoking and alcohol consumption and improved health outcomes. Multijurisdictional culturally acceptable policies directed at distal variables relating to the psychosocial determinants of health and personal mastery and control can be cost effective. While the content of this paper is focused on the conditions of colonized peoples, it has broader relevance.
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Johnston L, Doyle J, Morgan B, Atkinson-Briggs S, Firebrace B, Marika M, Reilly R, Cargo M, Riley T, Rowley K. A review of programs that targeted environmental determinants of Aboriginal and Torres Strait Islander health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:3518-42. [PMID: 23939388 PMCID: PMC3774452 DOI: 10.3390/ijerph10083518] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Revised: 08/02/2013] [Accepted: 08/05/2013] [Indexed: 11/15/2022]
Abstract
Objective: Effective interventions to improve population and individual health require environmental change as well as strategies that target individual behaviours and clinical factors. This is the basis of implementing an ecological approach to health programs and health promotion. For Aboriginal People and Torres Strait Islanders, colonisation has made the physical and social environment particularly detrimental for health. Methods and Results: We conducted a literature review to identify Aboriginal health interventions that targeted environmental determinants of health, identifying 21 different health programs. Program activities that targeted environmental determinants of health included: Caring for Country; changes to food supply and/or policy; infrastructure for physical activity; housing construction and maintenance; anti-smoking policies; increased workforce capacity; continuous quality improvement of clinical systems; petrol substitution; and income management. Targets were categorised according to Miller’s Living Systems Theory. Researchers using an Indigenous community based perspective more often identified interpersonal and community-level targets than were identified using a Western academic perspective. Conclusions: Although there are relatively few papers describing interventions that target environmental determinants of health, many of these addressed such determinants at multiple levels, consistent to some degree with an ecological approach. Interpretation of program targets sometimes differed between academic and community-based perspectives, and was limited by the type of data reported in the journal articles, highlighting the need for local Indigenous knowledge for accurate program evaluation. Implications: While an ecological approach to Indigenous health is increasingly evident in the health research literature, the design and evaluation of such programs requires a wide breadth of expertise, including local Indigenous knowledge.
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Affiliation(s)
- Leah Johnston
- Onemda VicHealth Koori Health Unit, Centre for Health and Society, Melbourne School of Population & Global Health, The University of Melbourne, Carlton, VIC 3010, Australia; E-Mails: (L.J.); (J.D.); (B.F.); (M.M.); (R.R.); (K.R.)
| | - Joyce Doyle
- Onemda VicHealth Koori Health Unit, Centre for Health and Society, Melbourne School of Population & Global Health, The University of Melbourne, Carlton, VIC 3010, Australia; E-Mails: (L.J.); (J.D.); (B.F.); (M.M.); (R.R.); (K.R.)
| | - Bec Morgan
- Centre of Excellence in Intervention and Prevention Science, Carlton, VIC 3053, Australia; E-Mail:
| | | | - Bradley Firebrace
- Onemda VicHealth Koori Health Unit, Centre for Health and Society, Melbourne School of Population & Global Health, The University of Melbourne, Carlton, VIC 3010, Australia; E-Mails: (L.J.); (J.D.); (B.F.); (M.M.); (R.R.); (K.R.)
| | - Mayatili Marika
- Onemda VicHealth Koori Health Unit, Centre for Health and Society, Melbourne School of Population & Global Health, The University of Melbourne, Carlton, VIC 3010, Australia; E-Mails: (L.J.); (J.D.); (B.F.); (M.M.); (R.R.); (K.R.)
| | - Rachel Reilly
- Onemda VicHealth Koori Health Unit, Centre for Health and Society, Melbourne School of Population & Global Health, The University of Melbourne, Carlton, VIC 3010, Australia; E-Mails: (L.J.); (J.D.); (B.F.); (M.M.); (R.R.); (K.R.)
- South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
| | - Margaret Cargo
- School of Population Health, University of South Australia, Adelaide, SA 5000, Australia; E-Mail:
| | - Therese Riley
- Centre of Excellence in Intervention and Prevention Science, Carlton, VIC 3053, Australia; E-Mail:
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +61-03-8344-0814
| | - Kevin Rowley
- Onemda VicHealth Koori Health Unit, Centre for Health and Society, Melbourne School of Population & Global Health, The University of Melbourne, Carlton, VIC 3010, Australia; E-Mails: (L.J.); (J.D.); (B.F.); (M.M.); (R.R.); (K.R.)
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Kingsley J, Townsend M, Henderson-Wilson C, Bolam B. Developing an exploratory framework linking Australian Aboriginal peoples' connection to country and concepts of wellbeing. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:678-98. [PMID: 23435590 PMCID: PMC3635170 DOI: 10.3390/ijerph10020678] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2012] [Revised: 01/17/2013] [Accepted: 01/18/2013] [Indexed: 11/16/2022]
Abstract
Aboriginal people across Australia suffer significant health inequalities compared with the non-Indigenous population. Evidence indicates that inroads can be made to reduce these inequalities by better understanding social and cultural determinants of health, applying holistic notions of health and developing less rigid definitions of wellbeing. The following article draws on qualitative research on Victorian Aboriginal peoples’ relationship to their traditional land (known as Country) and its link to wellbeing, in an attempt to tackle this. Concepts of wellbeing, Country and nature have also been reviewed to gain an understanding of this relationship. An exploratory framework has been developed to understand this phenomenon focusing on positive (e.g., ancestry and partnerships) and negative (e.g., destruction of Country and racism) factors contributing to Aboriginal peoples’ health. The outcome is an explanation of how Country is a fundamental component of Aboriginal Victorian peoples’ wellbeing and the framework articulates the forces that impact positively and negatively on this duality. This review is critical to improving not only Aboriginal peoples’ health but also the capacity of all humanity to deal with environmental issues like disconnection from nature and urbanisation.
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Affiliation(s)
- Jonathan Kingsley
- School of Health and Social Development, Deakin University, Burwood, Victoria 3125 Australia; E-Mails: (M.T.); (C.H.-W.)
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +61-396-679-076
| | - Mardie Townsend
- School of Health and Social Development, Deakin University, Burwood, Victoria 3125 Australia; E-Mails: (M.T.); (C.H.-W.)
| | - Claire Henderson-Wilson
- School of Health and Social Development, Deakin University, Burwood, Victoria 3125 Australia; E-Mails: (M.T.); (C.H.-W.)
| | - Bruce Bolam
- Melbourne School of Population Health, University of Melbourne, Carlton, Victoria 3010 Australia; E-Mail:
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Rigby CW, Rosen A, Berry HL, Hart CR. If the land's sick, we're sick:* The impact of prolonged drought on the social and emotional well-being of Aboriginal communities in rural New South Wales. Aust J Rural Health 2011; 19:249-54. [DOI: 10.1111/j.1440-1584.2011.01223.x] [Citation(s) in RCA: 88] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Hart CR, Berry HL, Tonna AM. Improving the mental health of rural New South Wales communities facing drought and other adversities. Aust J Rural Health 2011; 19:231-8. [DOI: 10.1111/j.1440-1584.2011.01225.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Berry HL, Butler JRA, Burgess CP, King UG, Tsey K, Cadet-James YL, Rigby CW, Raphael B. Mind, body, spirit: co-benefits for mental health from climate change adaptation and caring for country in remote Aboriginal Australian communities. NSW PUBLIC HEALTH BULLETIN 2011; 21:139-45. [PMID: 20637171 DOI: 10.1071/nb10030] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The evident and unresolved health disparity between Aboriginal and other Australians is testament to a history of systematic disenfranchisement. Stigma, lack of appropriate services and the expense of delivering services in remote settings make it impossible to adequately address mental health needs, including suicide, solely using a mainstream medical approach. Nor do mainstream approaches accommodate the relationship between Aboriginal health and connectedness to land, whether traditional or new land, remote or metropolitan. This review describes how caring-for-country projects on traditional lands in remote locations may provide a novel way to achieve the linked goals of climate change adaptation with co-benefits for social and emotional wellbeing.
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Campbell D, Burgess CP, Garnett ST, Wakerman J. Potential primary health care savings for chronic disease care associated with Australian Aboriginal involvement in land management. Health Policy 2011; 99:83-9. [PMID: 20708816 DOI: 10.1016/j.healthpol.2010.07.009] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2010] [Revised: 07/08/2010] [Accepted: 07/08/2010] [Indexed: 11/27/2022]
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Campbell D. Application of an integrated multidisciplinary economic welfare approach to improved wellbeing through Aboriginal caring for country. RANGELAND JOURNAL 2011. [DOI: 10.1071/rj11025] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The lands held by Aboriginal people are mostly located in the Australian desert, aside from pastoral country purchased under the Indigenous Land Corporation, they are among the least amenable to agricultural production. Social expectations regarding land use are undergoing a multifunctional transition with a move away from a focus on production, to increased amenity and conservation uses. This change means that Aboriginal people with cultural connections to country enjoy an absolute advantage in managing country through their application of land care involving Indigenous ecological knowledge. An integrated multidisciplinary economic welfare approach, based on data from northern Australia and the central Australian desert, is used to demonstrate the role Aboriginal people can play in caring for country. Such engagement can be to the advantage of Aboriginal people through a multiplicity of private and public good benefits, such as improving Aboriginal health, maintaining biodiversity, and the mitigation of climate change impacts through possible greenhouse gas biosequestration and the reduction of dust storms – which are an important vector of disease.
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Zander KK, Garnett ST, Straton A. Trade-offs between development, culture and conservation--willingness to pay for tropical river management among urban Australians. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2010; 91:2519-2528. [PMID: 20724063 DOI: 10.1016/j.jenvman.2010.07.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2009] [Revised: 06/09/2010] [Accepted: 07/06/2010] [Indexed: 05/29/2023]
Abstract
Australia's system of tropical rivers constitutes one of the largest and least changed drainage networks in the world. However increasing demand for water in parts of Australia, along with ongoing drought, is driving pressure to develop these rivers. This paper reports the results of a choice experiment (CE) to assess the benefits of different management strategies for three tropical rivers in northern Australia: the Daly, Mitchell and Fitzroy Rivers. The CE was carried out using a survey mailed to Australian urban populations. The results showed that 90% of Australians were willing to pay a once-off payment for the management of tropical rivers. Respondents who had visited or lived near the rivers were willing to pay more for cultural, recreational and environmental services than those who had not. Respondents classed as 'developers', who made up only 4% of the 684 respondents, considered a substantial income from irrigated agriculture as important. Unlike 'environmentalists' and 'neutrals', 'developers' were unwilling to pay for high quality recreational fishing or for having floodplains in good environmental condition. All groups, however, were willing to pay for high cultural values.
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Affiliation(s)
- Kerstin K Zander
- School for Environmental Research, Charles Darwin University, Ellengowan Drive, Darwin, NT 0909, Australia.
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Burgess CP, Johnston FH, Berry HL, McDonnell J, Yibarbuk D, Gunabarra C, Mileran A, Bailie RS. Healthy country, healthy people: the relationship between Indigenous health status and "caring for country". Med J Aust 2009; 190:567-72. [PMID: 19450204 DOI: 10.5694/j.1326-5377.2009.tb02566.x] [Citation(s) in RCA: 95] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2008] [Accepted: 04/01/2009] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate associations between "caring for country" -- an activity that Indigenous peoples assert promotes good health -- and health outcomes relevant to excess Indigenous morbidity and mortality. DESIGN, SETTING AND PARTICIPANTS Cross-sectional study involving 298 Indigenous adults aged 15-54 years in an Arnhem Land community, recruited from March to September 2005. MAIN OUTCOME MEASURES Self-reported involvement in caring for country, health behaviours and clinically measured body mass index (BMI), waist circumference, blood pressure, type 2 diabetes status, albumin to creatinine ratio (ACR), levels of glycated haemoglobin (HbA(1c)) and high-density lipoprotein (HDL) cholesterol, lipid ratio, score on the five-item version of the Kessler Psychological Distress Scale (K5), and 5-year cardiovascular disease (CVD) risk. RESULTS Controlling for sociodemographic characteristics and health behaviours, multivariate regression revealed significant and substantial associations between caring for country and health outcomes. An interquartile range rise in the weighted composite caring-for-country score was significantly associated with more frequent physical activity, better diet, lower BMI (regression coefficient [b] = - 2.83; 95% CI, - 4.56 to - 1.10), less abdominal obesity (odds ratio [OR], 0.43; 95% CI, 0.26-0.72), lower systolic blood pressure (b = - 7.59; 95% CI, - 12.01 to - 3.17), less diabetes (OR, 0.12; 95% CI, 0.03-0.52), lower HbA(1c) level (b = - 0.45; 95% CI, - 0.79 to - 0.11), non-elevated ACR (OR, 0.28; 95% CI, 0.13-0.60), higher HDL cholesterol level (b = 0.06; 95% CI, 0.01-0.12), lower K5 score (b = - 0.97; 95% CI, - 1.64 to - 0.31) and lower CVD risk (b = - 0.77; 95% CI, - 1.43 to - 0.11). CONCLUSIONS Greater Indigenous participation in caring for country activities is associated with significantly better health. Although the causal direction of these associations requires clarification, our findings suggest that investment in caring for country may be a means to foster sustainable economic development and gains for both ecological and Indigenous peoples' health.
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Affiliation(s)
- Christopher P Burgess
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.
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