Beyond Bandaids: Exploring the Underlying Social Determinants of Aboriginal Health Papers from the Social Determinants of Aboriginal Health Workshop, Adelaide, July 2004 Edited by Ian Anderson, Fran Baum and Michael Bentley © Joint copyright is held by the author or authors of each chapter and the Cooperative Research Centre for Aboriginal Health, 2007. ISBN 978-0-7340-3744-2 First printed in September 2007 This work has been published as part of the activities of the Cooperative Research Centre for Aboriginal Health (CRCAH). The CRCAH is a collaborative partnership partly funded by the Cooperative Research Centre Program of the Australian Government Department of Education, Science and Training. This work may be reproduced in whole or in part for study or training purposes, or by Aboriginal and Torres Strait Islander Community organisations subject to an acknowledgment of the source and no commercial use or sale. Reproduction for other purposes or by other organisations requires the written permission of the copyright holder(s). Additional copies of this publication can be obtained from the CRCAH in a CD–Rom format or downloaded as a pdf version from the CRCAH website. Cooperative Research Centre for Aboriginal Health PO Box 41096, Casuarina NT 0811 AUSTRALIA T: +61 8 8922 8396 F: +61 8 8922 7797 E: [email protected] W: www.crcah.org.au Editors: Professor Ian Anderson, Professor Fran Baum and Dr Michael Bentley Managing Editors: Jane Yule and Cristina Lilley Copy Editors: Cathy Edmonds and Ali Edmonds Cover Photograph: www.waynequilliamphotography.com.au © Design and Printing: Inprint Design For citation: I. Anderson, F. Baum & M. Bentley (eds), Beyond Bandaids: Exploring the Underlying Social Determinants of Aboriginal Health. Papers from the Social Determinants of Aboriginal Health Workshop, Adelaide, July 2004, Cooperative Research Centre for Aboriginal Health, Darwin. Table of Contents Acknowledgments VI Glossary VII Introduction IX Fran Baum, Michael Bentley and Ian Anderson Social determinants of health and wellbeing X History of social determinants approach to health XI Current attention to the social determinants of health XII The process of compiling this monograph XIII The contents XIII Call for action XV References XVI Chapter 1 1 ‘If You Don’t Have Health, What’s the Acknowledgments 1 Use of Living?’—Koori Voices from the Introduction 2 Goulburn–Murray Rivers Region on Setting 3 Methods 4 Health and its Determinants Findings 5 Discussion 11 Michael Tynan, Petah Atkinson, Policy implications and conclusions 13 Lisa Bourke and Vicki Atkinson References 14 Appendix 16 Chapter 2 19 Indigenous Insights into Oral Introduction 19 History, Social Determinants Rationale 19 and Decolonisation Australian Indigenous oral history 20 Social determinants of Indigenous health 20 Methods 21 Joan Vickery, Shannon Faulkhead, Indentifi cation of oral histories 22 Karen Adams and Angela Clarke Results 22 Discussion 33 Conclusion 34 References 35 Beyond Bandaids Exploring the Underlying Social Determinants of Aboriginal Health I Chapter 3 37 Education as a Determinant of Introduction 37 Indigenous Health The research evidence 38 Indigenous health leadership views 43 Towards a model of the education–health relationship 45 Stephanie Bell, Bob Boughton Research and development priorities 50 and Ben Bartlett References 53 Chapter 4 56 You Can’t Have One without the Other— Introduction 56 Transactions between Education and Enduring expectations 58 Wellbeing for Indigenous Peoples The statistics 58 Health as wellbeing 59 A transactional model of relationships 60 Helen Askell-Williams, Michael Coughlan, Prior research on the education–wellbeing relationship 61 Michael J. Lawson, Felicity Lewis, Rosalind Contemporary perspectives on learning and teaching 63 Murray-Harvey, Kim O’Donnell, Judith Peppard, Sites for educational intervention 66 Phillip Slee and Simone Ulalka Tur Educational effects at the inner level 67 Educational effects at the middle level 69 Educational effects at the outer level 70 Summary and conclusion 72 References 73 Chapter 5 77 Aboriginality, Poverty and Health— Introduction 77 Exploring the Connections Measuring and defi ning Aboriginal poverty 78 Dimensions of poverty versus measuring poverty 80 The domain of Aboriginality and Aboriginal poverty 81 Maggie Walter Aboriginal poverty as a causal factor in Aboriginal health 82 Discussion: Advancing the research agenda 86 Conclusion 87 References 88 Chapter 6 91 Labour Force Participation as a Introduction 91 Determinant of Indigenous Health Labour force participation of Indigenous Australians: Context 92 Health and labour force status 95 The experience of Indigenous Australians at work 98 Diannah Lowry and Megan Moskos Conclusion and recommendations 101 References 101 Chapter 7 104 Framework for Research on Aboriginal Executive summary 104 Health and the Physical Environment Background 105 Methods 106 Findings 108 Kayli Wayte, Ross Bailie, Natalie Gray and Discussion 111 Graham Henderson Conclusion 115 References 116 Beyond Bandaids II Exploring the Underlying Social Determinants of Aboriginal Health Chapter 8 136 Social and Emotional Wellbeing of Introduction 136 Aboriginal and Torres Strait Islander The social determinants framework of health 138 People within the Broader Context of Social and emotional wellbeing 139 Measuring and assessing social and emotional wellbeing 145 the Social Determinants of Health Towards a research agenda in social and emotional wellbeing 147 References 149 Graham Henderson, Carrie Robson, Leonie Cox, Craig Dukes, Komla Tsey and Melissa Haswell Chapter 9 165 Community Development and Abstract 165 Empowerment: A Review of Social determinants of health and community 166 Interventions to Improve Aboriginal development theory Methodology 168 Health Discussion 168 Conclusion 176 Danielle Campbell, Priscilla Pyett, Leisa References 177 McCarthy, Mary Whiteside and Komla Tsey Chapter 10 181 Governance, Indigenous and Non- Introduction 181 Indigenous, as a Social Determinant of Aboriginal political life and custom 182 Aboriginal Health Aboriginal organisations 183 Non-Indigenous organisational culture 185 Approaches to organisational culture 186 Patrick Sullivan and Katharine Oliver Whole-of-government coordination of service delivery 188 Conclusion 189 References 190 Chapter 11 191 Social Capital and Aboriginal and Torres Introduction 191 Strait Islander Health—Problems and Theorising social capital 192 Possibilities Measuring social capital 194 Social capital in public health practice 197 What we already know about social capital in Aboriginal and 199 Mark Brough, Graham Henderson, Rosemary Torres Strait Islander Australia Foster and Heather Douglas Implications for the development of an Aboriginal and Torres 200 Strait Islander social capital research agenda References 201 Beyond Bandaids Exploring the Underlying Social Determinants of Aboriginal Health III Chapter 12 208 Law as a Determinant of Indigenous Introduction 208 Health—Some Constitutional Issues The preamble and a case for change 209 A case for ‘positive’ rights 211 Regional Indigenous autonomy 213 Chris Reynolds, Genevieve Howse and Anna Autonomy as a constitutional arrangement 215 Beesley —treaty arrangements Exploring the value of constitutional reforms 216 —here and overseas References 218 Table of cases 220 Chapter 13 221 Healthy Change at the Micro-Level— Introduction 221 Victoria’s Koori Courts The Koori Court 222 Two case studies 224 Is the Koori Court good for health? 226 Rosie Smith References 227 Chapter 14 229 The Meaning of Culture within Public Introduction 229 Health Practice—Implications for the Method 230 Study of Aboriginal and Torres Strait Culture as biology 231 Culture as a label 232 Islander Health Culture as behaviours 232 Culture as ideology 233 Chelsea Bond and Mark Brough Culture as a surrogate 234 Culture as cure 234 Conclusion 235 References 236 Chapter 15 239 Culture as a Determinant of Aboriginal Introduction 239 Health Culture 240 The uses of culture in Aboriginal health research 242 Culture and methodology 246 Michael Morrissey, Rogelia Pe-Pua, Alex Brown Paths forward 248 and Ahmed Latif Concluding remarks 251 References 251 Beyond Bandaids IV Exploring the Underlying Social Determinants of Aboriginal Health Chapter 16 255 Culture in Health Research and Introduction 255 Practice Health systems as cultural domains 256 Racist attitudes within health services 258 Socio-cultural factors that inhibit the development of 262 Heather McDonald healthy behaviours and successful participation in healthcare delivery Ways to work with ‘culture’ to contribute to improved 266 Indigenous health outcomes Appendix 271 References 271 Conclusion 281 Ian Anderson, Fran Baum and Social determinants within the National Strategic Framework for 281 Michael Bentley Aboriginal and Torres Strait Islander Health Research and Indigenous health 284 The social determinants of Indigenous health in a global context 285 References 288 Tables, Diagrams and Figures Introduction FIGURE 1: Respiratory tuberculosis—mean annual death rates (standardised to 1901 population, XI England and Wales) Chapter 1 TABLE 1: Health issues and their causes as reported by participants 6 FIGURE 1: Conceptualising the Aboriginal experience of health 12 Chapter 2 TABLE 1: Social determinants of health identifi ed by WHO and their relationship to literature on 21 Indigenous social determinants of health TABLE 2: Colonisation and decolonisation social determinants of health present and not present 23 in literature