Indigenous health: power, politics and citizenship (original) (raw)
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Human Rights Law Review, 2016
The Aboriginal Community Controlled Health sector in Australia has been described as a best practice example of the implementation of the right to self-determination as enshrined in the United Nations Declaration on the Rights of Indigenous Peoples. By prioritizing the expression of Indigenous cultural values within a predominantly western health sector, Aboriginal Community Controlled Health Services shift the dynamics of power to centre Aboriginal knowledges, understandings and perspectives. The effect, over time, has been to establish more equitable health services based on principles of self-determination, empowerment and coexistence. In this article, I examine more closely the role of Aboriginal Community Controlled Health Services and the tensions that exist in embodying the principles of self-determination and the right to health at international law in the Australian health care context.
Indigenous Health and Human Rights: A Reflection on Law and Culture
In Australia, Aboriginal and Torres Strait Islander peoples bear a greater burden of disease and have lower life expectancy than their non-Indigenous counterparts. These combined indicators are evidence of an entrenched health crisis in the Indigenous population that is linked to systemic disadvantage over many decades. In an effort to improve life expectancy and lessen the burden of disease, a number of strategies and national frameworks now embed a human rights-based approach to achieving health equality. This paper explores the application of human rights to Indigenous health and examines the inherent tensions that exist in engaging a system of law based on universal assumptions of the Enlightenment to advance Indigenous rights. What becomes apparent through this exploration is that the strategic approach of Indigenous peoples' use of human rights, despite its genesis in a system of law that justified colonisation, has opened up opportunities to reframe fixed ideas of law and culture.
Social Science & Medicine, 2005
Public health practitioners in Australian indigenous health work in a complex political environment. Public health training is limited in providing them with conceptual tools needed to unpack the postcolonial nexus of 'fourth-world' health. A workshop was designed by the authors to facilitate critical reflection on how the concepts of race and culture are used in constructions of indigenous ill-health. It was attended by researchers, students, clinicians and bureaucrats working in public health in northern Australia.
Journal of Social Policy, 2019
The paper analyses the policy process which enabled the successful adoption of Australia's National Aboriginal and Torres Strait Islander Health Plan 2013–2023 (NATSIHP), which is grounded in an understanding of the Social Determinants of Indigenous Health (SDIH). Ten interviews were conducted with key policy actors directly involved in its development. The theories we used to analyse qualitative data were the Advocacy Coalition Framework, the Multiple Streams Approach, policy framing and critical constructionism. We used a complementary approach to policy analysis. The NATSIHP acknowledges the importance of Aboriginal and Torres Strait Islander (hereafter, Aboriginal) culture and the health effects of racism, and explicitly adopts a human-rights-based approach. This was enabled by a coalition campaigning to ‘Close the Gap’ (CTG) in health status between Aboriginal and non-Aboriginal Australians. The CTG campaign, and key Aboriginal health networks associated with it, operated as an effective advocacy coalition, and policy entrepreneurs emerged to lead the policy agenda. Thus, Aboriginal health networks were able to successfully contest conventional problem conceptions and policy framings offered by government policy actors and drive a paradigm shift for Aboriginal health to place SDIH at the centre of the NATSIHP policy. Implications of this research for policy theory and for other policy environments are considered along with suggestions for future research.
Indigenous engagement in health: lessons from Brazil, Chile, Australia and New Zealand
International Journal for Equity in Health
Background Given the persistence of Indigenous health inequities across national contexts, many countries have adopted strategies to improve the health of Indigenous peoples. Governmental recognition of the unique health needs of Indigenous populations is necessary for the development of targeted programs and policies to achieve universal health coverage. At the same time, the participation of Indigenous peoples in decision-making and program and policy design helps to ensure that barriers to health services are appropriately addressed and promotes the rights of Indigenous peoples to self-determination. Due to similar patterns of Indigenous health and health determinants across borders, there have been calls for greater global collaboration in this field. However, most international studies on Indigenous health policy link Anglo-settler democracies (Canada, Australia, Aotearoa/New Zealand and the United States), despite these countries representing a small fraction of the world’s In...
Closing the Gap of health inequalities between Indigenous and non-indigenous Australians
Deakin Public Policy Review, 2011
This essay seeks to demonstrate that whilst Indigenous health policy may have been on the Australian public policy agenda since the 1960s, the gap between Indigenous and non-Indigenous health has remained. A brief description of the lives of Indigenous Australians prior to the colonisation of Australia is given, followed by a description of various policies that have been introduced by the Australian government to combat these inequalities. This essay demonstrates why these policies have been inadequate, in turn highlighting why the incorporation of Indigenous knowledge in creating Indigenous health policies is important. This essay closes with a brief examination of the Closing the Gap policy, which is utilising the knowledge of Indigenous Australians in creating culturally sensitive Indigenous health policies. In conclusion, this essay demonstrates that by including Indigenous Australians in the policy making process, we might be starting to close the gap.
2020
The potential for public health legislation to improve health outcomes for Indigenous Australians has been the focus of recent interest in Australia. This paper examines the Northern Territory's package of public health legislation in an attempt to assess its current and potential impact on health and to identify barriers to its ability to achieve better health for Indigenous people living in remote communities. It is argued that the current legislation in the Northern Territory has little or no practical application in health improvement. This is primarily due to the fact that its directive and regulatory approach is unsuited to dictating the social and environmental conditions that would lead to health improvements in Indigenous communities, or to generating the social change that would be required to initiate these improved living conditions. Proposed technical amendments to the legislation are thus unlikely to alter this lack of effect. Public health legislation does, however, have symbolic value and ensures that the health of Indigenous Australians remains on the political agenda. It may be that a more appropriate role for public health law in this context would be as an educative and non-directive structure, which aims to promote and protect health by supporting the attempts of Indigenous Australians to achieve reconciliation and selfdetermination.
Towards Healthier Aboriginal Health Policies? Navigating the Labyrinth for Answers
2013
This research is based on two years of community-based participatory research that draws on Indigenous understandings of health policy in five First Nations in Ontario, Canada. While a number of policies have been put in place to increase Indigenous control over community health services, we argue that policies enacted to promote Indigenous self-determination in health care have been counterproductive and detrimental to Indigenous health and wellbeing. Instead, we suggest that Indigenous health policy exists on a continuum and aim to balance the need for including diverse Indigenous groups with comprehensive control from program funding and design to implementation. This poses some difficult questions: How do Indigenous peoples perceive the concept of self-determination, community-controlled health care and the efforts of the Canadian government to form collaborative arrangements between Indigenous communities, organisations and government? What does an inclusive and comprehensive I...