“We don’t tell people what to do”: Ethical practice and Indigenous health promotion

Health promotion aspires to work in empowering, participatory ways, with the goal of supporting people to increase control over their health. However, buried in this goal is an ethical tension: while increasing people’s autonomy, health promotion also imposes a particular, health promotion-sanctioned version of what is good. This tension positions practitioners precariously, where the ethos of empowerment risks increasing health promotion’s paternalistic control over people, rather than people’s control over their own health. Here in we argue that this ethical tension is amplified in Indigenous Australia, where colonial processes of control over Indigenous lands, lives and cultures are indistinguishable from contemporary health promotion ‘interventions’. Moreover, the potential stigmatisation produced in any paternalistic acts ‘done for their own good’ cannot be assumed to have evaporated within the self-proclaimed ‘empowering’ narratives of health promotion. This issue’s guest editor’s call for health promotion to engage ‘with politics and with philosophical ideas about the state and the citizen’ is particularly relevant in an Indigenous Australian context. Indigenous Australians continue to experience health promotion as a moral project of control through intervention, which contradicts health promotion’s central goal of empowerment. Therefore, Indigenous health promotion is an invaluable site for discussion and analysis of health promotion’s broader ethical tensions. Given the persistent and alarming Indigenous health inequalities, this paper calls for systematic ethical reflection in order to redress health promotion’s general failure to reduce health inequalities experienced by Indigenous Australians.

Drink driving among Indigenous Australians in outer regional and remote communities and development of a drink driving program: A summary of findings and recommendations

Drink driving is a leading cause of criminal justice system contact for Indigenous Australians. National and state strategies recommend Indigenous road safety initiatives are warranted. However, there is sparse evidence to inform drink driving-related preventive and treatment measures. Using quantitative and qualitative methods, the study examines the profile of Queensland’s Indigenous drink drivers using court convictions and identifies the contributing psycho-social, cultural and contextual factors through qualitative interviews.

Regional variation in social isolation amongst older Australians

Regional studies globally have a strong focus on understanding the causes of variation in the economic performance and wellbeing of regions and this emphasis acknowledges that the strength of the local or regional economy plays a determinant role in shaping quality of life. Regional research has been less active in considering spatial variation in other factors that are critical to individual and societal wellbeing. For example, the regional studies community has been absent from the debate on the social determinants of health and how these influences vary spatially. This paper considers the results of a cross sectional survey of Australians aged 65 and over that focussed on social connections and wellbeing. It examines regional variations in the incidence of social isolation within the older population. It finds that while the incidence of self-reported social isolation amongst older persons is broadly consistent with earlier studies, it demonstrates a spatial patterning that is unexpected. The paper considers community-building activities in addressing the impacts of social isolation, including the role of urban design, and suggests that there is a need to supplement the national overview presented there through more detailed studies focussed on individual localities.

Air pollution levels measured at traffic hot spots : Brisbane urban corridor study

Air pollution levels were monitored continuously over a period of 4 weeks at four sampling sites along a busy urban corridor in Brisbane. The selected sites were representative of industrial and residential types of urban environment affected by vehicular traffic emissions. The concentration levels of submicrometer particle number, PM2.5, PM10, CO, and NOx were measured 5-10 meters from the road. Meteorological parameters and traffic flow rates were also monitored. The data were analysed in terms of the relationship between monitored pollutants and existing ambient air quality standards. The results indicate that the concentration levels of all pollutants exceeded the ambient air background levels, in certain cases by up to an order of magnitude. While the 24-hr average concentration levels did not exceed the standard, estimates for the annual averages were close to, or even higher than the annual standard levels.

How can land and urban development make houses healthier?

Traditionally, the main focus of the professional community involved with indoor air quality has been indoor pollution sources, preventing or reducing their emissions, as well as lowering the impact of the sources by replacing the polluted indoor air with "fresh" outdoor air. However, urban outdoor air cannot often be considered "fresh", as it contains high concentrations of pollutants emitted from motor vehicles - the main outdoor pollution sources in cities. Evidence from epidemiological studies conducted worldwide demonstrates that outdoor air quality has considerable effects on human health, despite the fact that people spend the majority of their time indoors. This is because pollution from outdoors penetrates indoors and becomes a major constituent of indoor pollution. Urban land and transport development has significant impact on the overall air quality of the urban airshed as well as the pollution concentration in the vicinity of high-density traffic areas. Therefore, an overall improvement in indoor air quality would be achieved by lowering urban airshed pollution, as well as by lowering the impact of the hot spots on indoor air. This paper explores the elements of urban land and vehicle transport developments, their impact on global and local air quality, and how the science of outdoor pollution generation and transport in the air could be utilized in urban development towards lowering indoor air pollution.