Aboriginal and Torres Strait Islander people in Australia, education and health literacy

Health literacy is a vital tool to build health knowledge and enable empowerment in health decision making at a community and individual level. There are different views of what constitutes health literacy with the most inclusive addressing broadly the skills and competencies required “to seek out, comprehend, evaluate, and use health information and concepts to make informed choices, reduce health risks, and increase quality of life” (Zarcadoolas 2005). Poor health literacy has been shown to impact health seeking behaviour, access and awareness to preventive health.

Indigenous health: Embracing and enacting the spirit of change. Opening keynote address

In speaking at the Cardiac Society this morning, I am conscious of this year’s 60th Anniversary. It is 60 years since motivated and impassioned people travelled to form the organisation that became the Cardiac Society. They started an organisation and a movement of sorts which was joined by many others over the years and which brings us to this room on this morning. This started in 1952. What were you doing in 1952? Where you just born and for some of you were? Others here were not born and may be your parents hadn’t even met yet. I want you to gain a sense of this time, of 60 years ago.

Study protocol : establishing good relationships between patients and health care providers while providing cardiac care. Exploring how patient-clinician engagement contributes to health disparities between indigenous and non-indigenous Australians in South Australia

Abstract Background: Studies that compare Indigenous Australian and non-Indigenous patients who experience a cardiac event or chest pain are inconclusive about the reasons for the differences in-hospital and survival rates. The advances in diagnostic accuracy, medication and specialised workforce has contributed to a lower case fatality and lengthen survival rates however this is not evident in the Indigenous Australian population. A possible driver contributing to this disparity may be the impact of patient-clinician interface during key interactions during the health care process. Methods/Design: This study will apply an Indigenous framework to describe the interaction between Indigenous patients and clinicians during the continuum of cardiac health care, i.e. from acute admission, secondary and rehabilitative care. Adopting an Indigenous framework is more aligned with Indigenous realities, knowledge, intellects, histories and experiences. A triple layered designed focus group will be employed to discuss patient-clinician engagement. Focus groups will be arranged by geographic clusters i.e. metropolitan and a regional centre. Patient informants will be identified by Indigenous status (i.e. Indigenous and non-Indigenous) and the focus groups will be convened separately. The health care provider focus groups will be convened on an organisational basis i.e. state health providers and Aboriginal Community Controlled Health Services. Yarning will be used as a research method to facilitate discussion. Yarning is in congruence with the oral traditions that are still a reality in day-to-day Indigenous lives. Discussion: This study is nestled in a larger research program that explores the drivers to the disparity of care and health outcomes for Indigenous and non-Indigenous Australians who experience an acute cardiac admission. A focus on health status, risk factors and clinical interventions may camouflage critical issues within a patient-clinician exchange. This approach may provide a way forward to reduce the appalling health disadvantage experienced within the Indigenous Australian communities. Keywords: Patient-clinician engagement, Qualitative, Cardiovascular disease, Focus groups, Indigenous

Aboriginal and Torres Strait Islander cookbooks : promoting Indigenous foodways or reinforcing Western traditions?

This article examines the recent emergence of cookbooks written for Aboriginal and Torres Strait Islander people in Australia. The cookbooks are health promotion initiatives, developed through a desire to improve the health status of Indigenous Australians. They focus on nutritious, family meals that can be cooked on a low budget. In this article, the authors argue that the cookbooks designed for Aboriginal and Torres Strait Islander people are developed within a Western paradigm of health and nutrition that subtly reinforces Western approaches to food and disregards traditional diets. While the authors recognize the value of the cookbooks as health promotion tools, they suggest that cookbooks centred around Indigenous foodways – with a focus on traditional ingredients and traditional cooking methods – may be more appropriate for improving the health of Indigenous people and helping Indigenous cultures to thrive. They advocate for a decolonizing approach to food and nutrition, that specifically promotes Indigenous traditions and culture, and incorporates traditional foodways into modern recipes.

Beyond the accolades : a postcolonial critique of the foundations of the Ottawa Charter

Introduction: The Ottawa Charter is undeniably of pivotal importance in the history of ideas associated with the establishment of health promotion. There is much to applaud in a charter which responds to the need to take action on the social and economic determinants of health and which seeks to empower communities to be at the centre of this. Such accolades tend to position the Ottawa Charter as ‘beyond critique’; a taken-for-granted ‘given’ in the history of health promotion. In contrast, we argue it is imperative to critically reflect on its ‘manufacture’ and assess the possibility that certain voices have been privileged, and others marginalized. Methods: This paper re-examines the 1986 Ottawa Conference including its background papers from a postcolonial standpoint. We use critical discourse analysis as a tool to identify the enactment of power within the production of the Ottawa health promotion discourse. This exercise draws attention to both the power to ensure the dominant presence of privileged voices at the conference as well as the discursive strategies deployed to ‘naturalize’ the social order of inequality. Results: Our analysis shows that the discourse informing the development of the Ottawa Charter strongly reflected Western/colonizer centric worldviews, and actively silenced the possibility of countervailing Indigenous and developing country voices. Conclusion: The Ottawa Charter espouses principles of participation, empowerment and social justice. We question then whether the genesis of the Ottawa Charter lives up to its own principles of practice. We conclude that reflexive practice is crucial to health promotion, which ought to include a preparedness for health promotion to more critically acknowledge its own history.

‘We’ve always cooked kangaroo. We still cook kangaroo. Although sometimes we use cookbooks now’ : Aboriginal Australians and cookbooks

Aboriginal Australians have a long history of eating native animals and plants. Food preparation techniques were handed down through the generations, without any need for cookbooks. But colonisation changed the diets of Aboriginal Australians, introducing us to a processed diet high in salt, sugar and fat, and causing a wide range of diet-related health problems. Over the years, many Aboriginal Australians lost their connections to traditional food preparation practices. In this paper, the authors provide a brief overview of Aboriginal food history and describe a newly-emerging focus on reintroducing native foods. They describe the work of an Aboriginal chef, Dale Chapman, who is actively promoting native foods and creating a native-Western food fusion. Chapman has developed native food recipes and a cookbook, in an effort to make native foods accessible to all Australians. She promotes a future when native foods are part of the identity of all Australians – both Aboriginal and non-Aboriginal.

Developmental lessons from the Capricornia Arts Mob (CAM)

The Capricornia Arts Mob (CAM) is a collective of Aboriginal and Torres Strait Islander visual artists, sculptors, photographers, carvers and writers based in the Rockhampton region of Central Queensland. This paper explores the early development of CAM, identifies some of the lessons its members have learned about working together, and considers its role as a regional artists’ collective. The authors identify that traditional Indigenous practices, such as yarning and the sharing of food, have helped to facilitate the emergence of CAM as a vibrant, challenging, eclectic artistic family. They recognise the cultural challenges faced by the collective – including finding a culturally appropriate place to meet and work, and the cross-cultural issues that can emerge within Aboriginal and Torres Strait Islander groups. In just 18 months, CAM has held successful exhibitions and developed public artworks. It is a strong part of regional Queensland’s arts scene, which supports emerging artists and provides a space to celebrate and support Indigenous art.

Treaty talk : past, present and future -- [Edited version of the inaugural Ngunnawal Lecture at the University of Canberra]

WELL I HEARD it on the radio and I saw it on the television. John Howard said there would be no talk of a treaty between his government and Indigenous people. He is not the first government leader to hold such views. Let me consider some of the public and official conversations that the concept of a treaty has invoked and what they reveal about white sovereignty. My interest in such dialogues stems from the fact that the idea of a treaty between white Australia and Indigenous people is not new and in the year of the centenary of Federation the Australian nation is still having trouble discussing it. Australian culture is less white than it used to be, but Anglicised whiteness forms the centre where white men established and defend institutions encouraging a possessive investment in white sovereignty. My intention is to invoke critical thought about these conversations. White sovereignty is a subject that asserts its dominance on social, political...

Global indigenous studies in the first world: some reflections and epistemological matters

Indigenous studies in First World nation states such as Australia, Canada, New Zealand, the United States of America and Hawaii, appear to have acquired the status of a discipline, although the accounts of its formation vary. Indigenous studies is formally recognised as part of university curricula in these countries and is included in inter‐disciplinary contexts and degree programs or is offered as a program and a degree in its own right. Indigenous scholarship is being published in unprecedented numbers with publishing houses competing for manuscripts. Indigenous studies journals have proliferated having emerged in the 1970s though most were, and continue to be, edited by non‐Indigenous people. In addition, Indigenous studies professional associations have been established organising research related activities as well as convening conferences to enable intellectual engagement and the formation of national and international networks. The nature and extent of this institutionalisation and the conditions of existence, though often marginalised and under resourced, may allude to the coherence of Indigenous Studies as a discipline with global reach but what remains unclear are its epistemological boundaries and the degree to which it perpetuates cultural entrapment . This paper will reflect on some of these epistemological matters.

Ethics in Research with Children

Widespread scholarly interest in ethics in research with children, as an extant field of inquiry and practice, is a relatively new phenomenon. The discipline of ethics can be traced back to the Hippocratic school, but its contemporary applications in the everyday worlds of children and those around them are gaining greater attention from theorists, practitioners, and those involved in policy. Heightened international awareness of the United Nations Convention on the Rights of the Child (1979) gave significant impetus to increasing international awareness of children’s rights to provision, protection, and participation in everyday contexts, including those in which research occurs. Understandings of research ethics and of children’s involvement in research relate to broader understandings of children and childhood drawn from developmental science, sociology, human geography, health sciences, and children’s human rights to participation and protection. Key understandings pertain to children’s competence to participate in research, to operate as reliable informants with respect to their own lives, to provide voluntary informed consent and dissent in research, and to make meaningful decisions about the nature and extent of their participation. The field is international and interdisciplinary, although bounded by legislative, policy, and jurisdictional requirements governing research—its conduct and dissemination. So, too, the burgeoning work of ethics committees, whether in relation to health research or social research, is evidence of a sharpened focus on governance of child research. Oxford Bibliographies offers a suite of perspectives, resources, and strategies to guide the researcher, practitioner, and policymaker and serves to challenge readers to interrogate conceptual understandings, methodologies, and dissemination of research with and about children. Exploration of the suite opens up new possibilities for considering children’s rights to participation in matters that affect their lives and for children to be seen and heard in research.