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Session H3: The Effects of racism on health and wellbeing

1. Yin. Paradies & N. Priest: Understanding the impact of racism on Indigenous child and youth health

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Abstract

Racism is increasingly being recognised as a key determinant of health and wellbeing. Although the importance of studying the impacts of racism on children and youth has been widely recognised, only 15% of the 253 worldwide studies published until 2007 in this field have focused on children. Although the continued existence of racism in Australia is document by recent surveys, research on racism and child health remains very limited. Given the high levels of disadvantage and racism experienced by Indigenous peoples in Australia, it is appropriate that the small Australian body research on racism and health has, to date, focused on Indigenous people. However, this body of research remains under-utilised. This presentation will a) discuss current evidence for the impact of racism on Indigenous child and youth health, particularly within urban settings, and b) provide an overview of a recently commenced research project examining the impacts of racism on Indigenous child and youth health through the analysis of several existing data sets. These data include the Longitudinal Study of Indigenous Children, Aboriginal Birth Cohort study, Housing Improvement for Child Health study and the Victorian Aboriginal Health Service Young People’s Project. Recommendations for future directions in this area of research will also be discussed.

Author bios:

Dr Naomi Priest is a Research Fellow at the McCaughey Centre, Melbourne School of Population Health, University of Melbourne. Her current research is in the area of child public health and health inequalities, with a focus on promoting health through combating racism and social exclusion. Her PhD was a collaborative project with Aboriginal organisations and community members exploring Aboriginal perspectives of health, development and wellbeing in an urban setting. She also has a strong interest in public health evidence, particularly evidence synthesis and knowledge translation and exchange. Naomi has also worked as an occupational therapist with children and families from diverse cultural and socio-economic backgrounds in a range of community settings.

Dr Yin Paradies is a Research Fellow jointly at the Menzies School of Health Research and the University of Melbourne. He has qualifications in mathematics and computing (BSc), medical statistics (MMedStats), public health (MPH), and social epidemiology (PhD). Yin’s research focuses on the health, social and economic effects of racism as well as anti-racism theory, policy and practice. Yin also teaches professional development short courses on multicultural competence and anti-racism.

2. J. Guthrie, R. Lovett, P. Dance, R. Brown, N. Poroch, J. Tong: ‘Where’s your Country?’ Who’re your people?’ Asking the right questions when treating problematic alcohol use amongst Indigenous Australians

Full paper | Audio | Video | Slideshow pdf 357KB

Abstract

Winnunga Nimmityjah Aboriginal Health Service in the ACT and the National Centre for Epidemiology and Population Health (NCEPH) at The Australian National University were funded in March 2008 by the Department of Health and Ageing to collaborate on the implementation of treatment interventions for Indigenous people in the ACT experiencing problematic alcohol use. To assist Winnunga to find ways of assessing and managing problematic alcohol use, we developed the case management tool, Walan Girri, to implement and evaluate brief intervention, integrated screening and assessment and shared care/integrated care/case management.

Walan Girri has built on the existing model of holistic model of care which has always been provided by Winnunga. It also addresses the great historical and cultural significance of Australia’s Indigenous peoples’ country. Many Indigenous people are dislocated from country, particularly in the ACT which is home for Indigenous Australians from many other parts of Australia.

We know of no research that has empirically examined relationships between country and health, including those related to problematic alcohol use in an urban setting. We argue that for addressing problematic alcohol use, acknowledging a person’s country and that some might have been removed from country, is central to providing case management and integrated care.

We will report on how, as part of the assessment for case management, Horton’s map of country has been used to elicit information from clients with problematic alcohol use about their country and any relationship between that, and loss of or dislocation from country.

1 Horton D. Aboriginal Australia: Map. Australian Institute of Aboriginal and Torres Strait Islander Studies, Canberra (AUST); 1994 [Cited 2007 Jan 1] http://www.aiatsis.gov.au/

Author bios:

Jill Guthrie is a descendant of the Wiradjuri people of western NSW, and has lived in Canberra ACT for over twenty years.  In March 2009 she was appointed as a Research Fellow at AIATSIS.  Her PhD, undertaken through the School of Public Health and Community Medicine at the University of New South Wales is titled A phenomenological exploration of the experiences of families of Indigenous children hospitalised in the Australian Capital Territory.  Jill is a graduate of the Master of Applied Epidemiology (MAE) Program at the National Centre for Epidemiology and Population Health (NCEPH) at the Australian National University (ANU).  Following graduation from the MAE Program, Jill worked as an academic member of the MAE staff and continues to work in the programShe has an adjunct appointment with the ANU and is supervising Masters and PhD students enrolled at NCEPH as well as being involved in other research projects.

3. Angela Scotney (co-investigators: K. Lokuge, P. Kelly, J. Guthrie): Identifying as Indigenous at Primary Health Care Services: a consumer perspective

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Abstract

On the 13th February 2008, Prime Minister Kevin Rudd gave an apology to the Aboriginal and Torres Strait Islander people affected by the Stolen Generations. His speech also acknowledged continued inequities between Indigenous and non-Indigenous people, including health. The Coalition of Australian Governments (COAG) set targets to address these gaps. The projects that I am undertaking in the MAE Program explore some of those targets: one is specifically exploring identification of Indigenous status in mainstream health services. My study explores the views of Aboriginal and Torres Strait Islander people on the circumstances which make them feel comfortable about identifying their Indigenous status when seeking care at mainstream health facilities. This study is unique in that this is the first time the issue has been from the perspective of the Indigenous consumer. The research has been conducted with Aboriginal and Torres Strait Islander people living within the Australian Capital Territory. This research projects is relevant to the current COAG targets and will offer valuable insights for future policy direction.

Such work is vital in the urban context as Indigenous Identification is a major issue not just for health professionals and researchers but for major government agencies dealing with Indigenous Affairs. It is a fact that most statistics are gathered from the NT, WA, SA and QLD due to the ability to recognise people as being either Indigenous or Non-Indigenous. Research has been done on Indigenous Identification by looking at what happens from the GP Clinic and the Hospital systems. In this research people have said that they didn't like to ask if people were either Aboriginal or Torres Strait Islander descent as they didn't want to offend anyone who wasn't.
In the urban setting with cross cultural relationships many Australian Indigenous people today have fair skin, blue or green eyes and features not associated with being "Indigenous", with this stereotyping my work looks specifically on the following objectives:

1. To examine the barriers and enabling factors that Aboriginal and/or Torres Strait Islander people experience when they access mainstream primary health care services and how it influences identification as Indigenous;

2. To understand how Aboriginal and/or Torres Strait Islander people perceive the importance of identifying as Indigenous within mainstream primary health care services;

3. To gain Aboriginal and/or Torres Strait Islander insights on how the process of identifying as Indigenous can be improved in mainstream primary health care services.

My work is based solely with Aboriginal and Torres Strait Islander people who live in a urban setting and who want to share their experiences about how they feel they are treated in Mainstream Health Services. This work is important as it will provide a valuable insight to researchers and to whole of government stakeholders on how to develop appropriate practical policies to address the issues and concerns around Indigenous Identification.

Author bios:

As a Worimi woman from the Mid-North Coast NSW, Angela has worked in Aboriginal Health and Indigenous Affairs for the past 19yrs starting as an Aboriginal Health Worker in a Aboriginal Health Service. Since that time she has worked as a Crisis Worker, Researcher, Community Development Officer and Coordinated Aboriginal Health Promotion at State Government level. Angela has trained many Aboriginal and Torres Strait Islander Health Workers in attaining their competency skills at tertiary level.  As a current 2nd year scholar in the Master of Applied Epidemiology Program at the National Centre for Epidemiology and Population Health she has taken on projects that have public health impact and can be used towards changing policies in Aboriginal and Torres Strait Islander Health at State and Federal Levels. Angela has spent all of her life dedicated to improving the health and wellbeing of Aboriginal and Torres Strait Islander people and aims to will continue doing this well into to future.