NACCHO Aboriginal health :Culture is an important determinant of health: Professor Ngiare Brown at NACCHO Summit

Ian Ring

It’s time to move away from the deficit model that is implicit in much discussion about the social determinants of health, and instead take a strengths-based cultural determinants approach to improving the health of Aboriginal and Torres Strait Islander people. This is one of the messages from Ngiare Brown, Professor of Indigenous Health and Education at the University of Wollongong.

Professor Brown also stresses the importance of a focus on resilience, and the value of the Aboriginal Community Controlled Health sector as a national network for promoting cultural revitalisation and sustainable intergenerational change.

The summary below is taken from her presentation at the recent NACCHO summit

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Connections to culture and country build stronger individual and collective wellbeing

Professor Ngiare Brown writes:

Although widely accepted and broadly researched, the social determinants approach to health and wellbeing appear to reflect a deficit perspective – demonstrating poorer health outcomes for those from lower socioeconomic populations, with lower educational attainment, long term unemployment and welfare dependency and intergenerational disadvantage.

The cultural determinants of health originate from and promote a strength based perspective, acknowledging that stronger connections to culture and country build stronger individual and collective identities, a sense of self-esteem, resilience, and improved outcomes across the other determinants of health including education, economic stability and community safety.

Exploring and articulating the cultural determinants of health acknowledges the extensive and well-established knowledge networks that exist within communities, the Aboriginal Community Controlled Health Service movement, human rights and social justice sectors.

Consistent with the thematic approach to the Articles of the United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP), cultural determinants include, but are not limited to:

•Self-determination;

•Freedom from discrimination;

•Individual and collective rights;

•Freedom from assimilation and destruction of culture;

•Protection from removal/relocation;

•Connection to, custodianship, and utilisation of country and traditional lands;

•Reclamation, revitalisation, preservation and promotion of language and cultural practices;

•Protection and promotion of Traditional Knowledge and Indigenous Intellectual Property; and

•Understanding of lore, law and traditional roles and responsibilities.

The power of resilience

The exploration of resilience is a powerful and culturally relevant construct.

Resilience may be defined as the capacity to “cope with, and bounce back after, the ongoing demands and challenges of life, and to learn from them in a positive way”, positive adaptation despite adversity or “a class of phenomena characterized by good outcomes in spite of serious threats to adaptation or development”

Resilience is important because:

• It is culturally significant – we are a resilient culture, surviving and thriving;

• Resilient people/communities are better prepared for stronger, smarter, healthier, successful futures and have better outcomes across the social determinants of health (education, health, employment);

• Resilient individuals are more likely to provide a positive influence on those around them and are better able to develop and maintain positive relationships with others – family, friends, peers, colleagues;

• Resilience promotes collective benefits – social cohesion, community pride in success, economic stability, and improved health and wellbeing.

There is a developing body of international work describing cultural continuity and cultural resilience.

Scholars such as Fleming and Ledogar propose dimensions including traditional activities, traditional spirituality, traditional languages, and traditional healing.

Further, Native American educators propose cultural protective factors and cultural resources for resilience such as symbols and proverbs from common language and culture, traditional child rearing philosophies, religious leadership, counselors and Elders.

(For example, Chandler, M. J. & Lalonde, C. E. (2008). Cultural Continuity as a Protective Factor Against Suicide in First Nations Youth. Horizons –A Special Issue on Aboriginal Youth, Hope or Heartbreak: Aboriginal Youth and Canada’s Future. 10(1), 68-72; Olsson 2003, Stockholm Resilience Centre; John Fleming and Robert J Ledogar, ‘Resilience, an Evolving Concept: A Review of Literature Relevant to Aboriginal Research’,  Pimatisiwin. 2008 ; 6(2): 7–23. Iris Heavyrunner et al 2003).

The cultural determinants of health and wellbeing may be seen to be wrapping around, or cutting across individual, internal, external and collective factors.

A ‘social and cultural determinants’ approach recognises that there are many drivers of ill-health that lie outside the direct responsibility of the health sector and which therefore require a collaborative, inter-sectoral approach.

There is an increasing body of evidence demonstrating that protection and promotion of traditional knowledge, family, culture and kinship contribute to community cohesion and personal resilience.

Current studies show that strong cultural links and practices improve outcomes across the social determinants of health.

There are certain services only NACCHO and ACCH sector can and should do – child protection; mental health; women’s business; and men’s health.

This is useful in assisting policy and resourcing decision-making dependent upon context, geography, demography and tailoring services to local needs and priorities

The ACCH sector provides a true national network and a vehicle for cultural revitalisation. A cultural determinants approach and cultural revitalisation drive sustainable intergenerational change.

NACCHO funding news: $2.4 Million awarded for Aboriginal Health Research Centre

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NACCHO response

Professor Ngiare Brown, (pictured above being interviewed for SBSTV last week at the NACCHO summit) Executive Manager of Research for NACCHO and a co-Chief Investigator of the new centre, says:

“This is an exciting opportunity to work in collaboration with leaders in their field. Translation health is often overlooked but it will be critical in helping to address the biggest priorities in the Indigenous health gap.

“This centre will build leadership and capacity in Aboriginal health and the community controlled sector, and will support the development of culturally relevant services that will lead to positive change,” she says.

PRESS RELEASE

The University of Adelaide has won $2.48 million to establish a new national Centre of Research Excellence, in partnership with the South Australian Health and Medical Research Institute (SAHMRI), the National Aboriginal Community Controlled Health Organisation (NACCHO) and the University of Wollongong.

The centre will use the best available evidence to prevent, manage and treat chronic disease among Indigenous people.

The funding from the National Health and Medical Research Council (NHMRC) has been awarded to the University of Adelaide’s Professor Alan Pearson AM, who is Chief Investigator of the new NHMRC Centre of Research Excellence (CRE) for Translational Research in the Management of Chronic Disease in Indigenous Populations.

“The aim of our centre is clear: to improve health outcomes among Aboriginal and Torres Strait Islander people with a chronic disease,” says Professor Pearson.

“As a population, Indigenous people have significantly poorer health than other Australians and typically die at much younger ages. We hope to save lives and improve people’s quality of life by translating science to better health practice.”

Professor Pearson has an international reputation in the field of translating evidence into policy and practice in health care. He is Head of the University of Adelaide’s School of Translational Health Science and Executive Director of the Joanna Briggs Institute.

“Our research will review existing knowledge about the prevention, management and treatment of chronic disease in Indigenous populations. Based on that information, we will conduct much-needed programs to translate and implement evidence into Indigenous health care,” Professor Pearson says.

“Importantly, to maximise outcomes, this work will be conducted in close collaboration with NACCHO and their member services.”

Professor Alex Brown, Leader of the Aboriginal Research Unit at SAHMRI and a co-Chief Investigator of the new centre, says chronic diseases such as heart disease, diabetes and kidney disease account for 80% of the life expectancy gap between Aboriginal and non-Aboriginal Australians.

“The reasons why Indigenous people suffer from high rates of chronic disease are extremely complex. Our work is aimed at making inroads into this massive problem on a clinical, policy and population level,” Professor Brown says.

Professor Ngiare Brown, Executive Manager of Research for NACCHO and a co-Chief Investigator of the new centre, says: “This is an exciting opportunity to work in collaboration with leaders in their field. Translation health is often overlooked but it will be critical in helping to address the biggest priorities in the Indigenous health gap.

“This centre will build leadership and capacity in Aboriginal health and the community controlled sector, and will support the development of culturally relevant services that will lead to positive change,” she says.

The University’s Deputy Vice-Chancellor (Research), Professor Mike Brooks, says today’s announcement is further proof of the strong research collaborations that exist in Adelaide.

“The awarding of this new Centre of Research Excellence is a major vote of confidence in the quality of research being conducted in this State, and our researchers’ ability to translate their work into real health outcomes,” Professor Brooks says.

“Congratulations to all of the partners involved in this new centre, which has the opportunity to make a significant impact on a national scale.”

Media Contacts:

Professor Alan Pearson

Head, School of Translational Health Science

Executive Director, Joanna Briggs Institute

The University of Adelaide

Phone: 08 8313 6157

Mobile: 0408 727 624

David Ellis

Media and Communications Officer

The University of Adelaide

Phone: 08 8313 5414

Mobile: 0421 612 762

Innovative community-led response to alarming Aboriginal youth incarceration rates

 Press release sent out on behalf of the Aboriginal Youth Healing Centre (AYHC):

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Pictured above:Two of the prominent Aboriginal supporters of this project Professor Ngiare Brown (left) and David Peachey

An Aboriginal Youth Healing Centre (AYHC) currently being planned for Western NSW will use proven techniques to reduce crime, unacceptably high incarceration rates and recidivism.

Local Aboriginal leaders are working together with local agencies, the University of Wollongong, NACCHO and the David Peachey Foundation to develop the service, which will draw together best-practice prevention methods with cultural immersion to stem the flow of young people into gaols and detention centres.

“It’s time for us to stand up and acknowledge jail doesn’t work for our young people,” said Uncle Isaac Gordon, senior Brewarrina community member and Walgett ACLO, “it doesn’t work as a deterrent and it doesn’t work as a rehabilitation or education service.”

The Centre will engage at risk and vulnerable young people; provide diversionary opportunities to help break the cycle of offending, incarceration and recidivism; build social capabilities; and ultimately improve health and social justice outcomes.

“We know from what we’ve seen in other places that when communities get active in taking care of their own kids and draw in top level professional services there is an impact. There’s an impact not only on the kids, but on the savings to taxpayers.  Jail is not only ineffective, it’s expensive,” Uncle Isaac Gordon said.

The AYHC will be established on a working property in the Orana region of western NSW, delivering programs that contribute to the education and training of young Aboriginal men in a supportive family environment. It is anticipated the property will be developed into a commercial, financially sustainable venture over time, engaging house parents, property managers, drovers and other expertise to oversee the running of the station.

“The Centre is about breaking the damaging patterns we see out here and establishing new patterns, using the foundations of our culture, heritage and community to build those patterns,” Uncle Isaac said.

“National and international evidence tells us that family, culture and kinship contribute to community cohesion and personal resilience,” said University of Wollongong’s Professor Ngiare Brown, who is working with the community leaders to develop the Centre

“Current studies show that strong cultural links and practices such as extended family, access to traditional land, revitalisation of traditional languages, learning dance and story, understanding traditional roles and responsibilities – are protective factors and improve childhood and adolescent resilience against emotional and behavioural problems,” Professor Brown said.

A proposal for resourcing of the project is going to Commonwealth and NSW Government departments.

Media contacts:

Uncle Isaac Gordon 0458 814705

Professor Ngiare Brown 0428 892960;

Superintendent Bob Noble 0419 610 430