Cultural determinants of health for Aboriginal and Torres Strait Islander people – a narrative overview of reviews

Abstract Introduction The cultural determinants of health centre an Indigenous definition of health, and have been linked to positive health and wellbeing outcomes. There is growing evidence for the importance of the cultural determinants of health; however, to date, no high-level overview of the evidence-base has been provided. Synthesising existing literature on cultural determinants of health for Aboriginal peoples in a single manuscript will highlight what we know, and what needs to be explored in future research. It will also contribute to global efforts to capture the evidence of cultural determinant approaches amongst Indigenous populations. We therefore endeavoured to identify cultural determinants and highlight their impact on Aboriginal health and wellbeing outcomes, and outline the relationship and interconnection of different cultural determinants of health. Methods An overview of reviews was conducted. Medline (Ovid) and Scopus were searched using terms related to ‘cultural determinants of health’ and an ‘Aboriginal definition of health’. The database search was complemented by a web-based search of grey literature. Nine reviews were retrieved and included in our overview. Results Family/community, Country and place, cultural identity and self-determination were strongly identified across reviews as having a positive impact on the health and wellbeing outcomes of Aboriginal peoples. Family/community and Country and place were found to be components of ‘culture’ that shaped cultural identity. Self-determination was outlined as a requirement for Aboriginal peoples to pursue their cultural, social, and economic rights. Discussion/conclusions Cultural determinants are associated with health benefits for Indigenous peoples. A causal framework, developed to discuss the relationship and interconnection of the cultural determinants of health, demonstrates that cultural identity at an individual-level is important to benefiting from other cultural determinants of health. While self-determination and connection to culture and community-controlled organisations are integral factors to increase Aboriginal resilience and resistance and improve health and wellbeing outcomes. Further research is required to shift towards a multi-level understanding of the cultural determinants of health and to develop an Indigenous-led evidence-base around causal pathways. Such a shift would ensure priorities important to Indigenous peoples are captured in policy and practice. </jats:sec

‘We walked side by side through the whole thing’: A mixed-methods study of key elements of community-based participatory research partnerships between rural Aboriginal communities and researchers

Objectives: To advance the rural practice in working with Aboriginal communities by (a) identifying the extent of community partners' participation in and (b) operationalising the key elements of three community-based participatory research partnerships between university-based researchers and Australian rural Aboriginal communities. Design: A mixed-methods study. Quantitative survey and qualitative one-on-one interviews with local project implementation committee members and group interviews with other community partners and project documentation. Setting: Three rural Aboriginal communities in New South Wales. Participants: Thirty-seven community partners in three community-based participatory research partnerships of which 22 were members of local project implementation committees and 15 were other community partners who implemented activities. Intervention: Community-based participatory research partnerships to develop, implement and evaluate community-based responses to alcohol-related harms. Main outcomes measures: Community partners' extent of and experiences with participation in the community-based participatory research partnership and their involvement in the development and implementation processes. Results: Community partners' participation varied between communities and between project phases within communities. Contributing to the community-based participatory research partnerships were four key elements of the participatory process: unique expertise of researchers and community-based partners, openness to learn from each other, trust and community leadership. Conclusion: To advance the research practice in rural Aboriginal communities, equitable partnerships between Aboriginal community and research partners are encouraged to embrace the unique expertise of the partners, encourage co-learning and implement community leadership to build trust

Indigenous research and broader issues in the Academy

Martin Albrow referiert heute am Käte Hamburger Kolleg über die Aktualität der Herrschaftssoziologie und der Rechtssoziologie Max Webers. Der Veranstalter kündigt an: Unser „Globales Zeitalter", so Martin Albrow, mag zwar von der Moderne zu Max Webers Zeiten weit entfernt sein, für die Erfassung dieser neuen Wirklichkeiten liefert seine analytische und komparative Soziologie allerdings eine erstaunlich aktuelle Perspektive. In seinem Vortrag führt Martin Albrow aus, warum er Webers Herrschaf..

Illicit and injecting drug use among Indigenous young people in urban, regional and remote Australia

Introduction and Aims: To examine patterns of illicit drug use among Australian Indigenous young people, identify correlates of frequent use separately in urban, regional and remote settings and characterise those who inject. Design and Method: Cross-sectional design at 40 Indigenous events. Self-complete surveys were administered to Indigenous people aged 16–29 years using mobile devices. Results: 2,877 participants completed the survey. One in five reported using cannabis at least weekly in the previous year, but the use of other drugs was less prevalent. Patterns of drug use were largely similar across regions, although more participants in urban and regional areas reported using ecstasy (12% vs 11% vs 5%) and cocaine (6% vs 3% vs 1%) and more reported weekly cannabis use (18% vs 22% vs 14%). Injecting was rare (3%) but those who did inject reported a high incidence of needle sharing (37%). Methamphetamine (37%), heroin (36%) and methadone (26%) were the most commonly injected drugs, and injecting was related to prison experience (AOR 5.3 95% CI 2.8–10.0). Discussion and Conclusion: Attention is needed in relation to cannabis use, particularly among those Indigenous young people living in regional and urban settings. Also, although injecting is uncommon, it is associated with prison involvement. Priority must be given to reducing the numbers of Indigenous youth entering justice settings, delaying the age at first entry to justice settings, and reducing the risk of BBV acquisition while in custody through, for example, prison-based NSP, BBV education, and Indigenous-specific treatment that emphasises connection to country and culture. [Bryant J, Ward J, Wand H, Byron K, Bamblett A, Waples-Crowe P, Betts S, Coburn T, Delaney-Thiele D, Worth H, Kaldor J, Pitts M. Illicit and injecting drug use among Indigenous young people in urban, regional and remote Australia. Drug Alcohol Rev 2016;35:447–455]