Talking about the ‘r’ word: a right to a health system that is free of racism

Carmen Parter · Donna Murray · Janine Mohamed · Boe Rambaldini · Tom Calma · Shawn Wilson +3 more

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Indigenous Health, Education, and Rights Racial and Ethnic Identity Research Cultural Competency in Health Care

Abstract

Australia's local, state, territory and federal governments have agreed that the 10-year life expectancy gap between Indigenous and non-Indigenous Australians will be closed by 2031. However, annual Closing the Gap reports tabled by the various prime ministers in the Australian Parliament (for the past 12 years) have consistently indicated that the life expectancy gap continues to widen. Australia has seen more than three decades of government policies since the landmark 1989 National Aboriginal health strategy. What has been missing from these policy commitments is the genuine enactment of the knowledges that are held by Indigenous Australians relating to their cultural ways of being, knowing and doing. Privileging Indigenous knowledges, cultures and voices must be front and centre in developing, designing and implementing policies and programs. The sharing of power, provision of resources, culturally informed reflective policy making, and program design are critical elements. In this paper, we provide a conceptual model of practice, working at the cultural interface where knowledges are valued and innovations can occur. This model of practice is where knowledges and cultures can co-exist, and it could be the answer to Closing the Gap in life expectancy by 2031. Despite a growing willingness and need to consider these models, there remains a deep-seated resistance to identifying and addressing institutional and systemic racism and racist attitudes, including unconscious biases held by individuals. Further, western non-Indigenous worldviews of ways of being, knowing and doing continue to dominate the decisions and actions of governments - and consequentially dominate public health policies and practices. There is an unacceptable standard approach, for and about Indigenous health instead of with Indigenous peoples, resulting in the neglectful dismissal of Indigenous knowledges and Indigenous cultures of ways of being, knowing and doing.

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References

2000Decolonizing Methodologies: Research and Indigenous Peoples 2018United Nations Declaration on the Rights of Indigenous Peoples, 2007 2007Disciplining the Savages, Savaging the Disciplines 2014Indigenous statistics: a quantitative research methodology 2015Aboriginal and Torres Strait Islander health performance framework 2014 report 2005The Need for Reflexivity in Public Administration 1989National Aboriginal Health Strategy Working Party 2011Time to bring down the twin towers in poor Aboriginal hospital care: addressing institutional racism and misunderstandings in communication

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2023Mitigating the impacts of racism on Indigenous wellbeing through human rights, legislative and health policy reform 2023Putting Indigenous Cultures and Indigenous Knowledges Front and Centre to Clinical Practice: Katherine Hospital Case Example 2022Engage, understand, listen and act: evaluation of Community Panels to privilege First Nations voices in pandemic planning and response in Australia

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