Ms Pat Anderson, chairperson of the Lowitja Institute and co-author of the Little Children are Sacred inquiry’s report, has delivered a damning indictment of the NT intervention in a keynote address to an Aboriginal health research conference in Sydney this morning.
I recommend reading her speech in full (PDF available here, titled “Research for a better future“). A brief summary follows below…
Anderson says many aspects of the intervention were not evidence-based, and that it was paternalistic, and promoted blame of Aboriginal people rather than empowerment and inclusion.
“… in my view the Intervention was neither well-intentioned nor well-evidenced,” says the speech.
Anderson says the Labor Government has continued the Intervention’s essential structures and thinking. “Explicitly or implicitly, it rejects self-determination as a ‘failed policy’,” she said.
“It does not approach our communities as having anything valuable to offer or indeed of having achieved anything in the past. Instead, they are to be the passive recipients of non- Aboriginal “help”.
“This has left many Aboriginal people marginalized from the decision-making processes in their own communities. It adds to the sense of disempowerment and stress that many already feel.
“And we know that this diminished sense of control and increased stress will lead to poorer health and social outcomes in the future.”
In the speech, Anderson also reflects upon her long experience of working in Aboriginal health, and the often-vexed history of the relationship between research and Aboriginal communities.
The biggest challenge for the future, she says, is ensuring that public-policy is based on what we know works and that the rhetoric of ‘evidence-based policy’ becomes a reality, not just “an empty phrase”.
“Unfortunately, when it comes to policy on Aboriginal health – or Aboriginal anything – in Australia, this does not appear to be the case,” she says.
“Instead, all sorts of other factors seem to take their place ahead of the evidence when it comes to making the ‘big’ decisions on Aboriginal health and well-being.
“These other factors may include calculations about narrow political advantage, unexamined prejudices and assumptions, even sheer personal ego. Overwhelmingly, they remain hidden.”
This was Anderson’s call to action for the research and policy community:
We have a responsibility to ensure that, as a nation, we get beyond the ‘we know best’ attitudes that so often set policy directions, while in reality, it is other unspoken and even unconscious agendas which are determining the direction we are all expected to go. This is the great challenge for the future of Aboriginal health research – making sure that public policy is based on sound evidence, and on what we already know will lead to healthier, happier communities.
Meanwhile, the AIHW’s latest overview of the health and welfare of Aboriginal and Torres Strait Islander people was also released at the conference of the Coalition for Research to Improve Aboriginal Health (CRIAH).
The report (which I haven’t had a chance to examine yet) is available here.
According to the AIHW media statement:
• about 80% of the mortality gap can be attributed to chronic diseases, most significantly heart diseases (22%), followed by diabetes (12%) and liver diseases (11%).
• much of this chronic disease is potentially preventable and related to social and economic disadvantage in areas such as housing, education and employment.
• there have been some improvements. For eg, the proportion of Indigenous people who were daily smokers dropped from 49% to 45% between 2002 and 2008; Year 12 retention rates for Indigenous students rose from 29% in 1996 to 47% in 2010. For housing, between 1994 and 2008, the proportion of Indigenous households who were home owners or buyers rose from 26% to 32%, and between 2002 and 2008, the proportion of Indigenous households living in dwellings with structural problems fell from 34% to 26%.