Introduction by Croakey: On 10 November, The Lancet Regional Health Western Pacific published a collection of articles on cultural health from the Gaawaadhi Gadudha Research Collaborative, a group of Aboriginal cultural knowledge holders from the Yuwaalaraay, Gamilaraay and Yuin Nations in NSW, and interdisciplinary researchers from UNSW, Neuroscience Research Australia, James Cook University and Swinburne University of Technology:
What is Indigenous cultural health and wellbeing? A narrative review
“Indigenous cultural health encompasses the interconnectedness of Country, people and culture, demanding a holistic approach that integrates Indigenous knowledges and practices. In Australia, these core components of cultural health must be situated in a contemporary context of ongoing colonisation. This narrative review underscores the importance of culturally centred approaches in addressing health inequities and enhancing the wellbeing of Indigenous peoples.”
“’On-Country’ camps that are facilitated by place-based knowledge holders, provide a unique and promising platform that supports Aboriginal health and wellbeing through therapeutic, sensory experiences that strengthen cultural health; including cultural identity, knowledge gain and sharing, connection to Country, mob, and ancestors, and engagement in cultural practices. Access to Country and land to conduct camps remains a barrier to their delivery.”
“This study underscores the need for further research to explore the long-term impacts of cultural engagement on health and wellbeing and highlights the potential of cultural camps as a model for health promotion initiatives within Aboriginal communities.”
Redefining the gap in Aboriginal health: from deficit to cultural connection
“To shift to strengths-based approaches to improving the health and wellbeing of our people, data exploring the different aspects of ‘the gap’ in cultural health discussed here, as opposed to the gap in deficit and disease, are urgently needed.”
Below, several of the researchers give an overview of their work, including highlighting the importance of caring for Country for peoples’ health and wellbeing. This article was first published at The Conversation under the headline, ‘Practising culture on Country can improve Aboriginal people’s health and wellbeing’.
Brett Biles, Aryati Yashadhana, Michelle Jean O’Leary, Nina Serova, Ted Fields and Warren Foster write:
Despite decades of policy interventions, the health of Aboriginal and Torres Strait Islander peoples is declining against defined targets. And yet, health and wellbeing continue to be measured against deficit-focused “gaps” between Aboriginal and non-Aboriginal Australians in health research and policy.
Our new research, published in The Lancet challenges these approaches with Aboriginal cultural ways of knowing, being and doing. We do so by exploring the impact of “cultural camps” on Aboriginal people’s health and wellbeing.
Our study shows that when Aboriginal people are facilitated by cultural knowledge holders to practise culture on Country, they feel a positive impact.
The “gap” in health outcomes is often expressed in life expectancy. Aboriginal women’s and men’s lives are 8.1 and 8.8 years shorter than those of non-Aboriginal women and men.
When it comes to social and emotional wellbeing, suicide is the primary way disparity is measured nationally. Suicide rates are highest among Aboriginal men, at 2.6 times that of non-Aboriginal men. For Aboriginal women, the suicide rate is 2.5 times that of non-Aboriginal women.
Assessing individual health outcomes against non-Aboriginal counterparts inadvertently positions Aboriginal people as deficient. These figures also neglect Aboriginal ways of understanding health.
In Aboriginal knowledges, the health of people, family, Mob, culture and Country are symbiotic, and involve spiritual, emotional and physical dimensions. While comparative epidemiology remains a useful tool in addressing health inequity, it is not the only way.
Cultural health matters
Aboriginal peoples have sustained their cultural practices for more than 60,000 years. However, dominant Western models of living, shaped by ongoing colonisation and dispossession, influence healthcare in Australia.
Mainstream health systems do not sufficiently recognise cultural ways of being and thinking about health. For example, a recent study found traditional cultural healing programs are not supported by health systems in Australia as they are in Aotearoa New Zealand.
Another review of research highlighted the “untapped potential” of connection to Country as a way to improve social and emotional wellbeing.
Cultural health considers how the interdependent and equally important elements of Country, people and culture act to protect and enhance health and wellbeing.
This concept also helps us see that if Country is not cared for, or culture is not practised and maintained, there is a negative impact on people’s health and wellbeing.
This way of understanding health and wellbeing is shared by Indigenous peoples across the world.
Camps on sacred Country
Our team, the Gaawaadhi Gadudha Research Collaborative, undertook a novel study of Aboriginal “cultural camps”.
Gaawaadhi Gadudha translates to “from freshwater to saltwater” and represents the collaboration between Yuwaalaraay, Gamilaraay (freshwater) and Yuin-Djirringanj (saltwater) cultural knowledge holders, and Aboriginal and non-Aboriginal researchers.
We held cultural camps in three different locations across the Yuwaalaraay, Gamilaraay (Northwestern New South Wales) and Yuin (Far South Coast NSW) Nations. These camps provided a unique platform to study cultural health in place.
The camps were facilitated by cultural knowledge holders of Country in these Nations. They were held in cultural landscapes minimally impacted by colonisation and urbanisation.
Camps took participants to sacred teaching sites, used language and invited people to do cultural practices, such as ceremonial dance, weaving, tools and weapon making, and identifying foods and medicines.
Our evidence shows that participation in cultural camps had an overwhelmingly positive impact on indicators of cultural health. These included an increase in how people rated their:
- sense of connection to Country, other people (Mob) and Ancestors
- pride in Aboriginal identity
- knowledge of cultural stories, foods and medicines.
Camps also provided a platform for language renewal.
Almost all participants (97.5%) reported a sense of healing as a result of camp attendance. In yarning circles, participants described the camps as helping to relieve stress, overcome trauma and catalyse intergenerational healing.
Sensory experiences – the ability to see, touch and smell Country – were driving factors of better health and wellbeing. Alongside this was the ability to share language and cultural knowledge and do cultural practices with others.
Addressing challenges
This research shows the potential of cultural camps as a model for health and wellbeing initiatives among Aboriginal peoples. Yet, challenges remain in maintaining camp delivery.
In NSW, access to Country and traditional cultural camp sites is often mitigated by government bureaucracy or locked up in private property. This highlights the importance of land rights to improving Aboriginal health and wellbeing.
Funding and resourcing of cultural camps also remains a challenge.
We need better resourcing for new and existing cultural health initiatives, as well as further research that explores the largely untapped potential and long-term impacts of cultural engagement on health and wellbeing.
Author details
Associate Professor Brett Biles is Pro Vice-Chancellor Indigenous Engagement and Research; Senior Scientia Lecturer, UNSW Sydney. Brett is a Murrawarri man from Brewarrina. He has been living on Wiradjuri country for the last 20 years. He holds a Bachelor of Physiotherapy, a Masters in Indigenous Health and a PhD.
Dr Aryati Yashadhana is Senior Research Associate, School of Population Health, UNSW Sydney.
Michelle Jean O’Leary is Cultural knowledge holder, UNSW Sydney
Nina Serova is Research Officer & PhD Candidate in Anthropology, UNSW Sydney
Ted Fields is Cultural knowledge holder, UNSW Sydney
Warren Foster is Cultural knowledge holder, UNSW Sydney
See Croakey’s archive of articles on the cultural determinants of health
