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Understanding health literacy among young Aboriginal men and boys in the NT

New research is showing how Facebook can be a useful source of information – particularly when used in conjunction with other methods – to develop broader understandings of health literacy among young Aboriginal males in the Northern Territory, and to spark different conversations, policies and health promotion programs.

The project led by the Menzies School of Health Research found its participants were very open about sharing information about their health and wellbeing on social media — including the benefits of being on country and the importance of family and friends — and how this influenced their own health-related decision making.

Some  research team members — Professor James A Smith, Anthony Merlino and David Aanundsen, from the Freemasons Centre for Male Health and Wellbeing – Northern Territory, Menzies School of Health Research, and Dr Mick Adams from Australian Indigenous HealthInfoNet at Edith Cowan University in Western Australia — report on three components of the research below.


James A Smith, Anthony Merlino, Mick Adams and David Aanundsen write:

There is a complex nexus between masculinities, culture, and health literacy for young Aboriginal males.

This was evident from nine yarning sessions with young Aboriginal males aged 14-25 years from the Top End of the Northern Territory, including Darwin, Katherine and Nhulunbuy.

Kids here…Family too…To feed them. Or teach them, the right way. Because tell them go to school, get the education…Learn something…. You’ve got to put your family’s health there…. All the Elders, the Yolŋu. Helping all the sick people. Yo.” (Yarning Session 6, Yirrkala)

Mum, dad and siblings…family are really important, they are our personal connections. If I’m feeling sad or something [I’ll reach out].” (Yarning Session 5, Katherine)

Key themes that emerged included:

  • navigating Western conceptualisations of health
  • prioritising cultural concepts of health and identity
  • attention on the social determinants of health and conditions for success
  • strength in relationships with family
  • the importance of friends and mates.

School – I just come to school to try to get myself a job, license and friends. I come to school to see my friends. Most positive ways, some negative ways. Sometimes you’re stressed out, mad, angry, you just need to go check your friends out and calm down.” (Yarning Session 5, Katherine)

These themes were reinforced through a separate research component which involved analysing Facebook posts (with informed consent) from a selection of the young males involved in the yarning sessions.

We found they are required to navigate a variety of complex intersections — Western and Indigenous worldviews; youth-elder relationships; and hegemonic and alternative forms of masculinities, and that we need to be much more mindful of these tensions when tailoring health promotion interventions and outreach services for these vulnerable, but highly resilient, young males.

We also need to urgently shift dominant and often negative public discourses about young Aboriginal males to have a more explicit strengths-based focus with more positive narratives about success and achievement.

Facebook post of participant: published with permission

Exploring health literacy

Our project, Health literacy among young Aboriginal and Torres Strait Islander males, led by Menzies School of Health Research with multiple collaborating partners, emerged from an understanding that Aboriginal and Torres Strait Islander males face multiple health and social inequities, spanning health, education and justice settings.

Unfortunately, these health and social inequities start early in life and persist across different stages of their life-course. They are particularly pronounced for young Aboriginal and Torres Strait Islander boys and men.

More often than not, media and public commentary depicts them in a negative light, with deficit focused narratives about crime, risk taking and social deviance.

The Lowitja Institute identified the unproductive nature of this discourse and invested in a grant round specifically focused on valuing young Aboriginal and Torres Strait Islander males.

Our focus has been on exploring health literacy among Aboriginal males in the Top End of the Northern Territory.

Health literacy, which generally refers to the abilities, relationships and external environments required to promote health, is an influential determinant of health that impacts individuals, families and communities, a key to reducing health inequities.

Addressing the intersections between health literacy, gender, age and culture can help to improve health equity for young Aboriginal and Torres Strait Islander males.

However, prior to our research this nexus had been understudied.

Three papers, based on this study, have been published throughout 2020 and prioritise the perspectives of this marginalised yet highly resilient population:

Their findings have potential to inform strengths-based and contextualised health promotion interventions for this group.


Strengths-based approaches

What do we know about the links between health literacy, age, gender and culture for young Aboriginal males?

To start, we drew together disparate research on health literacy, gender, culture, and age to better understand what the existing literature tells us about the connections between these variables.

Our article, published in the International Journal of Men’s Social and Community Health, showed that young Indigenous males across the world navigate health literacy through a complex cultural interface that balances both Western and Indigenous understandings of health, with masculinities and youth perspectives uniquely influencing this process.

For example, hunting or fishing on-country was viewed by some as fulfilling a ‘traditional’ male provider role, but was also perceived as a legitimate cultural practice important for improving their social and emotional wellbeing.

Facebook post of participant: published with permission

Practices and policies at many levels of society, from healthcare contexts to family environments, were influential in shaping health literacy too.

This means that diverse groups of people need to come together and work collaboratively to improve health literacy and reduce health inequities among this group.

But our research also showed that for this to work researchers, policymakers and practitioners need to more explicitly understand and prioritise the needs and aspirations of young Indigenous males as they relate to health literacy, while amplifying strengths-based narratives that empower and enable.

At the moment current policy documents, and health promotion programs, seldom value the lived experiences of these young people in a meaningful way. This needs to change.

To help with this process, we wanted to hear from young Aboriginal males, in their own words, about what health literacy means to them – and how it relates to issues like culture, age and gender.

The novel aspect of this health literacy research was the use of social media through our project.

We argue this provided deeper insights and an authentic window into the lives of young Aboriginal males. It allowed us to compare to compare the stories shared during yarning sessions with the photos, images, comments and memes posted on their Facebook profiles.

We found our participants to be very open about sharing information about their health and wellbeing on social media, and how this influenced their own health-related decision making.  This included information about mental health, the benefits of being on-country, and the importance of friends and family.

Importantly we demonstrated that their health is viewed holistically, and seldom from an individual perspective. That is, their health was fundamentally influenced by their family and community networks.

However, it wasn’t without its challenges. There were unique ethical considerations that needed to be navigated, including strategies for seeking informed consent, and minimising research participant burden.

Scratching the surface

This research and the interaction with Aboriginal males has, really, only just started to scratch the surface with respect to health literacy among young Aboriginal males.

We now plan, through collaboration with Aboriginal male partners, to use these research findings to develop applied action-oriented health promotion strategies through the Freemasons Centre for Male Health and Wellbeing – Northern Territory.

The Centre represents a research alliance between Menzies School of Health Research, University of Adelaide, Flinders University, the South Australian Health and Medical Research Institute and the Masonic Charities Trust to improve the health and wellbeing of boys and men in the Northern Territory and South Australia, and that of their families and communities.

This will include and reaffirm close partnerships with Aboriginal community controlled organisations, such as the Darwin Indigenous Men’s Service and other male support groups. We welcome other organisations to join this journey with us.

Disclosure: Croakey editor Marie McInerney provides casual writing and other communications services for Lowitja Institute.

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Indigenous health
#CTG10
#NTRC
Acknowledgement
cultural safety
Indigenous education
Lowitja Institute
NT Intervention
social and emotional wellbeing
Uluru Statement
WA community closures
News about Croakey
PIJ Commissions 2021
Public health and population health
#PreventiveHealthStrategy
#UnmetNeedsinPublicHealth
air pollution
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COVIDwrap
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Health in All Policies
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Media Doctor Australia
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#LoveRural 2014
Croakey Conference News Service 2013 – 2019
2013 conferences
Australian Centre for Health Services Innovation Forum 2013
Australian Health Promotion Association Conference 2013
Closing the Credibility Gap 2013
CRANAplus Conference 2013
FASD Conference 2013
Health Workforce Australia 2013
International Health Literacy Network Conference 2013
NACCHO Summit 2013
National Rural Health Conference 2013
Oceania EcoHealth Symposium 2013
PHAA conference 2013
2014 conferences
#IPCHIV14
AIDA Conference 2014
Congress Lowitja 2014
CRANAplus conference 2014
Cultural Solutions - Healing Foundation forum 2014
Lowitja Institute Continuous Quality Improvement conference 2014
National Suicide Prevention Conference 2014
Racism and children/youth health symposium 2014
Rural & Remote Health Scientific Symposium 2014