Closing the gap in health care

Indigenous Education Feature

Opinion piece: Associate Professor Jenny Baker, Director, Yaitya Purruna Indigenous Health Unit

My entry into research has only been recent so, despite my age, I am still termed an early career researcher. The first small project that I submitted was motivated by research on African-American youth in Chicago and what the investigators described as 'steep future-discounting'. While it was not about an Australian country town such as Port Augusta (where 20% of the population are Aboriginal), but rather an old US city (where 30% plus are 'black' and where there are well established universities), the factors affecting the youth in that study that led to them discounting their own futures 'steeply' were issues such as the shortened life expectancy of their fathers, mothers, uncles, aunts and cousins. These are the people who provide the love and sustenance for youth and who prepare a future for youth. When they pass on before their time as they do in the Aboriginal community, the impact is powerful.

Aboriginal people know this picture and they know the extreme outcome of that; of what youth suicide does to Aboriginal communities across Australia and they want action to stop it as any community would, but especially a community who were systematically excluded both socially and psychologically from Australian society. Doing research on such matters requires a long-term relationship with a community.

When I worked as a clinical manager in an Aboriginal health service in the late 1980s, my response in an interview about Aboriginal health research overall was that it was 'over-researched and under-resourced'. In those days, all health research was led by non-Indigenous researchers as there were very few Indigenous health graduates (the first Indigenous medical graduate was 1984). The research was also dominated by a biomedical approach and overall served government agendas and non-Indigenous perspectives on what needed to be done. Thankfully, this has changed and the leadership provided today by that first medical graduate and many others like her has changed the approach to Aboriginal health research to an inter-disciplinary response and an agenda that is determined by Aboriginal people as well as non-Aboriginal people.

A way of building that long-term relationship, and participating in action that is crucial to long-lasting wellbeing for Aboriginal youth and the Aboriginal community in general, is through addressing the social determinants of health. Education and early life experience is an essential part of that and the Commonwealth - through the COAG's Addressing Indigenous Disadvantage - outlines this in detail. Port Augusta and the northern suburbs of Adelaide are the two sites that the Commonwealth is focusing on in South Australia in the work on Closing the Gap.

Health programs offered by the University of Adelaide in Port Augusta show a commitment to all these matters. It also reminds us of what we need to be doing in the metropolitan area where voices in the community are easily drowned out.