Cultural and social determinants of health
For Aboriginal and Torres Strait Islander peoples, health has always been understood as a holistic and multifaceted concept – one that encompasses mental, physical, cultural, environmental, and spiritual wellbeing. This framework has supported our wellbeing for tens of thousands of years, being shared through complex kinship systems and passed
down through law, lore, ceremony and songlines.
Western models of public health have only much more recently (within the last 25 years) come to emphasise the social determinants of health – the social and economic factors leading to health inequity.
However, the cultural determinants of health, and their interactions with the social determinants, have remained largely unexplored in the public health policy discourse.
Further, governments in Australia have generally not demonstrated substantive commitments to strengthening the social and cultural determinants of health in Aboriginal and Torres Strait Islander communities.
For more than a decade, the Lowitja Institute, along with many others, has worked to understand how culture as a determinant of health can be utilised to improve health outcomes for Aboriginal and Torres Strait Islander people. In recent years, Lowitja Institute became a key partner of Mayi Kuwayu: The National Study of Aboriginal and
Torres Strait Islander Wellbeing (Mayi Kuwayu), an ongoing longitudinal study analysing the influence of Aboriginal and Torres Strait Islander cultures on health and wellbeing.
This work has been influential in the development of key frameworks for health and social and emotional wellbeing policy – including, for example, the 2021–2031 NATSIHP and the National Agreement on Closing the Gap. Nonetheless, there is still work to be done to extend the shared understanding of how the cultural determinants should be reflected in health policy design and delivery.
