Reframing discourse and changing the narrative of Aboriginal and Torres Strait Islander health and wellbeing: an analysis
To identify the national and international methods and approaches that have been effective in changing the deficit narrative.
- Document and critically analyse existing interventions to reframe Indigenous health towards a strengths-based approach.
- Summarise the characteristics of successful programs and initiatives and build the evidence of best practice and the benefits of a strengths-based discourse on Indigenous peoples’ health and wellbeing.
- Make recommendations of future actions to reframe discourse in the Australian Aboriginal and Torres Strait Islander health context.
Project leader: Professor Mick Dodson, Director of the National Centre for Indigenous Studies at ANU, Professor of Law at the ANU College, The National Centre for Indigenous Studies, ANU
Project partner: Deakin University
Administering organisation: Australian National University
Project timeline: January 2017-31 July 2017
The first project ‘The narrative framing of Aboriginal and Torres Strait Islander health and wellbeing: a review’ provided the necessary groundwork for this research by establishing the nature and prevalence of deficit discourse in the health and wellbeing context. This project takes the analysis to the next stage. The methodology for this analysis includes:
- Literature review.
- Identification and documentation of Australian and International literature that examines the relationship between discourse and outcomes, and the benefits of moving to strengths-based discourse.
- Identification of effective national and International methods and approaches for changing health narratives.
- Typology of relevant approaches and scholarship.
- Data synthesis to summarise characteristics of successful programs and initiatives.
- Production of report, analysis and recommendations.
This process allowed for a complex analysis of the path to leadership in the health workforce for Indigenous professionals.
This research project is the culmination of findings from a previous project. As such, much of the work in this report provides building blocks to assist ways to shift dominant narratives of deficit in Indigenous health development.
There are several key findings of importance in trying to reframe the narrative of Indigenous health in order to challenge or eliminate the effects of discourse of deficit. These findings are:
- Deficit discourse has a demonstrable impact on Indigenous health.
- ‘Strengths-based’ approaches are the most common concepts used and accepted as successful in Indigenous health to either explicitly or implicitly counter deficit.
- ‘Strengths-based’ approaches are not a set of policies or programs, rather they are conceptual frameworks for approaching Indigenous health and development and intervention.
- ‘Strengths-based’ approaches are not a simple corollary or antidote to deficit and can be seen to grow out of the same deficit-based models. A strengths-based approach can be a highly effective method for shifting or changing narratives of Indigenous health. It can also be used to provide and illuminate alternative ways to deal with Indigenous health issues.
- There are some barriers to implementing strengths-based models of development for Indigenous health. These include:
- an often broad, weak or ill-defined conceptual base for research, policy and program design
- a tendency in the grey literature in particular to use platitudes or to ‘pay lip service’ to strengths-based ideation
- a real paucity of strong qualitative evaluation. This includes a lack of formative evaluation design and almost a complete lack of evaluation of actual impact on discourse itself and, in turn, Indigenous health outcomes. Similarly, no evaluation techniques specifically designed to measure or demonstrate shifts in Indigenous health discourse.
The study also identified two successful justifications for using strengths-based approaches to influence a narrative change in Indigenous health. The first is the ‘Utilitarian’ approach and the other is the ‘Binary’ approach.
In addition, the national and international samples analysed showed:
- The international semantic field of Indigenous health seems to demonstrate a far greater congruence with the epistemology of the strengths-based discourse than the Australian semantic field.
- The Australian field of Indigenous health development may be significantly underutilising ‘binary justifications’ as a way to shift, change or challenge current framings of the Indigenous health narrative at a national level.
- Identified alternative approaches that are useful in reframing the narrative of Indigenous health and eliminating the effects of deficit discourse.
- Recommendations for policy have been designed using the identified benefits of strength-based approaches.
- There is increasing acknowledgement that how Indigenous people are represented and choose to represent themselves may have significant impact on health outcomes.
- Language use is crucial to changing the narrative for Indigenous health.
- This project has provided an enormous opportunity to enable Indigenous scholars and emerging academics to foster an understanding of a highly technical (deficit discourse analysis) and cutting-edge research agenda
Report: Deficit discourse and strengths-based approaches: Changing the narrative of Aboriginal and Torres Strait Islander health and wellbeing
- W. Fogarty, H. Bulloch, S. McDonnell & M. Davis 2018, Deficit Discourse and Indigenous Health: How narrative framings of Aboriginal and Torres Strait Islander people are reproduced in policy, The Lowitja Institute, Melbourne
- W. Fogarty, M. Lovell, J. Lagenberg & M-J. Heron 2018, Deficit Discourse and Strengths-based Approaches: Changing the Narrative of Aboriginal and Torres Strait Islander Health and Wellbeing, The Lowitja Institute, Melbourne
- Deficit Discourse and Indigenous Health – summary report
- Reframing Discourse and Changing the Narrative of Aboriginal and Torres Strait Islander Health and Wellbeing: An Analysis
- Videos from the 2018 Knowledge Translation forum, including interview with Dr Hannah Bulloch and Mr Scott Gorringe
- Bulloch, H., Fogarty, W. & Bellchambers, K 2019, Aboriginal Health and Wellbeing Services - Putting community-driven, strengths-based approaches into practice, The Lowitja Institute, Melbourne