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Social Determinants

Social determinants of health

Improving Aboriginal and Torres Strait Islander health relies on addressing broader issues than biomedical health. Social factors – such as housing, education, employment and transport – must also be addressed if we are to achieve lasting health gains.

'Smoke-busters': Maningrida’s experience implementing a tobacco control program

Tobacco is a major cause of the gap in life expectancybetween Aboriginal and non-Aboriginal Australians [1]. Smoking prevalence in remote Aboriginal communities is several times higher than the national average [2] and has not declined over recent decades - suggesting that mainstream health promotion campaigns have been ineffective in this challenging setting. Following a community outreach program of Adult Health Checks, tobacco control was identified as a major priority to improve the health of people in Maningrida.

'They Weren’t Separated': Missions, dormitories and generational health

In 1997 the Bringing Them Home Report brought attention to those Aboriginal and Torres Strait Islander children who were taken away from their families for the purpose of assimilation. Less attention was given to those children who were also taken away but grew up in mission and settlement dormitories. Over a number of decades, and until the early 1970s, a large number of Aboriginal and Torres Strait Islander children were taken into mission and settlement dormitories. In various ways they were physically and socially separated from their families.

A Cluster of Melioidosis Cases from an Endemic Region Is Clonal and Is Linked to the Water Supply Using Molecular Typing of Bukholderia Pseudomallei Isolates

Nine cases of melioidosis with four deaths occurred over a 28-month period in members of a small remote Aboriginal community in the top end of the Northern Territory of Australia. Typing by pulsed-field gel electrophoresis showed isolates of Burkholderia pseudomallei from six of the cases to be clonal and also identical to an isolate from the community water supply, but not to soil isolates. The clonality of the isolates found in this cluster contrasts with the marked genetic diversity of human and environmental isolates found in this region which is hyperendemic for B. pseudomallei.

A Global Snapshot of Indigenous and Tribal Peoples' Health: The Lancet–Lowitja Institute Collaboration

The purpose of this report is to provide a more detailed understanding of the context of each population included in a paper published by The Lancet in April 2016, 'Indigenous and Tribal Peoples' Health (The Lancet–Lowitja Institute Collaboration): A population study' by I. Anderson, B. Robson, M. Connolly et al. 

A Longitudinal Data Resource on Key Influences on Health in the Northern Territory: Opportunities and Obstacles

This is the first in the CRC for Aboriginal Health's Discussion Paper Series. The purpose of this study is to increase understanding among researchers, health professionals, and government policy makers of the social and environmental determinants of health. Determinants include income, employment, education, housing, community infrastructure, social disruption, crime and violence.

A Multifaceted Health-service Intervention in Remote Aboriginal Communities: 3-year follow-up of the impact on diabetes care

Objective: To examine the trends in processes of diabetes care and in participant outcomes after an intervention in two remote regions of Australia. Design: Follow-up study over 3years. Setting: Seven health centres in the Tiwi Islands and the Katherine West region of the Northern Territory. Participants: 137Aboriginal people with type 2diabetes.

A New Variant of Dual-record Population Estimation with an Application in Remote Indigenous Communities

Dual-record system methods are commonly used as a basis for population estimation. A basic assumption is that the units sampled are drawn only from the population to be estimated. This assumption cannot be met for remote Indigenous communities in Australia. A new variant of dual-record population estimation is presented, which relies on the availability of specific additional information to relax the assumption of perfect frame specification. This variant is applied to two remote Indigenous communities in the Northern Territory of Australia, using locally available data sources.

A Review of Programs that Targeted Environmental Factors for Improving Aboriginal and Torres Strait Islander Health


Effective interventions to improve population and individual health require environmental change as well as strategies that target individual behaviours and clinical factors. This is the basis of implementing an ecological approach to health programs and health promotion. For Aboriginal People and Torres Strait Islanders, colonisation has made the physical and social environment particularly detrimental for health.

Aboriginal Adult Literacy Campaign

The Lowitja Institute is a founding partner of Literacy for Life Foundation, an Aboriginal-led initiative aiming to lift adult literacy in Aboriginal and Torres Strait Islander communities. An estimated 40 per cent of Aboriginal and Torres Strait Islander adults have minimal English literacy, a figure that rises to as high as 70 per cent in many remote areas. So long as these adult illiteracy rates exist, meaningful progress towards many Closing the Gap targets will be impossible.

Aboriginal Adult Literacy Campaign: Stage 1

Researchers in this project conducted a pilot Aboriginal Adult Literacy Campaign in one region, to establish whether or not government should be asked to undertake a national Aboriginal Adult Literacy Campaign.

Aboriginal adult literacy program set to expand beyond Wilcannia

The Lowitja Institute has approved funding for Stage 2 of the Aboriginal adult literacy campaign following the successful pilot of the program over the past year in the New South Wales outback community of Wilcannia.

Aboriginal and Torres Strait Islander urban location and health project

This project, conducted in Adelaide, explores how urban Aboriginal and Torres Strait Islander people feel about where they live and whether they think their neighbourhood and social networks influence their health and if so, in what ways.

Aboriginal people travelling well

This project resulted several actions aimed at improving the safety or sufficiency of transport for Aboriginal people in South Australia, including that driver education and licensing be added to the State's Strategic Plan to improve mobility, establish identity and give improved employment opportunities.

Aboriginal People Travelling Well literature review: driver licensing issues, seat restraint non-compliance, Aboriginal health, Aboriginal disability

This review focuses on the interaction between access to safe and sufficient transport, and the effects on the wellbeing and health of Aboriginal people. Aspects under specific consideration are driver licensing, use of seat restraints, and health and disability needs. Attaining and retaining a drivers license for life, and travelling safely, which includes being trained to drive safely and being educated and aware of the efficacy of seat restraints are important issues for Aboriginal people.

Aboriginal Prisoner Health Industry Roundtable

The CRCAH hosted a research development roundtable on Aboriginal prison health in Canberra on 28 November 2007, in partnership with the Public Health Association of Australia and the Australian Institute of Aboriginal and Torres Strait Islander Studies (AIATSIS).

The roundtable aimed to bring together community representatives, correction staff (policy, program, management and custodial staff), researchers and advocates in order to:

Aboriginality, Poverty and Health — Exploring the connections (Beyond Bandaids, Chapter 5)

Beyond Bandaids is a collection of sixteen papers from the CRCAH Social Determinants of Aboriginal Health Workshop held in Adelaide in July 2004.

Alternative VET Pathways to Indigenous Development: Review of research

This publication reports on a research project which set out to analyse recent research and policy documents on indigenous peoples' development needs and aspirations, and was aimed at assessing the extent to which current developments in vocational education and training research and policy were sufficiently informed by this separate but related body of literature. The report argues that current policy settings and research on the educational needs of indigenous Australians have been overly influenced by human capital theory and economic rationalist policy.

Ambivalent Helpers and Unhealthy Choices: Public health practitioners' narratives of Indigenous ill-health

Public health practitioners in Australian indigenous health work in a complex political environment. Public health training is limited in providing them with conceptual tools needed to unpack the postcolonial nexus of fourth-world health. A workshop was designed by the authors to facilitate critical reflection on how the concepts of race and culture are used in constructions of indigenous ill-health. It was attended by researchers, students, clinicians and bureaucrats working in public health in northern Australia.

An Aboriginal Adult Literacy Campaign in Australia Using Yes I Can

In 2012, the remote Aboriginal community of Wilcannia in western NSW hosted the first Australian pilot of a Cuban mass adult literacy campaign model known as Yes I Can. The aim was to investigate the appropriateness of this model in Aboriginal Australia. Building on an intensive community development process of ‘socialisation and mobilisation’, sixteen community members with very low literacy graduated from the basic literacy course, with the majority continuing on into post-literacy activities, further training and/or employment.


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