Indigenous Health & Wellbeing: Importance of Country


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Boab Tree, Kimberely, WA

Native Title Research Report No. 1/2009 April 2009

Introduction to paper

For Aboriginal people, land is not only our mother – the source of our identity and our spirituality – it is also the context for our human order and inquiry.

Our identity as human beings remains tied to our land, to our cultural practices, our systems of authority and social control, our intellectual traditions, our concepts of spirituality, and to our systems of resource ownership and exchange. Destroy this relationship and you damage – sometimes irrevocably – individual human beings and their health.

A key aspect to improving Indigenous wellbeing is exploring the relationship between land and wellbeing. Evidence exists which suggests there are positive physical health outcomes from living or working on country. However, it has also been argued that Indigenous health cannot improve whilst Indigenous peoples continue to live outside urban areas.

These competing views will lead to the adoption of very different strategies for addressing Indigenous health issues. Therefore, it is critical to develop an understanding of the value of native title, the return of lands generally, or the capacity to live or work on country, to Indigenous peoples' wellbeing. The aim of this paper is to provide an overview of relevant material. The central argument is that Indigenous health strategies should take into consideration the importance of connection to country to maximise their effectiveness.

Wellbeing is part of a holistic understanding of life. The Social and Emotional Well Being Framework, based on Aboriginal definitions of health, recognises that a holistic and whole-of-life view of health is essential to achieve positive life outcomes for Indigenous peoples.

Notions of health are encompassed in the broader concept of wellbeing. Consequently, studies of the social determinants of health are useful in considering influences on wellbeing. Broadly speaking there are two models of health – the biomedical model and the social determinants model. The biomedical model of health focuses on isolating the specific cause of illness. Medical research centres on the different levels of the human body and the way these interact in order to explain illnesses.

Although this approach has been successful it is limited. In contrast, the social determinants of health model focuses on societal structure and psychosocial factors, such as socioeconomic status, housing and gender.

In a seminal study, Garnett and Sithole found positive associations between activities that Indigenous people perceived as beneficial to their health and health outcomes linked to excess morbidity and mortality.

The activities were related to time spent 'caring for country', that is, time spent on traditional lands (‘on country') engaged in traditional activities. This finding suggests that health initiatives must look beyond the traditional biomedical model and adopt a model that incorporates the broader social determinants of health. The study supports the assertion that connection to country, or behaviours related to forming a connection to country, are an important influence on the social determinants of Indigenous health.

Given that wellbeing is affected by social determinants of health, the implication is that connection to country is also central to positive wellbeing.

The paper begins with a discussion of the meaning of ‘wellbeing'. Section 3 presents research that investigates the impacts of country and connection to country on aspects of wellbeing. Section 4 contrasts two different explanations of why living or working on country has not improved Indigenous health thus far. Section 5 outlines current programs that provide opportunities for living or working on traditional lands or land generally. Section 6 draws together the information presented in the preceding sections.

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