Disclaimer: The views expressed in this submission are the personal views of the authors and do n... more Disclaimer: The views expressed in this submission are the personal views of the authors and do not necessarily reflect views of the organisations where they work. i
Indigenous peoples in Australia, New Zealand, Canada, and the United States of America (USA) have... more Indigenous peoples in Australia, New Zealand, Canada, and the United States of America (USA) have a higher burden of chronic lung disease than non-Indigenous people. Exercised-based interventions, such as pulmonary rehabilitation, are highly effective to manage chronic lung disease. The outcomes of these interventions for Indigenous people require evaluation. The aim of this review was to critically appraise the literature on the impact of exercise-based interventions on quality of life, exercise capacity and health care utilisation in Indigenous adults with chronic lung disease in Australia,
Worldwide health and social outcomes of Indigenous people are poorer than those of non-Indigenous... more Worldwide health and social outcomes of Indigenous people are poorer than those of non-Indigenous. In Australia, the Indigenous population experience disability at more than twice the rate of the non-Indigenous population, and a quarter live in geographically remote areas. The challenges associated with accessing services and supports in remote communities can impact on a good life for Aboriginal people with disability. Interviews were conducted with Aboriginal people (Anangu) with disability and family carers from remote Central Australian communities and service workers. Thematic data analysis determined factors Anangu viewed as essential to living a good life: connection to their Lands, being with family and engaging in cultural activities. Workers' support for a good life involves "Proper Way" help and an understanding of Anangu culture. Three culturally relevant strengths-based concepts are important in supporting Anangu with disability to live a good life: being connected to the Lands and family, sharing together and working together.
Background: Traumatic brain injury (TBI) is a leading cause of disability worldwide. Previous stu... more Background: Traumatic brain injury (TBI) is a leading cause of disability worldwide. Previous studies have shown that males have a higher incidence than females, and Indigenous populations have a higher rate than non-Indigenous. To date, no study has compared the incidence rate of TBI between Indigenous and non-Indigenous Australians for any cause. Here we add to this rather sparse literature. Methods: Retrospective analysis of data from North Queensland Emergency Departments between 2007 and 2015 using Australian Bureau of Statistics population estimates for North Queensland residents aged 15-64 years as denominator data. Outcome measures include incidence rate ratios (IRR) for TBI presentations by Indigenous status, age, sex, year of presentation, remoteness, and socioeconomic indicator. Results: Overall incidence of TBI presentations per 100,000 population was 97.8. Indigenous people had an incidence of 166.4 compared to an incidence in the non-Indigenous population of 86.3, providing an IRR of 1.93 (95% CI 1.77-2.10; p < 0.001). Males were 2.29 (95% CI 2.12-2.48; p < 0.001) times more likely to present than females. Incidence increased with year of presentation only in the Indigenous male population. Conclusions: The greater burden of ED presentations for TBI in the Indigenous compared with the non-Indigenous population is of concern. Importantly, the need to provide quality services and support to people living with TBI in remote and very remote areas, and the major role of the new National Disability Insurance Scheme is discussed.
Indigenous and other minority populations worldwide experience higher rates of disease including ... more Indigenous and other minority populations worldwide experience higher rates of disease including poor oral health than other populations. Cultural competence of practitioners is increasingly being recognized as fundamental to health care and quality of life in addressing these disparities. The aims of this study were to conduct a systematic review of the literature about teaching cultural competence in dental education and to explore the particular relevance of that teaching for the oral health care of Indigenous populations in Australia. A systematic review employing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was conducted of published studies that explored cultural competency interventions in dental curricula. A total of 258 studies from 2004 to 2015 were identified; after removing duplications and applying criteria for exclusion, 12 were selected for analysis, involving 1,360 participants. The principal themes identified in the qualitative analysis of these studies were curriculum content, curriculum delivery, community service-learning, reflective writing, and evaluation. Students need knowledge of health disparities and community health to better understand the perspectives of culturally diverse populations and to communicate effectively with people from various cultures. The principal strategies that improved cultural competence in the articles examined in this study were educational seminars, community service-learning, and reflective writing. These findings suggest that integration of cultural competency curricula using a combination of didactic or online training, community engagement, and reflective writing may increase the cultural knowledge and skills of dental students. link http://www.jdentaled.org/content/81/8/956.abstract
This chapter will examine research about the Indigenous peoples of Australia to explore the histo... more This chapter will examine research about the Indigenous peoples of Australia to explore the historical foundations of colonisation, colonialism and research on impairment and disability. The first section of this chapter presents a critical historical analysis of ethnographic and anthropological literature from the 1800s. This is followed by a critique of the current approaches used to address the ethics of research involving Indigenous persons with disability. In response to the continued gap between the prevalence of disability in Australian Indigenous communities and their low participation rates in support services, this chapter proposes that Indigenous Standpoint Theory (IST) can be used to critique how research represents, frames and defines Indigenous persons with disability.
Purpose: To identify approaches for developing workforce capacity to deliver the National Disabil... more Purpose: To identify approaches for developing workforce capacity to deliver the National Disability Insurance Scheme (NDIS) to Indigenous people with disability in Australian rural and remote communities. Method: A narrative review of peer-reviewed and gray literature was undertaken. Searches of electronic databases and websites of key government and non-government organizations were used to supplement the authors’ knowledge of literature that (a) focused on Indigenous peoples in Australia or other countries; (b) referred to people with disability; (c) considered rural/remote settings; (d) recommended workforce strategies; and (e) was published in English between 2004 and 2014. Recommended workforce strategies in each publication were summarized in a narrative synthesis. Results: Six peer-reviewed articles and 12 gray publications met inclusion criteria. Three broad categories of workforce strategies were identified: (a) community-based rehabilitation (CBR) and community-centered approaches; (b) cultural training for all workers; and (c) development of an Indigenous disability workforce. Conclusion: An Indigenous disability workforce strategy based on community-centered principles and incorporating cultural training and Indigenous disability workforce development may help to ensure that Indigenous people with a disability in rural and remote communities benefit from current disability sector reforms. Indigenous workforce development requires strategies to attract and retain Aboriginal workers.
Family and cultural inclusion are essential for the healthy development of young Australian Indig... more Family and cultural inclusion are essential for the healthy development of young Australian Indigenous peoples with low cognitive ability. To date, this issue has received limited research attention. A secondary analysis of data collected in Wave 4 of Footprints in Time, Australia's Longitudinal Study of Indigenous Children, was conducted to help address this research gap. The study results indicated that in some areas, Indigenous children with low cognitive ability are at a higher risk of social exclusion than their peers. We discuss the policy implications of these findings with regards to addressing Indigenous disadvantage.
Objective: There is limited understanding of the views of Aboriginal and non-Aboriginal workers a... more Objective: There is limited understanding of the views of Aboriginal and non-Aboriginal workers about the factors that influence the participation of Aboriginal people in disability services. This inquiry identified and explored the factors that influence the participation of Aboriginal people in disability services, as described from the experiences of a sample of paid non-government disability service workers in New South Wales, Australia. Methods: Interviews and focus groups were conducted with Aboriginal and non-Aboriginal paid employees of an Aboriginal community controlled organisation and a generic disability organisation. Results: Twelve factors that influenced the participation of Aboriginal people in disability services were identified from the data. These factors are inter-related historically, socially and institutionally. Conclusions: The study has both identified issues relevant to the participation of Aboriginal people in disability services and has provided indicators of strategies that could ensure greater and more appropriate participation by Aboriginal people. It is imperative that service access barriers are addressed for Aboriginal peoples during the current national government reforms to the disability services sector (NDIS). Implications: The findings from this study have significant implications for disability service policy and practice relating to Aboriginal people with disability, their families and carers.
Australian Aboriginal Studies Journal, 2013, No. 2, Dec 2013
This paper explores the barriers faced by Indigenous peoples to participation in research higher ... more This paper explores the barriers faced by Indigenous peoples to participation in research higher degree (RHD) programs -one of the critical mechanisms for increasing the presence of Indigenous students, staff and senior decision makers in universities. Indigenous RHD participation has emerged as a critical dimension of social inequity, particularly in relation to Indigenous struggles to be heard in major Australian institutions (IHEAC 2011). It plays a central role in Indigenous Australia's capacity to voice its concerns and represent its interests in all the major institutions that shape people's access to economic and social resources. In analysing the obstacles encountered by Indigenous peoples in accessing and completing postgraduate research education, we argue that while Commonwealth Government higher education policy has progressed Indigenous RHD participation, it has simultaneously contributed to consolidating universities as international businesses whose main priority is to compete in an increasingly integrated global knowledge economy in order to survive. The organisational dynamics required of such institutions marginalise the advancement of social goals related to equitable participation, such as Indigenous participation in RHD programs. The paper suggests that although some universities have begun to include Indigenous academics in management, more thoroughgoing integration of Indigenous Australians at all levels of university organisation is required.
International Journal of Environmental Research and Public Health, May 15, 2015
International trends towards people-centred, integrative care and support require any measurement... more International trends towards people-centred, integrative care and support require any measurement of functioning and disability to meet multiple aims. The information requirements of two major Australian programs for disability and rehabilitation are outlined, and the findings of two searches for suitable measures of functioning and disability are analysed. Over 30 current measures of functioning were evaluated in each search. Neither search found a generic measure of functioning suitable for these multibillion dollar programs, relevant to a wide range of people with a variety of health conditions and functioning experiences, and capable of indicating support needs, associated costs, progress and outcomes. This unsuccessful outcome has implications internationally for policy-relevant information for disability, rehabilitation and related programs. The paper outlines the features of an Integrative Measure of Functioning (IMF) based on the concepts of functioning and environmental factors in the International Classification of Functioning, Disability and Health (ICF). An IMF would be applicable across a variety of health conditions, settings and purposes, ranging from individual assessment to public health. An IMF could deliver person-centred, policy-relevant information for a range of programs, promoting harmonised language and measurement and supporting international trends in human services and public health.
Disclaimer: The views expressed in this submission are the personal views of the authors and do n... more Disclaimer: The views expressed in this submission are the personal views of the authors and do not necessarily reflect views of the organisations where they work. i
Indigenous peoples in Australia, New Zealand, Canada, and the United States of America (USA) have... more Indigenous peoples in Australia, New Zealand, Canada, and the United States of America (USA) have a higher burden of chronic lung disease than non-Indigenous people. Exercised-based interventions, such as pulmonary rehabilitation, are highly effective to manage chronic lung disease. The outcomes of these interventions for Indigenous people require evaluation. The aim of this review was to critically appraise the literature on the impact of exercise-based interventions on quality of life, exercise capacity and health care utilisation in Indigenous adults with chronic lung disease in Australia,
Worldwide health and social outcomes of Indigenous people are poorer than those of non-Indigenous... more Worldwide health and social outcomes of Indigenous people are poorer than those of non-Indigenous. In Australia, the Indigenous population experience disability at more than twice the rate of the non-Indigenous population, and a quarter live in geographically remote areas. The challenges associated with accessing services and supports in remote communities can impact on a good life for Aboriginal people with disability. Interviews were conducted with Aboriginal people (Anangu) with disability and family carers from remote Central Australian communities and service workers. Thematic data analysis determined factors Anangu viewed as essential to living a good life: connection to their Lands, being with family and engaging in cultural activities. Workers' support for a good life involves "Proper Way" help and an understanding of Anangu culture. Three culturally relevant strengths-based concepts are important in supporting Anangu with disability to live a good life: being connected to the Lands and family, sharing together and working together.
Background: Traumatic brain injury (TBI) is a leading cause of disability worldwide. Previous stu... more Background: Traumatic brain injury (TBI) is a leading cause of disability worldwide. Previous studies have shown that males have a higher incidence than females, and Indigenous populations have a higher rate than non-Indigenous. To date, no study has compared the incidence rate of TBI between Indigenous and non-Indigenous Australians for any cause. Here we add to this rather sparse literature. Methods: Retrospective analysis of data from North Queensland Emergency Departments between 2007 and 2015 using Australian Bureau of Statistics population estimates for North Queensland residents aged 15-64 years as denominator data. Outcome measures include incidence rate ratios (IRR) for TBI presentations by Indigenous status, age, sex, year of presentation, remoteness, and socioeconomic indicator. Results: Overall incidence of TBI presentations per 100,000 population was 97.8. Indigenous people had an incidence of 166.4 compared to an incidence in the non-Indigenous population of 86.3, providing an IRR of 1.93 (95% CI 1.77-2.10; p < 0.001). Males were 2.29 (95% CI 2.12-2.48; p < 0.001) times more likely to present than females. Incidence increased with year of presentation only in the Indigenous male population. Conclusions: The greater burden of ED presentations for TBI in the Indigenous compared with the non-Indigenous population is of concern. Importantly, the need to provide quality services and support to people living with TBI in remote and very remote areas, and the major role of the new National Disability Insurance Scheme is discussed.
Indigenous and other minority populations worldwide experience higher rates of disease including ... more Indigenous and other minority populations worldwide experience higher rates of disease including poor oral health than other populations. Cultural competence of practitioners is increasingly being recognized as fundamental to health care and quality of life in addressing these disparities. The aims of this study were to conduct a systematic review of the literature about teaching cultural competence in dental education and to explore the particular relevance of that teaching for the oral health care of Indigenous populations in Australia. A systematic review employing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was conducted of published studies that explored cultural competency interventions in dental curricula. A total of 258 studies from 2004 to 2015 were identified; after removing duplications and applying criteria for exclusion, 12 were selected for analysis, involving 1,360 participants. The principal themes identified in the qualitative analysis of these studies were curriculum content, curriculum delivery, community service-learning, reflective writing, and evaluation. Students need knowledge of health disparities and community health to better understand the perspectives of culturally diverse populations and to communicate effectively with people from various cultures. The principal strategies that improved cultural competence in the articles examined in this study were educational seminars, community service-learning, and reflective writing. These findings suggest that integration of cultural competency curricula using a combination of didactic or online training, community engagement, and reflective writing may increase the cultural knowledge and skills of dental students. link http://www.jdentaled.org/content/81/8/956.abstract
This chapter will examine research about the Indigenous peoples of Australia to explore the histo... more This chapter will examine research about the Indigenous peoples of Australia to explore the historical foundations of colonisation, colonialism and research on impairment and disability. The first section of this chapter presents a critical historical analysis of ethnographic and anthropological literature from the 1800s. This is followed by a critique of the current approaches used to address the ethics of research involving Indigenous persons with disability. In response to the continued gap between the prevalence of disability in Australian Indigenous communities and their low participation rates in support services, this chapter proposes that Indigenous Standpoint Theory (IST) can be used to critique how research represents, frames and defines Indigenous persons with disability.
Purpose: To identify approaches for developing workforce capacity to deliver the National Disabil... more Purpose: To identify approaches for developing workforce capacity to deliver the National Disability Insurance Scheme (NDIS) to Indigenous people with disability in Australian rural and remote communities. Method: A narrative review of peer-reviewed and gray literature was undertaken. Searches of electronic databases and websites of key government and non-government organizations were used to supplement the authors’ knowledge of literature that (a) focused on Indigenous peoples in Australia or other countries; (b) referred to people with disability; (c) considered rural/remote settings; (d) recommended workforce strategies; and (e) was published in English between 2004 and 2014. Recommended workforce strategies in each publication were summarized in a narrative synthesis. Results: Six peer-reviewed articles and 12 gray publications met inclusion criteria. Three broad categories of workforce strategies were identified: (a) community-based rehabilitation (CBR) and community-centered approaches; (b) cultural training for all workers; and (c) development of an Indigenous disability workforce. Conclusion: An Indigenous disability workforce strategy based on community-centered principles and incorporating cultural training and Indigenous disability workforce development may help to ensure that Indigenous people with a disability in rural and remote communities benefit from current disability sector reforms. Indigenous workforce development requires strategies to attract and retain Aboriginal workers.
Family and cultural inclusion are essential for the healthy development of young Australian Indig... more Family and cultural inclusion are essential for the healthy development of young Australian Indigenous peoples with low cognitive ability. To date, this issue has received limited research attention. A secondary analysis of data collected in Wave 4 of Footprints in Time, Australia's Longitudinal Study of Indigenous Children, was conducted to help address this research gap. The study results indicated that in some areas, Indigenous children with low cognitive ability are at a higher risk of social exclusion than their peers. We discuss the policy implications of these findings with regards to addressing Indigenous disadvantage.
Objective: There is limited understanding of the views of Aboriginal and non-Aboriginal workers a... more Objective: There is limited understanding of the views of Aboriginal and non-Aboriginal workers about the factors that influence the participation of Aboriginal people in disability services. This inquiry identified and explored the factors that influence the participation of Aboriginal people in disability services, as described from the experiences of a sample of paid non-government disability service workers in New South Wales, Australia. Methods: Interviews and focus groups were conducted with Aboriginal and non-Aboriginal paid employees of an Aboriginal community controlled organisation and a generic disability organisation. Results: Twelve factors that influenced the participation of Aboriginal people in disability services were identified from the data. These factors are inter-related historically, socially and institutionally. Conclusions: The study has both identified issues relevant to the participation of Aboriginal people in disability services and has provided indicators of strategies that could ensure greater and more appropriate participation by Aboriginal people. It is imperative that service access barriers are addressed for Aboriginal peoples during the current national government reforms to the disability services sector (NDIS). Implications: The findings from this study have significant implications for disability service policy and practice relating to Aboriginal people with disability, their families and carers.
Australian Aboriginal Studies Journal, 2013, No. 2, Dec 2013
This paper explores the barriers faced by Indigenous peoples to participation in research higher ... more This paper explores the barriers faced by Indigenous peoples to participation in research higher degree (RHD) programs -one of the critical mechanisms for increasing the presence of Indigenous students, staff and senior decision makers in universities. Indigenous RHD participation has emerged as a critical dimension of social inequity, particularly in relation to Indigenous struggles to be heard in major Australian institutions (IHEAC 2011). It plays a central role in Indigenous Australia's capacity to voice its concerns and represent its interests in all the major institutions that shape people's access to economic and social resources. In analysing the obstacles encountered by Indigenous peoples in accessing and completing postgraduate research education, we argue that while Commonwealth Government higher education policy has progressed Indigenous RHD participation, it has simultaneously contributed to consolidating universities as international businesses whose main priority is to compete in an increasingly integrated global knowledge economy in order to survive. The organisational dynamics required of such institutions marginalise the advancement of social goals related to equitable participation, such as Indigenous participation in RHD programs. The paper suggests that although some universities have begun to include Indigenous academics in management, more thoroughgoing integration of Indigenous Australians at all levels of university organisation is required.
International Journal of Environmental Research and Public Health, May 15, 2015
International trends towards people-centred, integrative care and support require any measurement... more International trends towards people-centred, integrative care and support require any measurement of functioning and disability to meet multiple aims. The information requirements of two major Australian programs for disability and rehabilitation are outlined, and the findings of two searches for suitable measures of functioning and disability are analysed. Over 30 current measures of functioning were evaluated in each search. Neither search found a generic measure of functioning suitable for these multibillion dollar programs, relevant to a wide range of people with a variety of health conditions and functioning experiences, and capable of indicating support needs, associated costs, progress and outcomes. This unsuccessful outcome has implications internationally for policy-relevant information for disability, rehabilitation and related programs. The paper outlines the features of an Integrative Measure of Functioning (IMF) based on the concepts of functioning and environmental factors in the International Classification of Functioning, Disability and Health (ICF). An IMF would be applicable across a variety of health conditions, settings and purposes, ranging from individual assessment to public health. An IMF could deliver person-centred, policy-relevant information for a range of programs, promoting harmonised language and measurement and supporting international trends in human services and public health.
Indigenous Australians have experienced the horrific consequences of European invasion and coloni... more Indigenous Australians have experienced the horrific consequences of European invasion and colonisation. Some of these consequences include wars, geographic displacement and attempted genocide. Both the high prevalence and experience of disability among Indigenous peoples remain directly linked to the events that followed European invasion. Critical Disability Studies and Media Studies can investigate the process of decolonisation. This chapter is cross disciplinary in so far as we are concerned with the representation of Indigenous people in the mass media and decolonising Indigenous disability. We examine data collected from an analysis of the print media during the colonial period; that is, representation of " disabled " Indigenous people in mainstream newspapers during the first 100 years of the press from 1830. We use Martin Nakata's Indigenous Standpoint Theory and Decolonising frameworks to deconstruct and analyse the material collected.
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Method: A narrative review of peer-reviewed and gray literature was undertaken. Searches of electronic databases and websites of key government and non-government organizations were used to supplement the authors’ knowledge of literature that (a) focused on Indigenous peoples in Australia or other countries; (b) referred to people with disability; (c) considered rural/remote settings; (d) recommended workforce strategies; and (e) was published in English between 2004 and 2014. Recommended workforce strategies in each publication were summarized in a narrative synthesis.
Results: Six peer-reviewed articles and 12 gray publications met inclusion criteria. Three broad categories of workforce strategies were identified: (a) community-based rehabilitation (CBR) and community-centered approaches; (b) cultural training for all workers; and (c) development of an Indigenous disability workforce.
Conclusion: An Indigenous disability workforce strategy based on community-centered principles and incorporating cultural training and Indigenous disability workforce development may help to ensure that Indigenous people with a disability in rural and remote communities benefit from current disability sector reforms. Indigenous workforce development requires strategies to attract and retain Aboriginal workers.
Methods: Interviews and focus groups were conducted with Aboriginal and non-Aboriginal paid employees of an Aboriginal community controlled organisation and a generic disability organisation.
Results: Twelve factors that influenced the participation of Aboriginal people in disability services were identified from the data. These factors are inter-related historically, socially and institutionally.
Conclusions: The study has both identified issues relevant to the participation of Aboriginal people in disability services and has provided indicators of strategies that could ensure greater and more appropriate participation by Aboriginal people. It is imperative that service access barriers are addressed for Aboriginal peoples during the current national government reforms to the disability services sector (NDIS).
Implications: The findings from this study have significant implications for disability service policy and practice relating to Aboriginal people with disability, their families and carers.
Method: A narrative review of peer-reviewed and gray literature was undertaken. Searches of electronic databases and websites of key government and non-government organizations were used to supplement the authors’ knowledge of literature that (a) focused on Indigenous peoples in Australia or other countries; (b) referred to people with disability; (c) considered rural/remote settings; (d) recommended workforce strategies; and (e) was published in English between 2004 and 2014. Recommended workforce strategies in each publication were summarized in a narrative synthesis.
Results: Six peer-reviewed articles and 12 gray publications met inclusion criteria. Three broad categories of workforce strategies were identified: (a) community-based rehabilitation (CBR) and community-centered approaches; (b) cultural training for all workers; and (c) development of an Indigenous disability workforce.
Conclusion: An Indigenous disability workforce strategy based on community-centered principles and incorporating cultural training and Indigenous disability workforce development may help to ensure that Indigenous people with a disability in rural and remote communities benefit from current disability sector reforms. Indigenous workforce development requires strategies to attract and retain Aboriginal workers.
Methods: Interviews and focus groups were conducted with Aboriginal and non-Aboriginal paid employees of an Aboriginal community controlled organisation and a generic disability organisation.
Results: Twelve factors that influenced the participation of Aboriginal people in disability services were identified from the data. These factors are inter-related historically, socially and institutionally.
Conclusions: The study has both identified issues relevant to the participation of Aboriginal people in disability services and has provided indicators of strategies that could ensure greater and more appropriate participation by Aboriginal people. It is imperative that service access barriers are addressed for Aboriginal peoples during the current national government reforms to the disability services sector (NDIS).
Implications: The findings from this study have significant implications for disability service policy and practice relating to Aboriginal people with disability, their families and carers.