New reports to be released at a Lowitja Institute forum in Canberra on Monday (14 May) will challenge researchers and policymakers to better address the priorities of Aboriginal and Torres Strait Islander communities.
Dr Megan Williams, a UTS scholar of Wiradjuri descent and a Croakey contributing editor, is covering the #ResearchIntoPolicy event for the Croakey Conference News Service, and in the article below sets the scene for some of the discussions.
Megan Williams writes:
“We all know, and can all feel, that data has increasing power and influence over our lives.”
That is what Professor Ian Anderson AO, a Palawa man who is Deputy Secretary for Indigenous Affairs in the Department of Prime Minister and Cabinet, recently told the Australia and New Zealand School of Government (ANZSOG) conference.
That power and influence, for Aboriginal and Torres Strait Islander people, reinforces us as “less than”, telling us we must expect to live shorter, poorer, less educated and less healthy lives than other Australians.
It’s a traumatic take-home message, a deficit discourse, and one that our children learn about at school, our university students learn about at Close the Gap Day barbeques and the general public is reminded annually by the Prime Minister’s report to Parliament.
The report’s tone suggests it’s a fait accompli that few targets have been met, and this year when the Closing the Gap Refresh was announced, I saw first-hand the cynicism that this engendered amongst non-Indigenous students and staff in a tertiary institution.
There were more than just a few subtle eye-rolls around the room. “What’s the Aboriginal community do with all the money, then?” was the sentiment, spoken and unspoken.
The real answers to this question are rarely shared, and certainly not with the same snappy info graphics that are printed about the health status of Aboriginal and Torres Strait Islander people in government reports.
The healthiness of services, policies or the evidence base is very rarely assessed.
Transform the use of data
In his ANZSOG speech, Anderson advocated for a transformation in how data is used to influence policy to improve Aboriginal and Torres Strait Islander people’s health.
He and other Aboriginal and Torres Strait Islander health research leaders have explained how administrative data collected by governments and health and welfare services is often incomplete, that it lacks contextual detail, and when aggregated to present national trends portrays a vastly different reality to local lives and needs.
Reports rarely include information about Aboriginal and Torres Strait Islander people who work, are connected to their community, or are healthy.
Virtually no research has been funded to identify and address lack of accountability in government and service systems.
The National Health and Medical Research Guidelines for Research Involving Aboriginal and Torres Strait Islander Peoples have provided important parameters for ethical research.
These have been enlivened by the work of the Lowitja Institute, Australia’s National Aboriginal and Torres Strait Islander Health Research Institute and its Cooperative Research Centres in Aboriginal and Torres Strait Islander health over approximately 20 years.
The CRCs and Lowitja Institute have resulted in dozens of universities, research centres and institutes, Aboriginal and Torres Strait Islander community-controlled health services and students collaborating, building capacity and developing key resources to support ethical research.
As Aboriginal and Torres Strait Islander health research leadership has grown, so too has the intolerance for the deficit discourse, or for research “on” Aboriginal and Torres Strait Islander peoples.
The NHMRC Guidelines and researchers’ association with the Lowitja Institute bring with them a responsibility to ensure research is Aboriginal and Torres Strait Islander community-driven, rather than researcher-driven.
This concept is old news in the marketing and business world. “If you want change,” they say, “First you need to ask your consumers, and secondly, you need to do what they want”.
The last decade of Closing the Gap has shown that top-down approaches to funding models, policy-making and research have not worked, but have potentially worsened an already profoundly inequitable situation. The question remains about how system-level transformation can occur.
One important step is convincing more researchers that regardless of their cultural background or discipline, Aboriginal and Torres Strait Islander research ethics, methodologies and methods are useful for everyone. They are not only for Aboriginal and Torres Strait Islander people, as their core concepts – of engagement, capacity building, social justice and prevention – are more widely applicable.
Most Aboriginal and Torres Strait Islander health researchers are trained in both western sciences and Indigenous knowledges, rather than only one or the other. This results in a highly-developed, diverse skills-set among people who have the courage and impetus to innovate, and community support to do so.
This point was reinforced by Sir Professor Michael Marmot, Director of The University College London Institute of Health Equity, during his recent visit to the Central Australian Aboriginal Congress in Alice Springs.
He saw how Aboriginal and Torres Strait Islander health research and community controlled health services clearly identify and address the social determinants of health – with relevance for any nation in its efforts to reduce health inequity.
Another key area where Aboriginal and Torres Strait Islander health researchers are leading the way is research translation. The Lowitja Institute’s Knowledge Translation planning process begins before a project is fully funded or implemented. No other mainstream funding body requires, expects or stimulates this.
The recent Federal Budget included $75 million for research translation through the Medical Research Futures Fund as part of its promised $20 billion by 2020-21. None appear to be specifically allocated to Aboriginal and Torres Strait Islander health.
The biomedical, mental health, women’s health, hospital and health systems research programs prioritised will have to ensure they meet the needs and aspirations of Aboriginal and Torres Strait Islander peoples too. This is always a cause for concern, given so few non-Indigenous people are confident partnering with Aboriginal and Torres Strait Islander communities and researchers.
I am looking forward to some illuminating discussions around many of these concerns, questions and possibilities during the Lowitja Institute forum in Canberra.
As an alumni of the Lowitja Institute, I am active in research translation through the Sydney Partnerships for Health Education and Research Enterprise (SPHERE) Maridulu Budyari Gumal Aboriginal and Torres Strait Islander Health and Wellbeing Clinical Academic Group.
I am delighted to cover the #ResearchIntoPolicy forum for Croakey readers.
We will hear about an evaluation framework to improve Aboriginal and Torres Strait Islander health from Professor Margaret Kelaher and Ms Fran Eades; deficit discourse and Indigenous health – reframing discourse and strength-based approaches, from Dr Hannah Bulloch and Mr Scott Gorringe, and service integration for Aboriginal and Torres Strait Islander early childhood development from Professor Kerry Arabena.
During the forum, the winner of the 2018 Lowitja Institute Research Leadership Award will be announced.