Cultural determinants of health for Aboriginal and Torres Strait Islander people – a narrative overview of reviews

Abstract

Introduction The cultural determinants of health centre an Indigenous definition of health, and have been linked to positive health and wellbeing outcomes. There is growing evidence for the importance of the cultural determinants of health; however, to date, no high-level overview of the evidence-base has been provided. Synthesising existing literature on cultural determinants of health for Aboriginal peoples in a single manuscript will highlight what we know, and what needs to be explored in future research. It will also contribute to global efforts to capture the evidence of cultural determinant approaches amongst Indigenous populations. We therefore endeavoured to identify cultural determinants and highlight their impact on Aboriginal health and wellbeing outcomes, and outline the relationship and interconnection of different cultural determinants of health. Methods An overview of reviews was conducted. Medline (Ovid) and Scopus were searched using terms related to ‘cultural determinants of health’ and an ‘Aboriginal definition of health’. The database search was complemented by a web-based search of grey literature. Nine reviews were retrieved and included in our overview. Results Family/community, Country and place, cultural identity and self-determination were strongly identified across reviews as having a positive impact on the health and wellbeing outcomes of Aboriginal peoples. Family/community and Country and place were found to be components of ‘culture’ that shaped cultural identity. Self-determination was outlined as a requirement for Aboriginal peoples to pursue their cultural, social, and economic rights. Discussion/conclusions Cultural determinants are associated with health benefits for Indigenous peoples. A causal framework, developed to discuss the relationship and interconnection of the cultural determinants of health, demonstrates that cultural identity at an individual-level is important to benefiting from other cultural determinants of health. While self-determination and connection to culture and community-controlled organisations are integral factors to increase Aboriginal resilience and resistance and improve health and wellbeing outcomes. Further research is required to shift towards a multi-level understanding of the cultural determinants of health and to develop an Indigenous-led evidence-base around causal pathways. Such a shift would ensure priorities important to Indigenous peoples are captured in policy and practice.

Centering Indigenous Knowledge in Suicide Prevention: A Critical Scoping Review

“…It is within the family and the community where Indigenous culture, knowledge and language is transmitted, positive cultural identity forms, and where one can seek out support in a crisis [103]. However, in many Indigenous contexts, family and community environments have been severely damaged with colonization [13,104]. Hence why community engagement outcomes consistently point to a need to move beyond the individual to support family and community strengths [49].…”

Waka ama: An exemplar of indigenous health promotion in Aotearoa New Zealand

“…Participants are provided with a gateway into te ao Māori and a safe space to learn about and explore their cultural identity in relation to the teachings of tikanga Māori. Studies have shown that cultural practices have an inextricable link to health and wellbeing, with evidence that a secure cultural identity enhances mental wellbeing and alleviates symptoms of depression 21–25 . This shows that securing cultural identity is an important determinant of health from an indigenous perspective.…”

“…Studies have shown that cultural practices have an inextricable link to health and wellbeing, with evidence that a secure cultural identity enhances mental wellbeing and alleviates symptoms of depression. [21][22][23][24][25] This shows that securing cultural identity is an important determinant of health from an indigenous perspective.…”

Expanded Conceptual Framework for Ethical Action by Nurses on the “Further Upstream and Farther Downstream” Determinants of Health Equity

“…Cultural determinants : Verbunt et al (2021) examined cultural DOH among Aboriginal and Torres Strait Islander people in Australia. They identified four factors that have positive impacts on the health of indigenous populations.…”