Holistic Conceptualizations of Health by Incarcerated Aboriginal Women in New South Wales, Australia

Abstract

While there has been extensive research on the health and social and emotional well-being (SEWB) of Aboriginal women in prison, there are few qualitative studies where incarcerated Aboriginal women have been directly asked about their health, SEWB, and health care experiences. Using an Indigenous research methodology and SEWB framework, this article presents the findings of 43 interviews with incarcerated Aboriginal women in New South Wales, Australia. Drawing on the interviews, we found that Aboriginal women have holistic conceptualizations of their health and SEWB that intersect with the SEWB of family and community. Women experience clusters of health problems that intersect with intergenerational trauma, perpetuated and compounded by ongoing colonial trauma including removal of children. Women are pro-active about their health but encounter numerous challenges in accessing appropriate health care. These rarely explored perspectives can inform a reframing of health and social support needs of incarcerated Aboriginal women establishing pathways for healing.

Incarcerated Aboriginal women’s experiences of accessing healthcare and the limitations of the ‘equal treatment’ principle

“…Surveys with Aboriginal women in prison across Australia show that they experience high levels of psychological distress, depression and anxiety connected to social and emotional wellbeing, such as unresolved trauma, removal from their families as children, and separation from their community [20][21][22][23]. Qualitative research evidence shows that this level of social and emotional dis-ease is not considered by Aboriginal women to be exceptional, rather it is the norm [24].…”

“…Aboriginal women in prison in NSW experience poorer health outcomes than incarcerated non-Indigenous women and Aboriginal men [20,27]. The narratives of Aboriginal women in prison in NSW centre on the trauma of removal of their children, lack of access to secure housing on release allowing them to regain access to their children, and cycles of substance use for coping with unaddressed trauma leading to their imprisonment [24,28,29]. These findings correspond with international research on the experiences of Aboriginal women in prison [30,31].…”

“…Aboriginal women in prison in NSW identify the importance and need for holistic culturally safe healthcare, housing and education for supporting Aboriginal women in prison and outside [24]. Yet, Aboriginal women (and men) in prison have restricted access to Aboriginal Community Controlled Health Organisations (ACCHOs), Aboriginal Medical Services (AMS) and governmentfunded (Medicare) health assessments available to them in the community [32].…”

“…In addition, there has been a steady critique of the lack of attention to the subjective experiences of Aboriginal women in prison [42][43][44][45]. There is a particular dearth of evidence of incarcerated Aboriginal women's unique experiences of accessing prison health services in Australia [24,29,46].…”

Working with Aboriginal young people in sexual health research: a peer research methodology in remote Australia

“…To support principles of self-determination, a number of researchers have advocated a decolonizing approach to Aboriginal health research in Australia (Bainbridge et al, 2013;Bond, 2019;Clapham, 2011;Doyle et al, 2017;Humphery, 2001;E. Kendall et al, 2011;S. Kendall et al, 2019;Martin et al, 2019;Prior, 2007;Rigney, 1999;Rowe et al, 2015;Sherwood, 2010;Walker et al, 2014;West et al, 2012;Wilkin & Liamputtong, 2010), to redress long-standing power imbalances and ensure that colonized peoples have space to lead and communicate from their own perspectives.…”