Interrogating the intentions for Aboriginal and Torres Strait Islander health: a narrative review of research outputs since the introduction of Closing the Gap

Abstract

ince the 2005 Social Justice report criticised the Australian Government for not addressing the inadequate life expectancy of Aboriginal and Torres Strait Islander people, national efforts have been made towards closing the gap between Aboriginal and Torres Strait Islander people and non-Aboriginal Australians. The then Social Justice Commissioner, Professor Tom Calma AO, made three recommendations to address equality in life expectancy: i) a government commitment to achieving equality in health status in 25 years, ii) equality in access to primary care and health infrastructure, and iii) bipartisan support for this commitment. 2 Improvements in age-standardised mortality rates of about 10% have been observed for Aboriginal and Torres Strait Islander people since 2006, but similar improvements have occurred for non-Aboriginal Australians. 3 Therefore, Australia has fallen short of the federal government's targets to close the gap in disproportionate health outcomes and life expectancy for Aboriginal and Torres Strait Islander people. 3 In the Prime Minister's 2020 Closing the Gap statement to Parliament, he reported "despite the best of intentions; investments in new programs; and bi-partisan goodwill, Closing the Gap has never really been a partnership with Indigenous people". 4 The "best of intentions" for Closing the Gap has been widely questioned in academic literature 5,6 and mainstream media, 7,8 including highlighting the lack of Aboriginal and Torres Strait Islander peoples involvement in decision-making processes 9 and acknowledgement of Aboriginal Community Controlled Health Services as exemplars of best practice in providing holistic health care to Aboriginal and Torres Strait Islander people. 10 Over the past 12 years, the reported "investments in new programs" funding has fluctuated, 11,12 highlighting resources as finite. The Closing the Gap framework identifies the need for research and evaluation to inform effective policies, 13 with calls for increased research in urban settings 14 and to evaluate evidence-based practices, policy and programs. 6 Early research also explored the extent to which the policy changes informed new models for research conduct. 15 In 2021, with a reformed agenda for Closing the Gap now established with Aboriginal and Torres Strait Islander people represented by their community-controlled peak organisations, the Coalition of Peaks 16 -an Aboriginalled research team -felt it timely to interrogate the intentions for Aboriginal and Torres Strait Islander health through a critical review of research outputs since Closing the Gap was established in 2008.Providing an overview of Aboriginal and Torres Strait Islander health research since 2008 allows for an examination of the scope and characteristics of the knowledge base to inform evidencebased practices, policies and programs. To date, no review of Indigenous health research outputs have described the scope and characteristics of the research, most notably the burden of disease focus or the research designs being im...

Murru Minya–informing the development of practical recommendations to support ethical conduct in Aboriginal and Torres Strait Islander health research: a protocol for a national mixed-methods study

“…Potential participants will be identified through publications in Aboriginal and Torres Strait Islander health using publicly available contact information listed on publications. The publications are based on publications in Aboriginal and Torres Strait Islander health reported in a recent review, 38 from 2015 to present. The survey will also be promoted through peak partnerships such as the Lowitja Institute, NHMRC, AH&MRC, and the research team’s networks and social media channels encouraging all researchers working in Aboriginal and Torres Strait Islander health research to participate.…”

Decolonising qualitative research with respectful, reciprocal, and responsible research practice: a narrative review of the application of Yarning method in qualitative Aboriginal and Torres Strait Islander health research

“…A primary scoping review was conducted of all Aboriginal and Torres Strait Islander health research published since the establishment of the Closing the Gap campaign [ 21 ]. This parent review included 2,150 articles and is published elsewhere [ 22 ]. When conducting this review, the authors sought to extract information on the reported use of Indigenous research methodologies and found 5% of articles reported using Indigenous methodologies and/or methods.…”

From Deficit to Strength-Based Aboriginal Health Research – Learning from those Who Flourish

“…The broader body of Aboriginal health research and literature is difficult to quantify, and reflects huge investment of time and resources, but also an inability to facilitate outcomes leading to sustained wellbeing [4,74] and a certain myopia regarding the big picture of Aboriginal health and wellbeing. For example, on the one hand, the volume of literature on Aboriginal resilience is encouraging and suggests -arguably valorises -the strength of Aboriginal people [46][47][48].…”