How racism impacts Indigenous health

In April, the director of the US Centre for Disease Control, Dr Rochelle Walenksy, declared racism was a serious public health threat to her nation.

After acknowledging that the COVID-19 pandemic had claimed more than 500,000 lives in the US, Dr Walenksy made the point that a disproportionate number of COVID cases and deaths had occurred in communities of colour.  

“Yet, the disparities seen over the past year were not a result of COVID-19,’’ she said. “Instead, the pandemic illuminated inequities that have existed for generations and revealed for all of America a known, but often unaddressed, epidemic impacting public health: racism.’’

 

This week, Australian researchers revealed the toxic link between racism and the health and well-being of Aboriginal and Torres Strait Islander adults. The landmark national study involved more than 8000 participants from the national Indigenous-led Mayi Kuwayu Study, which includes support from philanthropic partners Gandel Philanthropy and The Ian Potter Foundation.

The results showed a consistent link between racism and poor mental health, physical health and cultural well-being. Research Associate at the ANU College of Health and Medicine, Roxanne Jones – a Palawa woman – and one of the study’s authors, says: “The everyday experience of discrimination has an impact on a whole heap of [negative] outcomes.’’

And those outcomes include pain, poor life satisfaction, psychological distress, anxiety, depression, heart disease, high blood pressure, high cholesterol and diabetes.

Almost six in 10 of the study participants reported having experienced discrimination in their daily life. Four out of 10 participants said they were treated with less respect than other people and the same proportion reported that “people act like I am not smart.’’

Younger participants, female and those living in remote parts of the country more commonly reported instances of discrimination.

“With the older generation, it may be that racism has become normalised and therefore there are less recording of those instances, so that doesn’t mean older people aren’t experiencing that discrimination,’’ Roxanne says.

The detailed research represents a significant milestone, both in its evidence and in the way the data was sourced and then collated. Roxanne explains that Mayi Kuwayu brought together a small team who spent some years talking to more than 25 communities about how best to structure the study to ensure it was relevant to those communities and best captured their experiences.

The study was then several years in development and was tested against Aboriginal and Torres Strait Islander governance guidance. The final study, published in the International Journal of Environmental Research and Public Health, has one telling conclusion: “There is a clear need to reduce experiences of interpersonal discrimination for Aboriginal and Torres Strait Islander peoples. The impacts of interpersonal discrimination need to be considered within the broader system of racism, including the interrelated and reinforcing influences of systemic and structural racism, including their impacts on social determinants of health.’’

The evidence is expected to inform a national policy agenda, and potentially become part of the annual Closing The Gap monitoring of Aboriginal and Torres Strait Islander health and life expectancy.

But as Roxanne explains it, the evidence will also go back to the source communities so they can use it for their own advocacy campaigns.

“We do need to get Aboriginal and Torres Strait Islander academics in this space to look at the evidence and to establish some priority setting within our networks,’’ she says. “We need to sit together as a group to set those priorities…[and] it’s important to have that collective voice.’’ 

Kungarakan Elder and Iwaidja tribal group member Professor Tom Calma AO, Chancellor of the University of Canberra and a study co-author, says; “Unfortunately these [study] results will be no surprise to Aboriginal and Torres Strait Islander people across the nation, but we hope the findings can be used to advocate for support for program and policy approaches to eliminate racism.’’

And one step towards that could be an official acknowledgement in Australia echoing the US declaration that racism was a public health threat.

The Gandel Philanthropy grant is supporting the Victorian and Tasmanian segments of the Mayi Kuwayu study, by funding the employment of two local community researchers as on-the-ground contacts to work with local communities. Their work will help maximise engagement and contribute to the impact of the study, especially for Victoria and Tasmania. Ray Lovett, the Mayi Kuwayu Study leader, said: “It’s really important for this study to use existing local networks in the community. It gives us an opportunity to provide training and employment, to gain an understanding of local issues, and to have a trusted means of communicating the information we receive back to those very communities.”

The Ian Potter Foundation Public Health Grant was awarded to support a community outreach researcher to increase community participation and engagement, including reporting back to communities with meaningful findings, to ensure communities are benefiting from their participation; a crucial step so often missed in studies with Aboriginal and Torres Strait Islander peoples. The Ian Potter Foundation five-year grant, with a funding match from the Australian National University, has enabled the Study to appoint Wiradjuri woman Makayla-May Brinckley as an Indigenous Postdoctoral Fellow in the Aboriginal and Torres Strait Islander Health Program, to advance the Study’s work on getting the results from Mayi Kuwayu back into the community and into the policy space.

The Mayi Kuwayu team is very grateful for the philanthropic partnerships with independent bodies like Gandel Philanthropy and The Ian Potter Foundation, who recognise the long-term impact of the Study to provide meaningful evidence to improve policies and programs; and empowering communities with evidence and knowledge to improve their health and wellbeing.

If you would like to learn more or get involved, please contact: Claudia Santangelo, Development Manager, ANU College of Health and Medicine.
M: +61 432 464 664 E: claudia.santangelo@anu.edu.au

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