Table 1 Cultural determinants and impact on the health and wellbeing of Aboriginal peoples
First Author [reference number] Year | Family/community | Country and place | Cultural identity | Self-determination |
|---|---|---|---|---|
Berry [21] 2010 | Unknown yet whether community-led caring-for-Country projects could produce both benefits for country and personal empowerment | Greater physical activity (associated with caring-for-country projects) is linked to better mental health directly and because it improves physical health, itself strongly linked to mental health [30, 31] | Caring for Country could support connectedness to identity and generate powerful co-benefits for social and emotional wellbeing | To reduce the current preventable burden of disease, we must address lack of control as one aspect of a broader experience of Aboriginal powerlessness [5, 32] |
Burgess [22] 2005 | Cohesion with kin, ancestors and geography are all important factors in the formation of collective esteem and efficacy [33, 34] | Engagement with Country provides opportunities for physical activity, improved diet as well as boosting individual autonomy and self-esteem [35, 36] | “Our identity as human beings remains tied to our land… Destroy this relationship and you damage – sometimes irrevocably – individual human beings and their health” [37] | Renewed ties to Country can form the basis of reinvigorated governance and can develop a sense of autonomy and mastery over life [38, 39] |
Salmon [23] 2018 | Social support, in the form of community affection, is a strong determinant of health for Aboriginal women [40] | Caring for country has benefits for the socio-political, cultural, economic, and physical and emotional wellbeing of Aboriginal peoples [22, 41,42,43,44,45] | Culture is critically important – it is the central core of Aboriginal child health and wellbeing | Leadership is critical to the long-term survival and growth of Koori [Aboriginal people from New South Wales and Victoria] communities [46] |
VicHealth [24] 2011 | Family and kinship networks and community connections can promote health and can be harmful to health [47] | Programs that involve Aboriginal Natural and Cultural Resource Management are associated with lower levels of risk factors for CVD and diabetes and improved self-esteem [48] | Caring for Country appears to be linked to improved identity and is recommended as a means to improving health [49] | A requirement for reversing colonisation is self-determination. Self-determination helps people restore control over their lives and destinies |
Weir [25] 2011 | Not reported | Caring for Country has benefits for individual health and wellbeing, and the health of communities | A relationship between identity, autonomy and wellbeing and caring for Country [48] | Control over life is an important determinant of wellbeing [50] |
Dahlberg [26] 2018 | Family determines a child’s level of activity and type of sport they practice [51, 52] | A big emphasis is placed on physical and social environment when it comes to physical activity | Evidence of the positive impact in the strong sense of collective identity and pride that is experienced when part of a team [51] | Not reported |
MacLean [27] 2017 | Welcoming extended family members to attend antenatal care and childbirth supports the expression of cultural identity and can decrease perinatal morbidity [53] | Activities on Country can be used to improve health [54] | Programs that include components to enable and support Aboriginal peoples to express cultural identity can have positive health and wellbeing effects | Not reported |
Behrendt [28] 2017 | Not reported | It is not possible to conceive of Aboriginal health determinants without appreciating the inseparable connection between wellbeing and Country | Valuing Aboriginal knowledge and cultural beliefs and practices is necessary for positive cultural identity and social and emotional wellbeing [55] | A link between self-determination and improved health and wellbeing; however, demonstrating this link can be challenging [55] |
Ypinazar [29] 2007 | Family is considered pivotal to emotional, physical and cultural health [56] | Not reported | A positive sense of identity is connected to individual and community wellbeing [56, 57] | Not reported |