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Aboriginal and Torres Strait Islander people must help lead research into Indigenous health issues to help ensure the closing of the gap, researchers say.
Currently, Australia has fallen short of federal targets to Close the Gap.
Aboriginal and Torres Strait Islander males born between 2015 and 2017 are expected to live to 71.6 years (here), while non-Indigenous males are expected to live to 80.2 years.
Aboriginal and Torres Strait Islander females are expected to live to 75.6 years, while non-Indigenous females are expected to live to 83.4 years (here).
The National Health and Medical Research Council (NHMRC) Principal Committee Indigenous Caucus chair, Professor Yvonne Cadet-James, has told InSight+ it is important to determine not just whether enough Indigenous health research is being funded, but who is conducting the research as well.
“[Funding] needs to happen if we need new knowledge and discoveries,” Professor Cadet-James said.
“When I started out in research in the early 2000s, there were very few indigenous researchers leading grants, or as chief investigators.
“That’s changed over time, with the NHMRC, MRFF [Medical Research Future Fund], and the ARC [Australian Research Council] having funding allocated for Indigenous research.
“And of course, the Lowitja Institute, which is the national Indigenous research institute.”
But Professor Cadet-James said that the way the research is done is the most important element in its success.
“As Aboriginal and Torres Strait Islander people we understand the historical, cultural and political perspectives, and that understanding helps us frame our research,” she said.
“[We have] insight into the difficulties in conducting that research due to the impact of colonisation.
“The real, on-the-ground needs, and what people are experiencing in terms of the social determinants of health, including poverty.”
“Most importantly, [we have] insight into the strength and resilience that people have in their cultural values and beliefs, in their traditional knowledge, and the resilience they’ve built over all those years,” said Professor Cadet-James.
Professor Cadet-James said that the important new research areas are genetics and genomics, but that First Nations input is crucial.
“We need to make sure that we’re involved, and that we have some very experienced researchers,” she said, pointing to the research of Professor Alex Brown and Professor Misty Jenkins as an example.
“As you know, people in research haven’t had a good a very good reputation in terms of taking tissue and blood samples , and conducting experiments on Aboriginal and Torres Strait Islander people. So, we have input into guidelines and how that research might look. And making sure that people are protected,” said Professor Cadet-James.
First Nations people driving research solutions
In a recent Medical Journal of Australia article, the Lowitja Institute CEO, Adjunct Professor Janine Mohamed, and executive manager of research and knowledge translation, Associate Professor Michelle Kennedy, explained the importance of ethics in research design.
“Indigenous peoples have been conducting research to understand complex systems of knowledge since time immemorial,” wrote Adjunct Professor Mohamed and Associate Professor Kennedy.
“Since colonisation, Aboriginal and Torres Strait Islander peoples have been subject to ongoing unethical and inhumane research.
“In an attempt for protection, Aboriginal and Torres Strait Islander people have acted swiftly and led the prioritisation, consultation, development and consensus of specific ethical guidance and principles,” they wrote.
“But little investment has been made to uphold the ethical principles and practices established for and by Aboriginal and Torres Strait Islander people.”
Changing perspectives to close the gap
In 2018, the Australian Human Rights Commission released Close the Gap: 10 Year Review, showing that Australian governments “have not succeeded in closing the health gap,” and arguing that the current course will need to change.
Two of four of its recommendations are for an investment in Aboriginal and Torres Strait Islander-led, community-driven data development, and an Aboriginal and Torres Strait Islander-led health research agenda, including investment in knowledge translation and research impact.
Assistant Minister for Indigenous Australians and Indigenous Health, Senator Malarndirri McCarthy, told InSight+ that working alongside talented and expert researchers provides an important opportunity.
“NHMRC-administered research projects engage directly with Aboriginal and Torres Strait Islander communities,” Assistant Minister McCarthy said in a statement.
“Many studies are led by prominent First Nations health researchers with cultural insight and specialist knowledge.”
The Lowitja Institute 3rd International Indigenous Health and Wellbeing Conference will be held this week, with leading researchers from around the world meeting to discuss implementing First Nations-led health research.
Professor Cadet-James is pleased to be attending the conference.
“What we need to do now is really strengthen the capacity of Aboriginal and Torres Strait Islander people in different health-related organisations and in our communities,” she said.
I too believe that Aboriginal researchers must be involved in Aboriginal health research. Nowadays, with more and more Indigenous persons entering tertiary education, this will happen a lot more in future years,
However, let us not overlook the work of the Lowitja Institute which, as hinted in this InSight article is an Aboriginal and Torres Strait Islander community-controlled organisation working for the health and wellbeing of Australia’s first Nations people through high-impact quality research, knowledge exchange, and by supporting a new generation of Aboriginal and Torres Strait Islander health researchers.
Let me draw your attention to an article that appeared in a 2015 edition [July, 6(3), pp 201-206] of the Journal of Community Genetics, authored by Minaya, G. and G. Rogue and titled ‘Ethical problems in health research with indigenous or originary peoples in Peru’. The following is an extrac from that article
Indigenous peoples have been promoting research by developing their own proposals, taking into account participatory and/or emancipatory approaches. It allows them to conduct their own research and make them less vulnerable (Justo 2004). For instance, it is worth to mention the following policy developed by the Kuna, Maori peoples and the new Nations of Canada:
The Ethnic Kaupapa Maori from New Zealand have been developing research inspired by the traditional Maori philosophy and participatory action research theories in accordance with Freire (1973). Based on his words: “The methodology we are defending requires that, in the research course, both investigator and research subject become subjects of research itself”, and in addition, he explained that “research…has also this fundamental dimension to its meaning and safeguard: the critical presence of representatives of the people, from its beginning to its final phase, which implies that the thematic analysis continue in the organization of the program content of educational action to become a liberating cultural action” (Freire 1973). The vision of Kaupapa Maori focuses on strong educational actions at the university level, including the training of technicians. Then, the Maori have under their control all stages of the research in the field of science and technology. As a result, their participation involves the determination of research priorities, the methodology design to be used, applicable ethical standards, criteria for peer review and publication, evaluation of the results in relation to the research objectives and the translation of these results into integrating evidence-based research with policy and practice. As a consequence, the Kaupapa Maori ethnic group has been developing “internal” mechanisms and methodologies, which comprise the criticism of “traditional” methods in research by implementing a research for Maori, with Maori and by Maori (Tuhiwai Smith 1999).
In the same way, in the First Nations in Canada, the development of research benefits included ownership, control, access and possession (OCAP), as well as their related areas, such as dissemination and publication of research findings (Schnarch 2004). Ownership refers to the relationship between the First Nations and their knowledge, data and cultural information. Control covers the whole research process by the First Nations and involves the management of the resources, review, the conceptual frameworks formulation and data handling, among other aspects. Access implies that they have the right to access all related information which concerns them, regardless of the place where it is stored. And, possession refers to the availability of data and information, which must be in the hands of the First Nations.
A loong reply but one that I hope persons will find interesting
Having followed the area of Aboriginal history for years I have found little or no recent publications mentioning the detailed works of Gillen and Spencer and Howitt . It seems to me that such primary sources are essential to any research projects both sociological and medical(my area).