Decolonizing Indigenous health

Generating a productive dialogue to eliminate Rheumatic Heart Disease in Australia

Datos Bibliográficos

ID4598993
AutoresEdgar Haynes (0000-0001-8017-9423, The University of Western Australia, autor de correspondencia), Roz Walker (0000-0002-3140-7036, The University of Western Australia), Alice G Mitchell, Alice Mitchell (0000-0001-5643-4201, Charles Darwin University), Judy Katzenellenbogen (0000-0001-5287-5819, The University of Western Australia), Heather D''Antoine, Heather D’antoine (Charles Darwin University), Heather D'Antoine, Dawn Bessarab (0000-0002-9716-1593, The University of Western Australia)
Año2021
Volumen277
Páginas113829
Fecha de publicación2021-05-01
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaSocial Science & Medicine (JOURNAL)
Identificadores de la revistaISSN: 0277-9536 • E-ISSN: 1873-5347
EditorialElsevier BV (PUBLISHER)
DOI10.1016/j.socscimed.2021.113829
PMID33895707
OpenAlexW3135045445
IdiomaEN
Citas recibidas12
Referencias citadas58

In common with colonized Indigenous people worldwide, many Australian Aboriginal people experience inequitable health outcomes. While the commitment and advocacy of researchers and health practitioners has resulted in many notable improvements in policy and practice, systemic and structural impediments continue to restrain widespread gains in addressing Indigenous health injustices. We take Rheumatic Heart Disease (RHD), a potent marker of extreme health inequity, as a case study, and critically examine RHD practitioners' perspectives regarding the factors that need to be addressed to improve RHD prevention and care. This study is an important explanatory component of a broader study to inform new clinical practices, and health system strategies and policies to reduce RHD. A decolonising, critical medical anthropology (CMA) analysis of findings from 22 RHD practitioner in-depth interviews conducted in May 2016 revealed both practitioners' perceptions of health system shortcomings and a sense of hopelessness and powerlessness to transform existing health system inequities, the negative impacts of which were subsequently confirmed in a separate study of RHD patients' lived realities. We reveal how biomedical dominance, normalized deficit discourses and systemic racism influence the current policy and practice landscape, narrowing the intercultural space for productive dialogue and reinforcing the conditions that cause disease. To counter biomedical approaches that contribute to existing health inequities in health care, we recommend localized, strength-based, community-led research projects focused on actions that use critical decolonizing social science approaches to achieve system change. We demonstrate the importance of integrating biological and social sciences approaches in research, education/training, and practice to: 1) be guided by Indigenous strengths, knowledges and worldview, and 2) adopt a critical reflexive stance to examine systems, structures and practices. Such an approach facilitates productive cross-cultural dialogue and social transformation; providing direction and hope to practitioners, enhancing their knowledge, skills and capacity and improving Aboriginal health outcomes

Biology · Cardiology · Coronary heart disease · Disease · Heart disease · Indigenous · Sociology · Indigenous Health, Education, and Rights · Infective Endocarditis Diagnosis and Management · Medicine · Musculoskeletal Disorders and Rehabilitation · Internal Medicine