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This perspective article discusses the importance of implementing the cultural determinants of health (CDoH) in Australia's health system to address the poor health outcomes experienced by Indigenous peoples. The article emphasizes the need for power sharing, leadership by Indigenous scholars, and greater self-determination and control by Indigenous peoples in policy-making and healthcare practices. The CDoH, which are based on Indigenous knowledges and rights, are crucial for improving health and wellbeing for Indigenous peoples. The article also highlights the resistance and systemic racism that hinder the implementation of CDoH and calls for a new approach that normalizes Indigenous knowledges and cultures in public health policies and practices. [Extracted from the article]

The Medical Journal of Australia has partnered with the Lowitja Institute, Australia's national Aboriginal Community Controlled Research Institute, to release a special issue focused on Indigenous knowledges. The collaboration aims to address the lack of Indigenous perspectives in health research and publishing practices. The special issue features 12 articles that cover a range of topics related to Aboriginal and Torres Strait Islander health and wellbeing. The journal acknowledges the need to cede power and decision-making to Indigenous experts in order to improve ethical publishing practices and promote meaningful change in Indigenous health. [Extracted from the article]

There are currently no registered Aboriginal and Torres Strait Islander community controlled HRECs in Victoria, Tasmania or Queensland,[10] and there is no Torres Strait Islander controlled HREC. Keywords: Ethics committees; Ethics, research; Public policy EN Ethics committees Ethics, research Public policy 9 11 3 06/30/23 20230701 NES 230701 Growth in Aboriginal and Torres Strait Islander health research requires urgent investment in Aboriginal and Torres Strait Islander ethical governance Indigenous peoples have been conducting research to understand complex systems of knowledge since time immemorial.[1] The embodiment of principles aligned with Indigenous ways of knowing, being and doing is central to the legacy of this expert research practice. [Extracted from the article]

Australia's local, state, territory and federal governments have agreed that the 10-year life expectancy gap between Indigenous and non-Indigenous Australians will be closed by 2031. However, annual Closing the Gap reports tabled by the various prime ministers in the Australian Parliament (for the past 12 years) have consistently indicated that the life expectancy gap continues to widen. Australia has seen more than three decades of government policies since the landmark 1989 National Aboriginal health strategy. What has been missing from these policy commitments is the genuine enactment of the knowledges that are held by Indigenous Australians relating to their cultural ways of being, knowing and doing. Privileging Indigenous knowledges, cultures and voices must be front and centre in developing, designing and implementing policies and programs. The sharing of power, provision of resources, culturally informed reflective policy making, and program design are critical elements. In this paper, we provide a conceptual model of practice, working at the cultural interface where knowledges are valued and innovations can occur. This model of practice is where knowledges and cultures can co-exist, and it could be the answer to Closing the Gap in life expectancy by 2031. Despite a growing willingness and need to consider these models, there remains a deep-seated resistance to identifying and addressing institutional and systemic racism and racist attitudes, including unconscious biases held by individuals. Further, western non-Indigenous worldviews of ways of being, knowing and doing continue to dominate the decisions and actions of governments - and consequentially dominate public health policies and practices. There is an unacceptable standard approach, for and about Indigenous health instead of with Indigenous peoples, resulting in the neglectful dismissal of Indigenous knowledges and Indigenous cultures of ways of being, knowing and doing. [ABSTRACT FROM AUTHOR]

Identifying Aboriginal and Torres Strait Islander scholarship in health research No one's discussing the elephant in the room: contemplating questions of research impact and benefit in Aboriginal and Torres Strait Islander Australian health research. Assessing the quality of health research from an Indigenous perspective: the Aboriginal and Torres Strait Islander quality appraisal tool. [Extracted from the article]

The article focuses on Growing and supporting the Aboriginal and Torres Strait Islander health workforce. Topics discussed include the National Aboriginal and Torres Strait Islander Health Workforce Implementation Plan is under development, part of a refresh of the National Aboriginal and Torres Strait Islander Health Workforce Strategic Framework 2021–2031; and Aboriginal and Torres Strait Islander peoples are likely to use health services where they experience culturally safe.

Indigenous communities shoulder a disproportionate burden of ill health compounded by climate change. In Australia, the oldest surviving cultures have adapted their ecological knowledge over millennia and across climatic ages. However, European colonization has severely curtailed Indigenous peoples’ ability to adjust to climate change. An effective response to the climate crisis requires decolonizing processes to reform our relationship with the planet. From an Australian Indigenous perspective, precursors for a self-determined and healthier future are justice, culture, and relationships. We review existing studies on Indigenous-led contemporary climate and health initiatives to assess these precursors. There are examples that highlight the need to attend to issues of restorative justice as the basis for respectful valuing of culture and genuine collaboration to address the climate crisis. [ABSTRACT FROM AUTHOR]

International and population-specific evidence identifies elevated psychological distress prevalence among those experiencing interpersonal discrimination. We aim to quantify the potential whole-of-population contribution of interpersonal discrimination to psychological distress prevalence and Indigenous–non-Indigenous gaps in Australia. We did a cross-sectional analysis of data from Mayi Kuwayu: the National Study of Aboriginal and Torres Strait Islander Wellbeing. Baseline surveys were completed between June 8, 2018, and Sept 28, 2022. We analysed responses from participants who were aged 18 years or older at survey completion, whose surveys were processed between Oct 1, 2018, and May 1, 2021. Sample weights were developed on the basis of national population benchmarks. We measured everyday discrimination using an eight-item measure modified from the Everyday Discrimination Scale and classified experiences as racial discrimination if participants attributed these experiences to their Indigeneity. Psychological distress was measured using a validated, modified Kessler-5 scale. Applying logistic regression, we calculated unadjusted odds ratios (ORs), to approximate incident rate ratios (IRRs), for high or very high psychological distress in relation to everyday discrimination and everyday racial discrimination across age-gender strata. Population attributable fractions (PAFs), under the hypothetical assumption that ORs represent causal relationships, were calculated using these ORs and population-level exposure prevalence. These PAFs were used to quantify the contribution of everyday racial discrimination to psychological distress gaps between Indigenous and non-Indigenous adults. 9963 survey responses were eligible for inclusion in our study, of which we analysed 9951 (99·9%); 12 were excluded due to responders identifying as a gender other than man or woman (there were too few responses from this demographic to be included as a category in stratified tables or adjusted analyses). The overall prevalence of psychological distress was 48·3% (95% CI 47·0–49·6) in those experiencing everyday discrimination compared with 25·2% (23·8–26·6) in those experiencing no everyday discrimination (OR 2·77 [95% CI 2·52–3·04]) and psychological distress prevalence was 49·0% (95% CI 47·3–50·6) in those experiencing everyday racial discrimination and 31·8% (30·6–33·1) in those experiencing no everyday racial discrimination (OR 2·06 [95% CI 1·88–2·25]. Overall, 49·3% of the total psychological distress burden among Aboriginal and Torres Strait Islander adults could be attributable to everyday discrimination (39·4–58·8% across strata) and 27·1% to everyday racial discrimination. Everyday racial discrimination could explain 47·4% of the overall gap in psychological distress between Indigenous and non-Indigenous people (40·0–60·3% across strata). Our findings show that interpersonal discrimination might contribute substantially to psychological distress among Aboriginal and Torres Strait Islander adults, and to inequities compared with non-Indigenous adults. Estimated PAFs include contributions from social and health disadvantage, reflecting contributions from structural racism. Although not providing strictly conclusive evidence of causality, this evidence is sufficient to indicate the psychological harm of interpersonal discrimination. Findings add weight to imperatives to combat discrimination and structural racism at its core. Urgent individual and policy action is required of non-Indigenous people and colonial structures, directed by Aboriginal and Torres Strait Islander peoples. National Health and Medical Research Council of Australia, Ian Potter Foundation, Australian Research Council, US National Institutes of Health, and Sierra Foundation. [ABSTRACT FROM AUTHOR]