“In Their Own Voice”—Incorporating Underlying Social Determinants into Aboriginal Health Promotion Programs

Shannen Vallesi, Lisa Wood, Lyn Dimer and Michelle Zada
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Shannen Vallesi: School of Population and Global Health (M431), The University of Western Australia, Crawley, WA 6009, Australia
Lisa Wood: School of Population and Global Health (M431), The University of Western Australia, Crawley, WA 6009, Australia
Lyn Dimer: Heart Foundation WA Division, Subiaco, WA 6008, Australia
Michelle Zada: Heart Foundation WA Division, Subiaco, WA 6008, Australia

IJERPH, 2018, vol. 15, issue 7, 1-15

Abstract: Despite growing acknowledgement of the socially determined nature of health disparities among Aboriginal people, how to respond to this within health promotion programs can be challenging. The legacy of Australia’s assimilation policies have left profound consequences, including social marginalisation, limited educational opportunities, normalisation of premature death, and entrenched trauma. These social determinants, in conjunction with a reluctance to trust authorities, create barriers to accessing healthcare services for the prevention, treatment, and rehabilitation of chronic disease. The Heart Health program is a culturally sensitive cardiac rehabilitation program run at the local Aboriginal Medical Service in Perth, Western Australia that has since moved beyond cardiac education to provide a holistic approach to chronic disease management. A participatory action research framework was used to explore Heart Health participant and service provider perspectives on the barriers, enablers, and critical success factors to program participation and behaviour change. Thematic analysis of interview transcripts was undertaken, and through yarning (Aboriginal storytelling) sessions, many participants made unprompted reference to the impacts of white settlement, discrimination, and the forced fracturing of Aboriginal families, which have been explored in this paper reiterating the need for a social determinants lens to be taken when planning and implementing Aboriginal health promotion programs.

Keywords: Aboriginal and Torres Strait Islander; social determinants of health; cardiac rehabilitation; health promotion program; Indigenous; chronic disease management; cultural competence; cultural safety (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2018
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