Credit: Steve Evans

More than a decade after committing $130+ billion to Closing the Gap, there has been little improvement in health outcomes experienced by Aboriginal and Torres Strait Islander populations.

A significant life expectancy gap remains, with the leading cause of death for Aboriginal and Torres Strait Islander , responsible for almost 20 per cent of this gap.

So where have things gone wrong?

A new study led by University of South Australia Ph.D. candidate Katharine McBride in partnership with Aboriginal women suggests the answer may lie partially in the Government's failure to approach health from an Aboriginal perspective.

"Current strategies to address disease in Aboriginal and Torres Strait Islander communities are framed within a western context and focus on bad behavior and a deficit approach," McBride says.

"These policies fail to take into account the unique world view of our first nations women, centered on spirit, culture and community."

The study explored the perspectives of 28 Aboriginal women from five different communities across central and southern Australia, with the work overseen by an Aboriginal Women's Advisory Group. Via yarning circles, women identified 10 attributes which either kept their heart strong or put it at risk, and the drivers of these.

"Identity as an Aboriginal woman, having a healthy body and life, connectedness within family and community and health knowledge all strengthen the heart, according to the Aboriginal women in our study. Stress, grief, racism, and financial hardship were recognized as weakening the heart."

The government's strategy, focusing solely on clinical and behavioral cardiovascular risk factors, fails to recognize the Aboriginal conceptualisation of health which is centered on strength, resilience and connectedness, according to McBride.

The research team, which included Aboriginal women with lived and professional experience of , recommends a new model of delivery and care in partnership with Aboriginal and Torres Strait Islander women and communities.

"Aboriginal women are leaders and nurturers of community. They have described what is needed to have a healthy heart; hopefully the government will heed the message," McBride says.

Her paper, titled "Good Heart: Telling Stories of Cardiovascular Protective and Risk Factors for Aboriginal Women," is published in Heart, Lung and Circulation.

More information: Katharine F. McBride et al, Good Heart: Telling Stories of Cardiovascular Protective and Risk Factors for Aboriginal Women, Heart, Lung and Circulation (2020). DOI: 10.1016/j.hlc.2020.09.931