Motivation and emotion/Book/2021/Indigenous Australian well-being

Overview
How do you define your own wellbeing? Wellbeing is complex because it is highly reflective of our cultural context. But, in its most simplistic form, wellbeing is the thoughts, beliefs, attitudes, and behaviours that, if engaged in, promote personal wellness. The wellbeing of Australian Indigenous populations similarly involves a complex and highly diverse interplay of social, environmental, and cultural factors. However, there are notable differences in expression, primarily that Indigenous Australian wellbeing is holistic. When these holistic needs are not being satisfied, it causes suffering.

In 1979, the Australian House Standing Committee on Indigenous Affairs noted that in the "Release of reports reflecting the poor state of Indigenous well-being is historically followed with outrage and shock, calling for immediate attention. However, these reports tend to have no real impact and the appalling state of Indigenous well-being is soon forgotten"; or at least until the next report. The same sentiment is still felt today and Indigenous wellbeing continues to suffer.

This chapter explores wellbeing in the context of Indigenous Australia, critically analysing why wellbeing is poorer in Indigenous Australian populations, and concludes with a segment proposing new ways towards achieving wellbeing based on Indigenous-led recommendation and empirical research.

 The Wilandra Lakes region in NSW is home to Australia's famous "Mungo Man" (see Figure 1), a forensic anthropological find in 1974. A week of torrential rain loosened the dirt around Mungo Lake lunette revealing Australia's oldest human remains and caused a stir in scientific circles. This find wasn't just significant for the scientific community; it was one of many finds which indefinitely prove Indigenous Australian land ownership, building a file of evidence to overturn [https://www.fedcourt.gov.au/digital-law-library/judges-speeches/justice-jagot/jagot-j-20171020#:~:text=Terra%20nullius%20means%20%22nobody's%20land,no%20one%20owns%20is%20legitimate. Terra Nullius]. It placed Indigenous Australians a step closer to native rights and helped prove that 1788 was an invasion, not a colonisation. Mungo man reminds modern Australians that Indigenous culture is a large part of Australia's collective identity; an identity to protect and one such identity currently under threat by poorer wellbeing.

What is wellbeing for Indigenous Australia?
The Oxford dictionary defines wellbeing as "The state of being comfortable, healthy, & happy". Nevertheless, wellbeing can be a challenging concept to define due to its cultural variation. Some consider wellbeing to encompass experiencing a high Quality of Life (QoL) operationalised by a variety of outcomes such as mental health, community connection (see Figure 2), and even level of pain. However, this chapter looks at wellbeing through the scope of Indigenous contexts, and therefore wellbeing is considered to encompass a holistic framework. Holistic wellbeing includwa physical, mental, emotional, spiritual, and social wellbeing of an individual. This model is not only empirically supported, but its five dimensions best fit a traditional Indigenous Australian lifestyle. The holistic nature of indigenous wellbeing demands a community-centred approach across the lifespan, a place on country, and traditional knowledge (Department of Health, 2013 ). Historical evidence suggests that prior to invasion, Indigenous Australians were free of illness such as heart disease, hypertension, obesity, and mental illness. Significant historical events such as the stolen generation and genocides, have resulted in transgenerational trauma, and while Indigenous wellbeing is attainable, Australia has a long way to go before reaching wellbeing equality. Therefore, Indigenous wellbeing should follow Indigenous ways of knowing, being, and doing, embodying the five dimensions of holistic wellbeing.

Aboriginal health does not mean the physical wellbeing of an individual but refers to the social, emotional, and cultural wellbeing of the whole community. For Aboriginal people, this is seen in terms of the whole-life-view -

Test your knowledge! {_______ is a dimension of holistic wellbeing:} - Religiosity - Community connection + Spiritual - Mental illness

{_______ trauma has played a role in poor wellbeing for Indigenous Australians} - Postgenerational + Transgenerational - Perigenerational - Antigenerational

{Sam feels connected to her community and her faith. Sam probably experiences good ______ and ______ wellbeing} - Physical, spiritual - Physical, mental - Spiritual, mental + Social, Spiritual

The Indigenous wellbeing crisis


A multitude of contemporary and historical factors have created a wellbeing crisis in Indigenous Australian communities. For example, the mortality rate of Indigenous Australians is at least 10 years less than for non-Indigenous counterparts. Mental illness and substance abuse accounts for 19% of Indigenous Australian mortality. Mental illness is a primary concern, with over 3,000 Indigenous Australian deaths per year as a result of suicide. Moreover, Australia's Indigenous male youth have the highest rate of suicide in the world. These extreme rates of mental illness are incredibly alarming and can be attributed to poor holistic wellbeing. Drug-related problems (see Figure 3) are concerning, with children as young as 12 having been exposed to class A drugs, subsequently increasing the risk of contracting HIV and Hepatitis C. Mental illness and substance abuse are closely followed by injuries (15%) and cardiovascular diseases (12%) as causes of deaths, contributing to a mortality rate three times higher than non-Indigenous populations.

Part of what makes this wellbeing crisis difficult to target is that wellbeing is tied to living on country, which often requires a degree of remoteness. However, this remoteness makes optimal health and education difficult to achieve (see case study: Wilcannia). At the same time, growing urbanisation increases health disparities, due to a lack of connection to culture. So while remoteness plays a role in health inequality, urban living is often just as detrimental.

Finally, incarceration rates among Indigenous populations are at record numbers. Indigenous Australians make up 3.3% of the total Australian population, but account for 27% of incarcerationed Australians. This rate is reflective of the innumerable wellbeing risk factors correlating with justice-involvement. Therefore, it is entirely conceivable that incarceration contributes to the growing gaps in wellbeing among Indigenous Australian's. Shepard and colleagues assessed this incarceration gap finding that educational attainment was positively correlated with lower incarceration. This study also reported a correlation between substance abuse and incarceration, supporting a link between substance use, education and jail time. More alarming studies revealed that 48% of all juveniles in detention were Indigenous, which was also linked to lower education and remoteness. Education's link to poorer wellbeing is discussed further in the next section.

Since 2004, the number of Aboriginal people in custody has increased by 88% compared to a 28% increase for non-Aboriginal Australians.

 Wilcannia is a small Australian town situated in North Western NSW. The town is roughly 74% Indigenous, primarily from the Barkindji nation. Even in 2021, Wilcannia is still a 'segregated' town; Indigenous community members living on its outskirts, despite being an ethnic majority in the township. It comes as no surprise, then, that wellbeing in Wilcannia has been suffering for a number of decades. The 2016 census revealed the average life expectancy of a Wilcannian male to be 37 years. High mortality rates are attributed to otherwise easily treatable pathologies such as heart attacks and nutritional diseases. Wilcannia also has a high crime rate. In the 2006 census, Wilcannia reported 95.3 domestic violence assaults per 1000. In comparison, neighbouring town Menindeehas rates of 26.0.

Wilcannia demonstrates the wellbeing statistics of a third-world country but is less than 800km from Australias capital, Canberra. Wilcannia is an illustrative example of the wellbeing crisis referred to in this chapter.

Social determinants of wellbeing
On average, Indigenous Australians live shorter, and typically, unhealthier lives. But why is this the case? In exploring various barriers, it is clear that social determinants of health (SDoH) pose major hurdles for the wellbeing of Indigenous Australians. SDoH include access to education, economic stability, neighbourhood factors, as well as social and community contexts. This section explores education, economics through the class system, and finally, prejudice in social contexts.

Prejudice and classism


Prejudice is holding assumptions about a particular individual based on their membership to a specific group. Often, prejudice is associated with privilege and class. Ongoing salient prejudices held against Indigenous Australian's are responsible for the development of damaging stereotypes. Common stereotypes such as “All Indigenous people are ‘lazy’ or ‘violent’ ”, create what is known as self-fulfilling prophecies, damaging mental and emotional wellbeing. Such attitudes subsequently prohibit social change as a proportion of non-Indigenous Australians simply don't believe in equal rights. The Victorian Attitudes of Race and Cultural Diversity (VARCD) & the Localities Embracing and Accepting Diversity (LEAD) surveys reported that young adults are aware of their privilege and associated prejudices, but demonstrate a reluctance to reflect or make reparations. Moreover, 9 to 13% of non-Indigenous Australians believed Aboriginals were an inferior race. What is incredibly concerning is that these figures are escalating. For example, in 2008, approximately 9% of Indigenous Australian's believed they themselves were inferior to non-Indigenous Australians, and in 2014, this figure had increased to 19%.

Classist attitudes are similarly important, particularly when assessing where prejudice is geographically potent. Income and education are correlates of prejudice. Tolerant attitudes tend to be higher in upper middle classes; those with higher income and education. Therefore, people with higher education are more likely to recognise wellbeing inequities and act accordingly, for example, reflecting on their privilege (VARCD, 2013). An important distinction is that lower socioeconomic status (SES) populations tend to live in rural and remote parts of Australia, like their Indigenous counterparts. So it comes as no surprise that some of the worst Indigenous wellbeing outcomes are geographically correlated with lower non-Indigenous SES households. Studies report that working-class Australians generally endorse a more ideological disposition of society, aligning more with right-wing authoritarianism (RWA). This attitude is consistent with higher prejudice and racism in remote areas (see Figure 4), where towns are often segregated into "white and black", even when the ethnic majority is Indigenous (see case study: Wilcannia). These findings are significant because they highlight a fundamental attitudinal barrier to better wellbeing; that classist attitudes foster prejudice, facilitating further community divide and overall poorer wellbeing.

Independent skills task 1: There are innumerable SDoH contributing to the wellbeing crisis. Using the resources here, address two or more additional determinants of poor Indigenous wellbeing.

Education
Poorer education is experienced by those who live rurally, regardless of ethnicity. Although, poorer education has vastly different implications for Indigenous communities. For example, we know that poorer education fosters RWA and ideological attitudes of a 'white' Australia. But poorer education in Indigenous communities doesn't directly result in racism, rather it impacts overall wellbeing through decision making. In the case that Indigenous children receive poor or no education, making educated choices on health outcomes becomes less likely, and ultimately poor choices, like substance abuse, become norm driven. Across Australia, drop-out rates are incredibly high, a Closing the Gap report indicating that remote and very remote communities have a 20% and 30% discrepancy between Indigenous and non-Indigenous school attendees. What highlights the desperate need for better school attendance is that education can improve life expectancy by up to 12 years. But, it is not as simple as informing Indigenous youth on the risks of drugs, sex, and alcohol. Rather, evidence demonstrates that Indigenous communities benefit greatly from traditional education, for example, teaching traditional land practices (see case study: Looking forward by looking back).

Schemes in Indigenous wellbeing


It is clear that the wellbeing of Indigenous communities is in crisis, and although there have been many steps towards improving their wellbeing, such as Closing the Gap interventions, there is still a long way to go. In contemporary Australia, programs are often developed to improve Indigenous wellbeing by applying frameworks with a modern psychology framework. Psychological theories are useful in many cases because they encompass many aspects of the human experience. However, while psychological frameworks can be moulded to 'fit' Indigenous needs, they inevitably apply rigid notions of wellbeing to populations that are incredibly fluid.

An alternate solution to supporting these communities would be to implement programs that support living on country. The benefits of living on country can have an invaluable impact on Indigenous wellbeing. Increasing urbanisation is linked to decreased wellbeing in Indigenous communities, and living on country has long been identified as a fundamental component of Indigenous wellbeing. Particularly because it enables full engagement in all five dimensions of wellbeing. This is in contrast to a previously held rigid ideology of holistic wellbeing, which better suits individualist cultures (see Figure 5). Geography raises considerable concern because it is often associated with poor access to health services, among other vital wellbeing contributors. However, initiatives designed to purposefully to return Indigenous populations back to country have demonstrated utility. A prime example of this is 'The Indigenous Protective Areas scheme' (IPA), which supports Indigenous communities in managing their land for conservation purposes.

Indigenous Protective Areas scheme

Developed in 1996, the IPA is present in 25 communities across Australia. The reason schemes such as the IPA are better suited to Indigenous communities is that they enable an incredibly important aspect of Indigenous wellbeing to take place, and that is a symbiotic relationship between the land and the people. This is a fundamental aspect of Indigenous culture and promotes wellbeing.

Such acts in conservation have a twofold effect:
 * 1) Country is traditionally managed through traditional practice which has been scientifically proved to be beneficial to the environment
 * 2) Traditional practice enables holistic wellbeing to take place.

Reports from 25 communities using an IPA found a range of benefits on social, cultural, environmental, and economic levels. Reports found that 95% of communities reported economic benefits. The reports also found that 74% of communities reported a reduction of substance abuse and improved wellbeing in the family unit. The IPA scheme has the capacity to positively influence wellbeing Australia-wide with higher efficacy than other models in holistic wellbeing.

Finally, in assessing how useful and appropriate the IPA was in the eyes of Indigenous participants, most communities praised the initiative stating that it allowed them to establish "connection to country, care for country and pass on traditional knowledge"; in other words, connection to country bolstered wellbeing through traditional ways of knowing, being and doing.

The Importance of Land

When asked, Aboriginal and Torres Strait Islander people draw attention to the importance of relationships with country (Government Department of health, 2013). The relationship between people and their country is rarely considered in policy development, and this is reflected in the state of Indigenous wellbeing. Each person belongs to a piece of land through the kinship and totem system (see Figure 6).

This provides a deep sense of identity, purpose, and belonging, fostering holistic wellbeing. In an interview for the 'First Peoples Exhibit at the National Gallery' in Sydney, Australia, Dhanggal Gurruwiwi, from Nhulunbuy in the Northern Territory, eloquently illustrates this tie to wellbeing:

“In our kinship system, as a custodian, I’m the child of that land ... a person dies of grief ... their soul has been torn; just like the earth moving equipment tears the land".

Independent skills task 2: Using the resources here, explore the positives and negatives of deurbanisation in Indigenous populations.

The future of Indigenous wellbeing
Indigenous wellbeing is dynamic, relying heavily on connection to country to achieve wellbeing. Fortunately, the causes of poorer wellbeing are not mysterious and, therefore, ways forward to achieve equal wellbeing are not either. The focal point to restoring Indigenous wellbeing is the restoration of culture and cultural practice through living on country.

Connection to country

The land serves Indigenous communities as a point of spirituality through ancestral and totemic ties, as an anchor for ritual practice and living, and as an important factor in the continuation of language. By making it easier for Indigenous communities to access traditional ways of knowing, being, and doing, through county, wellbeing will improve. The involvement in land management results in increased physical activity, less alcohol, and illicit substance use, greater access to bush foods, and reduced takeaway foods (Burgess et al., 2009). This is particularly evident in the results of the IPA. Research has also found that engagement in traditional practice promotes group cohesion and reduces violence (Day & Fransisco, 2013). Recognition of Aboriginal and Torres Strait Islander people’s knowledge and skills in land management might improve autonomy, identity, and feelings of control. Furthermore, community elders should hold a role in the education of traditional ways, given the hierarchical nature of traditional group dynamics. Addressing these factors may combat underlying wellbeing concerns which reflect a profound loss of disempowerment (Kingsley et al., 2013). For more information on why a connection to country is necessary in wellbeing, see the case study "Looking forward by looking back".

Case study: Looking forward by looking back

In August 2021 an article about caring for country was published by CBR City News. The article detailed the work of a Wiradjuri woman, Dhani Gilbert, to care for country in the Ngunnawal region (Canberra). Ms. Gilbert reported how growing up on country, learning the traditional way of caring for country from her parents, including cultural burning, edible and medicinal plant types, and wildlife care methods impacted her overall wellbeing.

"Growing up I was surrounded by caring-for-country practices taught to me by the community" - Ms. Gilbert.

Dhani's childhood is an illustrative example of how the passing on of tradition from language to practice, fosters wellbeing. Dhani's story of living a culturally relevant childhood, and now, life as a young adult, is reflective of how simple it can be to end the Indigenous wellbeing crisis across Australia. The article continues to explore how Indigenous ways of knowing have changed land care management, particularly after the 2019-2020 bushfires. Caring for the land is an integral role in Indigenous wellbeing, but also in caring for Australia as a nation, preserving the wellbeing of all Australians; Indigenous or not. Dhani is lucky to have grown up immersed in her rich heritage. This should not be a rarity, rather, Australia should work towards becoming a nation that embraces Indigenous ways of knowing, being, and doing. 



Considering the profound impact country has on wellbeing, actions to resolve the wellbeing crisis should almost exclusively utilise traditional ways of knowing, being, and doing. That is to say that Indigenous wellbeing programs and strategies should exclude western notions of wellbeing unless deemed appropriate by Indigenous communities. The IPA scheme is an eloquent illustration of such a program that can restore wellbeing in Indigenous communities. This scheme highlights the importance of country, but also provides foundations for future schemes and programs in improving wellbeing, and the opportunity to heal.

Conclusion
Indigenous wellbeing is a complex interplay between the five dimensions of holistic wellbeing: Physical, mental, emotional, spiritual, and social wellness. In understanding the holistic nature of Indigenous wellbeing, Australia can strive towards improving the health outcomes of Indigenous communities. This is evident across many remote communities, such as Wilcannia, where recent ABS reports illustrate an emerging wellbeing crisis. Some key considerations must be made if future schemes, such as the IPA, are developed. Firstly, Australia must listen to the needs of Indigenous communities. Secondly, programs should be Indigenous-lead and developed. Lastly, great efforts should be taken to preserve and protect country in the hopes that such land will one day be included on the growing list of native titles and traditional ownership. There appears to be sufficient evidence suggesting that Indigenous ways of knowing, being, and doing, and connection to country can have a long-lasting impact on holistic wellbeing.