INDH1006 Lecture Notes - Lecture 8: Institute For Operations Research And The Management Sciences, Community Structure, Anangu
26 May 2018
School
Course
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Notes – Family and Community structure
Learning Outcomes:
Aboriginal and Torres Strait Islander Families
Understanding the basis of any society involves knowing something of the family and kinship structure
and how it informs, guides, influences and formulates social, cultural, economic and political interactions
and relationships. Family organisation among Aboriginal and Torres Strait Islander communities can take
many forms and it is much more intricate than simply the extended family. Traditional Aboriginal and
Torres Strait Islander family relationships are often complex. Families tend to be extended and often go
beyond blood and marriage. Rights and responsibilities may be designated to each person within that
community (Kinship systems also vary across Aboriginal and Torres Strait Islander communities).
Elders are leaders within their community. Aunties or Uncles are not necessarily blood-related, the term
is a sign of respect. Equally the use of brother or sister does not necessarily relate to a blood-relative.
Responsibilities with regards to family are very important to Aboriginal and Torres Strait Islander
Australians. Caring for family members includes financial care, health care and care in general is often
shared within extended family and community.
Introduction to public health
Over the last two workshops we have considered the social and emotional wellbeing of Aboriginal and
Torres Strait Islander people and the concept of family. In order to address their poor health status we
need to consider how health services promote the health and wellbeing of individuals and communities
A public health approach and Aboriginal and Torres Strait Islander social and emotional wellbeing
• Aims to promote emotional and social wellbeing of Aboriginal and Torres Strait Islander families
and communities.
• Public health initiatives need to begin when people are well.
• It is by improving the social, physical and economic environments that affect social and emotional
wellbeing that the capacity of communities as well as individuals can be strengthened.
Dudgeon, Milroy & Walker, R. (2014).
Health Behaviours and Health Risk Behaviours and Behaviour change models
It has been argued that: “There are considerable differences in behavioural risk factors between social
groups, with more disadvantaged groups tending to adopt more health-damaging behaviour in terms of
1. Identify the basis of Aboriginal society and that a great deal of diversity exists.
2. Describe what is necessary when providing health care in Indigenous Australian contexts.
3. Explain the significance of Indigenous Australian's family structure and kinship and its relationship
to accessing and providing health care services.
4. Explain Public Health philosophy and its potential to contribute to ‘closing the gap’ between
Aboriginal and Torres Strait Islander and non-Indigenous health status.
5. Define health behaviours and health risk behaviours.
6. Explain The Health Belief and Behaviour Change models.
7. Examine traditional Aboriginal and Torres Strait Islander health beliefs, their relationship with
health behaviours and relevance to practice.
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smoking, diet, lack of exercise in leisure time and lower uptake of preventive health care for themselves
and their children... In this context, inequities in health arise when a person’s lifestyle is restricted by
socio-economic factors outside his or her direct control” (Dahlgren and Whitehead 1992, p. 33).
Health behaviour is “any activity undertaken by a person believing himself/herself to be healthy for the
purpose of preventing disease or detecting it in an asymptomatic stage” (Kasl & Cobb 1996, p. 246).
Health Risk behaviours are closely linked to Illness Behaviours and Sick Role Behaviours. These concepts
have caused some confusion.
Health Risk Behaviours
As discussed earlier, people’s health and their wellbeing are influenced by a number of factors including
biological, psychological, societal and environmental factors. Additionally, there are a number of lifestyle
factors that have an influence such as living conditions, hygiene, substance use, diet and exercise.
Behaviours that increase risk of ill-health are known as Health Risk Behaviours. For example, common
risk factors are alcohol, tobacco and other drug use, but also lack of exercise and being overweight/obese
as a result of our diet and lack of exercise. The consequences are many including risk of chronic health
conditions including diabetes, various forms of cancer, cardiovascular disease, and many other diseases.
Health Risk Behaviours among Aboriginal and Torres Strait Islander Australians include:
• Smoking.
• Poor nutrition.
• Physical inactivity.
• Alcohol/other drug use.
However, smoking was identified as the most concerning Health Risk Behaviours given that the rates
have been found to be significantly higher in Aboriginal and Torres Strait Islander populations when
compared to the non-Indigenous population.
See for example the following graph.
Figure 1: 'Percentage of current daily smokers in Australia by Indigenous status, people aged 15 and
over (age-standardised), 2001-2001 to 2011-2013., Australian Institute of Health and Welfare 2104.
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Poor diet and physical inactivity are other health risk behaviours affecting Aboriginal and Torres Strait
Islander Australians disproportionately. For example, 30% of Aboriginal and Torres Strait Islander
children aged between 2 and 14 years and 66% of Aboriginal and Torres Strait Islander people aged 15
years and over were reported to be overweight/obese in 2012-2013 according to the Australian Health
Survey. This is related to nutrition as Aboriginal and Torres Strait Islander Australians are known to be
statistically less likely to report access/eating fruit and vegetables every day when compared to non-
Indigenous Australians.
The Australian Government has specifically identified the following social determinants of Indigenous
health to contribute to health and heath behaviour issues among Indigenous Australians:
• Housing.
• Education.
• Income and employment.
• Transport - remoteness and access to health services.
• Racism.
Illness Behaviours
There are many illness behaviours. A classic definition is “any activity, undertaken by a person who feels
ill, to define the state of his/her health and to discover a suitable remedy” (Kasl & Cobb, 1966 p. 246).
Someone who experiences physical or mental symptoms may seek the advice of a doctor, treat
themselves with home/complementary remedies or choose to do nothing at all. Symptoms that become
acute and painful may result in presentation at an emergency department but some people but not by
others.
Age, gender, education, cultural beliefs about health and illness, stigma surrounding certain diseases
(e.g. sexually transmitted disease, socioeconomic status and previous experiences of illness) all influence
illness behaviours.
Illness behaviours are complex interactions between bodily functions and psychological appraisal by a
person in a certain situation. Examining this behaviour and the symptoms experienced may aid an
understanding of a person’s illness behaviours.
A person with a chronic condition often develops a self-consciousness and appraises the situation
cognitively, which has an effect on their emotions and behaviours. The person tries to maintain an
emotional equilibrium with helpful or unhelpful thinking styles and behaviours.
There is a reciprocity with regard to physical symptoms and psychological responses of distress to these
symptoms. Physical symptoms may predispose people to extreme distress, which in turn has a negative
effect on bodily systems. This then results in a vulnerability of people to both physical symptoms as well
as having to deal with the distress resulting from the psychological symptoms (thoughts and feelings
about the physical condition).
Consequently, certain behaviours are observable. For example, someone who lacks a strong social
network may seek reassurance and support from a health professional and has learned that certain
illness behaviours will satisfy this need. Illness behaviour has been associated with people trying to
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Document Summary
Understanding the basis of any society involves knowing something of the family and kinship structure and how it informs, guides, influences and formulates social, cultural, economic and political interactions and relationships. Family organisation among aboriginal and torres strait islander communities can take many forms and it is much more intricate than simply the extended family. Torres strait islander family relationships are often complex. Families tend to be extended and often go beyond blood and marriage. Rights and responsibilities may be designated to each person within that community (kinship systems also vary across aboriginal and torres strait islander communities). Aunties or uncles are not necessarily blood-related, the term is a sign of respect. Equally the use of brother or sister does not necessarily relate to a blood-relative. Responsibilities with regards to family are very important to aboriginal and torres strait islander.
