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Institutional racism silencing Indigenous knowledge in health care

Rachael Knowles -

A new report from the Poche Centre for Indigenous Health has found institutional racism leads to a silencing of Indigenous knowledges, perspectives and cultural practices which are crucial to closing the gap in health for Aboriginal and Torres Strait Islander peoples.

Published in Public Health Research and Practice, a peer-reviewed journal of the Sax Institute, the report was authored by several Indigenous leaders and noted the reluctance in health care structures to address systemic and institutional racism against Aboriginal and Torres Strait Islander peoples.

Lead author Dr Carmen Parter is a proud descendent of the Darumbal and Juru clans of the Birra Gubba Nation of Queensland. She also has South Sea Islander heritage and is a Senior Research Fellow at the University of Queensland's Poche Centre for Indigenous Health.

"Our paper gives voice to Indigenous communities who have consistently said that racism is a critical issue in the provision of health care, as is the incorporation of culture into the design of health care services," said Dr Parter.

"When an Aboriginal or Torres Strait Islander person accesses a health care service, there is always a level of mistrust and fear.

"A lot of people forget that our health system was one of the many institutions involved in the Stolen Generations that took children from their families and communities â€" which still happens today.

"Those stories resonate through our communities."

Dr Parter highlights the importance for health care providers in discussing and addressing racism.

"One of the biggest critical issues around making improvements to our health is talking about racism and understanding systemic and institutional racism â€" and how that plays out in the provision of healthcare to our mob when they're accessing services," she said.

"The time is right now to be talking about racism ... this research has demonstrated that you're not going to close the gap around our health, until you genuinely talk about racism."

"There is this paralysis in the health care sector, despite community consistently asking for government to respond to racism. It is challenging for governments and health care providers to really think about the impact it has on health outcomes."

Dr Parter said Australia's current health care system is "dominated by the dominant culture", excluding Indigenous knowledge and culture in care as a result.

"That dominant culture overtakes the knowledges that we have ... it excludes our knowledges and culture and in doing that it perpetuates systemic racism. It excludes us," she said.

The report outlines a model of practice where different knowledges and cultures, such as traditional healing and western medicine, can co-exist, which could be instrumental in closing the gap in life expectancy by 2031.Â

"Those fundamental practice changes are important but what is really required is that broader system change that changes the structures that are the huge barriers," Dr Parter said.

"Those structures are racialised, discriminatory structures ... practice needs to change."

Alongside Dr Parter, authors of the paper include:

Professor Tom Calma AO, Poche Centre

Boe Rambaldini, Poche Centre

Dr Josephine Gwynn, Poche Centre

Dr John Skinner, Poche Centre

Donna Murray, CEO of Indigenous Allied Health Australia Donna Murray

Janine Mohamed, CEO of Lowitja Institute

Associate Professor Donna Hartz, Molly Wardaguga Research Centre at Charles Darwin University

Dr Shawn Wilson, Gnibi College of Indigenous Australian Peoples at Southern Cross University.

Read the report here.

By Rachael Knowles

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