Deficit discourse and Indigenous health

The Narrative Framing of Aboriginal and Torres Strait Islander Health and Wellbeing: A Review

Project Aim:

To identify and summarise the narrative trends that frame and guide public discourse on the health and wellbeing of Aboriginal and Torres Strait Islander peoples, paying particular reference to identifying any shifts or change over time.

Objectives:

1. Examine the abstracts and first paragraph of selected research publications and policy documents in Aboriginal and Torres Strait Islander health between 1989 and 2015.
2. Identify the narrative or discourse that frames Aboriginal and Torres Strait Islander Health and wellbeing.
3. Examine the attributes of this narrative or discourse, including the attribution of causes of advantage or disadvantage.

Project Team:

Project leader: Professor Mick Dodson, Director of the National Centre for Indigenous Studies at ANU, Professor of Law at the ANU College, The National Centre for Indigenous Studies, ANU
Project partner: Deakin University
Administering organisation: Australian National University
Project timeline: 1 December 2016-31 August 2017

Methodology

TA combination of discourse and narrative analysis to identify:

1. The broader discursive frameworks and how they operate; and
2. How these discursive frameworks are used to create meaning by people of influence in the health and wellbeing sector.

The methodology of the research included:

1. Review of existing scholarly literature on deficit discourse in Indigenous health.
2. Identification of texts for meta-analysis (academic and policy 1989 till date).
3. Extraction of headings, abstracts and first paragraphs.
4. Discourse and narrative analysis of texts identified from the extraction of headings, abstracts and first paragraphs.
5. Detailed analysis on a subset of significant policy documents that address Indigenous disadvantage and demonstrate shifts in national priorities.
6. Production of report, analysis and recommendations.

Project Findings

Over a six-month period, meta-analysis of over 70 health and wellbeing texts from 1980 was conducted. The results and evidence from the research show that:

1. Deficit discourse has a demonstrable impact on Indigenous health and is very powerful in determining what can and cannot be considered as ‘truth’.
2. Deficit occurs when discussions and policy aimed at alleviating disadvantage becomes so mired in reductionist narratives of failure and inferiority that Indigenous people themselves are seen as the problem.
3. In certain discursive spaces in Australia, the term ‘Aboriginal and Torres Strait Islander people’ has come to be associated with particular negative tropes.
4. The dominant discourses that often marginalise or silence the voices, perspectives and worldviews of Aboriginal and Torres Strait Islander people are often propagated through media and politics.
5. Even where deficit data is initially deployed for emancipatory purposes, its dominance in the Australian context has at times seen it form a narrative that homogenises and dehumanises Indigenous people.
6. Policy discourse that focuses on indicators and ‘closing the gap’ often obscures consideration of the way structural discrimination and racism is affecting health outcomes.
7. There is no simple discursive position delineated by the state, nor is there a singular position advocated by a diversity of Indigenous views across the country. The discourse of policy making in a state of constant change and discourses of deficit in Indigenous health will, therefore, always remain open to challenge and disruption.

Project Outcomes

Report: Deficit discourse and strengths-based approaches: Changing the narrative of Aboriginal and Torres Strait Islander health and wellbeing

Summary report

Related resources:

• W. Fogarty, H. Bulloch, S. McDonnell & M. Davis 2018, Deficit Discourse and Indigenous Health: How narrative framings of Aboriginal and Torres Strait Islander people are reproduced in policy, The Lowitja Institute, Melbourne 
• W. Fogarty, M. Lovell, J. Lagenberg & M-J. Heron 2018, Deficit Discourse and Strengths-based Approaches: Changing the Narrative of Aboriginal and Torres Strait Islander Health and Wellbeing, The Lowitja Institute, Melbourne 
• Deficit Discourse and Indigenous Health – summary report
• Reframing Discourse and Changing the Narrative of Aboriginal and Torres Strait Islander Health and Wellbeing: An Analysis
• Bulloch, H., Fogarty, W. & Bellchambers, K 2019, Aboriginal Health and Wellbeing Services – Putting community-driven, strengths-based approaches into practice, The Lowitja Institute, Melbourne