Discourse, Data and Deficit: Deconstructing the ‘Indigenous Health’ paradigm and its effects on Aboriginal and Torres Strait Islander peoples

Project aims 

To conduct field-based research among Aboriginal and Torres Strait Islander communities on how local community discourses impact on health service provision by demonstrating the positive potential of strength-based approaches and scale up interrogation of deficit metrics inherent in large data which are informing policy.  

Objectives

  • Build the capacity of community-based health organisations to argue for strength-based program funding and to challenge constructions of deficit metrics in policy. 
  • Identify and gain a deeper understanding of localised and community-based discourses relating to health and wellbeing for Aboriginal and Torres Strait Islander peoples. 
  • Identify and gain a deeper understanding of community, social and organisational perceptions on indicators and metrics concerning Aboriginal and Torres Strait Islander health and wellbeing. 
  • Develop and empirically evaluate the impact of strength-based approaches on the statistical rigour of large-scale quantitative analysis. 
  • Make recommendations of future actions for Aboriginal and Torres Strait Islander research and health policy settings. 
  • Develop and submit an Australian Research Council grant on Discourses in Aboriginal and Torres Strait Islander health and wellbeing. 

Project team

Project leader: Professor Emeritus 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

Administering organisation: Australian National University 

Project timeline: 1 December 2017-31 May 2019 

Methodology 

Over the course of 18 months, the project team carried out literature reviews, documentary and text analyses and ethnographic field-based interviews and observations in the Northern Territory and New South Wales.  

The first phase of the project involved negotiating participation from communities, fieldtrips, ethics approval and proposals to potential case-study organisations. 

The second phase included ethnographic field-based interviews and in-depth research which was carried out in the participating communities. Using semi-structured interview principles, participants were asked about their backgrounds, perceptions and practices of strength-based approaches and their experiences of deficit discourse. 

The third phase involved data management and analysis as well as drafting of the findings. Interviews were transcribed and coded in NVivo. 

The final phase of the project was the dissemination of findings to the communities for reflection and further discussion on how to shape the emerging work. 

Project findings 

A total of 37 interviews was carried out: 22 Aboriginal (predominantly Koori and Yolŋu), 8 non-Aboriginal people and 2 Indigenous people from other backgrounds. The interviews were transcribed using NVivo and generated over 150 cross-cutting themes. Drawing from the themes, the following recommendations were made: 

  • Increase funding that embraces holism, innovation and responsiveness 
  • Longer-term funding cycles 
  • Co-designed KPIs 
  • Narrative-based reporting 
  • Reducing over-reporting 
  • Relationship building between funders and recipients 
  • Career public servants’ time for learning 

NCEPH also carried out empirical evaluations of the interviews comparing the strengths-based approach to the standard deficit approach used to assess Aboriginal and Torres Strait Islander Health and Wellbeing. The results of the comparison showed that Strengths-based approaches to assessing Aboriginal and Torres Strait Islander health can enable a more positive story to be told without altering statistical rigour.

Project outcomes   

Outcome Measure  

Describe the expected short-term outcome including the expected target audience  

Knowledge  

  • The project provided an enduring contribution to understanding how community, research and policy processes contribute to either reducing or producing deficit discourse.   

  • The project also provided a cohesive understanding of the relationship between Indigenous health discourse, policy and data  

  • The qualitative part of the research revealed both how communities present themselves to the outside and how the health discourse operates internally  

Awareness  

  • The work created collaborative resources and outputs governed by Aboriginal and Torres Strait Islander researchers’ communities that can be used by community-controlled organisations.  

  

Behaviour  

  • The potential benefit of this project to Aboriginal and Torres Strait Islander Health is that the use of strength-based approaches in health service provision will result in better health outcomes  

  • Also, the recommendations provided by the research are targeted at funders, policy makers and associated stakeholders and are useful for better enabling the NGOs in the Aboriginal and Torres Strait health and wellbeing arena  

Skills   

  • Development of Indigenous research capacity at the National Centre for Indigenous Studies (NCIS)  

  • The work also continues to enhance the quantitative research capacity in the Aboriginal and Torres Strait Islander Health Program (ATSIHO) at NCEPH by providing opportunities for early career Aboriginal researchers to develop their data analysis and writing skills and provided the opportunity the opportunity to be co-authors on papers  

Report: Aboriginal Health and Wellbeing Services: Putting community-driven, strengths-based approaches into practice

See also:

Acknowledgement of Country

We acknowledge the traditional owners of the land across Australia and pay our respects to their Elders past, present and future. Aboriginal and Torres Strait Islander people should be aware that this website may contain images, voices and names of deceased persons.

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