Understandings of the social determinants of Aboriginal health: A stakeholder perspective analysis
This research project explored the perspectives of a select group of researchers, policy makers, community-based service providers and members of Aboriginal representative peak bodies on the social determinants of Aboriginal health. It was expected there would be different perspectives and understandings of what is meant by the social determinants of health between the groups, and that a different term may be able to be identified that will have greater meaning and understanding for all of the CRCAH partners.
The project found that:
- While all respondents had a solid understanding of the basic concepts that underpin the social determinants of Aboriginal health, the challenge was being able to move away from a conceptual framework to either taking action or developing policy to support action.
- Most respondents felt that a systems approach was required in order to address the social determinants of Aboriginal health.
- Significant work still needs to be done to encourage ‘buy-in’ from other sectors outside the health sector to the concept that social determinants have a big impact on health.
The research indicated that:
- The CRCAH needs to support evaluations of innovative interventions on social determinants at a community level and support the translation of these learnings to other contexts and localities.
- The CRCAH should work across sectors to build capacity and awareness of social determinants of Aboriginal health, while encouraging all sectors to make efforts to place their work within a social determinants framework.
- More work is needed to understnad how best to operationalise ‘whole of government’ approaches to the social determinants of Aboriginal health, while ensuring accountability to the communities in which such approaches are used.
The outcomes of the research were used to inform the planning and implementation of activities in the CRCAH’s Social Determinants of Health Program.
The project aimed to improve the understanding of how different stakeholders use the concept of, and communicate about, the social determinants of Aboriginal health, in order to maximise the impact of outcomes from the CRCAH’s Social Determinants of Health Program. It sought to identify:
- What meanings do different stakeholders give to the term ‘social determinants of health’?
- How are the social determinants of health factored or planned into the work practices of different stakeholders?
- What are the barriers to dialogue and exchange about the social determinants of health between sectors (including government, research, service provider sectors) and disciplines?
- How could the social determinants of health be framed more effectively to better influence practice and policy?
The project involved semi-structured interviews with a sample of 16 decision makers from relevant sectors in research, government and service provider organisations relevant to the social determinants of Aboriginal health. All aspects of the project were overseen by a dedicated reference group, which also selected the first five individuals to be interviewed. These individuals:
- were representative of their sectors;
- held a senior position in an organisation with relevance to the social determinants of health; and
- were in a position to influence the direction or actions of their organisation.
Snowball sampling was used whereby this initial group was interviewed then asked to provide referrals to other people in organisations with whom they had worked in partnership in relation to the social determinants of health. The above criteria were then applied to the next group, who were approached to participate in this study.
Once the initial analysis of the data was completed, the CRCAH brought together the reference group members and an Expert Advisory Group to review and discuss the findings.
