Abstract
Social-epidemiology that excludes Aboriginal voices often fails to capture the full and complex social worlds of Aboriginal people. Using data from an existing co-designed Victorian government Adolescent Health and Wellbeing Survey (2008/9), we worked with Aboriginal organizations to identify data priorities, select measures, interpret data, and contextualize findings. Using this participatory co-analysis approach, we selected “cultural” and “structural” determinants identified by Aboriginal organizations as important and modelled these using principal component analysis. Resulting components were then modelled using logistic regression to investigate associations with “likely being well” (Kessler-10 score < 20) for 88 Aboriginal adolescents aged 11–17 years. Principal component analysis grouped 11 structural variables into four components and 11 cultural variables into three components. Of these, “grew up in Aboriginal family/community and connected” associated with significantly higher odds of “likely being well” (OR = 2.26 (1.01–5.06), p = 0.046). Conversely, “institutionally imposed family displacement” had significantly lower odds (OR = 0.49 (0.24–0.97), p = 0.040) and “negative police contact and poverty” non-significantly lower odds (OR = 0.53 (0.26–1.06), p = 0.073) for “likely being well”. Using a co-analysis participatory approach, the voices of Aboriginal researchers and Aboriginal organizations were able to construct a social world that aligned with their ways of knowing, doing, and being. Findings highlighted institutionally imposed family displacement, policing, and poverty as social sites for health intervention and emphasized the importance of strong Aboriginal families for adolescents.
Highlights
Epidemiology, translating to “the study of what is upon the people”, is often criticized for its failure to capture the often complicated relationships between multiple and interacting determinants impacting “upon” people’s lives [1]
Epidemiology relating to Aboriginal populations has in recent years increasingly taken a social approach to measuring health and its broader social determinants, including increasing focus on strengths-based approaches, much social-epidemiology continues to be limited by a failure to centre Aboriginal people, organizations, and knowledges in “the study of what is upon
In considering epidemiology relating to Aboriginal populations, this evolved in the twentieth century, when there was a vigour for collecting anthropological data about individual bodies and minds [7]
Summary
Epidemiology, translating to “the study of what is upon the people”, is often criticized for its failure to capture the often complicated relationships between multiple and interacting determinants impacting “upon” people’s lives [1]. This absence of Aboriginal voices has meant that many important social and cultural dimensions that make up the realities of Aboriginal people’s lives and prioritized as important by Aboriginal people are not attended to in epidemiology. We know that the origins of epidemiology are rooted in the ecological, in the understanding that social factors determine the health of populations [3]. In considering epidemiology relating to Aboriginal populations, this evolved in the twentieth century, when there was a vigour for collecting anthropological data about individual bodies and minds [7]. Epidemiology relating to Aboriginal people started at this point of knowing the individual
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