Working at the interface in Aboriginal and Torres Strait Islander health: focussing on the individual health professional and their organisation as a means to address health equity.

Michelle Jones,Annabelle M. Wilson,Anthea Magarey,Janet Kelly,Tamara Mackean

doi:10.1186/s12939-016-0476-8

Michelle Jones, Annabelle M. Wilson + Show 3 more

Open Access

https://doi.org/10.1186/s12939-016-0476-8

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Abstract

BackgroundAboriginal and Torres Strait Islander people experience inequity in health outcomes in Australia. Health care interactions are an important starting place to seek to address this inequity. The majority of health professionals in Australia do not identify as Aboriginal and/or Torres Strait Islander people and the health care interaction therefore becomes an example of working in an intercultural space (or interface). It is therefore critical to consider how health professionals may maximise the positive impact within the health care interaction by skilfully working at the interface.MethodsThirty-five health professionals working in South Australia were interviewed about their experiences working with Aboriginal people. Recruitment was through purposive sampling. The research was guided by the National Health and Medical Research Council Values and Ethics for undertaking research with Aboriginal communities. Critical social research was used to analyse data.ResultsInterviews revealed two main types of factors influencing the experience of non-Aboriginal health professionals working with Aboriginal people at the interface: the organisation and the individual. Within these two factors, a number of sub-factors were found to be important including organisational culture, organisational support, accessibility of health services and responding to expectations of the wider health system (organisation) and personal ideology and awareness of colonisation (individual).ConclusionsA health professional’s practice at the interface cannot be considered in isolation from individual and organisational contexts. It is critical to consider how the organisational and individual factors identified in this research will be addressed in health professional training and practice, in order to maximise the ability of health professionals to work with Aboriginal and Torres Strait Islander people and therefore contribute to addressing health equity.

Highlights

Aboriginal and Torres Strait Islander people experience inequity in health outcomes in Australia
While efforts have been made to increase the number of health professionals who identify as Aboriginal and/or Torres Strait Islander, in Australia, only one percent of the health workforce identify as Aboriginal and/or Torres Strait Islander [9]
Working effectively in the intercultural space is crucial if health professionals, health students and health educators are going to contribute to closing the gap; studies have shown that it is in this intercultural space that actual work and true collaboration are achieved [10, 13]

Summary

Introduction

Aboriginal and Torres Strait Islander people experience inequity in health outcomes in Australia. The majority of health professionals in Australia do not identify as Aboriginal and/or Torres Strait Islander people and the health care interaction becomes an example of working in an intercultural space (or interface). Aboriginal Australians experience a burden of disease two and a half times greater than non-Aboriginal Australians [1], and Aboriginal people born between 2010 and 2012 are estimated to have a life expectancy that is between 9.5 (males) and 10.6 (females) years lower than for non-Aboriginal Australians [2] Factors contributing to such inequity include processes of colonisation, discriminatory policies and practices and racism [3, 4]. It is necessary to identify the specific factors that influence a health professional’s experiences of working at the interface so that these factors can be addressed through health professional training and professional development This will support maximising the benefit of the healthcare interaction and address health inequity

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