Indigenous People In Australia Research Articles

Smallpox Geographies: vaccination, borders and Indigenous peoples in Australia's coastal north.

Australia's approach to its biosecurity and borders has always been two-pronged - quarantine first, vaccination second. This article asks what this combination looked like in practice by exploring two neglected smallpox vaccination campaigns directed towards Indigenous peoples in the early twentieth century. We argue these were important campaigns because they were the first two pre-emptive, rather than reactionary, vaccination programs directed towards First Nations people. Second, both episodes occurred in Australia's northern coastline, where the porous maritime geography and proximity to Southeast Asia posed a point of vulnerability for Australian health officials. While smallpox was never endemic, (though epidemic), in Australia, it was endemic at various times and places across Southeast Asia. This shifting spectre of smallpox along the northern coastline was made even more acute for state and federal health officials because of the existing polyethnic relationships, communities, and economies. By vaccinating Indigenous peoples in this smallpox geography, they were envisioned and embedded into a 'hygienic' border for the protection of white Australia, entwining the two-prongs as one approach. In this article, we place public health into a recent scholarship that has 'turned the map upside down' to re-spatialise Australia's history and geography to the north and its global connections, while demonstrating how particular coastlines and their connections were drawn into a national imaginary through a health lens.

The emergence of cultural safety within kidney care for Indigenous Peoples in Australia.

Cultural safety is increasingly recognised as imperative to delivering accessible and acceptable healthcare for First Nations Peoples within Australia and in similar colonised countries. A literature review undertaken to inform the inaugural Caring for Australians with Renal Insufficiency (CARI) guidelines for clinically and culturally safe kidney care for Aboriginal and Torres Strait Islander peoples revealed a timeline of the emergence of culturally safe kidney care in Australia. Thirty years ago, kidney care literature was purely biomedically focused, with culture, family and community viewed as potential barriers to patient 'compliance' with treatment. The importance of culturally informed care was increasingly recognised in the mid-1990s, with cultural safety within kidney care specifically cited from 2014 onwards. The emergence timeline is discussed in this paper in relation to the five principles of cultural safety developed by Māori nurse Irihapeti Ramsden in Aotearoa/New Zealand. These principles are critical reflection, communication, minimising power differences, decolonisation and ensuring one does not demean or disempower. For the kidney care workforce, culturally safe care requires ongoing critical reflection, deep active listening skills, decolonising approaches and the eradication of institutional racism. Cultural safety is the key to truly working in partnership, increasing Indigenous Governance, respectful collaboration and redesigning kidney care.

Systematic review of Aboriginal and Torres Strait Islander peoples’ experiences and supportive care needs associated with cancer

BackgroundPersistent disparities exist between Aboriginal and Torres Strait Islander peoples (the Indigenous peoples of Australia) and non-Indigenous Australians associated with cancer, with Aboriginal and Torres Strait Islander peoples experiencing a longer time to treatment, higher morbidity rates, and higher mortality rates. This systematic review aimed to investigate findings and recommendations in the literature about the experiences and supportive care needs of Aboriginal and Torres Strait Islander peoples with cancer in Australia.MethodsA qualitative systematic review was conducted using thematic analysis. Database searches were conducted in CINAHL, Informit, MEDLINE, ProQuest, Scopus, and Web of Science for articles published between January 2000 and December 2021. There were 91 included studies which were appraised using the Mixed Methods Appraisal Tool. The included studies reported on the experiences of cancer and supportive care needs in Aboriginal and Torres Strait Islander populations.ResultsSix key themes were determined: Culture, family, and community; cancer outcomes; psychological distress; access to health care; cancer education and awareness; and lack of appropriate data. Culture was seen as a potential facilitator to achieving optimal cancer care, with included studies highlighting the need for culturally safe cancer services and the routine collection of Aboriginal and Torres Strait Islander status in healthcare settings.ConclusionFuture work should capitalize on these findings by encouraging the integration of culture in healthcare settings to increase treatment completion and provide a positive experience for Aboriginal and Torres Strait Islander peoples with cancer.

After 1788*

Abstract Contemporary contact languages used by Indigenous people in Australia share many words and grammatical features and structures. I trace the development of contact varieties in Australia between 1788 to 1848, arguing that their similarities arise from the dominance of English-speakers among the invaders, their ways of talking to people who did not speak English fluently, the transfer of people between penal settlements, and the fact that sea traffic was the fastest form of travel between colonies. Evidence for zones of influence in which particular features appear is drawn from geographic distribution and time of first attestation. I use four types of reports for locating features: outsiders’ reports of direct speech by Aborigines and of outsiders’ speech to Aborigines, imitations by outsiders of Aboriginal speech, and outsiders’ comments on Aboriginal speech. Another kind of evidence comes from the adoption of contact variety words into Aboriginal languages. This is illustrated with a case study of words for ‘white woman’ in Aboriginal languages.

An Integrated Care Model for Aboriginal and Torres Strait Islanders Peoples in Southeast Queensland Australia: Establishing an Indigenous Hospital in The Home Program 

Health inequity and unjust access to care and a higher burden of chronic disease persist in Australia for Aboriginal and Torres Strait Islander (respectfully Indigenous) peoples. For example, in 2015 -2017, compared with non-Indigenous people, Indigenous people had 3.1 times higher rate of in hospitalisation, 4.7 times higher rate of Discharge Against Medical Advice, and almost three times the rate of Potentially Preventable Hospitalisations. These are significant measures of healthcare inequity that highlight the lack of an integrated care model for Indigenous people.
 Hospital in the Home (HITH) has been a successful integrated care model globally. There is an extensive international research base, including a meta-analysis of 61 randomised control trials, as well as growing experience in Australia. The demonstrated beneficial impact of HITH programs includes equal or better patient clinical outcomes, higher patient satisfaction, reduced hospital admission and re-admissions and reduced overall costs. Despite recognising the inequities in health outcomes for Indigenous people, there has been no published report of Indigenous-specific models of HITH in Australia.
 Culturally safe health services which address potential institutional barriers to acute inpatient care can improve Indigenous peoples’ access to and the quality of integrated health care. An Indigenous HITH program (I-HITH) will integrate the models of care between secondary and primary care sectors, aiming to improve care outcomes of Indigenous people, via bringing acute care, and the management of acute exacerbations of chronic conditions, closer to home and/or community.
 The need for an I-HITH program led by the Indigenous community was identified during extensive consultation undertaken by Brisbane North Primary Health Network, Metro North Health and Institute of Urban Indigenous Health, the largest Aboriginal community controlled primary healthcare provider in Australia which provides primary health care for approximately 50% of all Indigenous people in the catchment area. Community leaders, clinical, and system leaders have co-designed the I-HITH program with interventions across the health sectors including hospitals, primary and community-based services, and residential aged care. In the I-HITH model, there has been the establishment of a Primary Care Pathway whereby the GP has admitting rights and retains governance of the patient whilst they are admitted.
 In the process of establishing this innovative and integrated model of care for Indigenous people in Australia, there have been positive experiences and lessons learnt that could be valuable for other countries especially if the goal is to deliver timely and effectively care for priority groups of peoples. These include 1) co-design process in system innovation and changes in healthcare settings; 2) leadership and cross-sectorial partnerships focusing on integrated care transitions between organisations; 3) clinical governance especially from the whole person perspective in their care plans; 4) incremental referrals to I-HITH ensuring the shared-decision making process that aligns with clients’ values and principles; 5) evaluation team in the whole journey of the development, implementation, and outcome assessment, and continuous quality improvement.
 The program evaluation includes measures of process, implementation, and outcomes using mixed methods. The team is now ready to receive its first patient.

Indigenous Australian genomes show deep structure and rich novel variation

The Indigenous peoples of Australia have a rich linguistic and cultural history. How this relates to genetic diversity remains largely unknown because of their limited engagement with genomic studies. Here we analyse the genomes of 159 individuals from four remote Indigenous communities, including people who speak a language (Tiwi) not from the most widespread family (Pama–Nyungan). This large collection of Indigenous Australian genomes was made possible by careful community engagement and consultation. We observe exceptionally strong population structure across Australia, driven by divergence times between communities of 26,000–35,000 years ago and long-term low but stable effective population sizes. This demographic history, including early divergence from Papua New Guinean (47,000 years ago) and Eurasian groups1, has generated the highest proportion of previously undescribed genetic variation seen outside Africa and the most extended homozygosity compared with global samples. A substantial proportion of this variation is not observed in global reference panels or clinical datasets, and variation with predicted functional consequence is more likely to be homozygous than in other populations, with consequent implications for medical genomics2. Our results show that Indigenous Australians are not a single homogeneous genetic group and their genetic relationship with the peoples of New Guinea is not uniform. These patterns imply that the full breadth of Indigenous Australian genetic diversity remains uncharacterized, potentially limiting genomic medicine and equitable healthcare for Indigenous Australians.

Indigenous Knowledge-Sharing Interventions in Australia and the Use of Information and Communication Technology: A Scoping Review

Indigenous peoples in Australia are subject to significant disadvantages both socio-economically and in health, education and service provision. Knowledge-sharing interventions, including those with an information and communications technology (ICT) base, have the potential to address these challenges. Interventions occur against a background of an ancient culture with distinctive ways of knowing and doing, including storytelling, art and performance. This study documents the results of a scoping review of interventions that have been undertaken in this context. It considers the outcomes of these interventions, the extent to which Indigenous ways of knowing were accounted for and whether ICT was involved. Our review of the peer-reviewed literature located two prior reviews and seven primary studies. All of the primary studies were about health interventions; of these, all those that reported positive outcomes only had incorporated Indigenous ways of knowing, some in innovative ways. Only two studies used ICT as their main vehicle. This article provides a base for further work by documenting the current status of the field and identifying the gaps, such as the scarcity of non-health and ICT-based studies. The cases identified provide useful insights for those with an interest in developing future initiatives.

Mental health and use of Medicare Benefits Schedule follow-up mental health services by Indigenous people in Australia during the COVID-19 pandemic.

Mental health care has declined during the COVID-19 pandemic as has attendance for preventive mental health health services. This study aimed to investigate trends in all types of mental health service claims identified in an Indigenous-specific health assessment for Indigenous people before and during COVID-19. We conducted an analysis of Medicare Benefits Scheme (MBS) mental health service items (Items 81,325 and 81,355), to investigate the trends in all types of mental health service claims specifically intended for Indigenous people of Australia. Data were analysed using descriptive statistics, including the total annual numbers of Indigenous peoples' mental health service claims cross-tabulated by age groups and gender, between the calendar years 2017-2021. Multivariable Poisson regression modelling was used to determine associations that were statistically significant. Our results indicate an overall rise in MBS claims for mental health follow-up services during 2019-2020 followed by a decline in 2020-2021. In addition, there was an overall decline in claims for follow-up psychology services across the time period 2019-2021. We found a significant decline in MBS items specific to follow-up mental health services (MBS Items 81,325 and 81,355) for Indigenous people in Australia suggesting a decline in attendance for mental health service follow-up which in turn may indicate a deficit in mental health care during the COVID-19 pandemic, an issue that may lead to poorer mental health outcomes in the future. Further research is needed to understand whether these changes were due to the impact of the COVID-19 pandemic or other factors.

Negotiating senses of belonging and identity across education spaces

AbstractA multitude of educational programs attempt to facilitate young people’s engagement with ideas and practices of active citizenship. For young Aboriginal and Torres Strait Islander or Indigenous people in Australia, such interventions are often subject to complex experiences of senses of belonging and non-belonging. This paper responds to calls from researchers to develop better understandings of young Indigenous people’s own senses and practices of belonging and to better understand the ways in which these perspectives and practices are spatially influenced at the level of local communities, ‘country’ and cultural groupings, and within larger state, national or transnational settings. Their testimonies illustrate the tensions that young Indigenous people must navigate in a settler colony that has never truly recognised Indigenous sovereignty but show that sovereignty remains intact. Focus groups were conducted with 58 young Indigenous people in Melbourne and regional Victoria who were participating in an Indigenous youth leadership program designed to foster formal and informal active citizenship practices, and to nurture a strong, affirming sense of Indigenous identity. The testimonies of these participants provide valuable insights into educational sites as spaces in which young people experience a spectrum of weak to strong senses of belonging. They also provide insights into the possibilities of engaging the challenges faced by many young Indigenous people in educational settings, challenges that include race discordance and exclusion, deficit discourses and gaps and distances in educational practice. They highlight the need to recognise the aspirations of young Indigenous people and the capacities of colonial education systems to meet them, and the imperative to celebrate young Indigenous identities in meaningful, non-tokenistic ways.

Hidden in plain view: Indigenous early career researchers' experiences and perceptions of racism in Australian universities

ABSTRACT Despite extensive impact studies over the past two decades documenting the insipid and debilitating health, social, and emotional impacts of racism on Indigenous peoples in Australia, racism remains a key factor impacting negatively on the lives of Indigenous Australians at all levels of education. Racism experienced by Indigenous early career researchers is much-neglected area of research to date: the aim of this paper is to force a conversation about the prevalence of institutional racism in the higher education sector through an examination of the impact of racism on the experiences and career trajectories of Indigenous early career researchers in Australian universities. We challenge the day-to-day perceptions of normalcy where the Whiteness of the institution goes unnoticed and make clear that claiming ignorance does not absolve the individual or the institution of accountability. Although grounded in Australian experiences of institutional racism in higher education, the study has global significance to other relationally-like colonised nations. International literature highlights racism is imbricated across the Pan-Pacific nations; this is laid bared by the recounting of Australian Indigenous experiences and perceptions.

Indigenous Data Governance in Australia: Towards a National Framework

Australia's distinctive colonial administrative history has resulted in the generation and capture of large quantities of personal data about Indigenous Peoples in Australia, which is currently controlled and processed by government agencies and departments without coherent regulation. From an Indigenous standpoint, these data constitute stranded assets. Established legal frameworks for pursuing recovery of other classes of asset alienated by governments from Indigenous Peoples in Australia, including land, natural resources, and unpaid wages, have not yet been extended to the recovery of Indigenous data assets. This legacy scenario has created a disproportionate administrative burden for Indigenous organisations by sustaining their dependency on government for necessary data, while simultaneously suppressing the value of their own contemporary community-owned data assets. In this article, we outline leading international legal, economic, and scientific frameworks by which an equitable arrangement for the governance of Indigenous data might be restored to Indigenous Peoples in Australia.

The Impact of Contact: Isotope Geochemistry Sheds Light on the Lives of Indigenous Australians Living on the Colonial Frontier in Late 19th Century Queensland

Here, we report the first attempt to use isotope geochemistry to improve understanding of the experiences of Indigenous Australians living on the colonial frontier in late 19th century CE Australia. In the study, we analysed strontium (87Sr/86Sr), carbon (δ13C), and oxygen (δ18O) isotope ratios from the tooth enamel and dentine of six individuals who died in Normanton, Queensland, in the 1890s. The study was a collaboration between scientists and the local Traditional Owners, the Gkuthaarn and Kukatj people, and was carried out to promote truth and reconciliation. The enamel 87Sr/86Sr results suggest that the individuals moved to Normanton from three geologically distinct regions during the period of European expansion into the Gulf of Carpentaria, Cape York. This is consistent with the oral histories and historical documents, which suggest that many Indigenous people in the Gulf Country were displaced to camps on the outskirts of towns like Normanton because of European settlement. The δ13C values we obtained indicate that the individuals mostly ate C4 plants and/or C4-plant-consuming herbivores. When combined with the fact that some of the individuals’ teeth had dental caries, this suggests that the individuals may have had regular access to introduced foods. The enamel δ18O values are high compared to an international comparative sample, at 0.72–4.69‰ VPDB. We suspect the elevated values are due to a combination of a high degree of preferential loss of 16O through evaporation of surface water, the amount effect associated with the Australian monsoon, and high prevalence of introduced infectious diseases. Together, the results of our study demonstrate that isotopic analysis of human remains has the potential to further illuminate the effects of European colonisation on Indigenous people in Australia. Perhaps most importantly in connection with this, our study’s results show that isotopic analyses of human remains can provide surprisingly detailed information about the lives of a category of Indigenous Australians who rarely appear in the documents written by early ethnographers and colonial officials—subadults. That the analysis of the skeletal remains of Indigenous Australians can now contribute to the truth and reconciliation process is an unexpected, interesting, and welcome development in the story of bioarchaeology in Australia.

Māori aspirations following stroke: A pathway forward for the speech-language therapy field

ABSTRACT Background Attempts to improve Indigenous health outcomes are evident in the speech-language therapy (SLT) field, although they are restricted by a limited evidence base. Prior research has shown that SLT services do not always meet Indigenous stroke survivors’ needs, however, few studies have investigated this phenomenon and fewer have explored solutions. Consequently, the SLT field lacks knowledge of appropriate and optimal supports. Aims To identify and compare experiences and aspirations of Māori stroke survivors, whānau (family), and speech-language therapists (SLTs) in Aotearoa New Zealand regarding SLT service provision. Methods & Procedures Kaupapa Māori research and interpretive description methodologies underpinned this study. Four Māori stroke survivors, two whānau members, and five SLTs participated in semi-structured interviews. Data were analysed using constant comparative analysis and collaboratively interpreted during a hui (meeting) between researchers and participants. Outcomes & Results Analysis highlighted six themes spanning experiences and aspirations: (1) tautoko (support), (2) kaupapa Māori (Māori approach), (3) whanaungatanga (relationships), (4) tino rangatiratanga (autonomy), (5) taiao (environment), and (6) kōnekeneke (change). Positive aspects of SLT were described, however, Māori often did not receive optimal supports. Aspirations centred on changes to SLT services and the wider healthcare system. Conclusions Adaptations to SLT services are indicated to improve the quality of SLT received by Māori following stroke. To meet aspirations described in this study, the SLT profession may incorporate Māori approaches; prioritise strong, collaborative relationships; offer more autonomy to Māori stroke survivors; support the development of SLTs and SLT students; increase public awareness; and encourage change in the wider healthcare system. Many aspirations identified in the current study are consistent with those identified by Indigenous people in Australia, suggesting that some common solutions may exist to improving Indigenous SLT services.

R. Scott Sheffield and Noah Riseman. Indigenous Peoples and the Second World War: The Politics, Experiences and Legacies of War in the US, Canada, Australia and New Zealand.

Indigenous Peoples and the Second World War: The Politics, Experiences and Legacies of War in the US, Canada, Australia and New Zealand, by historians R. Scott Sheffield and Noah Riseman, focuses on a detailed comparison of the military service and postwar developments of Indigenous peoples in four settler colonial states during World War II: Native Americans of the United States, First Nations Peoples of Canada, the Māori of New Zealand, and the Indigenous peoples of Australia and the Torres Strait Islands. While the Native men and women from these regions served in varied roles and theaters of the war, and had a wide variety of assignments and experiences, their larger experiences, before, during, and following the war were overall similar. Due to stereotypes of possessing natural martial or warrior abilities, members of each group were often placed in forward combat roles, resulting in their groups seeing disproportionate amounts of combat in relation to their numbers.

Histopathology pattern and survival analysis of patients with kidney biopsy in the top end of Northern Australia from 2007 to 2020

AimRoyal Darwin Hospital (RDH) is the main tertiary hospital that has performed more than 600 biopsies since its establishment. Although Indigenous people in Australia’s Northern Territory (NT) has the highest rate of renal replacement therapy, the histopathology pattern of their renal diseases is still under discussed. We aimed to analyse the histopathology pattern of patients undergoing renal biopsy in RDH from June 2007 to June 2020. Secondary aims include clinical indication and survival analysis of patients with kidney biopsies.MethodsWe conducted a retrospective cohort study on all native kidney biopsy reports from patients over the age of 16, from June 2007 to June 2020. Descriptive statistics was used to summarise age, sex, indigeneity, histopathological pattern, and mortality. Categorical values were expressed as absolute frequencies and percentages. Survival analysis was performed using multivariate analyses and Cox proportional hazard regression model.ResultsThere were 364 native renal biopsies included in the analysis. Sub-nephrotic proteinuria was the most common clinical indication for kidney biopsy (n = 160,47.8%). Diabetes nephropathy (DN) was the most common pathological finding (n = 71,12.8%). Indigenous population who had dialysis performs poorly compared to their non-indigenous counterpart (HR 2.37,95% CI 1.53–3.67,p < 0.001).ConclusionDiabetic nephropathy is the most common native kidney biopsy in the NT with higher mortality among indigenous patients. This study supports the previous findings of indigenous female excess, younger age of kidney disease requiring kidney biopsy, and excess of diabetic nephropathy in the top-end of the NT. It can be speculated that some diabetic patients had atypical features prompting a biopsy.

Interscalar maintenance: configuring an Indigenous ‘premium carbon product’ in northern Australia (and beyond)

AbstractMitigating climate change requires us to constrain combustion in a double sense: decreasing both the use of fossil fuels and the flammability of the biosphere. Fire management by Indigenous peoples in Australia's northern savannas has been presented as a solution to offset the former and assist with the latter, leading to the foundation of a regional economy of projects generating ‘premium’ carbon credits on Indigenous lands. This article attends to the translational zone – predominantly made up of non‐Indigenous white professionals – that functions to configure the ‘right story’ of these credits across diverse epistemes and contexts. Following such commodities’ interscalar connections, I suggest, helps illustrate the contingencies and contradictions produced by tradeable carbon, as individuals and organizations seek to maintain a niche within a changing climate and shifting global atmospheric relations.

P010 Success and failure rates of ambulatory home sleep studies (Level 2) among Indigenous patients

Abstract Introduction/Aim Level 2 sleep studies are being increasingly performed worldwide in order to minimise the cost and access to level1 in-lab polysomnography. However, their accuracy and validity remain disputed. For populations residing in regional and remote localities, access to level1 sleep studies are further compromised, such as among Indigenous people of Australia, where 80% reside in remote communities. There is limited information in the literature regarding the efficacy of level2 sleep studies among Indigenous patients. Hence, in this study we evaluated the efficacy of level2 sleep studies amongst an Indigenous population. Methods 552 level2 sleep studies from Indigenous patients recorded between 2011-2020 were included. Sleep studies were analysed and scored manually by registered polysomnographic technologist as per standard guidelines. The studies were also assessed to determine the soundness of the study. Demographic and clinical information of patients was also collected. Results 50% of the patients were female, and 51% resided in remote or very remote locations. Of the 552 studies, 47(8.5%) were failed. There was no significant differences in demographic factors between failed and successful studies. The most common reason for failure was intolerance of the sensors which resulting in removing the device. Conclusion Level 2 sleep studies showed high success rate amongst this Indigenous population with just 8.5% failure rate. As there is limited access to level 1 sleep studies among the Indigenous Australian population due to remoteness, this study shows that level 2 sleep studies are a feasible alternative in the diagnosis for the presence of sleep disorders.

More than a ‘voice’: Indigenous transmission in the Murray-Darling Basin Plan

The Uluru Statement (2017) has recently focused attention on Indigenous state relations as an Indigenous ‘voice’ to government. For decades, Indigenous peoples in Australia have sought a meaningful voice in settler state environmental planning and management regimes, with limited success. Little attention has been paid to what constitutes an effective Indigenous voice. I conceptualise Australian Indigenous environmental planning and management as a dual deliberative system where Indigenous groups must transmit their messages into settler institutions and processes. I analyse the democratic quality of this transmission between two Indigenous deliberative forums, Northern Basin Aboriginal Nations and the Murray Lower Darling Rivers Indigenous Nations and the commonwealth Murray-Darling Basin Authority in developing the controversial Murray-Darling Basin Plan (2012). These deliberative forums improve the transmission quality of Indigenous environmental discourses. They are more than a voice; they are a democratic innovation which goes beyond the limits of state ‘inclusion’ of Indigenous environmental values.

The role of Indigenous Health Workers in ear health screening programs for Indigenous children: a scoping review

ObjectiveTo identify and describe the involvement of Indigenous Health Workers within ear health screening programs for Indigenous Peoples in Australia, Canada, the US and New Zealand. MethodsPeer‐reviewed and grey literature sources were systematically searched to identify evidence. This scoping review was conducted in accordance with the scoping review extension of the Preferred Reporting Items for Systematic reviews and Meta‐Analyses guidelines. ResultsForty pieces of evidence were included in this review. While almost all included studies identified the critical role of Indigenous Health Workers in ear and hearing health, Indigenous leadership and involvement in research projects and service delivery varied significantly and none of the included studies reported Indigenous health worker perspectives. Approximately half of the authorship teams had at least one Indigenous author. ConclusionsThere is a clear need for Indigenous leadership in ear and hearing health research and programming. Specialist teams involved in health service delivery and research need to enable this transition by understanding and privileging Indigenous leadership and investing in appropriate training for non‐Indigenous specialists providing care in Indigenous health contexts. Implications for public healthThese findings are discussed in terms of opportunities to improve Indigenous ear and hearing health research and programming.

Community-based social care models for indigenous people with disability: A scoping review of scholarly and policy literature.

Disability is experienced and understood by Indigenous people internationally in distinct ways from other populations, requiring different approaches in disability services. Furthermore, Indigenous populations access disability services at low rates. In response, policymakers, service providers and Indigenous organisations have developed specific models of care for Indigenous people with disability. Social care services, comprising personal care, transport and social activities, can support Indigenous people with disability to live with their families and in their communities. However, little is known about the range of social care models for Indigenous people with disability. To inform policy and practice, we conducted a scoping review of community-based models of social care designed to meet the needs of Indigenous peoples in Australia, Aotearoa New Zealand, Canada and the United States. Our methods were informed by best practice scoping review principles and a collaborative approach that centred Indigenous voices within research appraisal and project governance processes. Literature searches (conducted March-April 2021) yielded 25 results reporting on 10 models of care. We identified two over-arching themes (funding and governance arrangements; service delivery design) that encompass nine key characteristics of the included models. Our analysis shows promising practice in contextually relevant place-based social activity programs, support and remuneration for family carers and workforce strategies that integrate Indigenous staff roles with kinship relationships and social roles. While more research and evaluation are needed, disability funding bodies and service systems that facilitate these areas of promising practice may improve the accessibility of social care for Indigenous peoples.