Remote Aboriginal Communities Research Articles

Missed Opportunities for Preventing or Diagnosing Acute Rheumatic Fever: A Retrospective Cohort Study of 20 Young Australians Diagnosed With Rheumatic Heart Disease on Screening Echocardiography.

A cross-sectional echocardiographic screening study in a remote Aboriginal community in Australia identified hyperendemic levels of rheumatic heart disease (RHD). 20/613 screened were newly diagnosed with RHD, and 18/20 had no known history of acute rheumatic fever (ARF). Our aim was to explore the medical histories of those newly diagnosed with RHD for potential (1) missed opportunities for primary prevention of ARF through management of Group A Streptococcal (Strep A) infection, and (2) missed opportunities for diagnosis of ARF. We assessed community clinic and tertiary hospital medical records of those children with new diagnoses of RHD (n = 20), and collected information regarding previous episodes of possible Strep A infection or its sequelae. All 20 participants had previous documented possible or confirmed Strep A infections, predominantly in the form of impetigo or infected scabies (range 1-17 episodes per participant). At least 15/20 participants had potential Strep A infections where treatment that was documented may not have adequately covered Strep A. 11/20 participants had scabies diagnosed without documented scabies treatment. 2/20 participants had previously diagnosed ARF, however these were diagnosed within the month prior to the community-wide screening for RHD. 2/20 participants had undiagnosed, probable or possible ARF when classified retrospectively from review of their case documentation. 13/20 participants had non-specific presentations with joint complaints that may have represented an ARF episode but with inadequate workup to fulfil diagnostic criteria on retrospective assessment.

Measuring Food and Water Security in an Aboriginal Community in Regional Australia.

To measure current levels and experiences of food and water security in Walgett to guide a community-led program and to provide a baseline measure. A community-led cross-sectional survey conducted in April 2022 by trained local researchers. Walgett, a regional town in NSW, Australia. A total of 251 Aboriginal adults. Food and water security levels and experiences were measured using the Household Food Insecurity Access Scale (HFIAS) and Household Water InSecurity Experiences (HWISE) Scale. The relationship between food and water insecurity was determined through linear regression analysis. Almost half of the respondents experienced food insecurity (46%) or water insecurity (44%) in the last 12 months. Most participants attributed food insecurity to difficulties with food affordability (71%) and availability (63%). More than four in five participants reported relying on purchased or donated bottled water due to main water source interruption (83%) or quality concerns (86%). Water insecurity was associated with food insecurity; HFIAS score increased by 0.43 points for every point higher on the HWISE scale. This study is the first to measure levels and experiences of food and water security in an Aboriginal community in Australia using validated tools. The results highlight the interconnectedness of food and water insecurity and provide evidence of levels far higher than Australian national level estimates and comparable to low- and middle-income countries. A holistic government response alongside community-led efforts are needed to increasefood and water security to improve health and well-being in remote Aboriginal communities.

Remote Food Security Research Project: Applying an Indigenist Research Lens.

This paper aimed to reflect on how Rigney's model of Indigenist research informed the research design of a project which explored community-led solutions to improve food security in remote Aboriginal and Torres Strait Islander communities. The project was conducted in partnership with two Aboriginal Community Controlled Health Organisations (ACCHOs); Apunipima Cape York Health Council (Apunipima) and Central Australian Aboriginal Congress (Congress), communities in Central Australia and Cape York, Queensland and researchers from the University of Queensland, Monash University, Dalhousie University and Menzies School of Health Research. On reflection the principles of Indigenist research were evident providing a means of resistance to oppression through Indigenous stakeholders being in control of research to address social determinants, in this case food security. Aboriginal and Torres Strait Islander world views, lived experiences and knowledges were embedded in the research and informed governance, implementation and knowledge translation. ACCHOs and communities gained a political voice through advocacy and actions at the local, state and national levels. The development of a Community Framework led by ACCHOs and community stakeholders to address food security serves to talk to the three principles of 'Resistance, Political Integrity and Privileging Indigenous Voices'.

'They got my back': Thematic analysis of relationship building in nurse home visiting in Aboriginal communities.

The client-practitioner relationship is the cornerstone of nurse home-visiting programs. Little is understood about how relationship-based maternal and early childhood health care is perceived by women in remote Aboriginal communities. As part of an evaluation of nurse home-visiting in the Northern Territory, this research examines how relationships are established with clients, and what elements are valued most by women. Maternal Early Childhood Sustained Home-visiting (MECSH) is an Australian model of nurse-led home-visiting targeted at women facing adversity who need extra support. The model provides parenting information, health education and psychosocial support during pregnancy and the first 3 years of children's development. Interviews were conducted with 92 Aboriginal women and 11 practitioners including nurses, social workers and community workers. Qualitative semi-structured interviews were conducted with convenience samples of MECSH clients and practitioners. Data were analysed using a two-step process of structural coding and thematic analysis. Trust was the foundation of clients' positive perception of the relationship with their MECSH provider. Relationships took time to develop, often beginning with practical support to meet clients' basic needs. Practitioner dependability and flexibility to client priorities, communication, confidentiality and being helpful to the woman and her family was important. Clients emphasised emotional support and friendship. The relationship-based approach was valued and consistent with culturally safe and trauma informed ways of working with Aboriginal families. Effort is required to commit to the model to address ongoing healthcare engagement and health outcomes in remote Northern Territory communities.

Making it on the breadline – improving food security on the Anangu Pitjantjatjara Yankunytjatjara Lands, Central Australia

BackgroundThis longitudinal case study describes the efforts and impacts of community-controlled service organisations on the Anangu Pitjantjatjara Yankunytjatjara (APY) Lands in Central Australia to tackle food security since the 1980s, with a focus on the last decade, particularly during a year of concerted action from mid-2018.MethodsThe co-designed study comprised an interrupted time series with controls. Availability, affordability, accessibility and sales of foods in the community retail stores on the APY Lands were monitored regularly from 2014 to mid-2022, including by local research teams. Store nutrition policy was updated early 2018. For a year from mid-2018, of the eight communities with stores: (i) two were the focus for concerted intervention, including support from a locally based project officer to help implement the policy and action 105 community requests for nutrition activities (ii) three received usual support to implement the policy; and (iii) three were subject to ‘business as usual’. From mid-2019, all communities/stores received usual service, from 2020 with some restrictions related to the COVID-19 pandemic. Results were compared over time, across different community/store groups and with controls.ResultsIn the 12 months from mid-2018, all food security metrics improved most in the two focus communities. Impacts were less marked in the communities without additional support to implement the revised nutrition policy, and even less apparent, although more varied, in the other three communities/stores. Dietary intake improved only in the two focus communities.In all communities from early 2020 most gains eroded due to impacts of the COVID-19 pandemic and other external stressors. Food security metrics, including price of healthy food, appeared more resilient in the focus communities, although diet quality worsened. At all times assessed, healthy diets were unaffordable for welfare-dependant households.ConclusionsThis co-designed study demonstrates the effectiveness of community-led approaches, confirming that it is possible to improve food security and diet in remote Aboriginal communities. However, sustained action and monitoring, dedicated resources and employment of local people are critical for success. Results also highlight that low incomes are a major barrier to food security.

Community-led diphtheria vaccination campaign to manage a diphtheria outbreak in a remote Aboriginal community.

In 2022, five cases of diphtheria were identified in and around Wujal Wujal, a discrete Aboriginal community in Far North Queensland. This prompted a mass diphtheria vaccination campaign in the community which increased the proportion of residents aged ≥ 14 years receiving a diphtheria containing vaccine in the prior twelve months from 5% to 74%. No further cases were detected in the subsequent twenty-two months.

The Earphone Project pilot: a tele-otology study for remote Aboriginal communities

The Earphone Project pilot: a tele-otology study for remote Aboriginal communities

Optimising remote health workforce retention: protocol for a program of research

BackgroundNowhere is optimising healthcare staff retention more important than in primary health care (PHC) settings in remote Australia, where there are unacceptably high rates of staff burnout and turnover. Ensuing consequences for the remote health services and the community are acute – staffing shortfalls in clinics; organisational instability; excessive costs associated with frequent staff recruitment and orientation; diminished access to PHC for patients in need; and lack of continuity of patient care; all of which further entrench poor health outcomes for the community. Optimising remote healthcare staff retention is critical in order to provide high quality and continued PHC. Currently, however, there is paucity of knowledge to inform targeted and effective retention strategies in remote health services.This research program seeks to develop a stronger evidence base to understand (i) what retention strategies are effective in improving morale, job satisfaction, intention to remain in the job, and consequent length of service for remote healthcare staff; (ii) how best to ‘bundle’ these strategies for different health workforce groups; and (iii) how these ‘bundles’ work in different service contexts.MethodsThis paper describes a five-year implementation research program in partnership with twelve remote Aboriginal and Torres Strait Islander Community Controlled Health Services (ATSICCHS) in the Northern Territory and Queensland, Australia. Overall methodology follows a participatory action research approach which incorporates co-design and realist elements. The program comprises two broad phases involving evidence consolidation and synthesis (Phase 1), and co-design, implementation, and prospective evaluation of ‘bundles’ of retention strategies (Phase 2) to improve retention of healthcare staff in participating ATSICCHSs.DiscussionThis innovative research program has the potential to develop a comprehensive evidence base required to optimise health workforce retention in remote health services. This new evidence will strengthen understanding of what ‘bundles’ of retention strategies are effective, for which groups of employees, and how they work to improve staff retention.

Lessons learnt from the first two SARS-CoV-2 Omicron waves of the COVID-19 pandemic in six remote Aboriginal and Torres Strait Islander communities in Queensland, Australia: a retrospective epidemiological review.

To describe the preparedness for, epidemiological characteristics of and public health responses to the first and second waves of coronavirus disease 2019 (COVID-19) in six remote Aboriginal and Torres Strait Islander communities in Queensland from late 2021. This was a descriptive epidemiological study. Data were collated by each participating public health unit. Case and outbreak characteristics were obtained from the statewide Notifiable Conditions System. Six discrete remote First Nations communities across Queensland were selected to represent a broad geographic spread across the state: Badu Island, Cherbourg, Lockhart River, Palm Island, Woorabinda and Yarrabah. People with a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test result recorded between 13 December 2021 and 12 June 2022 who acquired the infection and isolated in one of the six communities. COVID-19 vaccination coverage among First Nations people; number of COVID-19 cases reported; and attack rates for each community. All six First Nations communities led the COVID-19 preparedness and planning. COVID-19 vaccination coverage rates before the first outbreak ranged from 59% to 84% for the first dose and from 39% to 76% for the second dose across the six communities. During the study period, 2624 cases of COVID-19 in these communities were notified to Queensland Health. Attack rates for each community were: Badu Island, 23%; Cherbourg, 34%; Lockhart River, 18%; and Palm Island, Woorabinda and Yarrabah, 35% each. The 2624 cases included 52 cases (2%) involving hospital admission and two cases (< 1%) in which the person died from COVID-19. It is likely that the co-designed, collaborative partnerships between local councils, community-controlled health services, state health services and public health units positively impacted the management and outcomes of COVID-19 in each of the six communities.

Benchmarking for healthy food stores: protocol for a randomised controlled trial with remote Aboriginal and Torres Strait Islander communities in Australia to enhance adoption of health-enabling store policy and practice

BackgroundAboriginal and Torres Strait Islander communities in remote Australia have initiated bold policies for health-enabling stores. Benchmarking, a data-driven and facilitated ‘audit and feedback’ with action planning process, provides a potential strategy to strengthen and scale health-enabling best-practice adoption by remote community store directors/owners. We aim to co-design a benchmarking model with five partner organisations and test its effectiveness with Aboriginal and Torres Strait Islander community stores in remote Australia.MethodsStudy design is a pragmatic randomised controlled trial with consenting eligible stores (located in very remote Northern Territory (NT) of Australia, primary grocery store for an Aboriginal community, and serviced by a Nutrition Practitioner with a study partner organisation). The Benchmarking model is informed by research evidence, purpose-built best-practice audit and feedback tools, and co-designed with partner organisation and community representatives. The intervention comprises two full benchmarking cycles (one per year, 2022/23 and 2023/24) of assessment, feedback, action planning and action implementation. Assessment of stores includes i adoption status of 21 evidence-and industry-informed health-enabling policies for remote stores, ii implementation of health-enabling best-practice using a purpose-built Store Scout App, iii price of a standardised healthy diet using the Aboriginal and Torres Strait Islander Healthy Diets ASAP protocol; and, iv healthiness of food purchasing using sales data indicators. Partner organisations feedback reports and co-design action plans with stores. Control stores receive assessments and continue with usual retail practice. All stores provide weekly electronic sales data to assess the primary outcome, change in free sugars (g) to energy (MJ) from all food and drinks purchased, baseline (July-December 2021) vs July-December 2023.DiscussionWe hypothesise that the benchmarking intervention can improve the adoption of health-enabling store policy and practice and reduce sales of unhealthy foods and drinks in remote community stores of Australia. This innovative research with remote Aboriginal and Torres Strait Islander communities can inform effective implementation strategies for healthy food retail more broadly.Trial registrationACTRN12622000596707, Protocol version 1.

The Experiences of Pregnant Women Accessing Food in Remote Aboriginal Communities on Haida Gwaii

Context: Despite strong evidence supporting the importance of good nutrition in pregnancy for optimal perinatal outcomes, little research exists regarding the experiences of women’s access to food in pregnancy. This is particularly true of research on remote Aboriginal women, who may be constrained by local availability and costs of local food. Methods: This research was carried out in a case study design and in a semi- structured qualitative interview format. Twelve women in the postpartum period on Haida Gwaii, British Columbia, were interviewed. Ethics approval was granted. Results were extracted, using a thematic analysis based on nine research questions. Results: Three main themes emerged through the interviews with the participants: (1) access to traditional foods, (2) enablers to access, and (3) financial limitations.Conclusion: Aboriginal women in remote communities experience challenges accessing food during pregnancy. However, the integration of traditional foods into their diet was viewed as a strong contributor to improving nutrition in pregnancy. For participants in this study, accessing traditional foods embodied cultural values, provided opportunities for autonomy, and directly contributed to the health and well-being of pregnant mothers. This article has been peer-reviewed.

“Talking about something no one wants to talk about”—navigating hepatitis B-related work in remote Australian Aboriginal communities: a decade of learning and growth

Abstract Background Chronic hepatitis B (CHB) is one of the leading causes of liver cirrhosis and liver cancer globally. In Australia, Aboriginal and Torres Strait Islander people of the Northern Territory (NT) have the highest prevalence of CHB (6%) and are six times more likely than non-Aboriginal people to be diagnosed with liver cancer. In 2010, a “liver one-stop shop” model of specialised care and research was initiated to address this disparity. Despite many challenges, the program was accepted in NT Aboriginal communities. This study aimed to identify the key elements linked to this success. Methods We conducted a retrospective case study using Stake’s methodology to understand the hepatitis B phenomenon. A constructivist approach allowed a holistic understanding from the real-life perspectives of those involved in the hepatitis B work. Information was sourced from the Aboriginal workforce, patients of remote clinics, interested community members and service providers. Results We identified six elements critical to the successful conduct of our hepatitis B program, which included the essential role of the local Aboriginal workforce, providing health education in a patient’s preferred language, addressing shame and stigma, respecting culture, taking time, and building trust in the community. Conclusions Commitment over the long term was crucial for the success of our hepatitis B program. Adhering to the identified elements was essential to create a culturally safe environment and engage more Aboriginal people in clinical care and research. This study provides powerful lessons and insights that can be applied to other programs and comparable settings worldwide.

Development of a Tool for Reporting Key Dietary Indicators from Sales Data in Remote Australian Aboriginal and Torres Strait Islander Community Stores.

Reporting key dietary indicators from sales data can help us guide store decision makers in developing effective store policy to support healthier customer purchases. We aimed to develop a web-based reporting tool of key dietary indicators from sales data to support health-promoting policy and practice in stores in geographically remote Aboriginal and Torres Strait Islander communities. Tool development included identifying key dietary indicators (informed by sales data from 31 stores), community consultation (19 Aboriginal and Torres Strait Islander store directors and two store managers) and a web-build. Tool evaluation involved feedback interviews with stakeholders (25 store managers and two nutritionists). Key dietary indicators aligned with Australian Dietary Guideline food groupings and recommendations. An online portal for accessing and customising reports was built. Stakeholder feedback indicated that the strengths of the reports were the visuals, ease of interpretation, providing information that was not currently available and potential to increase capacity to support healthy food retailing. Difficulties were defining healthiness classification with alignment to other nutrition guidelines used and ensuring reports reached relevant store decision makers. This tool may be valuable to support store decision makers in identifying and prioritising nutrition issues and optimising the health-enabling attributes of stores.

CULTURAL DISPLACEMENT AND ASSIMILATION IN KIM SCOTT’S TRUE COUNTRY

Kim Scott's True Country (1993) is a compelling exploration of identity, cultural hybsridity, and storytelling as acts of resistance against colonial erasure. Set in a remote Aboriginal community, the novel navigates the journey of Billy, an Aboriginal teacher, as he grapples with his dual heritage and seeks to reconcile his fragmented sense of self. Through a nuanced learning model—delearning, relearning, and learning—the narrative examines themes of cultural renewal, systemic injustice, and communal agency. Scott juxtaposes the enduring strength of Indigenous oral traditions and spirituality with the socio-economic challenges faced by Aboriginal communities. By portraying teachers as catalysts for dialogue between cultures, the novel highlights the transformative potential of education in fostering understanding and collaborative growth. Simultaneously, True Country underscores the resilience and complexity of Aboriginal identities, offering a vision of hope grounded in respect and reconciliation.

“We Need to Run Our Own Communities”

Australian Indigenous student participation rates in higher education are consistently lower than non-Indigenous students, especially in remote contexts. This has manifested in the usurpation of remote Aboriginal community control by ‘more qualified’ external staff. Here we present a reflexive assessment of the development, delivery, outcomes and challenges of the Wuyagiba Bush Uni that was designed to address the paucity of university education in remote Aboriginal communities of Arnhem Land, Northern Territory. From 2018 to 2022, 66 Indigenous students graduated with Wuyagiba Micro-credentials (accredited by Macquarie University), and 28 students proceeded to enrol in Bachelor level degrees at Macquarie University in Sydney, with the first graduate in 2023. Furthermore, the Wuyagiba model has created a successful remote Indigenous business that employs about 50 local Indigenous people annually and is working towards empowering endogenous community development in remote Arnhem Land. Nevertheless, many challenges remain including sustainable funding, remote service delivery, university and bureaucratic structural barriers, and lateral violence in remote communities. Several enabling factors of success are identified, such as the cross-cultural curriculum, strong Indigenous control and leadership, wrap-around support, and longstanding relationships between University staff and community leaders. Such reflections can be used by other remote Aboriginal communities who wish to replicate this model or create their own on-Country higher education programs to empower locally trained leaders of the future.

Using photovoice to generate solutions to improve food security among families living in remote Aboriginal and/or Torres Strait Islander communities in Australia

The right to food security has been recognised internationally, and nationally in Australia by Aboriginal Community Controlled Health Organisations. This study aims to explore food (in)security and solutions for improvement of food security in remote Aboriginal and/or Torres Strait Islander communities in Australia, from the perspective of caregivers of children within the context of the family using photovoice. Participants took part in workshops discussing participant photographs of food (in)security, including solutions. Themes and sub-themes with associated solutions included traditional food use, sharing as a part of culture, the cost of healthy food, energy and transport, and housing and income. Community leaders used these data in setting priorities for advocacy to improve food security in their communities.

Emotional reactions to concepts of racism and white privilege in non-Aboriginal professionals working in remote Aboriginal communities.

This research, conducted by a non-Aboriginal, White researcher, examines how health professionals working in remote Aboriginal communities engage with antiracism as instructed by national standards, whether strong emotions are elicited while reflecting on these concepts, and how these reactions impact on antiracist professional practice. Eleven non-Indigenous allied health professionals were interviewed in a semi-structured format. Interviews were transcribed, thematically analysed and compared to existing literature. Every participant identified overwhelming emotions that they linked to reflecting on racism, White privilege and colonisation. Professionals reported grappling with denial, anger, guilt, shame, fear, anxiety and perfectionism, loss of belonging, disgust and care. They reported that these emotions caused overwhelm, exhaustion, tensions with colleagues and managers, and disengagement from antiracism efforts, and contributed to staff turmoil and turnover. Previously, these emotional reactions and their impact on antiracism have only been described in the context of universities and by antiracist activists. This research identifies for the first time that these reactions also occur in health services in Aboriginal communities. Wider research is needed to better understand how these reactions impact on health service delivery to Aboriginal communities, and to evaluate ways of supporting staff to constructively navigate these reactions and develop antiracist, decolonised professional practice.

A qualitative exploration of the experiences of Aboriginal and Torres Strait Islander people using a real-time video-based telehealth service for diabetes-related foot disease.

Diabetes-related foot disease (DFD) is one of the most prevalent causes of global hospitalisation and morbidity, and it accounts for up to 75% of lower-extremity amputations globally. The 5-year mortality rate following any amputation ranges from 53% to 100%. Early identification of wounds and multidisciplinary management can reduce amputation rates by 39-56%. Rural and remote communities and Indigenous populations are disproportionately affected by DFD. This is reflected in amputation rates, which are much higher for Indigenous than for non-Indigenous Australians and for those in very remote areas than for those in major cities or inner regional areas. The large geographical spread of the population in Australia is a substantial barrier for those providing or accessing health services, particularly multidisciplinary and specialist services, which undoubtedly contributes to poorer DFD outcomes in rural and remote communities. A real-time, video-based telehealth service for DFD management was established at the Royal Adelaide Hospital Vascular Services clinic to improve access to specialist services for rural and remote Aboriginal and Torres Strait Islander communities. An exploratory qualitative study that utilised one-on-one, semi-structured interviews was conducted with 11 participants who identified as Aboriginal and who had participated in the telehealth foot service. Interviews were transcribed, de-identified and analysed using thematic analysis, using an inductive approach. Four interrelated themes emerged. 'Practical benefits of staying home' describes the reduced burden of travel and advantages of having local healthcare providers and support people at consultations. 'Access to specialists and facilities' highlights how some participants felt that there was a lack of appropriate facilities in their area and appreciated the improved access telehealth provided. 'Feeling reassured that a specialist has seen their feet' reflects the positive impact on wellbeing that participants experienced when their feet were seen by specialist health staff. 'Facilitates communication' describes how participants felt included in consultations and how seeing a person on screen assisted conversation. The advantages of real-time, video-based telehealth go beyond reduced travel burden and improved access to specialist care. This model of care may facilitate relationship-building, patient wellbeing, and feelings of trust and safety for Aboriginal and Torres Strait Islander DFD patients.

HipHop2SToP a community-led health promotion initiative empowering Aboriginal youth in the Kimberley region of Western Australia: a process evaluation.

For millennia, Aboriginal people's ways of knowing, doing and being were shared through art, song, and dance. Colonisation silenced these ways, affecting loss of self-determination for Aboriginal people. Over the past decade in Australia, hip-hop projects have become culturally appropriate approaches for health promotion. When community led, and Aboriginal worldviews centralised, hip-hop workshops are more likely to be effective. In 2020, during the COVID-19 pandemic, a community-led health promotion hip-hop music video, 'HipHop2SToP' was produced involving young people in Dampier Peninsula communities address healthy skin and healthy living practices. We report here a qualitative process evaluation of the HipHop2SToP project. Participants who had been involved in the planning and production of HipHop2SToP were selected using a purposive approach and invited either by email or face-to-face to participate in semi-structured interviews and share their experiences. Semi-structured interviews ranged from 30 to 60 min in duration and were conducted either face-to-face or virtually over MS Teams. Due to personal time constraints, two participants provided written responses to the semi-structured questions. All interviews were audio-recorded with consent and saved as a digital recording in a de-identified format. All audio recordings were transcribed verbatim and uploaded into QSR NVivo v12 along with written responses. As a health promotion project, the critical success factors were community-ownership and discovering novel ways to collaborate virtually with remote communities using Microsoft (MS) software. Highlights included observing the young people actively engaged in the project and their catchy lyrics and key messaging for environmental health and skin infections. COVID-19 presented some challenges. Gaps in communication, clarification of stakeholder roles and expectations, and post-production outcomes were also identified as challenges. HipHop2SToP validates the need for Aboriginal community led health promotion programs. While creating some challenges COVID-19 also strengthened community ownership and created novel ways of maintaining relationships with remote Aboriginal communities. Future hip-hop projects would benefit from clarity of roles and responsibilities. Strengthening post-production outcomes by including a launch and well-planned, targeted communication and dissemination strategy will ensure the wider translation of important health messages and potential strengthen sustainability.

Investment Policy Impacts on the Australian Aboriginal Art Market

AbstractLegislation designed for one purpose may have unrelated side effects. In this article we examine the impact of recent changes in the application of the sole purpose test for artworks to be used as assets in retirement funds on the Australian Aboriginal art market. This is important since art sales represent a significant source of non‐government income for remote Australian Aboriginal communities. In this article we estimate the impact of this change and others on the price index based on the hammer prices paid for 13,555 works by 187 artists at art auctions from 1994 to 2019.