The availability of timely, comprehensive and good quality data specifically relevant to remote Aboriginal and Torres Strait Islander notions of health and wellbeing has been a significant obstacle to understanding and addressing related disadvantage in a meaningful way. This literature review for the CRC-REP Interplay Between Health, Wellbeing, Education and Employment project explored existing wellbeing frameworks at global and local levels that are relevant to Aboriginal and Torres Strait Islander people in remote Australia.
Current government frameworks that collect data about Aboriginal and Torres Strait Islander people often produce a narrative that describes deficit, disadvantage and dysfunction. The frameworks include the Aboriginal and Torres Strait Islander Health Performance Framework, the Overcoming Indigenous Disadvantage Framework, the Australia Bureau of Statistics Aboriginal and Torres Strait Islander Wellbeing Framework and the National Aboriginal and Torres Strait Islander Social Survey. These frameworks gather statistical information for the purposes of policy analysis and program development and therefore use indicators that are important to policy. Increasingly, government frameworks are including holistic measures of health such as cultural health, governance and the impacts of colonisation.
This literature review has identified the need to develop a wellbeing framework that not only accurately represents education, employment, health and wellbeing and the interplay between these and other factors, but that also recognises the strengths and resilience of Aboriginal and Torres Strait people as well as reflecting their worldviews, perspectives and values. For example, a definition of ‘wellbeing’ that highlights the importance of physical, social, emotional, cultural and spiritual influences at the level of the individual and the community has been endorsed by Aboriginal and Torres Strait Islander groups and governments alike and sustained for over 20 years. Accordingly, this literature review has been organised along these topics.
In addition, the literature suggests that optimal wellbeing occurs when there is strong cultural identity in combination with control, achievement and inclusion at a wider societal level, such as through successful engagement in education and employment. Listening to Aboriginal and Torres Strait Islander people to learn of their conceptual thinking, knowledge and understanding, and responding to their priorities and ideas are crucial parts of the policy equation to improve outcomes across education, employment, health and wellbeing. The challenges in developing an appropriate wellbeing framework, then, are ensuring the active involvement and participation of the Aboriginal and Torres Strait Islander people.
One example of how this has worked is provided by the Community Indicators Victoria Project, which used local-level data to address issues that the local community identified as important. A focus on strengths is also important, and is exemplified in the Social and Emotional Wellbeing Framework of the National Aboriginal and Torres Strait Islander Health Council and National Mental Health Working Group. Various existing programs – such as ‘Caring for Country’ – can be adapted to capture data about connection to country, for example, and how that impacts on physical and mental health. Critically, the core domains of education, employment and health need to be extended to include activities and concepts that Aboriginal and Torres Strait Islander people consider important to these areas.
Recommendations for the development of a wellbeing framework are proposed here, derived from information available in the literature. Rather than being definitive, these recommendations provide a starting point for consultation and adaption towards establishing a wellbeing framework and operational system for collecting and analysing long-term health and wellbeing data for Aboriginal and Torres Strait Islander people in remote Australia as part of the research conducted by CRC-REP.