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Tier 2 - Determinants of health

2.14 Indigenous people with access to their traditional lands

Key facts

Why is it important?

Connection to family and community, land and sea, culture and identity has been identified as integral to health and wellbeing from an Aboriginal perspective (NAHSWP 1989). As stated by Anderson: ‘Our identity as human beings remains tied to our land, to our cultural practices, our systems of authority and social control, our intellectual traditions, our concepts of spirituality, and to our systems of resources ownership and exchange. Destroy this relationship and you damage—sometimes irrevocably—individual human beings and their health’ (FATSIS 1995). Ongoing access to traditional lands also offers socio-political, economic and environmental benefits (Weir 2012).

For many Aboriginal and Torres Strait Islander people, disconnection from Country is considered a form of homelessness. Similarly, many people are less likely to perceive themselves as homeless, regardless of the adequacy of their dwelling, if they are on Country (ABS 2014).

The recently established National Agreement on Closing the Gap has identified that Indigenous Australians have a distinctive cultural, spiritual, physical and economic relationship with their land and waters. The agreement outlines specific outcomes, targets and indicators to direct policy attention to support the cultural wellbeing of Indigenous Australians. Reporting arrangements for the new agreement are being established. The data presented in this report predates the establishment of the agreement.

Findings

What does the data tell us?

Self-reported data from the 2018–19 National Aboriginal and Torres Strait Islander Health Survey (Health Survey) showed that an estimated 357,800 (74%) Indigenous Australians aged 18 and over recognised their homelands or traditional Country as an area of land with ancestral and cultural links. Over a quarter (27% or 130,500) of Indigenous adults reported they lived on their homelands or traditional Country, 45% (218,000) lived elsewhere but were allowed to visit, and 0.4% (1,900) were not allowed to visit their homelands or traditional Country (Table D2.14.1, Figure 2.14.1).

Indigenous Australians who lived in Remote areas were more likely than those in Non-remote areas to: identify with a clan, tribal or language group (86% compared with 61%); recognise their homelands or traditional country (90% compared with 71%); and live on their homelands or traditional country (47% compared with 23%) (Table D2.14.1, Figure 2.14.1).

Figure 2.14.1: Indigenous Australians aged 15 and over who identify with a clan, tribal or language group or recognise homelands, by remoteness, 2018–19

This bar chart shows that in remote areas, 86% of Indigenous Australians aged 15 and over identified with a clan, tribal or language group, and 47% lived on their homeland/traditional country. Proportions for Indigenous Australians living in non-remote areas were lower (61% and 23% respectively).

Source: Table D2.14.1. AIHW and ABS analysis of National Aboriginal and Torres Strait Islander Health Survey 2018–19.

Indigenous Australians living in Very remote areas were more likely to recognise their homelands or traditional Country (92%) than those living in Non-remote areas (68%–78%). Indigenous Australians in Very remote areas were more likely than those in less remote areas to be living on their homelands or traditional Country (Table D2.14.1, Figure 2.14.2).

Figure 2.14.2: Access to homelands/traditional Country, Indigenous Australians aged 15 and over, by whether recognises homelands/traditional Country and remoteness, 2018–19

This stacked bar chart shows that the proportion of Indigenous Australians who recognized and lived on their homelands and who recognized and were allowed to visit their homelands ranged from 66% in Major cities to 91% in Very remote areas. In Major cities, 13% recognized and lived on their homelands and 53% recognized and were allowed to visit their homelands, while in Very remote areas, 53% recognized and lived on their homelands and 38% recognized and were allowed to visit their homelands.

Note: Column stacks do not add to 100 because they exclude 'don't know whether allowed to visit homelands/traditional country'.
Source: Table D2.14.1. AIHW and ABS analysis of National Aboriginal and Torres Strait Islander Health Survey 2018–19.

Based on the 2018–19Health Survey, an estimated 18% of Indigenous adults had been removed from their family, and 36% had relatives who had been removed from their family. Of those who recognise homelands or traditional Country 19% were removed from their family and 40% had a relative removed from their family. Compared to Indigenous Australians who do not recognise their homelands or traditional Country, 12% were removed, and 24% had a relative removed (Table D2.14.5).

In 2018–19, of Indigenous Australians who were allowed to visit their homelands or traditional Country, 39% reported they visit less than once per year, 17% visit once per year, 18% visit several times per year, 7% visit at least once a month and 19% never visit. Of those who visited at least once a year, 39% spent less than one week visiting, 43% spent between one week and a month visiting, 9% spent one to three months visiting and the remaining 9% spent more than three months visiting (Table D2.14.4).

Relationship with socioeconomic and health factors

The 2018–19 Health Survey provides an opportunity to analyse relationships between access to homelands and other factors. The analysis outlined below summarises simple associations found in the data; further multivariate analysis is needed to explore the complex interactions between these issues and how they relate to health outcomes.

Those who lived on their homelands or traditional Country were less likely to have completed Year 12, less likely to be employed, and less likely to be able to raise $2000 within a week when compared with Indigenous adults who were allowed to visit their homelands or traditional Country and those who did not recognise their homelands or traditional country (Table D2.14.2, Figure 2.14.3).

Indigenous Australians who lived on their homelands or traditional Country were more likely to self-assess their own health as excellent/very good/good (78% compared with 47%) than those who were not allowed to visit their homelands or traditional Country (Table D2.14.3).

Figure 2.14.3: Proportion of Indigenous Australians aged 18 and over with selected socioeconomic characteristics, by access to homelands/traditional country, 2018–19

This bar chart shows that, Indigenous Australians who were allowed to visit their homelands were more likely to complete year 12 (36%), be employed (51%) and be able to raise $2,000 in a week (47%) than those who lived on their homelands (29%, 40% and 37% respectively).

Source: Table D2.14.2. AIHW and ABS analysis of National Aboriginal and Torres Strait Islander Health Survey 2018–19.

In 2014–15, over 50% of Indigenous rangers and Indigenous Protected Areas projects reported an improvement in the health and overall wellbeing of their rangers in 2014–15 (PM&C 2016).

What do research and evaluations tell us?

Berry and others (2010) define Caring for Country as incorporating an interdependent relationship between Indigenous Australians and land and seas. It involves participation in activities on traditional land, with the objective of promoting ecological, spiritual and human health (Berry et al. 2010). Research continues to explore the importance of connections between Indigenous Australians and traditional values, cultural practices and the physical environment.

A study by Norman (2017) focuses on North American indigenous people and reveals a requirement for indigenous people to continually protect traditional ways of life by engaging in activism at personal, tribal and collective levels (Norman 2017). The author asserts that indigenous people around the world are leaders in social and environmental justice and highlights the need to vastly improve governance measures to protect ecological and human health for current and future generations. Norman identifies access to fishing rights in examples of activities with the traditional physical traditional environment.

A recent Australian study (Jarvis et al. 2018) focuses on Indigenous business development through Indigenous land and sea management programs (ILSMPs) in northern Australia. Key themes include the economic and environmental benefits of ILSMPs and inextricable links with connection to Country:

  • Economic activities are embodied in customary sectors such as hunting and fishing and are indivisible from the notion of looking after Country
  • ILSMPs benefit the environment and generate economic benefits
  • An analysis of eight years of data supported the proposition that expenditure on ILSMPs created positive benefits for Indigenous businesses including those not engaged in land management.

A separate analysis of data found a clear association between cultural attachment and positive socioeconomic outcomes and wellbeing (Dockery 2011). Research found cultural attachment has positive effects on subjective wellbeing, so that strong identification of Indigenous persons with traditional culture is associated with better mental health. The author concluded that preserving traditional cultures is an avenue to better wellbeing and to improving ‘closing the gap’ indicators.

In central Arnhem Land, a cross-sectional study of almost 300 Indigenous adults aged 15–54 found that participation in Caring for Country was associated with better health outcomes, including diet, physical activity, mental health and lowered risk of diabetes, kidney disease and cardiovascular disease, after controlling for socioeconomic characteristics and health behaviours (Burgess et al. 2009).

Rowley and others (2008) found lower than expected morbidity and mortality in outstations when people are provided regular primary health care outreach services and identify factors associated with outstation living that contribute to better health. These include physical activity, diet and limited access to alcohol, connectedness to culture, family and land, and opportunities for self-determination (Rowley et al. 2008). McDermott and others (1998) also found health benefits from decentralised outstation living. The study noted that Indigenous Australians living in homelands communities have more favourable mortality, hospitalisation, hypertension, diabetes and injury outcomes than those living in more centralised settlements in Central Australia (McDermott et al. 1998).

Access to traditional lands is not only a determinant of health in remote contexts where Indigenous Australians are more likely to have ownership and control over their Country; it is also a determinant of health for those living in Non-remote and urban areas. Research in Victoria identified the role of Country in: strengthening self-esteem, self-worth and pride; fostering self-identity and belonging; cultural and spiritual connection; and enabling positive states of wellbeing (Kingsley et al. 2013).

The Australian Government published the Study Away Review in 2017 (PM&C 2017). The report constitutes phase one of the review and focuses on the effectiveness of Commonwealth Government support for Indigenous Australian students who study away from home and traditional lands. Phase two of the review will seek to find ways to address these issues.

While there are academic benefits from studying in schools distant from home, the transition from home to studying away is difficult for many students. The findings of the review highlight issues that are integral to the health and wellbeing and the academic success for the student such as:

  • a need for better preparation for students and families prior to leaving home
  • the development of family and community capacity in understanding and engaging in their children’s education
  • the importance of in-school and accommodation support and family and community engagement
  • that school and boarding environments generate a sense of belonging for Indigenous students.

Implications

While the evidence suggests there are health benefits in connections to Country and culture, for many people, living on Country is no longer an option. For those living in Non-remote areas, visits may be the only realistic possibility. However, an emerging body of literature is improving knowledge about how relationships with Country are maintained by Indigenous Australians living in urban and metropolitan centres, and the effects of these relationships on health, wellbeing, cultural expression, heritage and education (Hansen & Butler 2013).

As at May 2019, Indigenous Australians’ rights and interests in land were formally recognised in around 49% of the land area of Australia. A further 15% of Australia was subject to application for the recognition of native title rights.

Australian governments recognise the importance to Indigenous Australians of maintaining their connection to land and waters. This connection is the basis of relationships, identities, cultural practices and Indigenous wellbeing at both the individual and community level. This has been recognised in the new National Agreement on Closing the Gap which has been developed in partnership between all Australian governments and the Coalition of Aboriginal and Torres Strait Islander Peak Organisations.

This new agreement outlines a better way of working, with governments working in genuine partnership with Aboriginal and Torres Strait Islander people to get better outcomes. The National Agreement sets out ambitious targets and new priority reforms that will change the way governments work to improve life outcomes experienced by Indigenous Australians. The National Agreement specifically outlines the following outcomes and targets to direct policy attention to support the cultural wellbeing of Indigenous Australians:

  • Outcome 15—Aboriginal and Torres Strait Islander people maintain a distinctive cultural, spiritual, physical and economic relationship with their land and waters.
    • Target A—By 2030, a 15 per cent increase in Australia’s landmass subject to Aboriginal and Torres Strait Islander people’s legal rights or interests.
    • Target B—By 2030, a 15 per cent increase in areas covered by Aboriginal and Torres Strait Islander people’s legal rights or interests in the sea.
  • Outcome 16—Aboriginal and Torres Strait Islander cultures and languages are strong, supported and flourishing
    • Target—By 2031, a sustained increase in the number and strength of Aboriginal and Torres Strait Islander languages being spoken.

There is a need for larger-scale research into the causal pathways for how the connection to culture and Country influences the health and wellbeing of Indigenous Australians. Much of the research has consisted of small observational studies and publications have tended to focus on social and emotional wellbeing outcomes (Bourke et al. 2018). The National Study of Aboriginal and Torres Strait Islander Wellbeing (Mayi Kuwayu Study) is a large-scale longitudinal study exploring culture and its relationship to health and wellbeing (Jones et al. 2018). It includes measures of culture that have been co-developed with Indigenous people, including connection to country. At the time of writing, the findings of the baseline wave of the study are yet to be published.

The policy context is at Policies and strategies.

References

  • ABS (Australian Bureau of Statistics) 2014. Information Paper: Aboriginal and Torres Strait Islander Peoples Perspectives on Homelessness 2014 Canberra: ABS.
  • Berry HL, Butler JR, Burgess CP, King UG, Tsey K, Cadet-James YL et al. 2010. Mind, body, spirit: co-benefits for mental health from climate change adaptation and caring for country in remote Aboriginal Australian communities. New South Wales Public Health Bulletin 21:139-45.
  • Bourke S, Wright A, Guthrie J, Russell L, Dunbar T & Lovett R 2018. Evidence Review of Indigenous Culture for Health and Wellbeing. International Journal of Health, Wellness & Society 8.
  • Burgess CP, Johnston FH, Berry HL, McDonnell J, Yibarbuk D, Gunabarra C et al. 2009. Healthy country, healthy people: the relationship between Indigenous health status and" caring for country". The Medical Journal of Australia 190:567-72.
  • Dockery AM 2011. Traditional culture and the wellbeing of Indigenous Australians: An analysis of the 2008 NATSISS. Perth: Centre for Labour Market Research.
  • FATSIS (Faculty of Aboriginal and Torres Strait Islander Studies) 1995. Aboriginal health, social and cultural transitions : proceedings of a conference at the Northern Territory University, Darwin, 29-31 September, 1995. Darwin.
  • Hansen C & Butler K 2013. Exploring Urban Identities and Histories. AIATSIS.
  • Jarvis D, Stoeckl N, Addison J, Larson S, Hill R, Pert P et al. 2018. Are Indigenous land and sea management programs a pathway to Indigenous economic independence? The Rangeland Journal 40:415-29.
  • Jones R, Thurber KA, Chapman J, D’Este C, Dunbar T, Wenitong M et al. 2018. Study protocol: Our Cultures Count, the Mayi Kuwayu Study, a national longitudinal study of Aboriginal and Torres Strait Islander wellbeing. BMJ Open 8.
  • Kingsley J, Townsend M, Henderson-Wilson C & Bolam B 2013. Developing an Exploratory Framework Linking Australian Aboriginal Peoples’ Connection to Country and Concepts of Wellbeing. International journal of environmental research and public health 10:678-98.
  • McDermott R, O'Dea K, Rowley K, Knight S & Burgess P 1998. Beneficial impact of the homelands movement on health outcomes in central Australian aborigines. Aust N Z J Public Health 22:653-8.
  • NAHSWP (National Aboriginal Health Strategy Working Party) 1989. A national Aboriginal health strategy / prepared by the National Aboriginal Health Strategy Working Party. Canberra: National Aboriginal Health Strategy Working Party.
  • Norman ES 2017. Standing Up for Inherent Rights: The Role of Indigenous-Led Activism in Protecting Sacred Waters and Ways of Life. Society & Natural Resources 30:537-53.
  • PM&C (Department of the Prime Minister and Cabinet) 2016. Reporting back...2014-15: How Indigenous Ranger and Indigenous Protected Areas programmes are working on country.  (ed., DPMC). Canberra: Commonwealth of Australia.
  • PM&C 2017. Study Away Review.  (ed., Cabinet DotPMa). Canberra.
  • Rowley K, O'Dea K, Anderson I, McDermott R, Saraswati K, Tilmouth R et al. 2008. Lower than expected morbidity and mortality for an Australian Aboriginal population: 10-Year follow-up in a decentralised community. The Medical Journal of Australia 188:283-7.
  • Weir JK 2012. Country, Native Title and Ecology. In: Weir JK (ed.). Country, Native Title and Ecology. Vol. 24. Canberra: Australian National University Press, 1-20.

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