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Better Aboriginal health

Timothy P M Senior
Med J Aust 2009; 190 (4): 1.
Published online: 16 February 2009
Aboriginal primary health care. An evidence-based approach. 3rd ed.
Sophia Couzos, Richard Murray. Melbourne: Oxford University Press, 2007 (i + 862 pp). ISBN 978 0 19 555138 9.

Let me tell you a secret. I admired this book for a long time before I actually read it. Like Dickens and Dostoyevsky, it’s a great achievement, and I knew I should read it, but the sheer size put me off. Fortunately, it’s worthy of the trust I had invested in it.

The authors, all experts in their fields, have done an incredible job of collating the evidence behind their recommendations. Just as important is the backing of the National Aboriginal Community Controlled Health Organisation (NACCHO). To close the gap in health outcomes, Aboriginal communities must be able to make decisions for themselves. NACCHO’s involvement means these guidelines don’t start off as outside impositions.

It’s a dry read at times. The most memorable parts are quotations from other authors. The chapters start with quotes from Puggy Hunter — if you read only these, you will understand more of Aboriginal health than when you started.

The opening chapters are essential reading for linking together history, policy and health (or if you want to argue with someone who believes Aboriginal health is overfunded). The heart of the book devotes chapters to important clinical topics. Each chapter sets out the goals to be achieved, goes through interventions on individual, service and community levels, and supplies performance indicators as measures of how well you are doing. Most practices would find useful ideas here, whatever their population.

This book should be used alongside good-quality clinical guidelines for more practical detail for individual patients. The references will direct you to the appropriate places, although a bibliography would have been more helpful. In some instances the evidence has moved on since publication, but in many remote clinics a book is still the best way to access information. This one is more than good enough to work from.

  • Timothy P M Senior

  • University of Sydney, Sydney, NSW

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