Improving shared understandings between health professionals and remote Indigenous people
The communication gap between health professionals and Indigenous Australians has a significant impact on health outcomes.1-4 Limited health literacy is not confined to Indigenous people,5 but it is greatly magnified for speakers of Indigenous languages in comparison, for example, to non-English speaking migrants from countries where a scientific approach to medicine is practised and where these health concepts are already codified. The communication gap is most pronounced in remote areas where cultural and linguistic differences are greatest. The close interdependence of language and culture amplifies the gap, such that communication difficulties in these communities run deeper than language barriers alone.
- 1. Lowell A, Maypilama E, Yikaniwuy S, et al. “Hiding the story”: Indigenous consumer concerns about communication related to chronic disease in one remote region of Australia. Int J Speech Lang Pathol 2012; 14: 200-208.
- 2. Cass A, Lowell A, Christie M, et al. Sharing the true stories: improving communication between Aboriginal patients and healthcare workers. Med J Aust 2002; 176: 466-470. <MJA full text>
- 3. Mitchell AG, Lowell A, Ralph AP. Report on the Patient Educator service at Royal Darwin Hospital, 2001-2009: insights into inter-cultural communication in healthcare. Darwin: Aboriginal Resource and Development Services, 2016. https://www.researchgate.net/publication/304121921_Report_on_the_Patient_Educator_service_at_Royal_Darwin_Hospital_2001-2009_insights_into_inter-cultural_communication_in_healthcare (accessed Mar 2017).
- 4. Amery H. They don’t give us the full story: attitudes to hospitalisation amongst Yolŋu people of north-east Arnhem Land, a comparative study. Darwin: Aboriginal Resource and Development Services, 1999. https://www.ards.com.au/resources/downloadable/they-dont-give-us-the-full-story-attitudes-to-hospitalisation-amongst-yolŋu-people-of-north-east-arnhem-land-a-comparative-study (accessed Mar 2017).
- 5. Phillips C. Improving health outcomes for linguistically diverse patients. Med J Aust 2016; 204: 209-210. <MJA full text>
- 6. Australian Institute of Health and Welfare. Life expectancy. http://www.aihw.gov.au/deaths/life-expectancy (accessed Dec 2016).
- 7. Georges N, Guthridge SL, Li SQ, et al. Progress in closing the gap in life expectancy at birth for Aboriginal people in the Northern Territory, 1967–2012. Med J Aust 2017; 207: 25-30.
- 8. Zhao Y, Wright J, Begg S, Guthridge S. Decomposing Indigenous life expectancy gap by risk factors: a life table analysis. Popul Health Metr 2013; 11: 1.
- 9. Trudgen R. Why warriors lie down and die. Towards an understanding of why the Aboriginal people of Arnhem Land face the greatest crisis in health and education since European contact. Darwin: Aboriginal Resource and Development Services, 2000.
- 10. Biddle N. Indigenous Population Project: 2011 Census Papers. Paper 1: Indigenous language usage. Canberra: Centre for Aboriginal Economic Policy Research, Research School of Social Sciences, Australian National University, 2012. http://caepr.anu.edu.au/sites/default/files/cck_indigenous_outcomes/2012/09/2011CensusPaper01_IndLangUsage.pdf (accessed Dec 2016).
- 11. Aboriginal Resource and Development Services. An absence of mutual respect. Bäyŋu Ŋayaŋu-Dapmaranhamirr Rom ga Ŋorra. Darwin: ARDS, 2008. https://ards.com.au/uploads/Downloads/114/39-114.Absence_of_mutual_respectFINAL.pdf (accessed May 2017).
- 12. Harris S Culture and learning: tradition and education in Northeast Arnhem Land. Darwin: Northern Territory Education Department, 1980.
- 13. Queensland Health Aboriginal and Torres Strait Islander Cultural Capability Team. Communicating effectively with Aboriginal and Torres Strait Islander people. Sept 2015. https://www.health.qld.gov.au/__data/assets/pdf_file/0021/151923/communicating.pdf (accessed May 2017).
- 14. Anderson K, Devitt J, Cunningham J, et al. “All they said was my kidneys were dead”: Indigenous Australian patients’ understanding of their chronic kidney disease. Med J Aust 2008; 189: 499-503. <MJA full text>
- 15. Strong J, Nielsen M, Williams M, et al. Quiet about pain: experiences of Aboriginal people in two rural communities. Aust J Rural Health 2015; 23: 181-184.
- 16. Reid J Sorcerers and healing spirits: continuity and change in an Aboriginal medical system. Canberra: Australian National University Press, 1983.
- 17. Maher P. A review of ‘traditional’ Aboriginal health beliefs. Aust J Rural Health 1999; 7: 229-236.
- 18. Peile AR. Body and soul: an Aboriginal view. Perth: Hesperian Press, 1997.
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