Beyond Structural Neglect: Using Evidence to Strengthen Primary Health Care Systems, Policies and Programs for Aboriginal and Torres Strait Islander Men

Despite decades of policy focus, Aboriginal and Torres Strait Islander men still face primary health care systems that are misaligned with their cultural and social needs, leading to low use. A strong body of evidence shows engagement improves when care is culturally safe, gender-responsive and community-led, yet these are inconsistently implemented. Short-term funding and fragmented commissioning undermine continuity, workforce stability and holistic care. Reliance on pilot programs reflects risk aversion and limits reform. Redesigning commissioning to ensure long-term funding, a stable workforce, stronger governance and learning-focused evaluation is essential. Continued delay perpetuates inequity, making reform an ethical and political imperative.