Collaborative social-epidemiology: A co-analysis of the cultural and structural determinants of health for Aboriginal youth in Victorian schools

Joanne Nicole Luke, Alister Thorpe, Carlina Black, Lisa Thorpe, David Thomas, Sandra Eades, Kevin Rowley

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Abstract

Social-epidemiology that excludes Aboriginal voices often fails to capture the full and complex social worlds of Aboriginal people. Using data from an existing co-designed Victorian government Adolescent Health and Wellbeing Survey (2008/9), we worked with Aboriginal organizations to identify data priorities, select measures, interpret data, and contextualize findings. Using this participatory co-analysis approach, we selected “cultural” and “structural” determinants identified by Aboriginal organizations as important and modelled these using principal component analysis. Resulting components were then modelled using logistic regression to investigate associations with “likely being well” (Kessler-10 score < 20) for 88 Aboriginal adolescents aged 11–17 years. Principal component analysis grouped 11 structural variables into four components and 11 cultural variables into three components. Of these, “grew up in Aboriginal family/community and connected” associated with significantly higher odds of “likely being well” (OR = 2.26 (1.01–5.06), p = 0.046). Conversely, “institutionally imposed family displacement” had significantly lower odds (OR = 0.49 (0.24–0.97), p = 0.040) and “negative police contact and poverty” non-significantly lower odds (OR = 0.53 (0.26–1.06), p = 0.073) for “likely being well”. Using a co-analysis participatory approach, the voices of Aboriginal researchers and Aboriginal organizations were able to construct a social world that aligned with their ways of knowing, doing, and being. Findings highlighted institutionally imposed family displacement, policing, and poverty as social sites for health intervention and emphasized the importance of strong Aboriginal families for adolescents.

Original languageEnglish
Article number8674
Pages (from-to)1-22
Number of pages22
JournalInternational Journal of Environmental Research and Public Health
Volume18
Issue number16
DOIs
Publication statusPublished - 2 Aug 2021

Bibliographical note

Funding Information:
Joanne Luke is recipient of an Australian Heart Foundation Indigenous Scholarship 2015. Acknowledgments: We recognize the late great Kevin Rowley for conceptualizing the study and coanalysis. We are indebted to Kevin as a supervisor, mentor, and friend. We acknowledge all the work Kevin did to strengthen and build the skills of J.L. and A.L. as early-career Aboriginal researchers. We also gratefully recognize the generous in-kind support provided by staff from Aboriginal-controlled organizations involved in this project. In particular, we recognize Chris Halacas, the late Tim Moore, and the Victorian Aboriginal Community Controlled Health Organization for their contributions to the co-analysis. We also thank Amanda Jones from the Victorian Aboriginal Child Care Agency. We also thank Lina Gubhaju for feedback on the draft.

Funding Information:
Funding: Joanne Luke is recipient of an Australian Heart Foundation Indigenous Scholarship 2015.

Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.

Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.

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