Abstract
Wellbeing is a broad multi-dimensional concept encompassing an individual’s perception of their position in life, as well as the context, culture and value systems in which they live, and their goals, expectations, standards and concerns [1]. Existing indicators of wellbeing are largely based on Western biomedical models and understandings of health.There is growing recognition that additional domains and indicators of wellbeing are required to more fully consider and reflect Indigenous paradigms. Many Indigenous populations conceptualise good health to be more than the absence of disease or illness for the individual, and commonly embrace a holistic and collectivist worldview of health and wellbeing. Concepts and understandings of wellbeing for Indigenous peoples must also be considered in the enduring context of colonisation, which includes inter-generational trauma, racism, socioeconomic disadvantage and poorer health outcomes. These issues raise the question of how to measure wellbeing for Indigenous populations and the effectiveness and cost-effectiveness of interventions using existing wellbeing measurements.
This thesis reports on the dimensions and understandings of wellbeing from the perspectives of Indigenous peoples in Australia, Canada, Aotearoa (New Zealand) and the United States. Further, the sociodemographic, socioeconomic and health conditions associated with lower self-rated wellbeing among a cohort of Aboriginal and Torres Strait Islander adults are presented, along with an exploration of change in wellbeing over the first wave of the COVID-19 pandemic in Australia. Lastly, an evaluation was undertaken of the suitability of the ‘think aloud’ method and cognitive validation of a set of wellbeing statements developed for inclusion in a new wellbeing measure for Aboriginal and Torres Strait Islander adults.
The main research findings were:
•Wellbeing for Indigenous peoples in Australia, Canada, Aotearoa (New Zealand) and the United States is cyclic in nature and encompasses holistic and collectivist concepts that include the physical, mental, emotional and spiritual aspects of the self, and are connected to the wellbeing of the family, community/Tribe and Country/land.
•Health-related quality of life is lower among Aboriginal and Torres Strait Islander adults compared to other Australians. Several factors were associated with Aboriginal and Torres Strait Islander adults having lower wellbeing and health related quality of life, both generally and in association with the COVID-19 pandemic in Australia.
. The ‘think aloud’ method was shown to be an acceptable method for use in research by Aboriginal and Torres Strait Islander adults.
These findings have implications for numerous aspects of health and healthcare. The findings of what is important to the wellbeing of Indigenous peoples, and what things may impact on their wellbeing, needs to be considered when developing individual health care plans, informing services, programs and policies, that include or impact on Aboriginal and Torres Strait Islander peoples.
Reference
1. The World Health Organization Quality of Life assessment (WHOQOL): Position paper from the World Health Organization. (1995). Social Science & Medicine. 41(10), 1403–1409. https://doi.org/10.1016/0277-9536(95)00112-K
Note: Chapter 6 not available due to 12 months embargo.
| Date of Award | 2022 |
|---|---|
| Original language | English |
| Supervisor | Gail Garvey (Supervisor), Abbey-Rose Diaz (Supervisor), Kirsten Howard (Supervisor) & Kate Anderson (Supervisor) |