“We’re the backbone, not the backseat”: Aboriginal insights into service provision for wellbeing and health

Author: Rosalie Schultz

Schultz, Rosalie, 2019 “We’re the backbone, not the backseat”: Aboriginal insights into service provision for wellbeing and health, Flinders University, College of Medicine and Public Health

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Aboriginal people, with Torres Strait Islanders, are the First Australians, but their unique position in Australia is often ignored or considered a barrier to development. Aboriginal people’s worldviews and values are built on profound knowledge of the continent, and contribute to their distinction from most non-Indigenous Australians. In remote regions of Australia, Aboriginal people report high levels of wellbeing, but this is overlooked in recurring images of disadvantage in standard indicators of education, employment, health, economic status, and interactions with police and justice systems.

Generally, when people assess their wellbeing, they reflect on their values, priorities and personal aspirations. Subjective measures of wellbeing are valid indicators of social progress. They could be used to support development in Australia, and the livelihoods of all Australians, particularly Aboriginal people. If services improve wellbeing they may lead to improvements in health, learning, work performance and productivity.

This thesis works with the strengths of Aboriginal people in remote Australia, exploring wellbeing as a goal of policy and service provision.


The research was undertaken in collaboration with Aboriginal and non-Indigenous researchers and government research users, with extensive Aboriginal community consultation.

A framework of wellbeing was developed, comprising government priorities of education, employment and health, and Aboriginal people’s priorities of culture, community and empowerment. Priorities interplayed, providing the project’s title “Interplay,” and this interplay framed our approach to the data.

Aboriginal communities in remote regions were invited to further explore the wellbeing framework. Four communities were selected, representing diverse geography, population, proportion Aboriginal, culture and language. Aboriginal community researchers from each community were employed to refine the methods and collect data in their home communities. Qualitative data were collected through focus groups and interviews, and quantitative data through a purpose-designed survey that measured aspects of the wellbeing priorities.


Findings were broad-ranging, reflecting the breadth of Aboriginal aspirations for wellbeing.

• Culture underpins Aboriginal visions for education, which include transmission of Aboriginal knowledge and skills in art, history, caring for Country, and literacy in both English and Aboriginal languages. Re-imagining Aboriginal education offers opportunities both for overcoming Aboriginal disadvantage and for Australia to reach its commitments to sustainable development goals.

• Caring for Country programs contribute to conservation outcomes and enhance Aboriginal wellbeing through providing access to bush foods, physical activity, respite from community conflict and access to alcohol, and separation of individuals at risk of interpersonal violence.

• Culturally appropriate primary health care would respond to Aboriginal perspectives of health, which include the health and wellbeing of communities and Country.

• For health care services, improving mental health is key to improving wellbeing.

• Cultural practice is strongly linked to empowerment and Aboriginal language literacy, important factors in Aboriginal wellbeing.


Culture, empowerment and Aboriginal language literacy are key priorities for Aboriginal wellbeing, while caring for Country programs provide opportunities to strengthen each of these priorities and a focus for service-collaborations based on Aboriginal aspirations.

Approaching Aboriginal wellbeing from Aboriginal perspectives reveals opportunities for policy and service development to support interplaying benefits for people and the Country.

Keywords: Aboriginal languages, Aboriginal Australians, caring for Country, community, culture, education, employment, empowerment, Indigenous land management, remote, wellbeing

Subject: Health Service Management thesis

Thesis type: Doctor of Philosophy
Completed: 2019
School: College of Medicine and Public Health
Supervisor: Sheree Cairney