Cultural determinants of health
Cultural determinants of health are interlinked elements including: cultural expression, continuity of culture, self-determination and leadership, family, kinship and community, language, Indigenous beliefs and knowledge and connection to Country (see Box 1) (Arabena 2020; Verbunt et al. 2021). Aboriginal and Torres Strait Islander peoples and communities draw strength, resilience and empowerment, and maintain or improve health and wellbeing though these cultural determinants (see Figure 1) (Arabena 2020; Verbunt et al. 2021).
Aboriginal and Torres Strait Islander culture – which incorporates knowledge and belief systems, languages, art and music, access to traditional lands and connection to Country – and extended family networks and kinship systems are recognised as protective factors and can positively influence overall health and wellbeing (Gee et al. 2014; Bourke et al. 2018; Verbunt et al. 2021; DoHAC 2020).
Figure 1. Causal framework of the cultural determinants of health for Aboriginal and Torres Strait Islander peoples
Source: adapted from Verbunt et al. 2021.
Box 1: What is Country?
Country is a term used by Aboriginal and Torres Islander peoples to describe complex ideas about the lands, waterways, and seas they are connected to and ideas about law, place, custom, language, spiritual belief, cultural practice, material sustenance, family and identity (AIATSIS 2022).
AIATSIS (Australian Institute of Aboriginal and Torres Strait Islander Studies) (2022) Welcome to Country, Australian Institute of Aboriginal and Torres Strait Islander Studies website, accessed 10 October 2022.
Arabena K (2020), ‘Country Can’t Hear English’: A guide supporting the implementation of cultural determinants of health and wellbeing with Aboriginal and Torres Strait Islander peoples, Melbourne: Karabena Publishing.
Bourke S, Wright A, Guthrie J, Russell L, Dunbar T and Lovett R (2018) ‘Evidence review of Indigenous culture for health and wellbeing’, International Journal of Health, Wellness & Society 8(4),doi:10.18848/2156-8960/CGP.
Department of Health and Aged Care (2020) Clinical Practice Guidelines: Pregnancy Care. Canberra: Australian Government Department of Health and Aged Care.
Gee G, Dudgeon P, Schultz C, Hart A, Kelly K (2014) Aboriginal and Torres Strait Islander social and emotional wellbeing. In Dudgeon, P. Milroy, H. Walker, R. (Ed.), Working together: Aboriginal and Torres Strait Islander mental health and wellbeing principles and practice (2nd ed.). Canberra: Department of the Prime Minister and Cabinet.
Verbunt E, Luke J, Paradies Y, Bamblett M, Salamone C, Jones A and Kelaher M (2021) ‘Cultural determinants of health for aboriginal and Torres Strait Islander people – a narrative overview of reviews’, International Journal for Equity in Health 20(181), doi: 10.1186/s12939-021-01514-2.