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We found that opposition to Voice is associated with poorer health for Indigenous people. And in some regions, the association is striking.
Aug
Most Australians he voted “no” to an Indigenous Voice in Parliament. But if we dig into the data from the 2023 referendum, there is more to learn, particularly about the health of Indigenous Australians living in communities that strongly oppose the Voice.
It is an image both striking and urgent.
In published studies Today For the first time, we have shown that Indigenous Australians living in regions with stronger opposition to the Voice experience poorer health.
When we mapped community opposition to Voice on Australian health, we found that Indigenous Australians were more likely than non-Indigenous Australians to report poorer overall and mental health. But Indigenous Australians were less likely to operate health care. These inequalities were greater in areas with greater opposition to Voice.
Our results likely reflect underlying negative attitudes towards Indigenous Australians and less culturally sensitive options for accessing health care in some regions, both of which impact the health of Indigenous Australians in multiple ways.
What we did and what we discovered
We began with a national map of voting patterns to identify regions with the highest levels of opposition to Voice (defined in this study as regions of Australia where more than 72% of community members voted “no”).
We then compared regions with high and low levels of opposition to Voice with the health of Australians, using data from 2021. national surveywhich included information about general health, mental health and health care operate over the last year.
Our study found that, compared with Indigenous Australians living in areas with low opposition to Voice, Indigenous Australians living in communities with the highest opposition to Voice were more likely to report destitute general and mental health, and were less likely to have used health care services in the past year.
We did not observe the same disparities for non-Indigenous Australians.
For example, in areas with the strongest support for Voice, Indigenous and non-Indigenous Australians reported similar levels of destitute mental health (16% for both Indigenous and non-Indigenous). While in areas with the strongest opposition to Voice, 27% of Indigenous Australians reported destitute mental health compared with 15% of non-Indigenous Australians.
In areas with the greatest support for Voice, the proportion of Indigenous Australians who had seen any doctor was 78%, which was higher than the 71% for non-Indigenous people. However, in areas with the greatest opposition to Voice, the proportion seeing any doctor was significantly lower among Indigenous Australians (54%), but not among non-Indigenous people (68%).
All of this suggests that, despite having poorer health outcomes, Indigenous Australians living in areas where there is stronger opposition to Voice are less likely to have access to healthcare.
Why is this happening?
There are several possible explanations for these results.
A great opportunity, in line with recent testswhether community-level opposition to Voice may be capturing latent negative attitudes towards Indigenous Australians. So what we see may reflect the impact of such negative attitudes on people’s health over time.
This is in line with many international studies showing how stigma throughout the community and discriminatory environments lead to worse health condition among minorities and historically marginalized groups. Generally, we see this manifesting itself in higher rates smoking and drinkingand confined access to Healthcare.
These attitudes may have an impact on Indigenous Australians’ experiences of healthcare. For example, we know of past experiences racism while access to healthcare scares away indigenous people engaging in mainstream healthcare. Alternatively, there may not be enough culturally safe healthcare options in regions where there is the greatest opposition to the Voice.
Indigenous leaders across Australia continue to share their experiences of racism before, during and after referendum Voice. While the direct impact of racism is evident in the testimonies of these individuals, relatively little attention has been paid to the impact of structural racism at the community level.
But we can’t say from our research what motivated people to vote “no,” and voting “no” can’t be taken as evidence of racism. But whatever the motivation for voting “no,” the health of Indigenous Australians is particularly affected in these high-opposition regions.
Where to from here?
Our results suggest that when it comes to future health policies and programs, we need to consider multiple solutions at the community level. In particular, we should pay special attention to areas where opposition to Voice was greater, because these are areas associated with poorer health and lower health care utilization.
In these areas in particular, we need more culturally safe healthcareadapted care that is inclusive and free from racism. This enables patients to access appropriate and appropriate health services to improve their health.
We also need to look at the bigger picture to change community attitudes towards Indigenous Australians if we are to reduce systemic racismstigma and its impact on health.
Our results are just a snapshot
The Voice referendum highlighted how challenging it is for Indigenous Australians to address the challenges of promoting Indigenous self-determination as the best way to improve their livelihoods and health.
But our findings reflect only one moment in time. That’s why we need more research to better understand the systemic nature of the health disparities we see.
Health and social policy must acknowledge these systemic issues and ultimately pay greater attention to how community-level attitudes may shape the health of Indigenous Australians.
