Brady Maggie
Centre for Aboriginal Economic Policy Research, Hanna Neumann Building #21, Australian National University, Canberra ACT 0200, Australia.
J Epidemiol Community Health. 2007 Sep;61(9):759-63. doi: 10.1136/jech.2006.057455.
Disseminating national health and alcohol policies to Aboriginal and Torres Strait Islander people in Australia has been a challenging task for governments and public servants. This has been for a number of reasons, including the enduring (negative) legacy of past "Aboriginal affairs" policies, the fact that Indigenous health programmes and alcohol programmes have been treated separately since the 1970s, and a more recent context in which the recognition of cultural difference was privileged. Confronted with the politics of difference, health departments were slow to examine avenues through which best practice advice emanating from WHO, and alcohol policies such as harm minimisation and early identification and treatment in primary health care, could be communicated in culturally recognisable ways to independent Indigenous services. In addition, there was hostility towards harm minimisation policies from Indigenous service providers, and Indigenous treatment programmes remained largely committed to abstinence-oriented modalities and the disease model of alcoholism, despite moves away from these approaches in the mainstream. However, genuinely innovative acute interventions and environmental controls over alcohol have been developed by Indigenous community-based organisations, approaches that are reinforced by international policy research evidence.
向澳大利亚原住民和托雷斯海峡岛民传播国家卫生与酒精政策，对政府和公务员来说一直是一项具有挑战性的任务。原因有很多，包括过去“原住民事务”政策遗留的持久（负面）影响、自20世纪70年代以来原住民健康项目和酒精项目一直被分开对待，以及最近文化差异受到重视的背景。面对差异政治，卫生部门在研究如何以文化上可识别的方式，将世界卫生组织提出的最佳实践建议以及诸如初级卫生保健中的危害最小化、早期识别与治疗等酒精政策传达给独立的原住民服务机构方面行动迟缓。此外，原住民服务提供者对危害最小化政策存在敌意，而且尽管主流做法已不再采用这些方法，但原住民治疗项目在很大程度上仍致力于以戒酒为导向的模式和酒精中毒的疾病模型。然而，原住民社区组织已经开发出了真正具有创新性的急性干预措施和对酒精的环境控制措施，这些方法得到了国际政策研究证据的支持。
