Centre for Rural Health, School of Health Sciences, College of Health and Medicine, University of Tasmania, Locked Bag 1322, Launceston, Tas. 7250, Australia.
Aust Health Rev. 2022 Apr;46(2):173-177. doi: 10.1071/AH21098.
Objective In light of concerns surrounding neoliberal government approaches to addressing Aboriginal disadvantage, this project examined how Elders consider the Closing the Gap programs for improving community health outcomes. Methods A participatory action research project was undertaken in collaboration with eight Elders from a remote Aboriginal community in Australia's island state of Tasmania. The findings emerged from thematic analysis of individual interviews and yarning circles. Results The Closing the Gap programs were seen by Elders as having instrumental value for addressing Aboriginal community disadvantage. However, the programs also represented a source of ongoing dependency that threatened to undermine the community's autonomy, self-determination and cultural foundations. The findings emerged to represent Elders attempting to reconcile this tension by embedding the programs with cultural values or promoting culture separately from the programs. Ultimately, the Elders saw culture as the core business of community well-being and effective program delivery. Conclusion The findings are reflective of tensions that arise when neoliberal policies are imposed on Aboriginal ways of knowing, being and doing. The Elders premised cultural well-being as the key determinant of Aboriginal community health. What is known about the topic? Closing the Gap represents successive neoliberal policy responses of Australian governments to address ongoing Aboriginal disadvantage. What does this paper add? Closing the Gap programs were recognised by Aboriginal Elders for providing the community with improved services, but also a threat to the community's cultural foundations and self-determination. The findings illustrate ongoing tensions between neoliberal principles and Aboriginal cultural values. What are the implications for practitioners? More effective Closing the Gap approaches require greater collaboration between policy stakeholders and community Elders.
目的 鉴于人们对新自由主义政府解决原住民劣势的方法存在担忧，本项目研究了老年人如何看待改善社区健康结果的“缩小差距”计划。
方法 在澳大利亚塔斯马尼亚岛一个偏远的原住民社区，与 8 位老年人合作开展了一项参与式行动研究项目。研究结果源自对个人访谈和讨论的主题分析。
结果 老年人认为“缩小差距”计划对于解决原住民社区的劣势具有工具价值。然而，这些计划也代表了一种持续的依赖，这有可能破坏社区的自主权、自决权和文化基础。研究结果表明，老年人试图通过将这些计划融入文化价值观或以独立于计划的方式来推广文化，来调和这种紧张关系。最终，老年人认为文化是社区福祉和有效项目实施的核心业务。
结论 这些发现反映了新自由主义政策对原住民认知、存在和行动方式的影响所产生的紧张关系。老年人将文化福祉作为原住民社区健康的关键决定因素。
关于这个主题已知的内容？ “缩小差距”代表了澳大利亚政府为解决原住民持续存在的劣势而采取的一系列新自由主义政策回应。
本文增加了什么内容？ 原住民老年人认识到“缩小差距”计划为社区提供了更好的服务，但也威胁到社区的文化基础和自决权。研究结果说明了新自由主义原则与原住民文化价值观之间持续存在的紧张关系。
对从业者的意义是什么？ 要使“缩小差距”计划更加有效，需要政策利益相关者和社区老年人之间进行更多的合作。
