Menzies School of Health Research, Charles Darwin University, PO Box 1294, Alice Springs, NT, 0871, Australia.
Pintupi Homelands Health Service, PMB 145 Kintore via Alice Springs, Alice Springs, NT, 0872, Australia.
Int J Equity Health. 2023 May 25;22(1):103. doi: 10.1186/s12939-023-01897-4.
An epidemic of type 2 diabetes in remote Aboriginal people in Central Australia, contributes to high rates of morbidity and mortality. Remote non-Aboriginal Health Care Workers (HCW) and the Aboriginal people they serve inhabit a complex cultural interface. This study aimed to recognise racial microaggressions in the everyday discourse of HCWs. It proposes a model of interculturality for remote HCWs that avoids racialisation and essentialising of Aboriginal people's identities and cultures.
Semi-structured in-depth interviews were undertaken with HCWs from two Primary Health Care services in very remote Central Australia. Fourteen interviews were analysed from seven Remote Area Nurse, five Remote Medical Practitioners and two Aboriginal Health Practitioners. Discourse analysis was employed to explore racial microaggressions and power relations. NVivo software assisted in the thematic organisation of microaggressions according to a predefined taxonomy.
Seven microaggression themes were identified - racial categorization and sameness, assumptions about intelligence and competence, false colour blindness, criminality and dangerousness, reverse racism and hostility, treatment as second-class citizens and pathologizing culture. A model of interculturality for remote HCWs was based on concepts of the third space, deCentred hybrid identities and small culture formation on-the-go combined with a duty-conscious ethic, cultural safety and humility.
Racial microaggressions are common in the discourse of remote HCWs. The model of interculturality proposed could improve intercultural communication and relationships between HCWs and Aboriginal people. This improved engagement is required to address the current diabetes epidemic in Central Australia.
澳大利亚中部偏远地区的 2 型糖尿病流行，导致发病率和死亡率居高不下。偏远地区的非原住民卫生保健工作者（HCW）及其服务的原住民居住在一个复杂的文化界面中。本研究旨在识别 HCW 日常话语中的种族微侵犯。它为偏远地区的 HCW 提出了一种文化间性模式，避免了对原住民身份和文化的种族化和本质化。
对来自澳大利亚中部非常偏远地区的两个初级保健服务中心的 HCW 进行了半结构化深入访谈。对 7 名远程护理护士、5 名远程医疗从业者和 2 名原住民健康从业者的 14 次访谈进行了分析。采用话语分析方法探讨种族微侵犯和权力关系。NVivo 软件根据预定义的分类法协助对微侵犯进行主题组织。
确定了 7 个微侵犯主题-种族分类和同质化、对智力和能力的假设、虚假的盲目、犯罪和危险性、反向种族主义和敌意、二等公民待遇和文化病理化。基于第三空间、去中心化的混合身份和在路上形成的小文化的概念，以及有意识的责任伦理、文化安全和谦逊，为偏远地区的 HCW 提出了一种文化间性模式。
种族微侵犯在偏远地区 HCW 的话语中很常见。所提出的文化间性模式可以改善 HCW 和原住民之间的跨文化沟通和关系。这种改进的参与对于解决澳大利亚中部当前的糖尿病流行至关重要。
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