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Glossary of acronyms
ACCHOs Aboriginal community-controlled health organisations
ACF Advocacy coalition framework
AMSs Aboriginal medical services
CTG ‘Close the Gap’
MSA Multiple streams approach
NACCHO National Aboriginal community-controlled health organisation
NATSIHP National Aboriginal and Torres Strait Islander Health Plan 2013– 2023
NATSIHEC National Aboriginal and Torres Strait Islander Health Equality Council
NHLF National Health Leadership Forum
NIRA National Indigenous Reform Agreement
SAG Ministerial stakeholder advisory group
SDIH Social determinants of Indigenous health
SDH Social determinants of health
1. Introduction
Background
Australians have among the highest average life expectancy in the world (Australian Institute of Health and Welfare [AIHW], 2016), but significant health inequities persist between Aboriginal and non-Indigenous Australians. Aboriginal people on average experience lower life expectancy and higher rates of chronic disease and disability than non-Indigenous Australians (AIHW, 2016).
An understanding of Aboriginal people's health requires appreciation of the Aboriginal definition of health, which incorporates ‘the social, emotional and cultural well-being of the whole community’ (Office for Aboriginal and Torres Strait Islander Health, 1989). Scholars on Aboriginal health have emphasised the ‘Social Determinants of Indigenous Health,’ (SDIH) which encapsulates a human-rights-based approach to health, recognition of Indigenous cultures, the health effects of racism, and past and contemporary impacts of colonisation (Carson et al., 2007; O'Donnell and MacDougall, 2016). This adds another dimension to the more commonly-acknowledged suite of social determinants of health (SDH), for which there has been mounting evidence (Commission on the Social Determinants of Health, 2008; Marmot et al., 2012). It is therefore crucial to examine how race is framed during policy development.
Community control in decision-making and self-determination are important principles for Aboriginal Australians, as reflected in the UN Declaration on the Rights of Indigenous Peoples (United Nations General Assembly, 2007). Community control is important as a process for empowerment and can lead to improved health outcomes (Donato and Segal, 2013). The self-determination movement for Aboriginal Australians accelerated in the 1970s and led to the first national Aboriginal health organisation and formation of Aboriginal Community Controlled Health Organisations (ACCHOs), where Aboriginal people govern and manage their health services. The National Aboriginal Community Controlled Health Organisation (NACCHO) was formed as the umbrella organisation for ACCHOs in 1992 and there are now over 150 ACCHOs across Australia (NACCHO, 2016). Community control...