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ABORIGINAL AND TORRES STRAIT ISLANDER
HEALTH PERFORMANCE FRAMEWORK 2017 REPORT

1.13 Community functioning

Why is it important?

Aboriginal and Torres Strait Islander peoples have long sought health outcomes encompassing the physical, social, cultural and emotional elements of life. This includes the ability to live proudly and freely as Aboriginal and Torres Strait Islander peoples (OATSIH, 2004). Functioning is about the things people achieve or experience, consistent with their account of wellbeing, varying from ‘being adequately nourished and being free from avoidable disease, to very complex activities or personal states, such as being able to take part in the life of the community and having self-respect’ (Sen, 1999; AIHW, 2014h). The conversion of capabilities into functioning is influenced by the values and personal features of individuals, families and communities and by the social and cultural environment in which they live. Different cultures give greater or lesser priority to different types of functioning, and do not necessarily align with Western perspectives (Sen, 1999; Taylor, J et al, 2012).

‘Community Functioning’ in the HPF is defined as the ability and freedom of community members and communities to determine the context of their lives (e.g. social, cultural, spiritual, organisational) and to translate their capability (knowledge, skills, understanding) into action (to make things happen and achieve a life they value).

To develop a picture of family and community functioning from Aboriginal and Torres Strait Islander peoples’ perspectives, workshops drawing together participants from across Australia were held in 2008 and 2010. Participants at the workshops described the various elements of family and community life essential for high levels of functioning. The workshops identified a number of key themes and weighted these functionings according to their relative value. In 2010, six themes were identified by Aboriginal and Torres Strait Islander participants and these have been used to analyse and present available data.

Participants were drawn from a number of jurisdictions and settings so the themes they identified appear to reflect widely held views among Aboriginal and Torres Strait Islander peoples.

While community functioning is a strengths-based measure, analysis of the institutional, interpersonal and internalised elements of racial discrimination suggest this factor deters and undermines community functioning and increases ill-health (Cunningham & Paradies, 2013). In 2014–15, one-third (35%) of Indigenous Australians aged 15 years and over reported being treated unfairly in the last 12 months because they were Aboriginal and/or Torres Strait Islander. These estimates are conservative, with research specialising in racial discrimination reporting 97% of Indigenous Australians in the sample experiencing racism (Kelaher et al, 2014). For more details, see Racism and discrimination and measure 3.08.

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Findings

Outlined below is a description of each of the six themes and the key findings for Aboriginal and Torres Strait Islander peoples, using data from the 2014–15 Social Survey.

Connectedness to country, land, and history; culture and identity

Data from the 2014–15 Social Survey showed:

Data from the 2012–13 Health Survey showed that 83% of Aboriginal and Torres Strait Islander adults reported feeling proud of who they are. Three-quarters reported that they get the emotional support and help they need from their family (75%) and that their family really tries to help them (76%).

Resilience

Data from the 2014–15 Social Survey showed:

Leadership

Data from the 2014–15 Social Survey showed that 44% of children aged 4–14 years had spent time with an Indigenous leader or Elder in the last week.

Having a role, structure and routine

Data from the 2014–15 Social Survey showed:

Feeling safe

Data from the 2014–15 Social Survey showed:

Vitality

The final theme, vitality, covers community infrastructure, access to services, education, health, income and employment.
Data from the 2014–15 Social Survey showed:

New analysis prepared by Biddle (2017) looked at the relationship between measures of community functioning and measures of wellbeing using the 2014–15 Social Survey. This analysis found that community functioning was strongly associated with individual measures of wellbeing. Those with high levels of all three measures of community functioning (connectedness, resilience and safety) were more likely to be satisfied with their life, more likely to report that they were a happy person all or most of the time, and less likely to report that they felt so sad that nothing could cheer them up.

High community functioning scores were positively associated with living in remote areas, post-school qualifications and high income. The young tended to have lower values, as did those with relatively low levels of education. Those who were not employed and those who had changed usual residence had lower values.

Living in a private rental or state housing were negatively associated with the safety measures; while living in community rentals and also overcrowded houses were positively associated with connectedness measures.

Those with higher values in the resilience and safety measures were more likely to report that they did not have any barriers to accessing services. However, controlling for those two measures and a range of demographic, socio-economic and geographic variables, there was a negative association between connectedness and service access.

One of the main findings from the analysis was that there was no single index that was able to summarise the variation in the community functioning measures. Rather, that community functioning is better thought of as a set of themes and related constructs with complex relationships with sociodemographic factors and wellbeing.

A recent qualitative study with Yaegl Indigenous community members between 2006-10, showed the importance participants placed on relationships for strength and functioning. The study found that strengths and resources of a community need to be recognised and valued in health and mental health initiatives, as tools in risk-prevention, strengthening recovery, and enhancing wellbeing (McLennan, 2015).

Lohoar and colleagues in 2014 showed the strengths of Aboriginal and Torres Strait Islander cultural practices in family life and child rearing. The study found that culture can be a protective factor for children, families and communities, dependent on necessary social conditions being in place (Lohoar et al, 2014).

Figures

Table 1.13-1
Selected variables contributing to community functioning among Aboriginal and Torres Strait Islander peoples, 2002, 2008 and 2014–15
Community functioning theme and associated variables  2002  2008  2014–15  2014–15
Per cent Number
Connectedness to family land and history, culture, identity
Recognises homelands 70 72 74 328,619
Speaks an Aboriginal/Torres Strait Islander language 21 19 18 81,101
Attended Aboriginal and Torres Strait Islander cultural event in last 12 months 68 63 63 277,740
Identifies with clan group or language group 54 62 62 276,275
Feels able to have a say with family and friends some, most or all of the time 89 90 397,717
Feels able to have a say within community on important issues some, most and all of the time 48 49 219,099
Contact with family or friends outside household at least once per week 94 95 419,447
Has friends can confide in 75 82 365,227
Able to get support in time of crisis from outside household—from family member 80 82 363,795
Provides support to relatives outside household 51 50 219,289
Resilience
Did not feel treated unfairly because Aboriginal/Torres Strait Islander in last 12 months(a) 65 272,565
Did not avoid situations due to past unfair treatment(a) 86 381,100
Can visit homelands 46 45 49 219,347
Involvement with Aboriginal/Torres Strait Islander organisation 26 18 20 88,339
Work allows for cultural responsibilities to be met (employed persons) 22 44 41 82,783
Household member(s) used strategies to meet basic living expenses in last 12 months 49 36 37 162,554
No community problems reported 25 26 28 125,569
Community problems reported, but less than three types 29 23 22 98,515
No problems reported for theft 57 59 56 249,651
No problems reported for alcohol 67 59 62 276,543
No problems reported for illicit drugs 68 64 63 279,230
No problems reported for family violence 79 75 75 333,810
No problems reported for assault 80 77 79 352,008
No problems reported for sexual assault 92 88 92 409,044
Agrees that most people can be trusted 36 33 147,493
Agrees that their doctor can be trusted 80 81 358,280
Agrees that the hospital can be trusted 62 65 290,074
Agrees that police in the local area can be trusted 52 58 256,724
Agrees that police outside the local area can be trusted 41 46 202,475
Agrees that the local school can be trusted 69 70 312,032
Knows someone in organisation that is comfortable contacting (non-remote areas) 54 57 196,708
Felt able to find general support from outside the household 89 89 396,555
Provided support to someone outside household in last 4 weeks 56 59 262,265
Participated in sport/social/community activities in last 12 months 97 429,771
Recreational or cultural group 14 19 85,598
Community or special interest group activities 13 18 80,806
Church or religious activities 24 15 22 95,429
Watched Indigenous TV 54 70 309,851
Listened to Indigenous radio 26 28 124,724
Leadership
Child spent time with an Indigenous leader or elder in last week (4–14 years) 42 44 75,994
Encouragement from elders and council would help child (currently in secondary school)
to complete Year 12
22 24 9,992
Structure and routine/having a role
Can communicate with English speakers without difficulty (Indigenous language is main language spoken at home) 72 62 29,030
Has lived in only one dwelling for the past year or longer 69 78 77 341,689
Child involved in informal learning activities with carer in last week (0–14 years) 94 96 232,525
Feeling Safe
Felt safe at home alone after dark 80 84 372,265
Felt safe walking alone in local area after dark 53 54 237,867
Not a victim of physical or threatened violence in the last 12 months 76 75 78 344,665
Indigenous culture taught at school (children aged 2–14) 53 54 112,787
Was taught Indigenous culture at school or as part of further studies 45 47 208,374
Learnt about own Indigenous clan/language 17 17 73,385
Not incarcerated in the last 5 years 93 97 97 429,112
Never incarcerated 91 91 404,346
Vitality
Self-assessed health status excellent or very good 44 44 40 175,967
Has no disability or restrictive long term-health condition 64 50 55 243,833
Low/ moderate level of psychological distress (5–11 K5 score) 68 66 294,290
Employed (persons aged 15–64 years in the labour force) 54 48 202,098
Year 12 highest year of school completed (excluding secondary school students) 18 22 26 114,114
Has a non-school qualification (persons aged 25–64) 32 40 54 150,105
Living in a dwelling that has no major structural problems /td> 72 317,747
Accessed internet in last 12 months 41 59 79 348,436
Has access to motor vehicles whenever needed 55 66 68 302,703
Can easily get to places needed 70 74 75 333,967
Total persons aged 15 years and over 100 100 443,419

Note: Unless otherwise indicated percentages are of the estimated total Aboriginal and Torres Strait Islander population aged 15 years and over. Where another population is indicated, this has been used to calculate the percentage.

(a) Not comparable to previous years as question asked differently in 2014–15

Source: ABS and AIHW analysis of 2002, 2008 and 2014–15 NATSISS

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Implications

Community functioning underpins health outcomes encompassing the physical, social, cultural and emotional elements of life.
The Family Wellbeing program is a social and emotional wellbeing program originally developed in 1993 in SA and in over 20 years has spread to 56 sites across most states and territories. Its objective is to develop people’s skills and capacity to move from a position of disempowerment to empowerment (Monson-Wilbraham, 2014). It has been found to increase the capacity of participants to exert greater control over their health and wellbeing (Tsey & Every, 2000).

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