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Book Review

Symposium on Indigenous Health and the Contribution of Sociology

Jane Shoebridge & Eileen Willis

vi+136 pages

Davina B Woods
Project Officer, CDAMS Indigenous Health Curriculum Project, Committee of Deans of Australian Medical Schools, Onemda VicHealth Koori Health Unit, University of Melbourne, VIC

Sociologists have a larger role to play in Indigenous public health in Australia than has previously been acknowledged or filled. The methodologies of research and reporting in Indigenous public health need to be reviewed. This is evident from reviewing Ian Anderson's paper Aboriginal society and health: critical issues demand what from sociologists and the works by Sherry Saggers and Dennis Gray, Peter d'Abbs and Chris Cunneen, published in Health Sociology Review Volume 10 (2) 2001 as a symposium on Indigenous health. The findings of the 2001 symposium are supported by Michael J Morrissey's papers Poverty and Indigenous Health and The social determinants of Indigenous health: a research agenda which appeared in Health Sociology Review Volume 12, Issue 1 in September 2003.

Anderson's work raises critical issues for social scientists, noting that little has been written on institutional responses to the health needs of Indigenous Australians. He questions the flow of power between the health professions and Indigenous health workers. Anderson explores the influence of Indigenous specific policies and health care provision for Indigenous peoples. In conclusion he promotes a sociology research agenda which focuses on both the social relations of Indigenous health care and on the social determinants of Indigenous health - challenging sociologists to engage in Indigenous health.

Saggers and Gray's work is framed by understandings derived from political economy. The political economy approach seeks explanations for social phenomena through examining political and economic relations in which individuals and groups exist. Bringing together health and social science perspectives their work illustrates the role of political and economic factors in determining the outcomes of important public health issues. Their work is founded on an analysis of the unequal access of Indigenous people in Australia to the country's political and economic resources and the intimate linkages to structural and situational disadvantage that this brings about.

Identifying a hole in the theory behind public health, d'Abbs work draws attention to the focus of public health which is, the 'population'. He observes how the population is depicted as asocial; having none of the characteristics of a society, the population is seen as a statistical aggregate of individuals. Correctly, d'Abbs argues that a model of population uninformed by sociology is conceptually deficient and that control of self is a sociological occurrence. He uses the work of Indigenous intellectuals and community leaders to support his assertion that public health problems require that epidemiological questions and analyses are complemented by sociological analyses.

The symposium papers conclude with Cunneen's evaluation of the outcomes of the Royal Commission into Aboriginal Deaths in Custody as being mainly intangible, multi-dimensional and related to political processes.

Morrissey's assertions that new research and theoretical paradigms which create greater descriptive accuracy and predictive efficiency as well as the capacity to inform effective action are long overdue, reflect themes in the symposium papers. The social determinants of health can only be fully understood through use of the broadest range of social research methods; both qualitative and quantitative. The social and political dimensions of issues such as Indigenous health are inseparable. Critical socio-political analysis of non-Indigenous institutions and social processes in terms of their contribution to Indigenous health and ill health must continue.



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