Culture-specific care for Indigenous people: A primary health care perspective

Anne M McMurray
Emeritus Professor, School of Nursing and Midwifery, Griffith University, Gold Coast, QLD; Emeritus Professor, Faculty of Health Sciences, Murdoch University, Perth, WA

Rani Param
School of Paediatrics and Child Health; Centre for Aboriginal Medical and Dental Health, School of Primary, Aboriginal and Rural Health Care, University of Western Australia, Perth WA

PP: 165 - 172


This article argues that a primary health care approach is an appropriate conceptual framework for addressing the health needs of Indigenous people. Primary health care is strategic, focusing on equity, access, empowerment and intersectoral partnerships as essential elements for maintaining health.

Stereotypical notions of Indigenous ill health as being embedded in a general view of ‘culture’ can mitigate against achieving equity, access to health care and ultimately self-determinism. Because health is embedded in the social conditions of people’s lives, the emphasis in Indigenous health care should first address Indigenous social disadvantage and ways of working in partnership with various groups of Indigenous people to achieve their health goals.

A critical multicultural approach situates cultural differences within the wider nexus of power relations, and helps overcome the negative stereotyping that often prevents inclusive, self-determined care. Recommendations are suggested for change at the societal, professional and individual level.


Indigenous culture, culture care, social inequality, Aboriginal health, primary health care

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Adelman M, Erez E and Shalhoub-Kevorkian N (2003) Policing against minority women in multicultural societies: 'Community' and the politics of exclusion, Police and Society 7: 105-133.

Adelson N (2005) The embodiment of inequity: Health disparities of Aboriginal Canada. Canadian Journal of Public Health 96: S45-S61.

Anderson J, Perry J, Blue C, Browne A, Henderson A, Koushambbi B, Reimer Kirkham S, Lynam J, Semiuk P and Smye V (2003) 'Rewriting' cultural safety within the postcolonial and postnational feminist project. Advances in Nursing Science 26: 196-214.

Astbury J, Atkinson, J, Duke, JE, Easteal, PL, Kurrie, SE, Tait, PR, Turner, J (2000) The impact of domestic violence on individuals, Medical Journal of Australia 173: 427-731.

Australian Council for Aboriginal Reconciliation (1994) Walking Together: the first steps. Report of the Australian Council for Reconciliation. Canberra: AGPS.

Australian Indigenous Doctors Association (2007) An Introduction to Cultural Competency. Royal Australasian College of Physicians, accessed on 23 January 2007 at

Australian Institute of Health and Welfare (2004) Australia’s Health 2004. Cat. No AUS 44. Canberra: AGPS.

Australian Medical Association (2007) Aboriginal and Torres Strait Islander Health: Institutionalised Inequity Not Just a Matter of Money. Report Card Series 2007. Canberra: AMA.

Bannerjee SB and Osuri,G (2000), Silences of the media: whiting out Aboriginality in making news and making history, Media, Culture and Society 22: 263-284.

Barnes D, Craig K and Chambers K (2000) A review of the concept of culture in the holistic nursing literature. Journal of Holistic Nursing 18: 207-221.

Browne A (2005) 'The Sociopolitical Context of Nurses’ Encounters with First Nations Women in a Canadian Health Care Setting'. International Conference on innovations in Nursing. Keynote Presentation. Fremantle Western Australia 12 Nov.

Brough M, Bond, C and Hunt J (2004) Strong in the City: towards a strength-based approach in Indigenous health promotion. Health Promotion Journal of Australia 15(3): 215-220.

Council of Aboriginal and Torres Strait Islander Nurses (2007) Professional Issues, Accessed on 13 June 2007 at

Culley L (2006) Transcending transculturalism? Race, ethnicity and health-care. Nursing Inquiry 13: 144-153.

Durie M (2004) An Indigenous model of health promotion, Health Promotion Journal of Australia 15: 181-185.

Eckermann A, Dowd T, Chong E, Nixon L, Gray R and Johnson S (2006) Binan Goonj: Bridging Cultures in Aboriginal Health 2nd edn, Marrickville: Elsevier.

Fisher R (2006) Congruence and functions of personal and cultural values: Do my values reflect my culture’s values. Personality and Social Psychology 32: 1419-1431.

Gustafson D (2005) Transcultural nursing theory from a critical cultural perspective. Advances in Nursing Science 28(1): 2-16.

Hertzman C and Power C (2006) A life course approach to health and human development. In Heymann J, Hertzman C, Barer M and Evans R (eds) Healthier Societies: From analysis to action. Oxford: Oxford University Press, pp.83-106.

Johns G (2006) 'Social Stability and Structural Adjustment', Bennelong Society 6th Annual Conference – Leaving Remote Communities, accessed on 1 June 2007 at

McMurray A (2006) Community Health and Wellness: A Socio-ecological Approach 3rd edn, Sydney: Elsevier.

Mignone J and O’Neil J (2005) Social capital and youth suicide risk factors in First Nations Communities. Canadian Journal of Public Health 96: S51-S54.

National Rural Health Alliance (2007). After Forty Years It’s Time, Media Release, accessed on 26 May 2007 online at

O’Brien A (2006) Moving toward culturally sensitive services for Indigenous people: A non-Indigenous mental health nursing perspective. Contemporary Nurse 21: 22-31.

Pearson N (2005) The Cape York Agenda. Address to the National Press Club. Canberra, Nov 30.

Pomaika’I Cook B, Tarallo-Jensen L, Withy K and Berry S (2005) Changes in Kanaka maoli Men’s Roles and Health: Healing the Warrior Self. International Journal of Men’s Health 4: 115-130.

Puzan E (2003) The unbearable whiteness of being (in nursing). Nursing Inquiry 10: 193-200.

Reading J, Ritchie A, Victor C and Wilson E (2005) Implementing empowering health promotion programs for Aboriginal youth in two distinct communities in British Columbia, Canada. Promotion and Education X11: 62-65.

Reimer Kirkham S and Anderson J (2002) Postcolonial nursing scholarship: From epistemology to method. Advances in Nursing Science 25: 1-17.

Sen A (1999) Development as Freedom. New York: Alfred A Knopf.

Scrimgeour D (2007) Town or country: which is best for Australia’s Indigenous peoples? Medical Journal of Australia 186: 532-533.

Shaw W (2000) Ways of Whiteness: Harlemising Sydney’s Aboriginal Redfern, Australian Geographical Studies 38: 291-305.

Shore J and Spicer P (2004) A model for alcohol-mediated violence in an Australian Aboriginal community. Social Science and Medicine 58: 2509-2521.

Smith R (2003) Learning from Indigenous people. Editorial, British Medical Journal 327: 1.

Ten Fingers K (2005) Rejecting, revitalizing, and reclaiming, Canadian Journal of Public Health 96: S60-S63.

Toussaint S (2003) ‘Our shame, blacks live poor, die young’. Indigenous health practice and ethical possibilities for reform. In Liamputtong P and Gardner H (eds) Health, Social Change and Communities. Melbourne: Oxford Press, pp.241-56.

Trewin D and Madden R (2005) The Health and Welfare of Australia’s Aboriginal and Torres Strait Islander Peoples. Canberra: ABS Cat. No 4704.0 AIHW Cat. No IHW14.

Whitehead M (2007) A typology of actions to tackle social inequalities in health. Journal of Epidemiology Community Health 61: 473-478.

World Health Organization (2005) Action on the Social Determinants of Health: Learning from previous experiences. A background paper prepared for the Commission on Social Determinants of Health, March. Geneva: WHO accessed on 6 June 2006 at http://www.who/int/social_determinants/en/.

Zubrick S, Silburn S, Lawrence D, Mitrou F, Dalby R, Blair E, Griffin J, Milroy H, de Maio J, Cox A and Li J (2005) The Western Australian Aboriginal Child Health Survey. The Social and Emotional well-being of Aboriginal Children and Young People. Perth: Curtin University of Technology and The Telethon Institute for Child Health Research.

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