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Relationships Between Indigenous People's Wellbeing and Education

Extract from a paper presented by the Educational Determinants of Aboriginal Health group from Flinders University, a collaborative group of Indigenous and non-Indigenous academics, teachers and community members at the Educational Determinants of Aboriginal Health workshop of the Cooperative Research Centre for Aboriginal Health. Flinders University, June, 2004.

In the 1968 Boyer lectures, W. E. H. Stanner (1969), Professor of Anthropology and Sociology at the Australian National University, drew from his own experiences in remote and disappearing Aboriginal communities, and from his own and others' research. He discussed how white people's colonisation of Aboriginal land and appalling treatment of Aboriginal people, together with their incorrect assumption that Australia was 'unoccupied', had decimated the Aboriginal peoples' deep wells of cultural, scientific and spiritual knowledge, had disempowered their complex social networks, and had marginalised from the broader community both the Aboriginal people and their issues. However, he felt that, following the referendum in the previous year which supported equal suffrage for Aboriginal people, and the development of a new swell of awareness in the general populace, Aboriginal people were about to re-enter Australian history with a vengeance. Stanner wrote:

Development over the next fifty years will need to change its style and philosophy if the outcome is to be very different. I have begun to allow myself to believe that there is now a credible prospect of that happening. (p. 28)

Twenty-five years later, in 1993, another series of Boyer lectures included papers by (among others) Noel Pearson (1994) who at the time was the Executive Director of the Cape York Land Council, and Manduway Yunupingu (1994), lead singer in Yothu Yindi, traditional owner of Gumatj land, and at the time principal of Yirrkala school. Pearson referred to:

the shameful health, sanitation, educational, employment and housing conditions of black Australians. (Pearson, 1994, p. 100)

However, like Stanner, Pearson showed optimism, drawing attention to another momentous event in Aboriginal history, the Mabo cases, which led to the High Court's finding in 1992 that British Crown sovereignty over Australia did not extinguish 'the beneficial title of the indigenous inhabitants which they held under their own laws and customs' (Pearson, 1994, p. 97).

For many Australians both black and white, Mabo represents an opportunity for the achievement of a greater national resolution of the question of Aboriginal land rights, and an improvement in relations between new and old of this land, a first step in a new direction which might yield the changes necessary for indigenous people to be genuinely re-possessed of their inheritance. (Pearson, 1994, p. 98)

Yunupingu (1994) also spoke with optimism about finding a balance between different cultures' ways of knowing, and between traditional Indigenous education and European-style education.

Ten years on, in the fifth printing of his book Why warriors lie down and die, Trudgen (2003) wrote of his early experiences in 1973 working with the proud, strong and healthy Yolnu people of Arnhem Land, who historically lived to old age. Trudgen also wrote of the current situation.

Scabies are endemic. Other diseases like diabetes, high blood pressure, heart attacks, stroke, cancer, renal failure and obesity are decimating the people. Yolnu are now dying in their early to mid-forties or even younger, and at such a rate that life seems to lurch from one funeral to another. (Trudgen, 2003, p. 7)

The health statistics
A brief overview of Indigenous population characteristics, especially as compared to non-Indigenous population characteristics, provides some context. Data from the Australian Bureau of Statistics (ABS, 2003) provides benchmark, national information about the mental health and wellbeing of Indigenous Australians at a national level. Although there are limitations (such as under-reporting) in the data that might contribute to under-estimates, the ABS figures identify that the Australian Aboriginal and Torres Strait Islander population is 458,520, some 2.4% of the total population. The age structures of the Aboriginal and Torres Strait Islander populations differ from the Australian non-Indigenous population. Specifically, greater proportions of the Indigenous population are found in the under-20 age group, and lower proportions are found in age groups from 40 years upwards. The median age of the Indigenous population is 20 years, compared with 36 years for the non-Indigenous population.

One-quarter of the Indigenous population live in areas described as remote or very remote, compared with 2% of the non-Indigenous population. Approximately 30% of the Indigenous population live in major cities. Thus, whereas Indigenous Australians comprise 2.4% of the total population, this proportion varies from 1% in major cities to 45% in very remote areas.

Prior to the arrival of Europeans, Aboriginal and Torres Strait Islander peoples enjoyed an active lifestyle that promoted good health, with little evidence of widespread illness or disease (Jackson & Ward, 1999). In the 18th and 19th centuries, Australian Indigenous peoples, along with Maori in New Zealand, native Hawaiians, Saami in Norway, native Americans and the First Nations of Canada were nearly decimated by infectious diseases such as measles, typhoid fever, tuberculosis and influenza (Durie, 2003).

The current health-related statistics for the Indigenous peoples of Australia are appalling, and there has been little, if any, improvement in the last 25 to 30 years (Peachey, 2003). Disease rates for Indigenous Australians are many times those of non-Indigenous Australians. Rate ratios (Indigenous: non-Indigenous) for notifiable communicable diseases include gonococcal infection (69:1), syphilis (42:1) and chlamydia (18:1), with most other communicable diseases reported to the national surveillance system being in the range of five to ten times higher for Indigenous Australians (ABS, 2003). Hospitalisation rates for Indigenous Australians are several times higher than for non-Indigenous Australians. Rates for ischaemic heart disease are 1.4:1 (males) and 2.4:1 (females); respiratory disease 2.6:1 (males) and 3.1:1 (females); infectious and parasitic disease 2.7:1 (males) and 3.1:1 (females); and injury and poisoning 1.9:1 (males) and 2.3:1 (females) (ABS, 2003). Overweight or obesity, smoking and high levels of alcohol consumption are substantially higher in the Indigenous population (ABS, 2003). After adjusting for different population composition, Aboriginal and Torres Strait Islander people die at more than three times the total population rate, with endocrine, nutritional and metabolic diseases being the major causes (ABS, 2003). The average age of death for an Indigenous male is 56 years, which is almost 21 years less than the average age for males in the total population. The average age of death for Indigenous females is 60 years, almost 20 years less than females in the total population (Australian Indigenous HealthInfoNet, 2004). These Australian figures compare with gaps of eight years between Indigenous and non-Indigenous people in New Zealand, five to seven years in Canada, and four to five years in the United States of America (Ring & Brown, 2003).

Health as wellbeing
At a superficial level, the above statistics imply only one dimension of health, that is, physical health. However, the 1999 Declaration on the Health and Survival of Indigenous Peoples by the World Health Organization (WHO) proposed a richer definition of health from Indigenous peoples' perspectives.

Indigenous peoples' concept of health and survival is both a collective and an inter-generational continuum encompassing a holistic perspective incorporating four distinct shared dimensions of life. These dimensions are the spiritual, the intellectual, the physical, and (the) emotional. Linking these four fundamental dimensions, health and survival manifests itself on multiple levels where the past, present, and future co-exist simultaneously. (cited in Durie, 2003, p. 510)

Thus, although inequalities in health status are a measure of the quality of the health system (Durie, 2003), the determinants of health are not located solely in that system, but are embedded in political, economic and educational systems, in cultural imperatives, and in local community and individuals' (Indigenous and non-Indigenous) people's actions (Boughton, 2000; Durie, 2003; Jackson & Ward, 1999; Malin & CRCATH, 2003). For example, Najman et al. (2004) found that family income was related to all measures of child cognitive development and emotional health.

Education
In presenting statistics about Indigenous education, McRae et al. (2002) began with a positive emphasis, pointing out that Indigenous peoples' participation in early childhood and primary schooling has improved dramatically. Year 12 retention rates increased from under 10% to about 38% in 2000, and participation rates of 15-24-year-old Indigenous students in vocational training approximately equate those of the total population.

However, McRae et al. (2002) also provide statistics that indicate substantial difficulties in the education sector. On average, Indigenous Australians:

  • are less likely to attend preschool
  • fall well behind mainstream rates in literacy and numeracy skills development before leaving primary school
  • have less access to secondary school in the communities where they live
  • have two to three times the rate of absenteeism of other students
  • leave school much younger than non-Indigenous students
  • are less than half as likely to complete Year 12
  • are more likely to be taking bridging and basic entry programs in universities and vocational education programs
  • obtain fewer and lower-level qualifications.

(McRae et al., 2002, p. 5)

The above statistics suggest that there is much ground to be made up if the social justice section of the Adelaide Declaration on National Goals for Schooling are to be achieved.

  • Students' outcomes from schooling are free from the effects of negative forms of discrimination based on sex, language, culture and ethnicity, religion or disability; and of differences arising from students' socioeconomic background or geographic location.
  • The learning outcomes of educationally disadvantaged students improve, and, over time, match those of other students.
  • Aboriginal and Torres Strait Islander students have equitable access to, and opportunities in, schooling so that their learning outcomes improve and, over time, match those of other students.
  • All students understand and acknowledge the value of Aboriginal and Torres Strait Islander cultures to Australian society and possess the knowledge, skills and understanding to contribute to, and benefit from, reconciliation between Indigenous and non-Indigenous Australians.
  • All students understand and acknowledge the value of cultural and linguistic diversity, and possess the knowledge, skills and understanding to contribute to, and benefit from, such diversity in the Australian community and internationally.
  • All students have access to high-quality education necessary to enable the completion of school education to Year 12 or its vocational equivalent and that provides clear and recognised pathways to employment and further education and training.

It is interesting that the above goals recognise the pathway from education to employment, but do not highlight a pathway from education to wellbeing. The impact of education upon employment, and subsequently upon socioeconomic status, is only one (albeit important) component of wellbeing. This is explicitly stated in the Ministerial Council on Education, Employment, Training and Youth Affairs (MCEETYA, 2000).

Schooling acknowledges the close relationship between low levels of Indigenous educational outcomes and poverty, health, housing and access to government services and infrastructure by developing cross-portfolio mechanisms to address these issues. (Principle 3)

It is also worth considering education in a much more broad sense than represented by schooling. Highlighting this is the recognition by MCEETYA (2000) that, 'Schooling acknowledges the role of Indigenous parents as the first educators of their children …' (Principle 2).

The National Inquiry into Rural and Remote Education (HREOC, 2000) heard evidence about high rates of disability and illness that affected Indigenous students' attendance and ability to learn at school. For example, under-nutrition, hepatitis B, anaemia, vision disabilities and hearing disabilities disproportionately affect Indigenous students and impact upon their education.

Hearing problems may account for some of the classroom disruption where hearing impaired Indigenous children make use of their peers (often seated adjacent) to 'translate'. In conventionally structured class situations, such activity is likely to be interpreted as disruptive behaviour and the removal of this source [of translation] can disadvantage a child's progress. (HREOC, 2000, p. 60)

However, although it is important to disseminate information about inequalities in education between Indigenous and other Australian students, it is also important to recognise that there is wide variation in Indigenous students' educational experiences. The National Inquiry into Rural and Remote Education (HREOC, 2000) observed that:

where parents and community members play an active and decision-making role in the school, students enjoy their schooling and feel optimistic about their current and future prospects. (p. 57)

McInerney (1991) drew attention to the inappropriate practice of extrapolating theories, principles and methodologies that were originally grounded in American and western European populations to other societies and cultures. Resulting deficit explanations of minority group poor performances compared with western norms divert attention away from deficiencies in the education systems. McInerney suggested that another problem with research has been the practice of extrapolating results found in one Indigenous community to other Indigenous communities, which is equally as inappropriate as extrapolating results obtained from western to Indigenous communities.

McInerney called for a combination of two approaches to research. The first is to look within communities, to take into account what members of that group value as meaningful and important. This approach of course, means that findings cannot be uncritically extrapolated across groups. The second approach is to examine data from many cultures, and to extract common themes. This approach has the failing that it does not take into account issues that may be of particular importance to specific communities. However, the two approaches employed together have the potential to uncover and highlight information that will benefit the education-wellbeing transaction in Indigenous populations.

Malin (2003) suggested that the positive health effects of schooling that have been found in third-world populations may be cancelled out for Australia's Indigenous peoples because of the socially exclusionary policies and practices that extend to school classrooms. Indigenous Australians are enrolled in schools that belong to a society from which Indigenous students are often excluded. Indeed, Trudgen (2003) suggested that the whole process of colonisation and dispossession by a dominant culture breeds new diseases, the 'diseases of development' (p. 8).

Boughton (2000) proposed that there are specific issues that must be considered in relation to Indigenous Australians. One such issue is the danger of ascribing disadvantage to Aboriginality, rather than to disadvantage per se, thus racialising explanatory frameworks, engendering a 'blame the victim' effect and promoting stereotypes. As White (2002) explained in detail:

the commonality of [humans'] genetic make-up overwhelms any claimed differences. Race is not a biological category, but rather it is a social category … [if] conditions are presented as a consequence of biological inevitability, of 'race', then the social processes around them can be dismissed. (p. 155)

Alternatively, White proposed that whereas race is an ideological tool of oppression, 'ethnicity', when grounded in political processes of self-claiming and political mobilisation, can empower minority groups. Ethnicity can be a powerful shaper of people's identity and a political resource that can be used to advance the interests of minority groups. However, linked to the potential power of proclaimed ethnicity lies a second problem identified by Boughton (2000), which is a tendency to treat Aboriginality as a homogenous category, thus masking 'the enormous differences, in terms of needs and aspirations, and of programs required' (Boughton, 2000 p. 5).

Issues of control
Simons (1989) proposed that factors underlying the education-health relationship can be substantially attributed to individuals' attributions of cause to, and sense of control over, life events. Locus of control, perceived as either internal or external, and due to luck or personal effort, is a key theory in educational psychology (Graham, 1991; Weiner, 1985).

However, control can also be viewed from another direction. Boughton (2000), after Friere, explained that an Indigenous person's perspective of lack of control, or lack of empowerment, may not be solely due to an individual's disposition or cultural beliefs, but can be a valid reflection of actual physical circumstances and life histories. Clear illustrations of this are the government policies and practices that led to the forced removal of Indigenous children from their parents, the 'stolen generation'. Another example is provided by Marmot's seminal Whitehall studies, which identified relationships between employment status, job demand-control, stress and health (Marmot, Siegrist, Theorell, & Feeney, 1999). Where poverty is not a factor, as with the civil servants at Whitehall, health remains unequally distributed according to social hierarchy, with 'rank or relative position in social hierarchy [being] one of the most important determinants of health, and that addressing this must necessarily involve addressing existing power relationships at all levels of our work' (Tsey, Whiteside, Deemal, & Gibson, 2003, S35). Thus, control, power and empowerment cannot be ignored in discussions of Indigenous peoples' health (Malin & CRCATH, 2003; Tsey et al., 2003) and education (Boughton, 1999; Boughton, 2000).

Indeed, as Boughton (2000) pointed out:

Education systems in Australia … often aimed to reduce Indigenous peoples' power and authority over their children, and helped to lower the status of Aborigines in society. (p. 15)

For example, although studies in third-world countries have found linear relationships between maternal education and infant and child health, Gray and Boughton (2001) reported an analysis of the relationship between age of leaving school and Indigenous Australians' reported actions concerning their children's health. Interestingly, a curvilinear relationship emerged, with relatively high levels of health action taken both by mothers with the least education (left school younger than 14 years) and by mothers with the most education (left school at 17 years and older). Gray and Boughton proposed that one possible explanation might be the disempowering nature of 'western' secondary education upon Indigenous Australians, thus making students who entered the system, but did not achieve success, less self-efficacious, and therefore less likely to take health-related action on behalf of their children. Although this explanation is untested, it finds parity with the above discussion of control.

Related to Gray and Boughton's analyses, Rigney et al. (1998) highlighted a number of issues that impact upon Indigenous students' ability to complete the South Australian Certificate of Education, including institutional peer and teacher racism in school environments; ineffective racial harassment policies; ineffective grievance procedures; lack of respect and value for all cultures; poor communication processes with individuals, peers, parents and communities; confusion about the roles of Aboriginal Education Workers; the need for cultural awareness training of teachers and counsellors; the need for support structures such as dedicated spaces for Indigenous students, homework and tutoring assistance; transience; and poverty. Rigney et al. (1998) grouped the above issues under the title 'non-SACE factors', thus highlighting the complex web of interactions that impact upon the education-wellbeing relationship.

To feel depressed, cheated, bitter, desperate, vulnerable, frightened, angry, worried about debts or job and housing insecurity; to feel devalued, useless, helpless, uncared for, hopeless, isolated, anxious and a failure; these feelings can dominate people's whole experience of life … (Wilkinson, 1996, cited in Shaw, Dorling, & Smith, 1999)

Constructivism
Constructivist philosophies are explicitly included in current educational theory and practice. For example, the South Australian Curriculum Standards and Accountability (SACSA) Framework includes the statement below.

The theoretical basis for the conception of learning in the SACSA Framework is provided by the family of theories of learning that are grouped under the title 'constructivism'. While theoretical distinctions exist between particular versions of constructivism, such as personal, social and radical, it is this family of theories which have guided the preparation of the Framework.

The central thesis of constructivism is that the learner is active in the process of taking in information and building knowledge and understanding; in other words, of constructing their own learning. Learning then is the active process of engaging in experience and its internalisation in terms of thinking. All forms of experience can be called upon here. Constructivism also has clear implications for the social situation or context in which learning happens, in so far as learners are more likely to engage in constructing their own understanding in a supportive social environment. (DETE, 2001, p. 10)

What seems to be lacking is evidence about the widespread application of teaching approaches that are compatible with the constructivist perspective on learning. If such application was widespread, then many of the points of criticism made of educational practices in Aboriginal schools in research such as that of Groome (1995) and Malin (2003) would not have been generated. Some of those criticisms suggest that some schooling practice has not been based on a sensitive analysis of Aboriginal students' life situations.

Hughes and More (1997) argued that differing cultural backgrounds provided differing learning experiences that caused students to develop and prefer certain learning styles or approaches over others. Three potential difficulties might then arise in formal schooling situations. First, there may be no relationship between the preferred, or habitual, learning style and the most effective, or strongest, learning style. Second, the preferred learning style might be inappropriate for the task at hand. Third, teachers may neglect to utilise the learning style strengths of their students. Employing less than optimum learning styles might hamper school performance, which could in turn lead to stress and a negative impact upon wellbeing. Hughes and More saw that two important tasks for teachers were to: 1) enable students to develop a range of learning styles and strategies that can be flexibly employed to suit varying tasks over varying contexts; and 2) design and deliver instructional interventions that meet the learning styles and approaches of their students.

In addition, students have idiosyncratic subject matter knowledge and world views that will affect how they interpret new information. Constructivist philosophies have strong implications for learning health-related information. Information that is presented in such a way that does not account for Indigenous peoples' world views is likely to be poorly connected in their mental models about health and wellbeing. One example of this is the application of western scientific paradigms to health and disease, while ignoring an holistic concept of health as wellbeing at all levels of land, spirituality, community and individuals. Many more specific examples of shattered links between prior knowledge and new knowledge are provided by Trudgen's (2003) accounts of the health-related education for Yolnu people, such as using existing knowledge about the life-cycle of turtles to scaffold the acquisition of new knowledge about the life-cycle of skin parasites.

Conceptual mismatches
Chi, Slotta and Leeuw (1994) described the learning problems that occur when students misclassify phenomena to the wrong ontological category, such as classifying electric current as a 'thing', a type of matter, when it is actually a process. The Chi et al. analysis reminds us that phenomena might also be misclassified within categories, so that an Indigenous-related conception might be categorised in incompatible ways by Indigenous and non-Indigenous groups. Conceptions of land, of schooling, or of health, might be problematic in this way. If such were the case, the problem of misclassification needs to be identified and explained, so that the implications of the differences in classification can be made explicit.

Teacher training
The preparation of teachers for working in classrooms with Indigenous students must be a site for attention. Thus, the content of the teacher preparation courses, the practicum experiences of the student teachers, and the induction of the newly qualified teachers should all be considered as possible sites for action. The importance of all forging strong links between each of these components of teacher preparation has been reinforced by recent research on teacher preparation in the United States that can be expected to have reasonable external validity in the Australian context (Wang & Odell, 2002).

Malin (2003) proposed that a teacher's effect upon a child can be profound, and is governed by the teacher's:

  • relationship with the students
  • depth of understanding of the students' backgrounds
  • expectations of students and methods of sanctioning
  • ways of organising the students' learning.

(Malin & CRCATH, 2003)

An extract from Keeffe (1992) illustrates the dawning of a teacher's conceptual change.

At an in-service training session in Canberra, a primary school teacher remarked that she had been 'doing' Aboriginal studies for twelve years …

'I don't know about the rest of you but I suddenly feel a little queasy. What else have I been teaching in my course but how to think about Aborigines in a negative, stereotyped, really a bit racist way? What's that old line about that to educate others we must first educate ourselves? I just never realised what I'd been doing.' (p. 69)

References
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Australian Indigenous HealthInfoNet (2004). Plain language summary of Indigenous health: February 2004. Retrieved on 4/6/04 from http://www.healthinfonet.ecu.edu.au/health-facts/summary

Boughton, B. (1999). Strategies to overcome institutional racism in education: A submission to the Collins review of Aboriginal education in the NT. Alice Springs, Northern Territory, Australia: Menzies School of Health Research.

Boughton, B. (2000). What is the connection between Aboriginal education and Aboriginal health? Alice Springs, Northern Territory, Australia: Menzies School of Health Research. Retrieved on 26/5/04 from http://192.94.208.240/Crc/General/CRCPubs/ocps/op%20files/issue002.pdf

Chi, M. T., Slotta, J. D., & Leeuw, N. (1994). 'From things to processes: A theory of conceptual change for learning science concepts.' Learning and Instruction, 4, 27-43.

DETE (2001). South Australian Curriculum, Standards and Accountability Framework. South Australia: DETE Publishing. Retrieved on 15/9/03 from http://www.sacsa.gov.au

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HREOC (2000). Emerging themes: National inquiry into rural and remote education. Human Rights and Equal Opportunity Commission (HREOC).

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