Leading the way: the contribution of Aboriginal community controlled health organisations to community health in Australia

Tamara Mackean; Toby Freeman; Connie Musolino; Denise Fry; Colin MacDougall; Virginia Lewis; Fran Baum

doi:10.1071/PY24223

RESEARCH ARTICLE (Open Access)

Next Contents Vol 31(3)

Leading the way: the contribution of Aboriginal community controlled health organisations to community health in Australia

Tamara Mackean ^A ^* , Toby Freeman

^B , Connie Musolino ^B , Denise Fry ^C , Colin MacDougall ^A , Virginia Lewis

^D Fran Baum ^B

+ Author Affiliations

- Author Affiliations

^A College of Medicine and Public Health, Flinders University, Sturt Road, Bedford Park, SA 5042, Australia.

^B Stretton Health Equity, University of Adelaide, Adelaide, SA 5001, Australia.

^C Sydney Local Health District, Missenden Road, Camperdown, NSW 2050, Australia.

^D La Trobe University, Melbourne, Vic3086, Australia.

^* Correspondence to: tamara.mackean@flinders.edu.au

Australian Journal of Primary Health 31, PY24223 https://doi.org/10.1071/PY24223

Submitted: 23 December 2024 Accepted: 23 March 2025 Published: 14 April 2025

© 2025 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Background

The Aboriginal community controlled health sector has been a leader in community health in Australia. We sought to understand the influence this sector has had on the non-Indigenous community health movement in Australia since the 1970s.

Methods

We interviewed 87 key informants on the history of community health in Australia, including policy makers, researchers, medical doctors, allied health, social workers, nurses and politicians. Five were Aboriginal, and 11 had particular experience in Aboriginal community health. A team approach was taken to qualitative analysis using a codebook. We interrogated data to seek evidence for the influence of Aboriginal community health on non-Indigenous community health, and the relationship between the two sectors. This was complemented by construction of a policy timeline.

Results

Aboriginal community health services were regarded as best practice community health, and informed and influenced practice in non-Indigenous community health services. Non-Indigenous community health was sometimes more of a competitor than an ally. The respect for the Aboriginal community health sector, particularly community controlled, was seen to have grown over time, acknowledging the strengths of the model. Although establishing Aboriginal community health services was a struggle, the resulting model has better resisted managerialist control compared with non-Indigenous community health.

Conclusions

The Aboriginal health sector developed a vision and practice of community health that went on to inform generalist non-Indigenous community health sector in Australia. The sector continues to remain strong today as an example model of community health that is relevant to all Australians.

Keywords: Aboriginal health, community control, community health, community participation, health policy, Indigenous health, primary health care, social determinants of Indigenous health.

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