Australia: Improving patient outcomes for our Aboriginal and Torres Strait Islander Community

Last Updated: 19 September 2016
Article by Nathan Taylor

My name is Nathan Taylor, I am Tubba-Gah man from the Wiradjuri Nation. I am also the Aboriginal Health Worker at St Vincent's Health Network, Sydney. Given my role as an Aboriginal Health Worker, I will predominately be providing my answers from a health perspective.

The modern history of Australia since colonisation has led to the Aboriginal and Torres Strait Islander Peoples having a difficult relationship with the various institutions that exist within our society e.g. 'health, justice, education'. In today's society, a higher proportion of Aboriginal and Torres Strait Islander Peoples have a lower socioeconomic status, when compared to the general population, meaning they have poorer health, poorer education, and higher rates of incarcerations, among other factors. All these factors cumulatively contribute to the life-expectancy of an individual, which is why the significance of 'closing the gap' in life-expectancy between the Aboriginal and Torres Strait Islander Peoples, and the general population, has become so important.

To properly improve outcomes for our Aboriginal and Torres Strait Islander communities we need to properly address not just the social determinants, but also the cultural needs of the individuals, the families, and the communities. However, due to effects of colonisation, and the various government policies since then, it has become increasingly difficult in today's society to separate the cultural needs of our Aboriginal and Torres Strait Islander Peoples, from the needs of those living within low socioeconomic conditions. The two are often talked about interchangeably, to a point where disadvantage has become synonymous with the various Aboriginal and Torres Strait Islander cultures.

In answering the below questions I will try to make the separation clearer, and only address the cultural needs of a patient.

  1. In meeting with an Aboriginal and/or Torres Strait Islander whose English communication skills are limited, what methods could be used to better communicate, including in obtaining a medical history, family history and life style? What questions should be and should not be asked?

Health, or the idea of health, can often be interpreted differently amongst patients from different Nations, communities, and even families, so there is no one-size-fits-all method to approaching this.

In my role I have found that patients identify with, and convey their health in holistic terms that relate more to their social and emotional wellbeing, rather than their physical wellbeing. Factors that are important to social and emotional wellbeing include a person's connection to country, spirituality and ancestry, relationships with family members and friends, and connection to community. However, it would be wrong to exclude the fact that poor health literacy within some individuals exists, with the association of a cause and effect, such as alcohol abuse and liver damage, not always known or understood properly.

In order to obtain the relevant information to perform your role, the health discussion should take a less formal approach through asking questions about an individual's family, and community and showing genuine empathy by validating or acknowledging how a patient might be feeling emotionally about their health. This can be an effective way of developing a good rapport with the patient.

  1. Are there any special issues to be considered in obtaining consent to medical treatment?

For a practitioner or clinician, it may be a relatively minor health procedure or treatment option, but it can be a daunting prospect for a patient. For this reason, individuals may wish to have family involved in the conversations surrounding major health considerations, and it would be best to ask the patient if they would prefer their family, and/or the Aboriginal Health Worker to be present when seeking consent for surgery or medical treatment.

  1. Can you please explain the role of community members and Elders? In dealing with Elders, how should they be addressed? What is their authority?

Within my Nation, the Wiradjuri Nation, the Elders are the keepers of knowledge, and oversee the education of the youth, the upholding of cultural beliefs and protocols, and seasonal migration to ensure sustainable use of the land. In today's society, the Elders roles still encompass many of the same values, but have also taken on roles that encompass our modern society such as community activism, and the representing the communities in dealing with corporations and governments.

Elders are currently addressed or known by the titles of Uncle, for males, and Aunty, for females. This is not a title that is formally bestowed, but rather signifies the status and respect an individual has within a community. The Elders within the Wiradjuri Nation are represented by the Wiradjuri Council of Elders; similar representative bodies exist within other Nations.

  1. Can you please explain men's and women's business? Is it best to have a doctor/nurse of the same gender involved?

Traditionally, these terms were used to represent how knowledge and cultural protocols were taught, and shared. In the Wiradjuri Nation, information was taught by the male Elders to the male youth; with the female Elders teaching the female youth.

In a modern health context, this would mean having a male Nurse/Doctor treating someone of the same gender, however in practice this is not always an available option. Some health Institutions have male and female Aboriginal Health Workers, others do not. I myself am a male Aboriginal Health Worker, and approx. 50% of my patients are female. Even as an Aboriginal person, I will ask in my first interaction if the patient would feel more comfortable speaking with a female Social Worker. These considerations of, and observing cultural protocols, can be significant in making a patient more receptive and comfortable in a delicate situation.

  1. What about communicating future appointments and medications?

As well as communicating the significance of future appointments and medications, it is important to address any inhibiting factors that could limit whether or not an individual might be able to attend an appointment, despite agreeing to it. When communicating future appointment and medications, ask questions that can address hindrances e.g. 'Do you have a way to get to the hospital? Do you have family who can bring you to your appointment? Do you know where the local pharmacy is, or have a preferred one? Have you used a Webster pack before? If I need to contact you, what is the best way to do so?'

In addressing the inhibiting factors, it will give the patient greater power and responsibility over their health care, and give you the opportunity to further build an open, honest, and positive relationship with your patient.

  1. Are there holistic medicine issues to be considered?

See question 1.

  1. What interpreter services are available?

Language revitalisation, particularly in South-Eastern Australia, is still in its infancy; I am not aware of any interpretation services that currently exist. Where the languages of Nations are still spoken more frequently, such as Northern and North-Western Australia, there may be interpretation services available. In other parts of the country, it would be best to involve your Aboriginal Health Worker, Aboriginal Liaison Officer, or other institution equivalent, when engaging with patient/client.

  1. What can and cannot be said about death and the deceased or other issues?

The protocols surrounding death vary from Nation to Nation. For instance, within the various cultures of the Noongar Peoples of WA, the first name of the recently deceased in not said for a period of time until the community sees fit; these protocols are, however, not shared across the country. To find out more information relevant to your community, you can seek advice and understanding from your local Elders Group/Council, Aboriginal Incorporated Body such as the Aboriginal Medical Services and Aboriginal Community Controlled Health Organisations, and Aboriginal Land Council.

  1. What is taboo?

Again, in a broader sense, to find out more specific information about the Nation's culture that your city is located in, you should seek advice from the local Elders Group/Council, Aboriginal Incorporated Body such as the Aboriginal Medical Services and Aboriginal Community Controlled Health Organisations, and Aboriginal Land Council. This can also vary in individuals, and it is important to be mindful of institutional, and/or intergenerational trauma, this is when an Aboriginal Mental Health Worker or other appropriate mental health services should be engaged.

Whilst not taboo, something that is often done, in order to build report with a patient, is to relay that you have been to or worked in an Aboriginal Community elsewhere in Australia. While that fact is in and of itself fantastic, it is not always relevant to the patient, and may come off as disingenuous. The similarities between the cultures, and communities in Arnhem Land in Northern Australia and the Biripi Nation on the Eastern Seaboard, are vastly different. It is better to ask the patient about where they are from, as their community and Nation will hold more significance.

  1. How else can patient outcomes for our Indigenous and Torres Strait Islander Community be improved?

As I hope this has come through in my answers, empowering our individuals to take further control and ownership over their health is an important way to improve patient outcomes within our communities. Aboriginal Community Controlled Health Services are also an effective means for improving health outcomes.

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.

To print this article, all you need is to be registered on

Click to Login as an existing user or Register so you can print this article.

Some comments from our readers…
“The articles are extremely timely and highly applicable”
“I often find critical information not available elsewhere”
“As in-house counsel, Mondaq’s service is of great value”

Up-coming Events Search
Font Size:
Mondaq on Twitter
Register for Access and our Free Biweekly Alert for
This service is completely free. Access 250,000 archived articles from 100+ countries and get a personalised email twice a week covering developments (and yes, our lawyers like to think you’ve read our Disclaimer).
Email Address
Company Name
Confirm Password
Mondaq Topics -- Select your Interests
 Law Performance
 Law Practice
 Media & IT
 Real Estate
 Wealth Mgt
Asia Pacific
European Union
Latin America
Middle East
United States
Worldwide Updates
Check to state you have read and
agree to our Terms and Conditions

Terms & Conditions and Privacy Statement (the Website) is owned and managed by Mondaq Ltd and as a user you are granted a non-exclusive, revocable license to access the Website under its terms and conditions of use. Your use of the Website constitutes your agreement to the following terms and conditions of use. Mondaq Ltd may terminate your use of the Website if you are in breach of these terms and conditions or if Mondaq Ltd decides to terminate your license of use for whatever reason.

Use of

You may use the Website but are required to register as a user if you wish to read the full text of the content and articles available (the Content). You may not modify, publish, transmit, transfer or sell, reproduce, create derivative works from, distribute, perform, link, display, or in any way exploit any of the Content, in whole or in part, except as expressly permitted in these terms & conditions or with the prior written consent of Mondaq Ltd. You may not use electronic or other means to extract details or information about’s content, users or contributors in order to offer them any services or products which compete directly or indirectly with Mondaq Ltd’s services and products.


Mondaq Ltd and/or its respective suppliers make no representations about the suitability of the information contained in the documents and related graphics published on this server for any purpose. All such documents and related graphics are provided "as is" without warranty of any kind. Mondaq Ltd and/or its respective suppliers hereby disclaim all warranties and conditions with regard to this information, including all implied warranties and conditions of merchantability, fitness for a particular purpose, title and non-infringement. In no event shall Mondaq Ltd and/or its respective suppliers be liable for any special, indirect or consequential damages or any damages whatsoever resulting from loss of use, data or profits, whether in an action of contract, negligence or other tortious action, arising out of or in connection with the use or performance of information available from this server.

The documents and related graphics published on this server could include technical inaccuracies or typographical errors. Changes are periodically added to the information herein. Mondaq Ltd and/or its respective suppliers may make improvements and/or changes in the product(s) and/or the program(s) described herein at any time.


Mondaq Ltd requires you to register and provide information that personally identifies you, including what sort of information you are interested in, for three primary purposes:

  • To allow you to personalize the Mondaq websites you are visiting.
  • To enable features such as password reminder, newsletter alerts, email a colleague, and linking from Mondaq (and its affiliate sites) to your website.
  • To produce demographic feedback for our information providers who provide information free for your use.

Mondaq (and its affiliate sites) do not sell or provide your details to third parties other than information providers. The reason we provide our information providers with this information is so that they can measure the response their articles are receiving and provide you with information about their products and services.

If you do not want us to provide your name and email address you may opt out by clicking here .

If you do not wish to receive any future announcements of products and services offered by Mondaq by clicking here .

Information Collection and Use

We require site users to register with Mondaq (and its affiliate sites) to view the free information on the site. We also collect information from our users at several different points on the websites: this is so that we can customise the sites according to individual usage, provide 'session-aware' functionality, and ensure that content is acquired and developed appropriately. This gives us an overall picture of our user profiles, which in turn shows to our Editorial Contributors the type of person they are reaching by posting articles on Mondaq (and its affiliate sites) – meaning more free content for registered users.

We are only able to provide the material on the Mondaq (and its affiliate sites) site free to site visitors because we can pass on information about the pages that users are viewing and the personal information users provide to us (e.g. email addresses) to reputable contributing firms such as law firms who author those pages. We do not sell or rent information to anyone else other than the authors of those pages, who may change from time to time. Should you wish us not to disclose your details to any of these parties, please tick the box above or tick the box marked "Opt out of Registration Information Disclosure" on the Your Profile page. We and our author organisations may only contact you via email or other means if you allow us to do so. Users can opt out of contact when they register on the site, or send an email to with “no disclosure” in the subject heading

Mondaq News Alerts

In order to receive Mondaq News Alerts, users have to complete a separate registration form. This is a personalised service where users choose regions and topics of interest and we send it only to those users who have requested it. Users can stop receiving these Alerts by going to the Mondaq News Alerts page and deselecting all interest areas. In the same way users can amend their personal preferences to add or remove subject areas.


A cookie is a small text file written to a user’s hard drive that contains an identifying user number. The cookies do not contain any personal information about users. We use the cookie so users do not have to log in every time they use the service and the cookie will automatically expire if you do not visit the Mondaq website (or its affiliate sites) for 12 months. We also use the cookie to personalise a user's experience of the site (for example to show information specific to a user's region). As the Mondaq sites are fully personalised and cookies are essential to its core technology the site will function unpredictably with browsers that do not support cookies - or where cookies are disabled (in these circumstances we advise you to attempt to locate the information you require elsewhere on the web). However if you are concerned about the presence of a Mondaq cookie on your machine you can also choose to expire the cookie immediately (remove it) by selecting the 'Log Off' menu option as the last thing you do when you use the site.

Some of our business partners may use cookies on our site (for example, advertisers). However, we have no access to or control over these cookies and we are not aware of any at present that do so.

Log Files

We use IP addresses to analyse trends, administer the site, track movement, and gather broad demographic information for aggregate use. IP addresses are not linked to personally identifiable information.


This web site contains links to other sites. Please be aware that Mondaq (or its affiliate sites) are not responsible for the privacy practices of such other sites. We encourage our users to be aware when they leave our site and to read the privacy statements of these third party sites. This privacy statement applies solely to information collected by this Web site.

Surveys & Contests

From time-to-time our site requests information from users via surveys or contests. Participation in these surveys or contests is completely voluntary and the user therefore has a choice whether or not to disclose any information requested. Information requested may include contact information (such as name and delivery address), and demographic information (such as postcode, age level). Contact information will be used to notify the winners and award prizes. Survey information will be used for purposes of monitoring or improving the functionality of the site.


If a user elects to use our referral service for informing a friend about our site, we ask them for the friend’s name and email address. Mondaq stores this information and may contact the friend to invite them to register with Mondaq, but they will not be contacted more than once. The friend may contact Mondaq to request the removal of this information from our database.


This website takes every reasonable precaution to protect our users’ information. When users submit sensitive information via the website, your information is protected using firewalls and other security technology. If you have any questions about the security at our website, you can send an email to

Correcting/Updating Personal Information

If a user’s personally identifiable information changes (such as postcode), or if a user no longer desires our service, we will endeavour to provide a way to correct, update or remove that user’s personal data provided to us. This can usually be done at the “Your Profile” page or by sending an email to

Notification of Changes

If we decide to change our Terms & Conditions or Privacy Policy, we will post those changes on our site so our users are always aware of what information we collect, how we use it, and under what circumstances, if any, we disclose it. If at any point we decide to use personally identifiable information in a manner different from that stated at the time it was collected, we will notify users by way of an email. Users will have a choice as to whether or not we use their information in this different manner. We will use information in accordance with the privacy policy under which the information was collected.

How to contact Mondaq

You can contact us with comments or queries at

If for some reason you believe Mondaq Ltd. has not adhered to these principles, please notify us by e-mail at and we will use commercially reasonable efforts to determine and correct the problem promptly.