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Determinants of Health (from health care to social):
identification, intervention and evaluation
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Current Projects List:
Past Projects List:
Click here for a full list of our research projects
Current Projects Details:
PROJECT NAME Improving the culture of hospitals
STAFF Angela Clarke
COLLABORATORS La Trobe University, Aboriginal Health Council of South Australia
FUNDING SOURCE Cooperative Research Centre for Aboriginal Health
DATE 2006-2009
PROJECT DESCRIPTION This project explores reforms to improve cultural sensitivity for Aboriginal people in hospitals.
PROJECT AIMS To support the delivery of services to Aboriginal people in ways that include recognition and response to cultural values, needs and preferences. Using the experience of Aboriginal people as the central reference point, systematic case studies of hospitals will be used to gather information and to inform the development and implementation of relevant tools and processes.
PUBLICATIONS
PROJECT NAME Reducing smoking amongst pregnant Aboriginal Women in Victoria: an holistic approach
STAFF Priscilla Pyett, Anke van der Sterren
COLLABORATORS Victorian Aboriginal Community Controlled Health Organisation,
FUNDING SOURCE Department of Human Services, Victoria
DATE 2008-11
PROJECT DESCRIPTION This is an action research project using appreciative inquiry methods to provide training for Aboriginal Health Workers (AHWs), Koori Maternity Service workers and In-Home Support workers around smoking interventions for pregnant women; to create a supportive environment in Aboriginal Community Controlled Health Organisations (ACCHOs) for more integrated support for smoking reduction; and to trial a holistic Group Support Program for women in 3 ACCHOs.
PROJECT AIMS To build the capacity for reducing smoking among AHWs and within ACCHOs, and to support pregnant women to reduce and give up smoking.
PROJECTED OUTCOMES Resource kit and strategies for supporting pregnant Aboriginal women to reduce smoking.
PROJECT NAME Building and supporting community led partnerships to respond to Indigenous family violence in Victoria
STAFF Kyllie Cripps, Ian Anderson
COLLABORATORS Marcia Langton, Maggie Walter, Mark Rose
FUNDING SOURCE Australian Research Council
DATE 2008-2010
PROJECT DESCRIPTION This project is examining Indigenous and mainstream models of practice that respond to Indigenous family violence and how these models build and nurture partnerships for future sustainability.
PROJECTED OUTCOMES The research methodology facilitates a process of information brokerage and critical reflection within and between Indigenous and mainstream family violence interventions that may influence ongoing community and organisational practices. The critical analysis of these models of practice and partnerships will also have implications for future policy and funding directions.
PROJECT NAME A framework for addressing ethnoracial discrimination in Victoria
STAFF Yin Paradies
COLLABORATORS McCaughey Centre (University of Melbourne) and VicHealth
FUNDING SOURCE VicHealth
DATE January 2008 – December 2008
PROJECT DESCRIPTION This project will provide a broad conceptual framework for understanding ethnoracial discrimination (racism) within a Victorian context. It will provide evidence, policy, practice and the legislative framework to establish a strategic, theory and evidence based approach to addressing this issue across Victorian society.
OUTCOMES A framework which can be utilised by various levels of government and appropriate NGOs to guide policy and practice in the area of anti-racism.
PROJECT NAME Constructing spatially sensitive anti-racism templates
STAFF Yin Paradies
COLLABORATORS University of Western Sydney, Murdoch University, Macquarie University, University of Queensland, Victoria University
FUNDING SOURCE Australian Research Council
DATE January 2008 – December 2010
PROJECT DESCRIPTION The project will use existing databases to construct regional-based typologies of racism. From these typologies, a series of toolkits will developed for each regional type, addressing particular attitudes towards and experiences of racism.
PROJECT NAME Predicting heart disease in Aboriginal and Torres Strait Islander people (The Heart Health Follow Up - NT)
STAFF Kevin Rowley, Joanne Luke
COLLABORATORS Baker-IDI Heart and Diabetes Research Institute (Alice Springs), University of Melbourne Department of Medicine (St Vincent’s Hospital), University of South Australia, University of Queensland, Menzies School of Health Research, Urapuntja Health Service
FUNDING SOURCE NHMRC program grant (“HOMELANDS”)
DATE 2004 - 2009
PROJECT DESCRIPTION This is a follow up of cardiovascular disease outcomes for a cohort of Aboriginal and Torres Strait Islander people in the Northern Territory who participated in a health screening program in the 1990s.
PROJECT AIMS To identify what clinical measures best predict the risk of heart attack and stroke in Indigenous communities in central Australia. To document local Indigenous cultural explanations of health outcomes in order to provide a more complete story of health than that provided by clinical and epidemiological methods.
CURRENT OUTCOMES Initial results from this cohort study identified good health outcomes (relatively low mortality rates and low cardiovascular disease incidence) for a decentralised community living on traditional lands and with a community-controlled health service that supports outstation living. Investigation of the social and cultural factors that allow these good outcomes is underway.
PUBLICATIONS
- Rowley, K., O’Dea, K., Anderson, I., McDermott, R., Saraswati, K., Tilmouth, R., Roberts, I., Fitz, J., Wang, Z., Jenkins, A., Best, J. D., Wang, Z. & Brown, A. 2008, ‘Morbidity and Mortality for an Australian Aboriginal Population: 10 year follow up in a decentralised community’, MJA, 188(5):283–7.
- Policy Brief (2008) Good health outcomes over two decades for a decentralized NT Aboriginal community.
- Rowley K, Wang Z, Luke J, Brown A (2008). Predicting cardiovascular disease for Aboriginal people in Central Australia. Preliminary analysis from the Heart Health Follow Up Study. The University of Melbourne and Baker-IDI Heart and Diabetes Research Institute, Melbourne.
CONFERENCE PRESENTATIONS
- Rowley K, Brown AD, Saraswati K, Tilmouth R, Roberts I, Fitz J, Wang Z, McDermott R, Anderson I, Thomas D, O’Dea K (2006). Outstation is not a dirty word: lower than expected morbidity and mortality for an Aboriginal population. The Chronicle 2006; 9(5): p5. Presented at the NT Chronic Disease Network Conference, Darwin.
- Tilmouth R, Saraswati K, Rowley K, Brown A (2008). Culture, primary health care and health outcomes at Utopia community. WONCA Asia Pacific Regional conference and RACGP 51st Annual Scientific Convention, Melbourne, October.
- Rowley K, Saraswati K, Tilmouth R, Rickards P, Guillemin M, Brown A (2008). Social determinants and heart health for Aboriginal people. NT Chronic Disease Network Conference, Alice Springs.
- Luke JN, Brown A, O'Neal D, Kelaher M, O'Dea K, Best JD, Wang Z, Rowley K (2008). Lipid treatment guidelines and cardiovascular risk for Aboriginal people in central Australia. NT Chronic Disease Network Conference, Alice Springs.
- Wang Z, Rowley K, Wang Z, O'Dea K, Brown A (2008). Cardiovascular disease risk prediction for Aboriginal populations in central Australia. Cardiac Society of Australia and New Zealand conference, Adelaide.
PROJECT NAME Health Indicators Project
STAFF Kevin Rowley, Leah Johnston, Ian Anderson
COLLABORATORS Victorian Aboriginal Community Controlled Health Organisation, Victorian Aboriginal Education Association Inc, Victorian Aboriginal Community Services Association Ltd, Victorian Aboriginal Corporation for Languages, Department of Human Services Victoria, L’Université de Montréal
FUNDING SOURCE Canadian Institutes of Health Research, through the International Collaborative Indigenous Health Research Partnership program and Global Health Research program (M. Daniel et al)
DATE ongoing
PROJECT DESCRIPTION Conventional predictors of health outcomes, such as employment, income etc, do not necessarily predict health for Indigenous populations in the same way as they do for mainstream communities. Other indicators of health at the community level and measures of service delivery are required for research, evaluation and policy development for Aboriginal communities. This project was an international collaboration involving indigenous community representatives from Canada, New Zealand and the Northern Territory in addition to the Victorian arm.
PROJECT AIMS To design and evaluate a rating tool for assessing the usefulness of potential health indicators. To identify valid and useful indicators of population health for Aboriginal communities.
OUTCOMES A rating tool for assessing the potential indicators of Indigenous community health was designed and evaluated. The rating tool proved useful for identifying valid and feasible indicators of Indigenous community health.
PUBLICATIONS
- Marks E, Cargo MD, Daniel M. Constructing a health and social indicator framework for Indigenous community health research. Social Indicators Research 2007; 82: 93-110.
PROJECT NAME Improving Mainstream Diabetes Care for Urban Indigenous Australians
STAFF Kevin Rowley, Priscilla Pyett
COLLABORATORS University of Melbourne Department of General Practice, Centre for Health Policy, Programs and Evaluation, Victorian Aboriginal Community Controlled Health Organisation
FUNDING SOURCE NHMRC
DATE 2008-2011
PROJECT DESCRIPTION Exploring the enablers and barriers for Aboriginal and Torres Strait Islander people accessing mainstream medical services in urban areas of Melbourne.
PROJECT AIMS To develop or adapt a mainstream diabetes care/intervention model to be culturally appropriate for urban Aboriginal and Torres Strait Islander people.
CURRENT OUTCOMES Steering Committee established; 2 Indigenous Project Research Officers appointed; 3 conference presentations.
PROJECTED OUTCOMES Community report, improved model of care.
PROJECT NAME Improving access to hepatitis C treatment services for disadvantaged groups - recognising and responding to hepatitis C in Indigenous communities in Victoria
STAFF Priscilla Pyett
COLLABORATORS Victorian Aboriginal Community Controlled Health Organisation, ARCSHS (La Trobe University)
FUNDING SOURCE Department of Human Services, Victoria
DATE 2006-2008
PROJECT DESCRIPTION Qualitative project investigating barriers to treatment for Indigenous people with Hepatitis C in Victoria.
PROJECT AIMS To identify barriers and enablers for Indigenous people with Hepatitis C in Victoria to access treatment.
PROJECTED OUTCOMES Community Report
PROJECT NAME VAHS Young People’s Project
STAFF Paul Stewart, Kevin Rowley, Ian Anderson
COLLABORATORS Victorian Aboriginal Health Service (VAHS), Macfarlane Burnet Centre, Institute of Koorie Education (Deakin University)
FUNDING SOURCE Cooperative Research Centre for Aboriginal Health
DATE 2007 - 2009
PROJECT DESCRIPTION This project aims to complete the data analysis and presentation of the results of the VAHS Young People’s Project (which was undertaken in a number of rounds).
PROJECTED OUTCOMES Employ and train an Indigenous Research Assistant to analyse data, write-up results and write reports. Disseminate research results.
PROJECT NAME Evaluating practice to reduce discrimination affecting culturally and linguistically diverse communities
STAFF Yin Paradies, Ian Anderson
COLLABORATORS McCaughey Centre and Centre for Health Policy Programs and Economics, University of Melbourne
FUNDING SOURCE VicHealth
DATE January 2008 – December 2010
PROJECT DESCRIPTION The project is an evaluation of Phase II of VicHealth’s Building Bridges initiative. The initiative aims to promote mental health and wellbeing by supporting opportunities for positive contact and cooperation between immigrant and refugee groups and others in the community. It is expected that this will in turn reduce racial discrimination. In Phase II, five community-based organisations have been funded to undertake collaborative projects that provide opportunities for people from diverse cultural backgrounds to work together. This study will evaluate the impact of these projects in achieving the aims of the Building Bridges initiative.
PROJECT NAME Building capacity of Indigenous Family Support Workers (FSWs) in Victoria
STAFF Kyllie Cripps, Priscilla Pyett
COLLABORATORS La Trobe University Bouverie Family Therapy Centre
FUNDING SOURCE Onemda VicHealth Koori Health Unit
DATE October 2006 – December 2009
PROJECT DESCRIPTION A Co-operative Inquiry Group has been established to reflect on and inform the process of developing and implementing training for Koori FSWs at the Bouverie Centre.
PROJECT AIMS To inform the development of training for FSWs.
CURRENT OUTCOMES Ongoing feedback to training team.
PROJECT NAME ACE Prevention: Indigenous Health
STAFF Ian Anderson
COLLABORATORS Centre for Health Policy Programs and Economics (University of Melbourne), Deakin University and University of Queensland
FUNDING SOURCE National Health and Medical Research Council and Cooperative Research Centre for Aboriginal Health
DATE 2004-2009
PROJECT DESCRIPTION The ACE (Assessing Cost Effectiveness) Prevention project uses economic methods to apply the 'ACE' approach to priority setting for the prevention of non-communicable diseases in Australia. The Indigenous health component investigates the relative cost effectiveness of interventions for Indigenous Australians.
PROJECT AIMS The project aims to identify the most efficient ways of implementing priority interventions in primary care in order to assist policy makers.
CURRENT OUTCOMES Indigenous Project Steering Committee has been established. Workshops have been held with stakeholders. Aims to develop a league table of prevention interventions in Indigenous and non-Indigenous health.
Past Projects Details:
PROJECT NAME A Demographic and Socio-medical History of the Aboriginal People of Victoria, 1800–2000: Colonisation and Epidemiological Transition
STAFF Ian Anderson
COLLABORATORS Museum Victoria, and the National Centre for Epidemiology and Population Health at the Australian National University
FUNDING SOURCE Australian Research Council
DATE January 2004 – April 2008
PROJECT DESCRIPTION Our innovative study of past life-courses enables others to better understand the unique experience of ‘fourth world’ people in health transition, and the deep historical forces that have shaped the health problems of Indigenous Australians.
OUTCOMES This project has produced a world-first historical demographic and epidemiological database of ongoing cultural and professional value to the Indigenous and research communities. It has fundamentally changed our understanding of the impact of colonisation on the Indigenous population of Victoria.
PUBLICATIONS
- Smith L, McCalman J, Anderson I, Smith S, Evans J, McCarthy G & Beer J, (2008), ‘Fractional identities: The political arithmetic of Aboriginal Victorians’, Journal of Interdisciplinary History Spring 2008, 38( 4): 533–551.
PROJECT NAME Healthy pregnancies, healthy babies for Koori communities
STAFF Priscilla Pyett
COLLABORATORS Victorian Aboriginal Community Controlled Health Organisation
FUNDING SOURCE Department of Human Services, Victoria
DATE 2004 - 2007
PROJECT DESCRIPTION Research and awareness-raising project for Koori community and community health services around health, nutrition and alcohol use during pregnancy.
PROJECT AIMS Identify current levels of knowledge and concern among health workers, GPs and community members around the effects of alcohol use during pregnancy. Develop resources and training material to increase knowledge around the effects of alcohol use during pregnancy.
OUTCOMES A resource kit has been developed with materials developed specifically for Koori communities. The resources were launched with specialist training workshops in Melbourne at VAHS and in four regional Aboriginal Community Controlled Health Services. Training and dissemination have been delivered to over 600 workers and presentations of the work have been made at 8 conferences.
PUBLICATIONS
- Pyett, P., Waples-Crowe, P., Loughron, K.H. & Gallagher, J. (2008) ‘Healthy pregnancies, healthy babies for Koori communities: some of the issues around alcohol and pregnancy’. Aboriginal and Islander Health Worker Journal 32 (1):30-32.
- (2007) Healthy Pregnancies, Healthy Babies for Koori Communities (Flipchart)
- Pyett, P., Loughron, K.H. & Waples-Crowe, P. (2007) ‘The real danger of fetal alcohol spectrum disorder for Aboriginal and Torres Strait Islander communities’ In Touch: the newsletter of the Public Health Association of Australia 24 (3) p4.
- Pyett, P., Waples-Crowe, P. & Loughron, K.H. (2007).‘Raising concerns about fetal alcohol spectrum disorder’. Gwalwa-Gai: the newsletter for the CRC for Aboriginal Health 7.
- Pyett, P. with Loughron, K., Waples-Crowe, P. & Williams, R. (2007) Fetal Alcohol Syndrome: A literature review for the‘Healthy Pregnancies, Healthy Babies for Koori Communities’ Project. Premier’s Drug Prevention Council, Department of Human Services, Melbourne, Victoria.
- Waples-Crowe, P., Pyett, P., Loughron, K. & Williams, R. (2007) Healthy Pregnancies, Healthy Babies for Koori Communities: A report for the Koori Community on Fetal Alcohol Syndrome. Premier’s Drug Prevention Council, Department of Human Services, Melbourne, Victoria.
PROJECT NAME Racism and Indigenous Health in Australia and New Zealand: setting the research agenda
STAFF Yin Paradies, Ian Anderson
COLLABORATORS Ricci Harris (University of Otago)
FUNDING SOURCE Cooperative Research Centre for Aboriginal Health
DATE July 2007 – June 2008
PROJECT DESCRIPTION The project involved organising a national symposium on racism and Indigenous health held in November 2007 and writing up the outcomes in a discussion paper.
OUTCOMES The discussion paper presents clear evidence that racism has a detrimental impact on the health of Indigenous peoples in Australia and New Zealand and highlights the need for further research to understand the extent and nature of racism, and to determine how it can be effectively addressed.
PUBLICATIONS
PROJECT NAME Identifying Psychosocial Mediators of Health among Indigenous Australians
STAFF Rachel Reilly, Kevin Rowley
COLLABORATORS Rumbalara Aboriginal Cooperative, Rumbalara Football and Netball Club, Viney Morgan Aboriginal Medical Service, The University of Melbourne Departments of Rural Health and Medicine (St Vincent's Hospital)
FUNDING SOURCE National Heart Foundation, VicHealth, NHMRC 'HOMELANDS' Program grant
DATE 2003-2006
PROJECT DESCRIPTION From interviews with Indigenous community researchers and participants, the study came up with key psychosocial determinants of Indigenous health for possible use in community health promotion interventions.
OUTCOMES Where possible, community health promotion interventions, such as the Rumbalara Football and Netball Club Healthy Lifestyles program, now incorporate social and psychological determinants as part of their design and focus.
PUBLICATIONS
- Reilly, R. E., Doyle, J., Bretherton, D., Rowley, K., Harvey, J. L., Briggs, P., Charles, S., Calleja, J., Patten, R. & Atkinson, V. 2008. Identifying psychosocial mediators of health amongst Indigenous Australians for the Health Heart Project. Ethnicity and Health. 13 (4): 351-373.
- Firebrace, B., Doyle, J. & Reilly, R. 2007. "Our Wellbeing". Shepparton: The Heart Health Project Steering Committee (poster).
CONFERENCE PRESENTATIONS
- Reilly, R., Doyle, J., Bretherton, D. & Rowley, K. 2006, ‘Identifying Psychosocial Determinants of Indigenous Health’, paper presented at 4th Annual NSW Health Promotion Symposium, 28–29 June, Sydney.
- Briggs, B. 2008. Developing a working model of Koori health, paper presented at ‘From Margins to Mainstream:
The 5th World Conference on the Promotion of Mental Health and the Prevention of Mental and Behavioural
Disorders’ in Melbourne from 10–12 September 2008.
PROJECT NAME Developing nutrition and physical activity guidelines and interventions for Aboriginal and Torres Strait Islander communities
STAFF Kevin Rowley, Rachel Reilly, Leah Johnston, Bradley Firebrace
COLLABORATORS Rumbalara Football and Netball Club, Rumbalara Aboriginal Co-operative, Viney Morgan Aboriginal Medical Service, University of Melbourne School of Rural Health
FUNDING SOURCE Department of Human Services Victoria, VicHealth, NHMRC ‘HOMELANDS’ Program grant
DATE 2006-2007
PROJECT DESCRIPTION This work evolved from the Heart Health Project, a collaborative program of participatory action research which addresses a broad range of clinical, behavioural and social determinants of heart health and disease. It is a community-directed project overseen by a steering committee with representatives from the community and academic partner organisations. The work includes designing and evaluating interventions within community organisations.
PROJECT AIMS To identify determinants of diet and exercise, and design effective guidelines and interventions to help improve dietary quality and physical activity.
OUTCOMES Several programs were run and evaluated as part of this work, and project workers undertook a health summer school in health promotion. Activities included: "Hungry for Victory", a nutrition program for under-seventeen footballers, which included education, match-day breakfasts, and mentoring; ‘Fruit-Share’ and other initiatives aimed at improving the dietary quality of food supplied through the RFNC canteen; a series of focus groups aimed at reviewing and re-designing nutrition guidelines; a Women’s Wellbeing Group; ‘10-week body challenge’, a workplace-based exercise program.
PUBLICATIONS
- The Heart Health Project Steering Committee. 2007. A collaborative cardiovascular health program for Aboriginal and Torres Strait Islander People in the Goulburn-Murray region: development and risk factor screening at Indigenous community organisations. Australian Journal of Primary Health; 13: 9-17. Contributors (in alphabetical order): Aitken L, Anderson I, Atkinson V, Best JD, Briggs P, Calleja J, Charles S, Doyle J, Mohamed J, Patten R, Rowley K, Simmons D.
- Reilly R, Doyle J, Rowley K. 2007. Koori community-directed health promotion in the Goulburn Valley. Australian Community Psychologist; 19: 39-46.
- Reilly R, Doyle J, Firebrace B, Morgan-Bulled D, Cargo M, Rowley K, for the Heart Health Project Steering Committee. Reflecting on Koori-Directed Health Promotion in the Goulburn Valley. In: Ranzijn R et al (eds), Psychology and Indigenous Australians: Teaching, Practice and Theory. Cambridge: Cambridge Scholars Publishing (in press).
- Rowley K, Reilly R, Firebrace B, van den tol G, Cincotta M, Johnston L, Doyle J, for the Heart Health Project Steering Committee (2007). Improving nutrition through sport, cultural and social connectedness. FoodChain;19:15-16.
- Doyle J, Reilly R, Cincotta M, Firebrace B, Rowley K. Developing nutrition and physical activity guidelines and interventions for Aboriginal and Torres Strait Islander communities . The Heart Health Project Steering Committee, Shepparton, 2007. (community report)
CONFERENCE PRESENTATIONS
- Reilly, R., Doyle, J., Firebrace, B., Morgan-Bulled, D., Cargo, M. & Rowley, K. for the Heart Health Project Steering Committee 2007, ‘Reflecting on Koori-Directed Health Promotion in the Goulburn Valley’, paper presented at Psychology and Indigenous Australians: Effective Teaching and Practice Workshop, The Australian Psychological Society, Adelaide, 13 July.
PROJECT NAME Use of emergency departments by Aboriginal and Torres Strait Islander peoples
STAFF Ian Anderson, David Thomas
COLLABORATORS Margaret Kelaher
FUNDING SOURCE NHMRC population health capacity building grant
DATE 2005 - 2006
PROJECT DESCRIPTION Preliminary examination of the use of emergency departments by Aboriginal and Torres Strait Islander peoples using extant datasets.
OUTCOMES An analysis of emergency department utilisation by Indigenous Australians in order to inform policy development.
PUBLICATIONS
- Thomas, D., Anderson, I. & Kelaher, M. 2008. Accessibility and quality of care received in emergency departments by Aboriginal and Torres Strait Islander people, Australian Health Review; 32 (4): 648-654
- Thomas, D. & Anderson, I. 2006, ‘Use of Emergency Departments by Aboriginal and Torres Strait Islander People’, Emergency Medicine Australasia, vol. 18, no. 1, pp. 68–76.
PROJECT NAME STI/BBV prevention and treatment & Koori people in prison
STAFF Angela Clarke, Karen Adams
COLLABORATORS ARCSHS La Trobe University, VACCHO
FUNDING SOURCE Department of Human Services, Victoria
DATE June 2005 - Dec 2006
PROJECT DESCRIPTION
This project investigated an evidence base for Sexually Transmitted Infections/Blood Born Viruses (STI/BBV) prevention and treatment of Victorian Koori people in prison.
OUTCOMES A literature review was undertaken. Focus groups and interviews were held with Koori people in prison. A report on findings was written up to provide improved evidence in STI/BBV prevention and treatment for Koori people in prison.
PUBLICATIONS
- Clarke, A. & Whyte , J.D. (2008) Evidence Base for STI/BBV Prevention and Treatment for Koori People in Prison, Department of Human Services, Victoria, Australia
PROJECT NAME Trends in Indigenous chronic disease death rates in the Northern Territory
STAFF Ian Anderson, David Thomas
COLLABORATORS John Condon, Shu Qin Li, Steve Guthridge, Joan Cunningham, Stephen Halpin
FUNDING SOURCE NHMRC Population health capacity building grant
DATE Sept 2004 – Dec 2005
PROJECT DESCRIPTION Analysis of long-term trends in NT Indigenous non-communicable disease (other than cancer) mortality between 1977 and 2001
OUTCOMES Research results were used to produce policy brief and media release in cooperation with Menzies School of Health Research and the Cooperative Research Centre for Aboriginal Health to present a good news story about trends in Indigenous health to the politicians and the media.
PUBLICATIONS
Click here for a full list of our research projects
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Artwork by Michelle Smith, Kevin Murray & Shawana Andrews
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