As a scientist who has spent decades investigating the health of Aboriginal people in remote parts of Australia, I am seriously concerned that the push to shut down communities deemed to be economically unviable seems to be gathering momentum.
The Australian and NT Governments have been urged, in the final report from the NT Emergency Response Taskforce, to assess which communities are viable in the longer term, and to plan future investment based on those assessments.
It will be a mistake if such assessments are based purely on economic indicators and fail to take account of the mounting scientific evidence suggesting that there can be very positive health benefits for Aboriginal people who live on their homelands.
For example, I have been involved in a study documenting very positive health outcomes for the Alyawarr and Anmatyerr people living on traditional lands as part of the decentralised Utopia community north-east of Alice Springs.
The study, published recently in The Medical Journal of Australia, found that people in these communities were 40% less likely to die prematurely, whether from cardiovascular disease or any other cause, than other Indigenous people in the NT.
These findings are in line with previous work showing this community had lower than expected rates of obesity, diabetes, and smoking.
Because people usually hunt and gather their traditional foods more regularly when they are on their homelands or outstations, not only are they therefore more physically active, their diets are also much higher quality. And because they are living in family groups on their traditional country, they are in supportive and secure environments, and are therefore less stressed than is often the case in the larger settlements — and substance abuse is generally much reduced or absent.
The Utopia community is made up of 16 outstations, dispersed over an area of about 10,000 km2. There is no centralised settlement, with outstations, administrative offices, a clinic and store located up to 100km apart. The community-controlled Urapuntja Health Service (UHS) provides primary health care, including outreach services.
Perhaps the economic rationalists would not call this an “economically viable” community. But it offers advantages for the people who live there, although there is no doubt that they need better housing and other infrastructure.
As my colleagues and I wrote in the MJA:
We caution against assumptions of expense associated with supporting outstations, given the savings to health care systems when successful primary prevention is achieved, and a broader (positive) economic context of outstation living related to activities such as art, food procurement and land management. A stereotype of outstation communities as cultural museums that prevent health and social gains for Aboriginal people is not supported by the present evidence.
We are also collating data to compare the health of Aboriginal people living on homelands versus centralised communities in other parts of the NT, and similar differences are emerging, including a lower risk of diabetes, heart disease and kidney failure on the homelands.
Perhaps not all small homelands communities are as successful as the ones we have worked with, but it would be a folly to abandon those that are working successfully.
The terrible irony of the current move against remote homelands is that it is the forces of westernisation and urbanisation which have contributed so much to the development of diabetes, heart disease and renal failure in Indigenous people.
All the evidence indicates that the risk of these conditions is related to sedentary westernised lifestyles, and that Indigenous peoples were free of these diseases when they lived a hunter gatherer lifestyle.
Indeed, I have myself observed first hand the positive impact of traditional lifestyles, when I accompanied a group of Aboriginal people returning to traditional country more than 25 years ago. In just seven weeks, people lost an average of 7-8 kgs, and showed marked reduction in the severity of type 2 diabetes and striking improvements in risk factors for cardiovascular disease.
I also saw the psychological benefits, including increased confidence and competence as a result of people feeling more in control of their lives.
The Federal Government has repeatedly stressed its commitment to evidence-based policy. My colleagues and I stand ready to point any interested parties in the direction of some relevant evidence.
Professor O’Dea was Director of the Menzies School of Health Research in Darwin from 2000-2005.