Health, Healing and Empowerment. Epidemiology for community policy makers

Abstract

This thesis comprises a collection several studies in applied epidemiology including a data analysis and epidemiological study, an outbreak investigation, and an evaluation. Each of the studies is done from a social epidemiological viewpoint, examining how social and cultural structures influence health and wellbeing. The first study is an evaluation of the Family Wellbeing Program, a community empowerment program developed in partnership with Aboriginal and Torres Strait Islander peoples that has been widely delivered to Aboriginal and Torres Strait Islander communities across Australia for close to 30 years. Empowerment is a concept commonly incorporated in Aboriginal and Torres Strait Islander health and wellbeing programs. To date there has been limited quantitative analysis of the program and links to health and empowerment outcomes. Using evidence from Mayi Kuwayu, the National Study of Health and Wellbeing (n= 9, 843) the study examined associations between personal control, life satisfaction, general health, family wellbeing and cultural wellbeing outcomes for Family Wellbeing participants (n=718) versus non-participants (n=9,125). The second study analyses an outbreak of COVID-19 in a predominantly culturally and linguistic diverse group to identify risk factors and public health implications. An outbreak investigation and a retrospective cohort study design was used to understand the characteristics of the outbreak and risk factors of transmission. Data on age, sex, country of birth, main language spoken at home, cultural/ethnic background, household size, symptoms and their onset, quarantine and isolation periods, close contacts, vaccination status, and hospitalisation were collected. Household secondary attack rates were calculated. This study was undertaken through placement with the Australian Capital Territory (ACT) Health Directorate's Public Health Emergency Coordination Centre (HECC). The study found that larger household size was linked to increased risk of transmission, and language spoken at home was not. The use of social and wellbeing services and cultural liaisons were important measures for supporting public health orders. More research is needed on how culturally and linguistically diverse knowledge is informing epidemiological driven policies and response, such as self-isolation and quarantine facilities, throughout the pandemic. The final study is a validation study of an Assessment Tool used by Yorgum Healing Services, an Aboriginal Community Controlled Organisation that provides Aboriginal people and their families with a wide a wide range of culturally secure, community based healing services that utilise a trauma informed approach to positively impact their social and emotional wellbeing services. Yorgum have developed a client assessment tool built around the Aboriginal Family Worldview Model that they operate. The study examines utility of the tool using a psychometric validation, and evaluates implementation of the tool as a wellbeing monitoring system. Show more