Acknowledge colonisation and systemic racism, social, cultural, behavioural and economic factors which impact individual and community health
First Nations Peoples have a lived experienced that is connected to the invasion of Sydney by the First Fleet in 1788. The effects of colonisation included exposure to epidemic disease, massacres, dispossession and displacement of families and land, suppression of Aboriginal and Torres Strait Islander law, rituals, customs, art, dance and spoken languages. The trauma and loss of identity are not easily healed and can transform into destructive coping mechanisms that flow from generation to generation.
While the mistakes of the past may be easier to identify, we must also recognise racist attitudes and current injustices within Australia’s economic, social, governmental, legal and regulatory systems. If we are aware of the social determinants of health we can take steps to address health inequalities. Up to 93% of First Nations peoples have experienced racism in the last 12 months, and are 12-13 times more likely to be arrested and charged with an offence. Racism can lead to poor oral health directly by limiting access to oral health resources such as safe drinking water and affordable and culturally safe healthcare. Racism can also affect oral health indirectly through stress that can lead to poor oral health behaviours such as smoking and poor diet.
Resources to explore Aboriginal Culture, Country and Community:
Cultural resource portal https://deadlystory.com/
Parter C, Murray D, Mohamed J, Rambaldini B, Calma T, Wilson S, Hartz D, Gwynn J, Skinner J. Taking about the ‘r’ word: a right to a health system that is free of racism. Public Health Research & Practice March. 2021; 31(1):e3112102 • https://doi.org/10.17061/phrp3112102
Hedges J, Haag D, Paradies Y, Jamieson L. Racism and oral health inequities among Indigenous Australians. Community Dental Health. 2021 May;38(2):150-155. DOI: 10.1922/cdh_iadrhedges06 . PMID: 33848408.
Acknowledge and address individual racism, your own biases, assumptions, stereotypes and prejudices and provide care that is holistic, free of bias and racism
Many dental practitioners come from privileged and ethnic majority backgrounds, and so are less likely to feel shame, fear and frustration associated with belonging to an under or mis-represented minority group. The lived experience and values of many Aboriginal and Torres Strait Islander Peoples can be radically different to the daily lives of dental practitioners. Self-reflection to identify bias and racist attitudes and behaviours is crucial to connect, engage and empower First Nations Peoples.
Resources to support self-reflection:
Recognise the importance of self-determined decision-making, partnership and collaboration in healthcare which is driven by the individual, family and community
Cultural safety is determined by Aboriginal and Torres Strait Islander Peoples. It is a lived experience that First Nations Peoples experience. To monitor and implement culturally safe practices we must build trust and respect with local Elders, Aboriginal and Torres Strait Islander Peoples, families and community to allow opportunities for truth telling. In this way it is important to listen more and talk less.
Resources to assist building relationships and trust with First Nations Communities
Foster a safe working environment through leadership to support the rights and dignity of Aboriginal and Torres Strait Islander people and colleagues
Safe working environments require protocols and procedures to prioritise, review and evaluate cultural safety in dental practices. Continued professional development about cultural safety is a strong tool to challenge our personal biases, prejudice and assumptions. It is also important to define objective measures of culturally safe practices. Some indicators of culturally unsafe workplaces may include:
Low utilisation of services from First Nations Peoples
Reticent or angry interactions with dental practitioners
Complaints about cultural safety, competency and/or appropriateness of services or tools.
Resources to provide a welcoming environment for First Nations Peoples:
- Commissioning artwork(s) to be hung and/or included on your website featuring Aboriginal and/or Torres Strait Islander artwork and the story behind the artwork;
- Playing emerging and popular Aboriginal and/or Torres Strait Islander musicians https://nima.musicnt.com.au/ (please note a warning for First Nations peoples is necessary if images and voices of deceased persons are used)