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Francis Nona stands in a blue suit jacket leaning against a glass bannister

Enough is enough: it's time to fix health inequality

UQ people
Published 21 Sep, 2022  ·  5-minute read

Francis Nona, Master of Public Health student and Lecturer in the UQ School of Public Health, explores what’s needed to improve health outcomes in vulnerable communities.

“The gap is far from closed.”

That’s the simple, unfortunate truth of health outcomes for Aboriginal and Torres Strait Islander people, according to Master of Public Health student and PhD candidate Francis Nona, a proud Badulaig man from the Torres Strait.

“The impact of the original terra nullius lie is still felt today, and the few improvements made in the past 20 years are largely inconsequential,” he says.

“I’ve personally seen the negative impact that the social determinants of health have on Aboriginal and Torres Strait Islander people.

“There needs to be change at many levels – including policy – to address the inequities in health outcomes for Indigenous Australians.”

Indigenous health statistics

  • Age-standardised mortality rates have improved by about 10 per cent for Indigenous Australians - but mortality rates for non-Indigenous Australians have improved at a similar rate, so the gap remains.
  • Indigenous mortality rates from cardiovascular disease have decreased - but cancer mortality has increased for Indigenous Australians.

Francis has been on all sides of the public health experience: on the floor as a nurse, in academia as a student and lecturer, and as a loved one seeing healthcare in action.

“I was first inspired to commence my career in nursing when I watched the nursing expertise my mother received when she was in palliative care,” he says.

“I wanted to be able to provide culturally appropriate care to Aboriginal and Torres Strait Islander individual patients and the communities they come from.”

Now, while lecturing at UQ in Social Perspectives and Health Promotion, Francis is also completing his Master of Public Health. He plans to take his studies even further to help the communities he says policy has left behind for too long.

“The skills I’m learning through my academic path at The University of Queensland will equip me to actively contribute to public health policy discourse in the future,” says Francis.

“My next academic goal is to complete a PhD.”

“The Close the Gap campaign commenced in 2007. So far, only two targets – both in education – have been achieved.”

Francis Nona sits on the steps of a staircase, looking at the camera

Stop asking what we can do. Start asking how we can help.

Francis doesn’t think health inequality is something the government can swoop in to fix.

“All strategies need to be led by the communities they affect,” says Francis.

“Indigenous-led strategies with appropriate resourcing and commitment from the whole of government need to address the impacts of the inequality in the social determinants of health.”

Francis believes turning a blind eye to the past’s problems isn’t the solution, and the ripples that continue to spread from those darker days could be the key to understanding and approaching the challenges of today. And it all starts with having a genuine voice in parliament and legislative acknowledgement.

“Intergenerational trauma from the successive policies since colonisation has had a significant impact on the health and wellbeing of Indigenous Australians, and this needs to be fully recognised and addressed,” says Francis.

“These policies have perpetuated racism, created marginalisation and made it harder to access resources many non-Indigenous Australians take for granted. This includes access to education, employment and a justice system that is fair.

“Despite having been here for over 60,000 years, Aboriginal and Torres Strait Islander people aren’t even recognised in the Constitution of Australia, no treaties were ever signed, and no land was ever ceded.”

“Generations of being marginalised and discriminated against has left a legacy of ill health that needs positive, Indigenous-led action to bring about an improvement.”

Francis says blanket policies don’t (and won’t) work when it comes to improving health outcomes for Indigenous Australians. A one-size-fits-all approach isn’t appropriate for such a diverse population.

“Aboriginal and Torres Strait Islander peoples aren’t one homogenous group, but many nations with their own languages and cultures,” says Francis.

“Each community has its own unique needs.”

Francis Nona stand with one arm resting against a bannister, looking directly at camera

That’s why, he believes, if we want to finally make strides to overcome public health inequality, consultation and allowing the impacted people to lead the strategy is crucial. These communities need the opportunity to have input at every stage of the strategy, and we need to combine this active involvement with the recommendations of trained experts – such as graduates of the Master of Public Health.

“Graduates learn how to critically analyse public health issues and advocate for the changes required at a local, national or international level,” says Francis.

“Being able to participate in developing the policy that can drive change to improve the lives of others is very exciting.”

How can you help?

Francis suggests:

  • As an individual: consider whether unconscious bias exists in your community and understand how privilege can give some people an advantage not enjoyed by many Indigenous people.
  • As a business leader: implement active strategies such as a Reconciliation Action Plan, an Indigenous Procurement Strategy and employment strategies that give opportunities to Aboriginal and Torres Strait Islander people.
  • As a member of government: invest appropriate resources to ensure Aboriginal and Torres Strait Islander people can fully participate. This includes Indigenous Procurement and having Identified Positions (using the appropriate sections of the Anti-discrimination Act).

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