Most Australians he voted “no” to an Indigenous Voice in Parliament. But if we dig into the data from the 2023 referendum, there is more to learn, particularly about the health of Indigenous Australians living in communities that strongly oppose the Voice.
It is a picture each striking and urgent.
In published studies Today For the first time, we’ve got shown that Indigenous Australians living in regions with stronger opposition to the Voice experience poorer health.
When we mapped community opposition to Voice on Australian health, we found that Indigenous Australians were more likely than non-Indigenous Australians to report poorer overall and mental health. But Indigenous Australians were less likely to use health services. These inequalities were greater in areas with greater opposition to Voice.
Our results likely reflect underlying negative attitudes towards Indigenous Australians and fewer culturally sensitive options for accessing health care in some regions, each of which impact the health of Indigenous Australians in multiple ways.
What we did and what we discovered
We began with a national map of voting patterns to discover regions with the highest levels of opposition to Voice (defined in this study as regions of Australia where greater than 72% of community members voted “no”).
We then compared regions with high and low levels of opposition to Voice with the health of Australians, using data from 2021. national surveywhich included details about general health, mental health and health care use over the last 12 months.
Our study found that, compared with Indigenous Australians living in areas with low opposition to Voice, Indigenous Australians living in communities with the highest opposition to Voice were more likely to report poor general and mental health, and were less likely to have used health care services in the past 12 months.
We didn’t observe the same disparities for non-Indigenous Australians.
For example, in areas with the strongest support for Voice, Indigenous and non-Indigenous Australians reported similar levels of poor mental health (16% for each Indigenous and non-Indigenous). While in areas with the strongest opposition to Voice, 27% of Indigenous Australians reported poor mental health compared with 15% of non-Indigenous Australians.
In areas with the best support for Voice, the proportion of Indigenous Australians who had seen any doctor was 78%, which was higher than the 71% for non-Indigenous people. However, in areas with the best opposition to Voice, the proportion seeing any doctor was significantly lower amongst Indigenous Australians (54%), but not amongst non-Indigenous people (68%).
All of this implies that, despite having poorer health outcomes, Indigenous Australians living in areas where there is stronger opposition to Voice are less likely to have access to healthcare.
Why is this happening?
There are several possible explanations for these results.
An incredible opportunity, in line with recent testswhether community-level opposition to Voice could also be capturing latent negative attitudes towards Indigenous Australians. So what we see may reflect the impact of such negative attitudes on people’s health over time.
This is in line with many international studies showing how stigma throughout the community and discriminatory environments lead to worse health condition amongst minorities and historically marginalized groups. Generally, we see this manifesting itself in higher rates smoking and drinkingand limited access to Healthcare.
These attitudes may have an effect on Indigenous Australians’ experiences of healthcare. For example, we all know of past experiences racism while access to healthcare scares away indigenous people engaging in mainstream healthcare. Alternatively, there might not be enough culturally protected healthcare options in regions where there is the best opposition to the Voice.
Indigenous leaders across Australia proceed to share their experiences of racism before, during and after referendum Voice. While the direct impact of racism is evident in the testimonies of those individuals, relatively little attention has been paid to the impact of structural racism at the community level.
But we will not say from our research what motivated people to vote “no,” and voting “no” cannot be taken as evidence of racism. But whatever the motivation for voting “no,” the health of Indigenous Australians is particularly affected in these high-opposition regions.
Where to from here?
Our results suggest that when it comes to future health policies and programs, we want to consider multiple solutions at the community level. In particular, we should always pay special attention to areas where opposition to Voice was greater, because these are areas associated with poorer health and lower health care utilization.
In these areas in particular, we want more culturally protected healthcareadapted care that is inclusive and free from racism. This enables patients to access appropriate and appropriate health services to improve their health.
We also need to take a look at the larger picture to change community attitudes towards Indigenous Australians if we’re to reduce systemic racismstigma and its impact on health.
Our results are only a snapshot
The Voice referendum highlighted how difficult it is for Indigenous Australians to address the challenges of promoting Indigenous self-determination as the best way to improve their livelihoods and health.
But our findings reflect just one moment in time. That’s why we want more research to higher understand the systemic nature of the health disparities we see.
Health and social policy must acknowledge these systemic issues and ultimately pay greater attention to how community-level attitudes may shape the health of Indigenous Australians.