Truth-telling is required for health equity for Aboriginal peoples: A qualitative study

Background: The World Health Assembly has called for a Global Action Plan to address health inequities imposed upon Indigenous peoples. In seeking equity, Aboriginal peoples and allies have called for truth-telling about colonisation and its relation to healthcare. Australian healthcare, largely based on the biomedical model, is inadequate in terms of design, delivery, and access for Aboriginal peoples. Healthcare employees are known to contribute to health inequities. Purpose: This study explores non-Indigenous healthcare employee perceptions and experiences of engaging with Aboriginal peoples. Methods: Forty-nine health professionals from an Australian hospital participated in qualitative interviews. Interviews were audio-recorded, and data analysed with reflexive thematic analysis. Interviewees volunteered for the study and were first recruited in January 2020. The study is not registered. Results: Four themes were identified, including perceptions of: colonisation, Aboriginal peoples and knowledges, racism toward Aboriginal people, and healthcare inequities imposed upon Aboriginal people. Many participants were oblivious to how colonisation and racism create present healthcare inequities. This limited understanding was a consequence of feelings of distress and subsequent disengagement with the history of colonisation. Conclusions: Healthcare education requires better truth-telling methods to achieve health equity. We suggest trials of collaborative modes of education from arts and humanities that simultaneously recognise continuing colonial ideology and promote antiracism. Crucially, as the World Health Assembly notes, from design to implementation, these strategies must foreground and involve Aboriginal peoples, and deeper understanding of what it is to be an Indigenous ally.