Promoting planetary health through culture
Authors: None The Lancet Planetary Health
Journal: The Lancet Planetary Health (2018)

Land, culture, and health are inextricably entwined in many Indigenous societies, but the intensity of depth of spiritual connection to land—colloquially called country—is unique to Australia's Aboriginal and Torres Strait Islander peoples. Relationship to country defines identity, kinship, and language group, and permeates every aspect of health and wellbeing. Historically, languages define familial relationships through highly complex and variable structures of kinship across more than 120 language groups, knowledge of foods, bush medicines, and craft skills. Oral history—encapsulating such culture—has been passed through generations of Aboriginal and Torres Strait Islander people for over 65 000 years, elucidated through art, song, and storytelling. Since the European invasion of Australia in 1788, displacement of Indigenous people has been near-continuous. Dispossession and repeated misguided government policies have forcibly separated Aboriginal and Torres Strait Islander people from their land, with frontier wars, sanctioned massacres, and resettlement policies with resultant stolen generations. Concurrent with such violence, relocation of Indigenous people to missions, government settlements, and amalgamated townships comprising overlapping language groups across rural Australia was common until the late 1970s. In spite of this, many dispersed communities have maintained their language or elements of their language (although 120 currently spoken Indigenous languages is fewer than half those spoken in 1788), thus reclaiming cultural history. Non-sacred aspects of culture have also become widely accessible in the past 60 years, in part through internationally lauded art movements emerging from multiple groups—including Yolngu, Pitjantjatjara, and Warlpiri speakers. Some groups have also had language, stories and cultural knowledge and belief systems recorded by anthropologists and linguists. Much of this work is being reclaimed and reinstated by diverse groups—including the Wiradjuri (language) and the Yorta Yorta (language and environmental management). Culture has long been understood by Aboriginal and Torres Strait Islander people as the bedrock of health and wellbeing, but epidemiological data to support this on a large scale do not exist—despite repeated calls by Indigenous peoples, and a national Aboriginal and Torres Strait Islander health policy with culture central to its approach. Contemporary Indigenous health is often described through high levels of alcohol and substance abuse, suicide rates, and levels of incarceration. But how cultural connections might interact with and reduce these phenomena remains anecdotal. In November, 2018, a team from the Australian National University led by Aboriginal (Wongaibon, Ngiyampaa) epidemiologist, Associate Professor Ray Lovett, launched a longitudinal study to understand the relationship between culture and health. Mayi Kuwayu: the National Study of Aboriginal and Torres Strait Islander Wellbeing is designed by and with Aboriginal and Torres Strait Islander people, and will gather comprehensive data to examine these links—an unprecedented goal among studies of Indigenous health from around the world. Through a postal survey, data collection is underway from an initial 20 000 Aboriginal and Torres Strait Islander people registered in Medicare, extending to 200 000 early next year. The study is designed to explore how culture affects health longitudinally, and pilot phases have shown promising results. Dr Lovett told The Lancet Planetary Health, “Although small scale, we have found positive significant relationships between Aboriginal Ranger work (a proxy for cultural participation) and improved general health, family wellbeing, and life satisfaction. The positive results remained after individual adjustment for education, employment, financial status and taking into account health conditions.” Australian government Acts and racist policies have aimed to shatter cultural continuity with alarming frequency, leading to intergenerational trauma, and creating and exacerbating inequitable health outcomes. Mayi Kuwayu is intended for Australian use, but aspects of the methods could potentially be generalisable to other nations' Indigenous communities in deepening understanding of culture and health. Against the backdrop of evolving human civilisation and the changing state of planetary health, evidence of connections between land, culture, and health might also offer far wider insights into how human societies could thrive in better harmony with our planet, ultimately promoting planetary health through culture. For the Mayu Kuwayu Study see https://mkstudy.com.au/ For the Mayu Kuwayu Study see https://mkstudy.com.au/