HLT101 Week 6: Belonging, History and Heart Health

Dr Ros Prichard

Welcome back to Weekly Wrap. It’s Ros here, and this week, well, we’re digging into some weighty ground: the history of Aboriginal and Torres Strait Islander health in Australia. I know we’ve talked about social determinants of health in the last few weeks—Today, we’re zooming out and looking at the roots of some of those health gaps for Indigenous Australians: the legacy of colonisation, disconnection, and, honestly, the roots for enormous resilience too.

Ethan Clarke

Yeah, cheers Ros. Ethan here. You know, in some of the communities I’ve worked with, you really feel the stories—the way loss of language or being moved off land is more than recent history - its still rippling today. Colonisation meant a whole way of life wiped out: language, land, ceremony. The British called it “terra nullius”; for Aboriginal people it was the start of invasion, dispossession, and policies that tried—sometimes very sharply and deliberately—to erase culture.

Neha Kapoor

I think that’s such a key point, Ethan. The policies—the Assimilation Policy, the removals... they weren’t just about geography, they were about identity. Intergenerational trauma, it travels through families. There’s evidence from studies on Holocaust survivors, too, about how trauma can even be passed epigenetically, changing stress responses across generations. For Indigenous Australians, that kind of pain—those ongoing layers of grief and stress—they shape health right now, and in a timeline stretching back many thousands of years - Colonisation is recent history .

Dr Ros Prichard

Absolutely. And grief like that doesn’t live neatly in the past. It changes how communities relate, what roles Elders and kin networks play, even who’s in the room. It impacts access—to healthcare, to education, to employment. You see lower life expectancy, higher chronic illness, and a cycle of disadvantage that doesn't just “happen.” It was made, over a few generations of policy and prejudice. As nurses, I reckon it’s critical that we know this context, so when we talk about social determinants, we remember they’ve got a history—and a present.

Ethan Clarke

Yeah, it’s about recognising wounds, not just patching symptoms. Nurses can’t help people to heal without seeing the story behind the stats. It’s something I’m still learning, honestly. But I think when we acknowledge what happened, and offer care that’s aware of this history, we do support real healing.

Neha Kapoor

So, moving from that, let’s talk about how health is seen differently. In many Indigenous communities, wellbeing is tied not just to body or illness, but to identity, belonging, and connectedness. This week we've been looking at some really interesting South Australian research, led by Katharine McBride. Sitting in familiar and culturally safe yarning circles, Aboriginal women talked about what keeps their hearts strong: family, community roles, pride in culture, responsibilities. Heart health, for them, included feeling seen and connected.

Dr Ros Prichard

Yes, Neha, that’s such a beautiful reframe. It’s the opposite of the old “deficit” model—you know, the one that points out problems instead of building solutions. The biomedical approach is “let’s fix your blood pressure,” and it isn’t wrong, but it misses that lived experience. For Aboriginal women, motivation to live healthily very often comes from their roles as mothers, carers, leaders—not just “doing it for me.” It’s “I stay well so I can look after my mob.”

Ethan Clarke

I hear that a lot in remote practice too—health is holistic. It’s the body, but it’s also mind, spirit, Country... all those things. Social and emotional wellbeing is core. What we sometimes forget is that connection to Country or culture is protective. It’s not just fancy talk—there’s actual evidence for it reducing heart disease, for example. Problem is, a lot of mainstream health services, with all due respect, can miss this. They’re set up for blood tests, and rapid turnover —not yarning or deep listening.

Neha Kapoor

Right, and that’s where “culturally safe care” comes in. Practically, it’s about making space for people’s stories and culture. It means starting with awareness of our own beliefs and biases—self-reflection, really. And then tailoring our communication, not assuming silence means disengagement, respecting kinship structures, bringing in family if that’s important, and focusing on care that’s preferred by the person, not just what’s “usual.” Ros, you’ve got a talent for inviting those conversations.

Dr Ros Prichard

Thanks Neha—though I don’t always get it right myself! Sometimes, I’ll think I’m being clear, but then realise I’ve missed a signal or gone too fast. The goal’s not to be perfect, but to be ready to listen, to check our assumptions, and to keep learning. Culturally safe care is, in my book, a lifelong practice—not a box you tick once and forget.

Dr Ros Prichard

Alright, so, if deficit thinking just points out what’s wrong, let’s flip it—what about strengths-based care?

Dr Ros Prichard

Take programs like Birthing on Country: they don’t just allow, but actively centre, Indigenous voices, women’s leadership, kinship, and traditional knowledge.

Dr Ros Prichard

We had a great discussion in the Caboolture tute this week about working with, with Indigenous health liaison officers, in prisons. If you can start by recognising someones's strengths—that deep cultural knowledge and resilience—engagement goes up, outcomes improve, trust is built.

Ethan Clarke

Yeah, and it’s more than a warm fuzzy feeling. Cardiovascular disease is still the leading cause of premature death for Aboriginal women—double the rate of non-Indigenous women, last I checked. And traditional government policies, the ones based on problems, haven’t shifted the needle much. What’s worked better? Ground-up programs, community-led health initiatives—Like the National Aboriginal Community Controlled Health Organisations. When you empower people, respect knowledge, and support cultural revival, you see better results and more engagement. And I can hear all the Principles of Health Promotion we talked about last week in that too!

Neha Kapoor

There’s so much evidence for this now, and yet sometimes primary health strategies still get stuck on “bad behaviours” instead of asking, “What’s working here?” Women in those studies described how after a health scare, they might change habits—but not just for themselves. They want to be strong for their children, their extended family, their community. Programs that work with these networks—stories, Elders, family—are just more meaningful and sustainable. It’s a reminder that holistic health models—valuing belonging and responsibility—are protective; they help buffer against stress, grief, and the effects of racism or disadvantage too.

Ethan Clarke

So, let’s bring it home. If we’re aiming for change—really shifting health outcomes—then culturally competent practice can’t be optional. Ongoing cultural safety training for nursing staff is huge. It isn’t just reading a handout once; it’s a cycle of learning—checking your biases, seeking out Indigenous voices, and understanding holistic models. In the clinics I’ve been in that get this right, it’s usually because they’ve built real partnerships with the local Indigenous community, from co-designing programs to just having a cup of tea with Elders to shape what matters most. There’s no shortcut, just showing up with respect and humility.

Dr Ros Prichard

And if you’re listening as a nursing student and wondering, “Where do I start?”—start small. Reflect on your own culture, biases, and knowledge gaps. Seek out stories and listen. Remember there is no single “right” way to care, but there are plenty of ways to be curious, respectful, and proactive. Building equity into the system is a marathon, not a sprint, but every time you listen deeply to someone's story, you’re helping shift the landscape just a little.

Ethan Clarke

Beautifully said, Ros. And there are some great links in the resources this week, to Older Australian of the year, Miriam Rose, and the concept of "Dadirri" - or Deep Listening - Really wonderful stuff that we can all learn and benefit from. This stuff takes a lifetime of learning, and a bit of humility—sometimes a surf break helps, too! Neha, Ros, thanks as always for the discussion. I reckon next week’s perinatal health deep dive will keep us rolling with these themes.

Neha Kapoor

Thank you both. It’s always a privilege to share perspectives, and I look forward to continuing this journey. Take care, everyone—and don’t forget to check those deadlines! Week 7 Quiz opens on Monday -

Dr Ros Prichard

Catch you next week, folks. Keep reflecting, keep asking questions.