Determinants

Determinants that affect health and wellbeing include socioeconomic factors (such as education level, employment, income), geographic factors (such as levels of remoteness), environmental factors (such as housing, overcrowding and passive smoking) and behavioural factors (such as alcohol consumption, physical activity and diet) [29647].

For Aboriginal and Torres Strait Islander (First Nations) peoples, the determinants of health and wellbeing can also be extended to include factors such as family/kinship, connection to community, cultural identity, language, traditional knowledge, connection to and caring for Country, and self-determination. These are interrelated and have been identified as having a positive impact for First Nations peoples and communities [47098][35507][43645]. They can also help to reduce the negative impacts of biomedical and psychological factors caused by racism and historical events, including the intergenerational trauma experienced due to the forcible removal of children from their families (Stolen Generations) [19042].

Conditions experienced before birth and during infancy also play a major role in influencing health throughout a person’s life [29647]. Therefore, strategies that focus on maternal and child health, early intervention and family support, will potentially have a greater impact on the health of individuals throughout their lives. First Nations-led services such as the Birthing in Our Community program, have helped to improve health outcomes for mums and bubs in Meanjin/Brisbane.

Another example of addressing the determinants of health is Queensland Health’s commitment to improve environmental health outcomes across the state. First Nations peoples are disproportionately affected by the diseases associated with environmental health due to factors such as the remoteness of some communities and the lack of adequate housing and home health hardware [42074]. The Queensland First Nations Environmental Health Strategy 2024-29 supports Queensland’s Aboriginal and Torres Strait Islander Environmental Health Program across the state’s 16 discrete communities [50035], and various Aboriginal and Torres Strait Islander community controlled organisations run healthy housing and hygiene programs to support good health.