Striving for health equality for Indigenous men

Kootsy, an Associate Professor in Aboriginal and Torres Strait Islander Health and Wellbeing at Flinders University’s Darwin campus, knows all too well the disparity faced by Indigenous men in his community and around Australia.

“Aboriginal and Torres Strait Islander men have the highest mortality and morbidity rates of anyone in Australia,” he says. “We also have the lowest rates of health service utilisation by a long way, whether in rural or remote areas or in the city.”

Kootsy, who was born and bred in Cairns, Far North Queensland, is a descendant of Mabuiag Island (the Wagadagam clan) in the Torres Strait.

Completing a PhD in 2018, his research focused on the underutilisation of primary health care and the enablers and barriers faced by Aboriginal and Torres Strait Islander men in using existing services.

Since then, Kootsy set out to improve engagement and utilisation of health services by developing programs specific to Aboriginal and Torres Strait Islander males.

He says it is a common misconception that Indigenous males are disinterested in their health.

“It’s no wonder men don’t want to go for health check-ups. It’s not suitable for us men,” Kootsy says.

“For most men, we don’t want to watch morning television in the waiting room and sit next to a pile of women’s magazines on the coffee table or play with the kids toys while we’re waiting to see the doctor who is 40 minutes late already.

“At the end of the day, the men still aren’t coming to the health service in desired numbers, so it doesn’t matter what it looks like or how good the health service thinks it is. If the men don’t walk through the front doors, then it’s pointless; they’ve missed the mark.

“We need a collaborate approach to reorient services to better suit men.”

Kooty’s work is supported by a prestigious NHMRC Investigator Grant (2020-2024) aimed at increasing and improving the engagement and quality of primary health care services for Aboriginal and Torres Strait Islander men.

With the help of findings from his PhD, Kootsy has spent the last few years implementing co-design strategies to bring primary health care services and men in Indigenous communities closer together.

“At the moment we’re holding fortnightly gatherings at a health service in South Australia where the community is provided with access to Aboriginal Health Practitioners, GPs, podiatrists and health information," he says.

“We are just starting to do our qualitative interviews now, so hopefully from that we will start to see how this type of continuous quality improvement approach within a health service is working in its first iteration.”

Kootsy also holds a Medical Research Futures Fund (MRFF) grant to respond to the social and emotional wellbeing needs of Aboriginal and Torres Strait Islander men.

The community-driven research project uses Indigenous research principles to guide the development of alternate solutions for primary health care services to create access to culturally safe and person-centred care.

According to Kootsy, mental health is by far the biggest issue facing Aboriginal and Torres Strait Islander men, who are experiencing disproportionately high rates of depression and psychosocial stress.

“The biggest challenge is increasing and improving our social and emotional well-being as we believe that it’s connected to all parts of who we are. If we’re good in our heads, then we’re good in our heart, and if that’s good, then we know we can stay on top of our physical health because we're feeling good.”

Another part of Kootsy’s research focus is on fatherhood for Aboriginal and Torres Strait Islander males and encouraging positive involvement in parenting roles.

In saying this, Kootsy acknowledges that Aboriginal and Torres Strait Islander fathers rarely rate a mention in discissions about parenting, unless framed in negative light such as the cause of dysfunctional family life.

Consequently, the roles and responsibilities of these Indigenous fathers have largely been ignored.

“It’s critically important for maternal and early years services to supply and deliver culturally appropriate information, services and programs for Aboriginal and Torres Strait Islander male parents," he says.

"This approach will allow for a better understanding of what is occurring, what to expect and how best these males can support their family during these important times”.

Kootsy admits he has just scratched the surface when it comes to research into Indigenous men’s health matters.

“The deeper I get the more I wish there were more people to influence health outcomes for our Indigenous communities,” he says.

“There is a hell of a lot still to do. I can’t stop being a Torres Strait Islander at the end of my work day and expect all the challenges and responsibilities to disappear. It doesn’t work like that.