Structural Determinants

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Structural determinants: socio-economic position
Poor wellbeing and health literacy is correlated with socio-economic factors such as low income, low education levels, unemployment and not having English as a first language, all common characteristics of Indigenous rural and remote populations (Jamieson et al., 2011, Parker et al., 2012).
Ethnicity or race is also significant in the oral health of Indigenous children and young people. Research on racism globally indicates that experiences of racism negatively affect health and well-being, but further research is needed within the Indigenous Australian context (Paradies, 2007), especially with oral health (Jamieson et al., 2011).
Studies have found mixed results in whether Aboriginality itself
…show more content…
Phelan et al.’s (2010) refinement of their Fundamental Cause Theory is a case in point. Until the 1950s, low SES Indigenous communities had better oral health than high SES non-Indigenous communities, thanks to a non-cariogenic traditional diet (Martin-Iverson, 1999). As our understanding of treatment and prevention grew, early childhood caries reduced in non-Indigenous communities (as predicted by the model) but increased in Indigenous communities – an unpredicted effect, as the model assumes all groups will benefit from this new knowledge (even though higher SES groups benefit more). The mechanisms affecting the worsening in Indigenous oral health are driven by a wider range of structural determinants unique to Indigenous people at both the socio-economic and socio-political levels. These factors may include cultural knowledge and continuity, connection to country, and the state of community and kinship networks (Shepherd et al, …show more content…
Using more appropriate measure of Indigenous wellbeing that valued Indigenous culture would weigh in favour of facilitating Indigenous people to remain on their traditional lands in small communities (Taylor, 2008). Marmot (2011) summarises this as enabling Indigenous people to ‘live lives they value’. This brings into question the value of the government’s Closing the Gap strategy, as it may not reflect an Indigenous perspective of wellbeing. We need to conduct research that considers Indigenous conceptualisations of wellbeing and elucidates the pathways between both traditional and Indigenous-specific factors affecting oral health in children and young

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