Social determinants of Australia's First Peoples' health : a multi-level empowerment perspective

![CDATA[Australia’s First Peoples are leading world citizens in the struggle for health equity and justice. They are leaders in culturally responsive, safe and respectful social support services, social and emotional well-being promotion and comprehensive primary healthcare practice. Despite their wisdom and innovation, these services and practices are severely constrained by external, socially determined factors. Assumptions are too often made when applying a western framework to non-western cultures. We must question ‘Who is the social in social determinants?’ and ‘What is the contemporary compared to the historical, social context?’ Importantly, these questions must be asked from First Peoples’ perspectives. In this chapter we will explore three different yet interrelated sets of factors implicated in the health and well-being of Australia’s First Peoples: cultural, historical and structural determinants. We explore First Peoples’ experience of determinants, and present examples of strengths-based, community-led services, programs and research. We then extend our understanding of determinants using a socio-ecological model of health that incorporates multi-level empowerment, with a particular focus on social support and the centrality of the value of relatedness. This provides a scaffold for our discussion about how all healthcare and social care providers can develop confidence in engaging with and providing support to First Peoples’ families and communities, and be a good partners within and through their practice.]]