By JudithRaftery . Published by Wakefield Press , South Australia , 2006 . RRP $39.95 . ISBN 1862547092 .
Reviewed by David Thomas, Menzies School of Health Research, Northern Territory
Public health has made poor use of historians and historical research. We usually just turn to historians to help us celebrate the achievements of public health. We less often complement our inspiration from these triumphs with a more complex under-standing of the entire story of our public health past. This past includes the history of Aboriginal health, with its dead-ends and failures of public health policy and practice.
There is no shortage of public health references to the importance of history in Aboriginal health: to the persisting legacy of massacres, land theft, racism, child removal and the whole suite of past government and mission policies and practices. But this acknowledgement has led to little detailed historical research explicitly about Aboriginal health. This new book by Judith Raftery, a historian in the public health discipline at the University of Adelaide, is a useful addition to this small field.
She has not concentrated on health care, health research or health outcomes but on the history of broader policies and practices that have influenced Aboriginal health in South Australia from its proclamation as a colony in 1836 until the Federal Government accepted responsibility for Aboriginal affairs in 1973. She justifies this broader approach in her discussion of the social determinants of health in her second chapter. Next follow five chronologically arranged chapters based on her historical research: her close reading of government and parliamentary records and reports, mission reports, personal papers and newspapers. These chapters describe the broad thrust of policies, how government and mission practices often seemed to belie the stated intent of these policies, and the impact of these policies and practices on Aboriginal people's lives, health or well-being. We also gain a sense that these large themes in the story of the past are made up of many stories of different individuals and different places, and not everyone's story has the same lines.
Raftery argues that Aboriginal people's poor health was and is due to their social exclusion and separate treatment as “not part of the public”. At times I wondered whether it was not so much the separate laws, ordinances and departments but the overwhelming government parsimony towards Aboriginal people that mattered most, combined with the more authoritarian control of people's lives, which was indeed facilitated by the separate policies and practices and the discourse of Aboriginal ‘otherness’. But of course all mattered.
Her final chapter returns to the present. She explores how respecting Aboriginal assertions of difference from non-Indigenous Australians can be compatible with, rather than just opposed to, the greater inclusion of Aboriginal people in Australian society. The nuances and ambiguities in this chapter seem to undermine her much neater explanations of the historical period.
All through the chapters of historical research we are reminded that all the policies and practices being described, while not involving the health sector explicitly, affected the social determinants of health. This means that public health workers and students interested in Aboriginal health do not need to restrict their reading to historical research explicitly about health, or from public health faculties. They can also go to the many other histories describing similar government and mission policies and practices; I am sure they will be able to make their own links to health. So indeed this new book happily joins a more formidable library available to help public health workers understand the antecedents of Aboriginal health.