Mapping pandemic responses in urban Indigenous Australia: Reflections on systems thinking and pandemic preparedness

Abstract

Mapping pandemic responses in urban Indigenous Australia: Reflections on systems thinking and pandemic preparedness Bronwyn Fredericks,1,2, * Abraham Bradfield,1 James Ward,2 Sue McAvoy,3 Shea Spierings,2 Agnes Toth-Peter,4 Troy Combo2 1 The University of Queensland Brisbane, QLD 4072, Australia 2 UQ Poche Centre Indigenous Health, Faculty of Health and Behavioural Sciences, The University of Queensland Brisbane, QLD 4072, Australia 3 Centre for the Business and Economics of Health, Faculty of Business, Economics and Law, The University of Queensland Brisbane, QLD 4072, Australia 4 Australian Institute for Business and Economics, The University of Queensland Brisbane, QLD 4072, Australia Submitted: 7 March 2023; Revision requested: 31 July 2023; Accepted: 5 August 2023 Abstract Objectives: We investigate some of the strengths and challenges associated with Covid-19 responses in urban Indigenous communities in Brisbane, Australia. Our research reflects on the interconnected dynamics that impact health outcomes and mitigate or exacerbate the risk of Covid-19 spreading within urban Indigenous communities. Methods: Three systems thinking workshops were held in 2021 with Indigenous and non-Indigenous stakeholders (N15/workshop) from State and Federal services, along with Aboriginal Community Controlled Health Organisations. All worked in the urban Indigenous health sector. Stakeholders produced a Causal Loop Diagram (CLD) incorporating the critical feedbacks determining the dynamics influencing health outcomes. The aim of the research was to help stakeholders’ build awareness of how the structure of the system influences health outcomes. Results: Stakeholders identified 6 key dynamics which have a negative or positive impact on mitigating risks of Covid-19 infection. By mapping these dynamics within a CLD, 7 intervention points were identified. Conclusions: Systems thinking provides a useful tool in identifying the complexities associated with navigating health challenges, but further research is needed to develop frameworks that work in conjunction with Indigenous Australian methodologies. Implications for public health: Indigenous voices and communities must lie central to health responses/policies for Indigenous peoples. When systems thinking is done by or in collaboration with stakeholders it provides a visual language that can help design public health policy. What can be ascertained is that their effectiveness is predicated on systems thinking’s integration with Indigenous methodologies that acknowledges Indigenous self-determination and challenges Eurocentric representations of health and Indigeneity. Keywords: COVID-19, Urban Indigenous Australia, Urban Health, Pandemic Preparedness, Aboriginal and Torres Strait Islander Health