Challenging the system.

Aboriginal and Torres Strait Islander males remain the lowest users of primary healthcare services in Australia, with poorer overall health, higher rates of chronic disease and hospitalisation, and lower life expectancy. Remoteness and socioeconomic disadvantage are frequently identified as contributing factors, but a Flinders University researcher contends that there’s another element which needs to be tackled – changing how males are treated within the health system. Associate Professor Kootsy Canuto has made this the focus of his studies, and he has clear ideas of how it must progress.

Associate Professor Canuto was born and raised on the traditional lands of the Yidinji people and identifies as a Torres Strait Islander, belonging to his father's people, the Wagadagam clan of Mabuiag Island. Now a Matthew Flinders Fellow working with Flinders Rural and Remote Health NT, based in Darwin, he’s leading pivotal research initiatives, including a Medical Research Future Fund (MRFF) project to examine male social and emotional wellbeing.

“This is a critical challenge for Aboriginal and Torres Strait Islander males, who have the highest rate of suicide in Australia,” he explains.

“The government has to appropriately resource primary healthcare services, especially Aboriginal Community Controlled Health Organisations and Aboriginal Medical Services, to meet the needs and wants of the Aboriginal and Torres Strait Islander men of their respective communities,” says Associate Professor Canuto.

“Without the resources to develop, accommodate and evaluate the services and programs, no amount of advocacy, research evidence or anecdotal evidence will change the low utilisation of primary healthcare services by Aboriginal and Torres Strait Islander men.

Associate Professor Canuto is part of a team of specialist researchers at Flinders dedicated to Aboriginal and Torres Strait Islander people’s health, which includes life partner Associate Professor Karla Canuto, and Deputy Dean of Rural and Remote Health Professor James Smith.

“There has been enough research done in this space to understand the problems; our research focuses on finding sustainable solutions and implementing them – but that’s easier said than done.”

“We know the barriers and enablers to meet the needs and wants of the Aboriginal and Torres Strait Islander men of their communities,” Associate Professor Canuto says. “This is a structural and systemic challenge that needs to be tackled by those in power, but to ensure the sustainability of change, it must be supported appropriately with trained staff to create men’s-only primary healthcare services.”

He is working with Watto Purrunna Aboriginal Health Care Service (an Aboriginal Medical Service provided through SA Health) to provide Aboriginal and Torres Strait Islander males with a safe space to come together and enjoy a meal while they meet and build rapport with health service staff. This connection to build trust and exchange information is a crucial foundation, necessary for greater interaction between Aboriginal and Torres Strait Islander males with health care professionals to flourish.

Thanks to an NHMRC Investigator grant, a project called ETTA (Enough Talk, Time for Action) has enabled Associate Professor Canuto and fellow researchers to conduct the first of four iterations of qualitative interviews in Port Adelaide with Watto Purrunna staff and participants. These gatherings have not only enabled men from Aboriginal and Torres Strait Islander communities to connect with each other, but also built their confidence in discussing and requesting information or appointments to address health issues, whether it be seeing a GP, Aboriginal Health Practitioner or Social and Emotional Wellbeing Worker.

“Unless primary healthcare services are resourced appropriately to develop, accommodate and evaluate the services and programs they deliver to the Aboriginal and Torres Strait Islander men of their community, no amount of advocacy, research evidence or anecdotal evidence will change the low utilisation of primary healthcare services by Aboriginal and Torres Strait Islander men,” he contends.