Health has a range of definitions. The choice of definition used in developing health services determines many aspects of the health services. If health is defined as absence of disease, then services will follow a medical approach to prevent and manage disease. If the health definition is focused on individual people, then services will be provided for individual people.
The National Aboriginal Health Strategy noted in 1989:1‘Aboriginal health is not just the physical wellbeing of an individual but is the social, emotional and cultural wellbeing of the whole community in which each individual is able to achieve their full potential thereby bringing about the total wellbeing of their community. It is a whole-of-life view and includes the cyclical concept of life–death–life. Health to Aboriginal peoples is a matter of determining all aspects of their life, including control over their physical environment, of dignity, of community self-esteem, and of justice. It is not merely a matter off the provision of doctors, hospitals, medicines or the absence of disease and incapacity’.
Thus Aboriginal definitions of health used in the Aboriginal Health Strategy reflect identity, community and culture. Aboriginal people continue to consider health in this way, even though the use of this definition has declined.
The Interplay Project is exploring the factors that contribute to the wellbeing of remote Aboriginal people.2 Important factors identified in interviews for the project are culture, community, empowerment, education, employment and health. Thus for remote Aboriginal people, health is only one contributor to wellbeing. Using these findings, the Interplay Project will support the development of health and other services that meet the needs of remote Aboriginal people.
Development strategies for remote Aboriginal people must focus on the educational, economic and health needs that the people themselves define, based on their culture and identity.