The role of empowerment in setting a foundation for social and emotional wellbeing

Abstract

Empowerment and community participation are major strategies, worldwide, for alleviating poverty and social exclusion, thereby reducing health disparities. In Australia, a lack of control, or mastery, has long been widely acknowledged as one aspect of a broader experience of powerlessness that needs to be addressed to reduce the current preventable Indigenous burden of disease and close the health disparity gap. Yet, it is hard to find empirical research examining the nature and attributes of empowerment and how to operationalise and evaluate these in the context of promoting Indigenous health.

This paper synthesises the findings of a five-year Family Wellbeing empowerment study aimed at enhancing the capacity of Indigenous Australian people in Cape York, far north Queensland, to take greater control over the issues affecting their health and wellbeing. Documenting and analysing empowering strategies over time can help us to better understand the process of empowerment and ways in which change is generated at multiple levels.

The study confirmed existing evidence that the process of empowerment is lengthy, taking years to achieve change beyond the individual level. It also highlighted the importance of initial engagement and personal capacity building, in socially and economically vulnerable communities where people experience relative powerlessness, as a critical foundation for improving the health of the broader community.

Authors

Komla Tsey
The Cairns Institute and the School of Education, James Cook University, Cairns and Townsville, QLD

Desley Harvey
Department of Social Work and Community Welfare, School of Arts and Social Sciences, James Cook University, Cairns QLD

Teresa Gibson
Apunipima Cape York Health Council, Cairns QLD

Liz Pearson
Apunipima Cape York Health Council, Cairns QLD

References

Australian Bureau of Statistics (2002) Deaths Australia 2001 (Cat no. 3302.0). Canberra: Australian Bureau of Statistics.

Australian Health Ministers (2003) National Mental Health Plan 2003-2008. Canberra: Australian Government.

Australian Indigenous HealthInfoNet (2005) Summary of Australian Indigenous Health, November 2005. Retrieved 24 July 2006 from http://www.healthinfonet.ecu.edu.au/html/html_keyfacts/keyfacts_plain_lang_summary.htm

Braun V and Clark V (2006) Using thematic analysis in psychology. Qualitative Research in Psychology 3, 77-101.

Cape York Institute for Policy and Leadership (2007) From Hand Out to Hand Up: Cape York Welfare Reform Project: Design Recommendations (Executive Summary pp.7-15). Cairns: Cape York Institute for Policy and Leadership. Available at: http://www.cyi.org.au/welfarereform.aspx  

Commonwealth of Australia (1997) Bringing Them Home: Report of the National Inquiry into the Separation of Aboriginal and Torres Strait Islander Children from their Families. Canberra: Stirling Press.

Denzin NK and Lincoln YS (2005) (Eds.) The Sage Handbook of Qualitative Research 3rd edn. pp.651-679. Thousand Oaks CA: Sage.

Fitzgerald T (2001) Cape York Justice Study: Volume 1. Summary, Conclusions and Recom-mendations. Brisbane: Queensland Department of the Premier and Cabinet. Available at http://www.communities.qld.gov.au/community/publications/capeyork.html

Flyvbjerg B (2001) Making Social Science Matter: Why Social Inquiry Fails and How it Can Succeed Again. Cambridge: Cambridge University Press.

Hunter E and Harvey D (2002) Indigenous suicide in Australia, New Zealand, Canada and the United States. Emergency Medicine 14(1), 14-23.

Laverack G and Wallerstein N (2001) Measuring community empowerment: a fresh look at organizational domains. Health Promotion International 16(2), 179-185.

National Aboriginal and Torres Strait Islander Health Council and National Mental Health Working Group (2004) Social and Emotional Wellbeing Framework: A National Strategic Framework for Aboriginal and Torres Strait Islander Peoples' Mental Health and Social and Emotional Wellbeing 2004-2009. Canberra: Commonwealth Department of Health and Ageing.

Pearson N (2000) Our Right to Take Responsibility. Cairns: Noel Pearson and Associates.

Rees S, Tsey K, Every A, Williams E, Cadet-James Y and Whiteside M (2004) Empowerment and human rights in addressing violence and improving health in Australian Indigenous communities. Health and Human Rights 8(1), 95-113.

Rissel C (1994) Empowerment: The holy grail of health promotion? Health Promotion International 9(1), 39-47.

Swan P and Raphael B (1995) Ways Forward: National Consultancy Report on Aboriginal and Torres Strait Islander Mental Health. Canberra: Australian Government Printing Service.

Thomas DP, Condon JR, Anderson IP, Li SQ, Halpin S, Cunningham J and Guthridge SL (2006) Long-term trends in Indigenous deaths from chronic diseases in the Northern Territory: A foot on the brake, a foot on the accelerator. Medical Journal of Australia 185(3), 145-149.

Travers H, Gibson T, Tsey K, Bambie J and McIvor R (2004) Just for Bama: An Evaluation of the Family Wellbeing Personal and Community Engagement Tool in a Cape York Community. Cairns: University of Queensland and Apunipima Cape York Health Council.

Tsey K and Every A (2000) Evaluating Aboriginal empowerment programs: The case of family wellbeing. Australian and New Zealand Journal of Public Health 24(5), 509-514.

Tsey K, Deemal A, Whiteside M and Gibson T (2003) It's An Eye Opener for People to See You Can Change Things: An Evaluation of a 'Family Wellbeing' Personal and Community Development Pilot Project in Two Cape York Communities. Cairns: University of Queensland and Apunipima Cape York Health Council.

Tsey K, Gibson T and Pearson L (2006) Family Wellbeing Evaluation Report 2006. Cairns: Apunipima Cape York Health Council.

Tsey K, Travers H, Gibson T, Whiteside M, Cadet-James Y, Haswell-Elkins M, McCalman J and Wilson A (2005) The role of empowerment through life skills development in building comprehensive primary health care systems in indigenous Australia. Australian Journal of Primary Health Care 11(2), 16-25.

Tsey K, Whiteside M, Daly S, Deemal A, Cadet-James Y, Wilson A, Santhanam R and Haswell M (2005) Adapting the family wellbeing empowerment program to the needs of remote Indigenous young people. Australian and New Zealand Journal of Public Health 29(2), 112-116.

Tsey K, Whiteside M, Deemal A and Gibson T (2003) Social determinants of health, the 'control factor' and the Family Wellbeing empowerment program. Australasian Psychiatry 11 (Supplement 1), S34-S39.

Wallerstein N (1992) Powerlessness, empowerment, and health: Implications for health promotion programs. American Journal of Health Promotion 6, 197-205.

Wallerstein N (2002) Empowerment to reduce health disparities. Scandinavian Journal of Public Health 30, 72-77.

Wallerstein N (2006) What is the Evidence on Effectiveness of Empowerment to Improve Health? Copenhagen: WHO Regional Office for Europe (Health Evidence Network Report). http://www.euro.who.iny/Document/E88086.pdf (accessed 1 February 2006).

Williams L, Labonté R and O'Brien M (2003) Empowering social action through narratives of identity and culture. Health Promotion International 18(1), 33-40.

World Health Organization (1986) Ottawa Charter for Health Promotion. Geneva: World Health Organisation.

Keywords

Indigenous, empowerment, social and emotional wellbeing, remote, program evaluation, social change

Meta

PP: 006 - 015

Introduction

Empowerment is central to the Ottawa Charter for Health Promotion (World Health Organization: WHO, 1986) and subsequent WHO health promotion strategies. As a theoretical construct, empowerment involves both processes and outcomes, generating change at multiple levels (individual, organisational and community) and strengthening the capacity for collective action to positively influence social situations (Rissel, 1994; Wallerstein, 1992; Wallerstein, 2002). However, how to operat-ionalise empowerment with marginalised populations, in ways that contribute to reducing health inequalities, has remained less clear (Laverack & Wallerstein, 2001; Wallerstein, 2002; Williams, Labonté & O'Brien, 2003).

In 2006, twenty years after the Ottawa Charter, the WHO Health Evidence Network published a review of the evidence for the effectiveness of empowerment in improving health (Wallerstein, 2006). The report identifies pathways through which empowerment is generated at psychological, organisational and community levels, linking the effect of these outcomes to improvements in health. The report concludes that there is evidence that initiatives based on empowerment, as a multi-level construct, can reduce health disparities but successful approaches cannot be replicated across populations. There is a need for the development and evaluation of strategies relevant to the lived experience of populations experiencing social exclusion (Wallerstein, 2006).

This paper examines the pathway to empowerment by analysing the results of a five-year Family Wellbeing empowerment study aimed at enhancing the capacity of Indigenous people in Cape York (far north Queensland) to achieve greater control over their lives. The study describes ways in which empowerment outcomes are being sustained over time and utilised to address broader social determinants through efforts to integrate Family Wellbeing into the core business of a range of health promotion and illness prevention programs and services.

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