Intersectionality and Its Relevance in the Context of Aboriginal People with Brain Injury in Australia

Elizabeth Armstrong; Kerri Colegate; Lenny Papertalk; Stuart Crowe; Meaghan McAllister; Deborah Hersh; Natalie Ciccone; Erin Godecke; Judith Katzenellenbogen; Juli Coffin

doi:10.1055/s-0043-1776755

Seminars in Speech and Language, Table of Contents

Semin Speech Lang 2024; 45(01): 056-070
DOI: 10.1055/s-0043-1776755

Review Article

Intersectionality and Its Relevance in the Context of Aboriginal People with Brain Injury in Australia

Authors

Elizabeth Armstrong

¹University Department of Rural Health, Edith Cowan University, Bunbury, Western Australia, Australia
Kerri Colegate

²School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
Lenny Papertalk

³WA Centre for Rural Health, University of Western Australia, Geraldton, Western Australia, Australia
Stuart Crowe

²School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
Meaghan McAllister

²School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
Deborah Hersh

⁴Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
Natalie Ciccone

²School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
Erin Godecke

²School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
Judith Katzenellenbogen

⁵Cardiovascular Epidemiology Research Centre, School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
Juli Coffin

⁶Ngangk Yira Institute for Change, Murdoch University, Broome, Western Australia, Australia

Abstract

In this article, we explore the benefits of recognizing the impact of intersectionality on access to, and provision of, brain injury care in a First Nations context. While disadvantage and discrimination are often associated with the intersection of culture, gender, disability, and socioeconomic disadvantage, it is only when these factors are explored together that clinicians can really understand what people need to recover and thrive following acquired brain injury. In this article, we challenge speech-language pathologists to examine their own practices, to look beyond Western models of health and constraints of many current institutional models of care and ways of framing research, to acknowledge historical and ongoing colonizing influences, and to engage with community-led solutions. We provide a model of Aboriginal-led care, where intersection of discrimination and marginalization is minimized and the multiple components of the individual, carers/communication partners, and the environment become empowering factors instead.

Keywords

Aboriginal - First Nations - brain injury - intersectionality - stroke

Full Text

References

References
Akbulut, N., & Razum, O. (2022). Why Othering should be considered in research on health inequalities: Theoretical perspectives and research needs. SSM - Population Health 20, 10128. Theoretical perspectives and research needs. Doi: 10.1016/j.ssmph.2022.101286
Armstrong, E., Hersh, D., Katzenellenbogen, J., Coffin, J., Thompson, S., Ciccone, N., Hayward, C., Flicker, L., Woods, D., & McAllister, M. (2014). Enhancing Personal factors: Working with people from Aboriginal and Torres Strait Islander backgrounds. In Aphasia Best Practice Statements 2014: Comprehensive supplement to the Australian Aphasia Rehabilitation Pathway. Accessed October 24, 2023 at: http://www.aphasiapathway.com.au/flux-content/aarp/pdf/2014-COMPREHENSIVE-FINAL-01-10-2014-1.pdf
Armstrong, E. M., Ciccone, N., Hersh, D., Katzenellebogen, J., Coffin, J., Thompson, S., Flicker, L., Hayward, C., Woods, D., & McAllister, M. (2017a). Development of the Aboriginal Communication Assessment After Brain Injury (ACAABI): a screening tool for identifying acquired communication disorders in Aboriginal Australians. International Journal of Speech-Language Pathology, 19(3), 297–308
Armstrong, E., McKay, G., & Hersh, D. (2017b). Assessment and treatment of aphasia in Aboriginal Australians: linguistic and cultural issues. Journal of Clinical Practice in Speech-Language Pathology, 19(1), 27–34
Armstrong, E., Robins, A. C., Lewis, T., & Carmody, A. (2019). Assessment and outcome measures for Australian Aboriginal and/or Torres Strait Islander peoples with communication disorders. Journal of Clinical Practice in Speech-Language Pathology, 21(2), 50–57
Armstrong, E., Coffin, J., Ciccone, N., Hersh, D., Katzenellenbogen, J., Brewer, K., & McAllister, M. (2016). Shaping clinical services to work with Indigenous peoples: Lessons learned from research in Indigenous contexts. Paper presented at the Speech Pathology Australia Conference, Perth
Armstrong, E., Coffin, J., Hersh, D., Katzenellenbogen, J. M., Thompson, S. C., Ciccone, N., Flicker, L., Woods, D., Hayward, C., Dowell, C., & McAllister, M. (2021). "You felt like a prisoner in your own self, trapped": the experiences of Aboriginal people with acquired communication disorders. Disability and Rehabilitation, 43(13), 1903–1916
Armstrong, E., Lewis, T., Robins, A., Malcolm, I., & Ciccone, N. (2022). Cross-cultural perspectives on conversational assessment and treatment in aphasia: learnings from a First Nations context. In: C. Coehlo, L. Cherney., & B. Shadden (Eds.), Discourse Analysis in Adults with and without Communication Disorders: A Resource for Clinicians and Researchers. San Diego: Plural Publishing
Armstrong, E., Mcallister, M., Coffin, J., Robinson, M., Thompson, S., Katzenellenbogen, J., Colegate, K., Papertalk, L., Hersh, D., Ciccone, N., & White, J. (2023). Communication services for First Nations peoples after stroke and traumatic brain injury: alignment of Sustainable Development Goals 3, 16 and 17. International Journal of Speech-Language Pathology, 25, 147–151
Armstrong, E., Maypilama, ?., Fasoli, L., Guyula, A., Yunupi?u, M., Garrutju, J., Gundjarranbuy, R., Gapany, D., Godwin-Thompson, J., & Lowell, A. (2022b). How do Yol?u recognise and understand their children's learning? Nhaltjan ?uli ga Yol?uy nhäma ga märr-dhara?an djamarrku?iw mar?githinyawuy? PLoS One, 17(8), e0272455
Australian Government. (2022). Diversity and Inclusion Report: Our Differences Make Us Stronger. Accessed October 24, 2023 at: https://www.apsc.gov.au/working-aps/diversity-and-inclusion/diversity-and-inclusion-report-2022
American Speech-Language and Hearing Association. (2019). A Demographic Snapshot of SLPs. ASHA Leader. Accessed October 24, 2023 at: https://leader.pubs.asha.org/doi/10.1044/leader.AAG.24072019.32
Australian Institute of Aboriginal and Torres Strait Islander Studies. (2023). Languages Alive. Accessed October 24, 2023 at: https://aiatsis.gov.au/explore/languages-alive
Australian Bureau of Statistics. (2021). Aboriginal and Torres Strait Islander people: Census. Information on Aboriginal and Torres Strait Islander peoples including language and ancestry. Accessed October 24, 2023 at: https://www.abs.gov.au/statistics/people/aboriginal-and-torres-strait-islander-peoples/aboriginal-and-torres-strait-islander-people-census/2021
Australian Institute of Health and Welfare. (2018). Indigenous health and wellbeing. Accessed October 24, 2023 at: https://www.aihw.gov.au/reports/australias-health/indigenous-health-and-wellbeing
Bennett, M., Cartwright, J., & Young, J. (2019). Is the speech-language pathology profession prepared for an ageing population? An Australian survey. International Journal of Speech-Language Pathology, 21(2), 153–162
Bryant, J., Bolt, R., Botfield, J. R., Martin, K., Doyle, M., Murphy, D., Graham, S., Newman, C. E., Bell, S., Treloar, C., Browne, A. J., & Aggleton, P. (2021). Beyond deficit: 'strengths-based approaches' in Indigenous health research. Sociology of Health & Illness, 43, 1405–1421
Bullen, J., Hill-Wall, T., Anderson, K., Brown, A., Bracknell, C., Newnham, E. A., Garvey, G., & Waters, L. (2023). From deficit to strength-based Aboriginal health research - moving toward flourishing. International Journal of Environmental Research and Public Health, 20, 5395
Chapey, R., Duchan, J., Elman, R., Garcia, L., Kagan, A., Lyon, J., . . .. (2008). Life participation approach to aphasia: a statement of values for the future. In: R. Chapey (Ed.), Language Intervention Strategies in Aphasia and Related Neurogenic Communication Disorders (5th ed., pp. 279–289). Philadelphia, PA: Lippincott, Williams & Wilkins
Coalition of Peaks. (2020). National Agreement on Closing the Gap: Coalition of Peaks. Accessed October 24, 2023 at: https://coalitionofpeaks.org.au/wp-content/uploads/2023/03/National-Agreement-new-target.pdf
Cochrane, F., Siyambalapitiya, S., & Cornwell, P. (2023). Assessment and rehabilitation of acquired communication disorders in Aboriginal and Torres Strait Islander adults with stroke or traumatic brain injury: a retrospective chart review. Disability and Rehabilitation, 45(7), 1154–1164
Commonwealth of Australia. (2013). National Aboriginal and Torres Strait Islander Health Plan 2013–2023. Accessed October 24, 2023 at: https://www.health.gov.au/natsihp
Department of Communications. Information, Technology and the Arts. (2005). National Indigenous languages survey report 2005. Accessed October 24, 2023 at: http://www.fatsilc.org.au/images/pdfs/NILS-Report-2005.pdf
Dudgeon, P., Milroy, H., & Walker, R. (Eds.). (2014). Working together: Aboriginal and Torres Strait Islander Mental Health and Wellbeing Principles and Practice. Accessed October 24, 2023 at: https://www.telethonkids.org.au/globalassets/media/documents/aboriginal-health/working-together-second-edition/working-together-aboriginal-and-wellbeing-2014.pdf
Durey, A., Thompson, S. C., & Wood, M. (2012). Time to bring down the twin towers in poor Aboriginal hospital care: addressing institutional racism and misunderstandings in communication. Internal Medicine Journal, 42(1), 17–22
Durey, A., McEvoy, S., Swift-Otero, V., Taylor, K., Katzenellenbogen, J., & Bessarab, D. (2016). Improving healthcare for Aboriginal Australians through effective engagement between community and health services. BMC Health Services Research, 16(1), 224
Gilroy, J., Dew, A., Barton, R., Ryall, L., Lincoln, M., Taylor, K., Jensen, H., Flood, V., & McRae, K. (2021). Environmental and systemic challenges to delivering services for Aboriginal adults with a disability in Central Australia. Disability and Rehabilitation, 43(20), 2919–2929
Gould, J. (2008). The effects of language assessment policies in speech-language pathology on the educational experiences of indigenous students. Current Issues in Language Planning, 9(3), 299–316
Government of Western Australia. (2020). The Western Australian (WA) Multicultural Policy Framework. Accessed October 24, 2023 at: http://www.omi.wa.gov.au/resources-and-statistics/publications/publication/wa-multicultural-policy-framework
Green, J. (2007). Taking account of aboriginal feminism. In: J. Green (Ed.), Making Space for Indigenous feminism (pp. 20–32). Winnipeg: Fernwood Publishing
Green, A., Abbott, P., Davidson, P. M., Delaney, P., Delaney, J., Patradoon-Ho, P., & DiGiacomo, M. (2018). Interacting with providers: an intersectional exploration of the experiences of carers of Aboriginal children with a disability. Qualitative Health Research, 28(12), 1923–1932
Guerrero-Arias, B. E., Agudelo-Orozco, A., & Pava-Ripoll, N. A. (2020). Intersectional identity chronotopes: expanding the disability experience. Disability & Society, 35(10), 1660–1681
Hankivsky, O., Grace, D., Hunting, G., Giesbrecht, M., Fridkin, A., Rudrum, S., Ferlatte, O., & Clark, N. (2014). An intersectionality-based policy analysis framework: critical reflections on a methodology for advancing equity. International Journal for Equity in Health, 13(1), 119
Hankivsky, O., Doyal, L., Einstein, G., Kelly, U., Shim, J., Weber, L., & Repta, R. (2017). The odd couple: using biomedical and intersectional approaches to address health inequities. Global Health Action, 10(Suppl 2), 1326686
Haynes, E., Walker, R., Mitchell, A. G., Katzenellenbogen, J., D'Antoine, H., & Bessarab, D. (2021). Decolonizing indigenous health: generating a productive dialogue to eliminate Rheumatic Heart Disease in Australia. Social Science & Medicine, 277, 113829
Holt, Y. (2022). Reflecting on the role of gender and race in speech-language pathology. Perspectives of the ASHA Special Interest Groups, 7(6), 2158–2168.
Human Rights and Equal Opportunity Commission. (1997). Bringing them home: report of the National Inquiry into the Separation of Aboriginal and Torres Strait Islander Children from their Families. Sydney: Human Rights and Equal Opportunity Commission
Hyter, Y. D., & Salas-Provance, M. B. (2019). Culturally responsive practices in speech, language, and hearing sciences. Plural Publishing
Indigenous Allied Health Australia. (2015). Cultural Responsiveness in Action: An IAHA Framework. Accessed October 24, 2023 at: https://iaha.com.au/workforce-support/training-and-development/cultural-responsiveness-in-action-training/
Jamieson, L., Ju, X., Haag, D., Ribeiro, P., Soares, G., & Hedges, J. (2023). An intersectionality approach to Indigenous oral health inequities; the super-additive impacts of racism and negative life events. PLoS One, 18(1), e0279614
Jones, B., Heslop, D., & Harrison, R. (2020). Seldom heard voices: a meta-narrative systematic review of Aboriginal and Torres Strait Islander peoples healthcare experiences. International Journal for Equity in Health, 19, 222
Katzenellenbogen, J. M., Atkins, E. R., Thompson, S. C., Hersh, D., Coffin, J., Flicker, L., Hayward, C., Ciccone, N., Woods, D., McAllister, M., & Armstrong, E. M. (2016). Missing voices: profile and extent of acquired communication disorders in Aboriginal and non-Aboriginal adult stroke survivors in Western Australia using linked administrative records. International Journal of Stroke, 11(1), 103–116.
Katzenellenbogen, J. M., Atkins, E., Thompson, S. C., Hersh, D., Coffin, J., Flicker, L., Hayward, C., Ciccone, N., Woods, D., Greenland, M. E., McAllister, M., & Armstrong, E. M. (2018). Missing voices: profile, extent and 12-month outcomes of non-fatal traumatic brain injury in Aboriginal and non-Aboriginal adults in Western Australia using linked administrative records. The Journal of Head Trauma Rehabilitation, 33(6), 412–423
Kerrigan, V., Lewis, N., Cass, A., Hefler, M., & Ralph, A. P. (2020). "How can I do more?" Cultural awareness training for hospital-based healthcare providers working with high Aboriginal caseload. BMC Medical Education, 20, 173
McDermott, D. (2019). "Big Sister" wisdom: How might non-Indigenous speech-language pathologists genuinely, and effectively, engage with Indigenous Australia? International Journal of Speech-Language Pathology, 21(3), 252–262
Markwick, A., Ansari, Z., Clinch, D., & McNeil, J. (2019). Experiences of racism among Aboriginal and Torres Strait Islander adults living in the Australian state of Victoria: a cross-sectional population-based study. BMC Public Health, 19, 309
McLellan, K. M., McCann, C. M., Worrall, L. E., & Harwood, M. L. N. (2014). Maori experiences of aphasia therapy: "But I'm from Hauiti and we've got shags". International Journal of Speech-Language Pathology, 16(5), 529–540
Moreton-Robinson, A. (2013). Towards an Australian indigenous women's standpoint theory. Australian Feminist Studies, 28(78), 331–347
Nair, V. K. K., Farah, W., & Cushing, I. (2023). A critical analysis of standardized testing in speech and language therapy. Language, Speech, and Hearing Services in Schools, 54, 781–793
Nakata, M. (2007). The cultural interface. Australian Journal of Indigenous Education, 36(S1), 7–14
National Aboriginal Community Controlled Health Organisation. (2023). Accessed October 24, 2023 at: https://www.naccho.org.au/
O'Halloran, R., Renton, J., Harvey, S., McSween, M. P., & Wallace, S. J. (2023). Do social determinants influence post-stroke aphasia outcomes? A scoping review. Disability and Rehabilitation, 1–14. Doi: 10.1080/09638288.2023.2193760
Penn, C., Armstrong, E., Brewer, K., Purves, B., McAllister, M., Hersh, D., Godecke, E., Ciccone, N., & Lewis, A. (2017). De-colonizing speech-language pathology practice in acquired neurogenic disorders. SIG 2, Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders, 2(3), 91–99
Penn, C., & Armstrong, E. (2017). Inter-cultural aphasia: new models of understanding for Indigenous populations. Aphasiology, 31(5), 563–594
Rigney, L.-I. (2001). A first perspective of Indigenous Australian participation in science: framing indigenous research towards Indigenous Australian intellectual sovereignty. Kaurna Higher Education Journal, 7, 1–13
Rigney, L.-I. (Ed.). (2023). Global perspectives and new challenges in culturally responsive pedagogies: super-diversity and teaching practice. Routledge, UK. Accessed October 24, 2023 at: https://doi.org/10.4324/9781003335719
UN General Assembly. (2007). United Nations, Declaration on the Rights of Indigenous Peoples: Resolution/Adopted by the General Assembly, A/RES/61/295. Accessed January 29, 2023 at: https://www.refworld.org/docid/471355a82.html
Victorian Government. (2018). Everybody Matters Inclusion and Equity Statement. Accessed October 24, 2023 at: https://www.vic.gov.au/everybody-matters-inclusion-and-equity-statement
Victorian Government. (2023). Understanding Intersectionality. Accessed October 24, 2023 at: https://www.vic.gov.au/understanding-intersectionality
Watego, C., Singh, D., & Macoun, A. (2021a). Partnership for Justice in Health: Scoping Paper on Race, Racism and the Australian Health System, Discussion Paper. The Lowitja Institute, Melbourne; doi: 10.48455/sdrt-sb97
Watego, C., Whop, L. J., Singh, D., Mukandi, B., Macoun, A., Newhouse, G., Drummond, A., McQuire, A., Stajic, J., Kajlich, H., & Brough, M. (2021b). Black to the future: making the case for Indigenist Health Humanities. International Journal of Environmental Research and Public Health, 18(16), 8704
Watermeyer, J., & Neille, J. (2022). The application of qualitative approaches in a post-colonial context in speech-language pathology: a call for transformation. International Journal of Speech-Language Pathology, 24, 494–503
Wilson, Y., White, A., Jefferson, A., & Danis, M. (2019). Intersectionality in clinical medicine: the need for a conceptual framework. The American Journal of Bioethics, 19(2), 8–19