By Bill Condie
We will never close the gap in Indigenous health unless we engage with the men, says Professor James Smith.
For Professor Smith, his career-long interest in men’s health will hit a new milestone this year when he partners with the Movember Institute of Men’s Health for its long-term, largescale evaluation of Indigenous men’s wellbeing across Australia, Aotearoa New Zealand, Canada, and the US.
Professor Smith, Dr Kootsy Canuto, Associate Professor in Aboriginal Torres Strait Islander male health and well-being, and their team will co-lead the evaluation of the Australian arm of Movember Foundation’s Indigenous Social and Emotional Wellbeing Initiatives program, which is aimed at combating the health inequalities faced by Indigenous men through holistic community-driven approaches.
“We will carry out the evaluation over a five-year timeframe,” says Professor Smith. “It’s a significant investment by Movember and, sadly, it’s urgently needed. Indigenous men everywhere experience higher rates of chronic disease, mental ill-health, earlier mortality, and substance use issues than the wider community. We need appropriately tailored health programs and services to better meet their needs.”
Professor Smith is no stranger to the problem. As the Deputy Dean of Rural and Remote Health – NT, and Matthew Flinders Professor (Health and Social Equity) at Flinders University, he has 20 years of experience working in men’s health, with much of his work focused on improving Aboriginal and Torres Strait Islander health and education outcomes in South Australia and the Northern Territory.
“We’re focused on growing Aboriginal and Torres Strait Islander researchers and research staff and building strong, meaningful relationships with Indigenous communities,” he says.
Professor Smith has always had a deep interest in men’s health since his undergraduate studies in human movement at the University of South Australia, where he completed a short course in men’s health.
“It was the first of its type in Australia and delivered by Professor Murray Drummond, who’s now also a Professor and Director of the Sport, Health, Activity, Performance and Exercise (SHAPE) Research Centre at Flinders,” says Professor Smith. After university, he began working in a men’s health practice role at the Royal Adelaide Hospital before pursuing a PhD.
“At the same time, I was developing a stronger interest in concepts of health equity and recognised that there were some priority populations of men who were marginalised, who were very vulnerable from a health and social equity point of view. And that included Aboriginal and Torres Strait Islander boys and men.”
That led him 16 years ago to the NT where he could marry his interest in men’s health with Aboriginal and Torres Strait Islander health and well-being research, policy and practice, with Flinders colleagues.
“I’m really interested in doing the practical stuff,” he says.
Together with Dr Canuto, he is working with Jason Bonson and Cameron Stokes, both program managers in Aboriginal and Torres Strait Islander men’s health research.
One of their projects, called YBMen NT (Young Black Men, Masculinities, and Mental Health) is an initiative also funded by the Movember Foundation, that had its origins in the US with Black college men. Professor Smith was a Fulbright Senior Scholar in 2020, when he visited the Vivian A. and James L. Curtis Center for Health Equity Research and Training at the University of Michigan to learn more about this program.
“We’re adapting that for high school aged Aboriginal and Torres Strait Islander males. And we’ve been doing a lot of co-design work in that space to make sure we’ve got a curriculum that works as part of a hybrid face-to-face online social and emotional wellbeing education and support program for young Aboriginal and Torres Strait Islander fellas in the greater Darwin region.”
The other project, where Professor Smith works with Flinders colleague Dr Bryce Brickley, harnesses the Aussie love of sport. Called Aussie-FIT, it targets men aged 35 through to 75. It’s not solely for Indigenous men, although they have certainly been keen participants of the program.
Standing for Aussie Football Fans in Training, the program which is funded through a Heart Foundation Behaviour Change Strategic Grant engages men through a sports setting – not just athletes, but spectators or people attached to a club.
“It’s using the sports setting as an opportunity to teach them a little bit about their physical activity and nutrition but also to have some fun at the same time,” says Professor Smith.
This program partnership between Curtin University, Flinders University, and the Queensland University of Technology is being implemented in Western Australia, Northern Territory and Queensland. Flinders is leading the program delivery in Darwin. These sorts of projects are vital if we are to close the gap between Indigenous men’s health and the wider community.
“We need more appropriately tailored and culturally-responsive health promotion and prevention engagement strategies with Aboriginal and Torres Strait Islander men, rather than an over reliance on the acute care system, when it’s often too late.”
PROFESSOR JAMES SMITH
“We need to really focus on the ways that we can engage with these men earlier. How can we make sure that they’ve got access to the right services at the right time in the right place?
“And we need to work with health services, and particularly Aboriginal community-controlled health organisations, to strengthen that approach and to change what that can look like so that men do feel comfortable in accessing primary health care services earlier.”