Benefits and barriers of participation in physical activity for First Nations People with Disability
By Dr Paul Oliver
First Nations people have the right to live free from violence, abuse, neglect and exploitation in their daily lives. However, compared to the non-Indigenous population, Aboriginal and Torres Strait Islander (ATSI) Australians experience higher mortality and morbidity rates; lower life expectancy; poor education outcomes; low socio-economic status; and poor employment opportunities (Bradley, Draca, Green, & Leeves, 2007).
Indigenous youth (aged between 15 and 24 years) were more likely to be overweight or obese than non-Indigenous youth (37% and 27% respectively), and twice as likely to be obese (15% and 6% respectively) (ABS 2012-2013). For ATSI people, “being overweight or obese, being physically inactive and consuming a diet low in fruit and vegetables have been estimated to contribute to the high rates of cardiovascular disease, diabetes and chronic kidney disease experienced by Australia’s Indigenous people” (AIHW, 2011, p.1).
Compared with non-Indigenous Australians, Indigenous Australians are also more likely to have certain types of health conditions and, for many conditions, experience earlier onset. They also have a continued high occurrence of certain diseases that are now virtually unreported in the non-Indigenous population, such as trachoma and acute rheumatic fever.
The figures paint a horrific picture: about 1 in 8 (13%) Indigenous Australians aged 2 and over reported having cardiovascular disease as a long-term condition in 2012–13; 11% of Indigenous adults had diabetes, a further 4.7% were at risk of developing diabetes; while the proportion having long-term kidney disease was 3.7 times as high as the proportion of non-Indigenous people (AIHW, 2015).
The benefits of sport participation
Sport can be a very powerful way of engaging First Nations people and providing positive outcomes in the areas of health and welfare. The Heart Foundation has pointed to the health benefits to Indigenous Australians of sport and physical activity, including a reduction in risk for chronic disease, coronary heart disease and stroke, bowel and breast cancer, diabetes and depression. (House of Representatives Standing Committee on Aboriginal and Torres Strait Islander Affairs & Saffin, 2013, Submission 58, pp. 1-2). While sporting events and carnivals, have helped to promote greater responsibility in managing health conditions and support greater awareness of issues impacting on health in communities.
Several recent reports clearly demonstrate the beneficial effects of participation in sports and recreation for supporting healthy Aboriginal and Torres Strait Islander communities. Supporting healthy communities through sports and recreation programs (Ware & Meredith, 2013), which reviewed over 30 studies, covering all geographic areas from inner city to remote regions, and age groups ranging from primary school to young adults, showed that there are many benefits to Aboriginal and Torres Strait Islander communities from participation in sport and recreational programs. Benefits highlighted include: some improvements in school retention, attitudes towards learning, social and cognitive skills, physical and mental health and wellbeing; increased social inclusion and cohesion; increased validation of and connection to culture.
The enjoyment or fun that active or passive participation in sporting activities generated is both intrinsically beneficial and a powerful hook for engaging communities in programs with other social or personal development objectives (Hartmann, 2003). The evidence suggests that providing locally relevant sports and recreation programs can be useful in building a sense of purpose, hope and belonging in these communities (Ruhanen & Whitford, 2011).
Indigenous Australians with disability
The Australian Government has ratified the United Nations Convention on the Rights of Persons with Disabilities (CRPD). This means that Australia has agreed to respect, protect and fulfil the rights described in the CRPD, including for First Nations people. Australia has also endorsed the United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP), which together with the CRPD, provide the foundational human rights standards for First Nations people with disability.
ABS research (2012) shows that the level of disability among Indigenous Australians is 23.4%, which is 70% higher than the general population (with children 14 and younger the figure is double).
Indigenous Australians with disability do not participate in sport at the same levels as other groups in the community and are under-represented in all areas of disability sport. Anecdotal evidence suggests that cultural issues associated with disabilities within Indigenous cultures limit the participation of people with a disability. And because ATSI people with impairments are so inactive, they are particularly prone to diseases of inactivity – diabetes, heart disease, mental illness, certain types of cancer. These diseases compound the effects of the primary impairment causing further health disadvantage.
For Indigenous people with disability, many barriers to sport participation exist. These include cost, access, organisational and governmental support, acceptance, safety and inclusion policies.
Another major barrier identified by people with disability and their families and carers, is they don’t know how to get involved in sport, what sports they would be most suitable for with their impairment, and what opportunities exist for them to join local clubs or progress to different pathways or levels should they choose to do so. These barriers can make navigating sport and physical activity very difficult.
Some literature indicates that ATSI people living in rural and remote settings experience more disadvantage (Marmot, Friel, Bell, Houweling, & Taylor, 2008; Tedmanson & Guerin, 2011) as there is often limited infrastructure and programming to provide leisure and other pursuits (Cunningham & Beneforti, 2005), at times leading to engagement in unhealthy or negative activities (Cappo, 2007).
We know that sport offers considerable benefits to Indigenous Australians who have a disability, in the same way it offers benefits to able-bodied Indigenous Australians. Engaging people in sport is a good way of reducing preventable health disadvantage in this vulnerable group. Participation in sports and active recreation activities has direct benefits in improving physical health and wellbeing; such as increased life expectancy and reduced heart disease (Higgins, 2005).
Australian Bureau of Statistics. (2012). Sports and Physical Recreation: A Statistical Overview (Catalogue No. 4156.0). Canberra: Author.
Australian Bureau of Statistics. (2012-13). Aboriginal and Torres Strait Islander Health Survey. (Catalogue No. 4727.0). Canberra: Author.
Australian Institute of Health and Welfare. (2011). Aboriginal and Torres Strait Islander Health Performance Framework 2010 report: Queensland.
Australian Institute of Health and Welfare, Canberra, ACT.
Australian Institute of Health and Welfare. (2015). The health and welfare of Australia’s Aboriginal and Torres Strait Islander peoples 2015. Cat. no. IHW 147. Canberra.
Bradley, S., Draca, M., Green, C. & G. Leeves. (2007). The magnitude of educational disadvantage of Indigenous minority groups in Australia. Journal of Population Economics, 20, 547-569.
Cappo, D. J. (2007). To break the cycle: prevention and rehabilitation responses to serious repeat offending by young people. Social Inclusion Unit, South Australia Department of the Premier and Cabinet.
Cunningham, J., & Beneforti, M. (2005). Investigating indicators for measuring the health and social impact of sport and recreation programs in Australian Indigenous communities. International Review for the Sociology of Sport, 40(1), 89-98.
Hartmann, D. (2003). Theorizing sport as social intervention: A view from the grassroots. Quest, 55(2), 118-140.
Higgins, D. (Ed.). (2005). Early learnings: Indigenous community development projects. Telstra Foundation Research report, Vol. 2. Melbourne: Australian Institute of Family Studies & Telstra Foundation.
House of Representatives Standing Committee on Aboriginal and Torres Strait Islander Affairs & Saffin, 2013, Submission 58, pp. 1-2.
Marmot, M., Friel, S., Bell, R., Houweling, T. A., & Taylor, S. (2008). Closing the gap in a generation: health equity through action on the social determinants of health. The Lancet, 372(9650), 1661-1669.
Ruhanen, L., & Whitford, M. (2011). Indigenous sporting events: more than just a game. International Journal of Event Management Research, 6(1), 33-51.
Tedmanson, D., & Guerin, P. (2011). Enterprising social wellbeing: social entrepreneurial and strengths based approaches to mental health and wellbeing in ‘remote’ Indigenous community contexts. Australasian Psychiatry, 19(1 suppl), S30-S33.
Ware, V., & Meredith, V. (2013, December). Supporting healthy communities through sports and recreation programs. Resource Sheet No. 26 produced for the Closing the Gap Clearinghouse. Australian Institute of Health and Welfare and Australian Institute of Family Studies.