What factors should be considered when exploring concepts of Aboriginal and Torres Strait Islander wellbeing?

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From: Cultural determinants of health for Aboriginal and Torres Strait Islander people – a narrative overview of reviews

First Author [reference number] Year	Family/community	Country and place	Cultural identity	Self-determination
Berry [21] 2010	Unknown yet whether community-led caring-for-Country projects could produce both benefits for country and personal empowerment	Greater physical activity (associated with caring-for-country projects) is linked to better mental health directly and because it improves physical health, itself strongly linked to mental health [30, 31]	Caring for Country could support connectedness to identity and generate powerful co-benefits for social and emotional wellbeing	To reduce the current preventable burden of disease, we must address lack of control as one aspect of a broader experience of Aboriginal powerlessness [5, 32]
Burgess [22] 2005	Cohesion with kin, ancestors and geography are all important factors in the formation of collective esteem and efficacy [33, 34]	Engagement with Country provides opportunities for physical activity, improved diet as well as boosting individual autonomy and self-esteem [35, 36]	“Our identity as human beings remains tied to our land… Destroy this relationship and you damage – sometimes irrevocably – individual human beings and their health” [37]	Renewed ties to Country can form the basis of reinvigorated governance and can develop a sense of autonomy and mastery over life [38, 39]
Salmon [23] 2018	Social support, in the form of community affection, is a strong determinant of health for Aboriginal women [40]	Caring for country has benefits for the socio-political, cultural, economic, and physical and emotional wellbeing of Aboriginal peoples [22, 41,42,43,44,45]	Culture is critically important – it is the central core of Aboriginal child health and wellbeing	Leadership is critical to the long-term survival and growth of Koori [Aboriginal people from New South Wales and Victoria] communities [46]
VicHealth [24] 2011	Family and kinship networks and community connections can promote health and can be harmful to health [47]	Programs that involve Aboriginal Natural and Cultural Resource Management are associated with lower levels of risk factors for CVD and diabetes and improved self-esteem [48]	Caring for Country appears to be linked to improved identity and is recommended as a means to improving health [49]	A requirement for reversing colonisation is self-determination. Self-determination helps people restore control over their lives and destinies
Weir [25] 2011	Not reported	Caring for Country has benefits for individual health and wellbeing, and the health of communities	A relationship between identity, autonomy and wellbeing and caring for Country [48]	Control over life is an important determinant of wellbeing [50]
Dahlberg [26] 2018	Family determines a child’s level of activity and type of sport they practice [51, 52]	A big emphasis is placed on physical and social environment when it comes to physical activity	Evidence of the positive impact in the strong sense of collective identity and pride that is experienced when part of a team [51]	Not reported
MacLean [27] 2017	Welcoming extended family members to attend antenatal care and childbirth supports the expression of cultural identity and can decrease perinatal morbidity [53]	Activities on Country can be used to improve health [54]	Programs that include components to enable and support Aboriginal peoples to express cultural identity can have positive health and wellbeing effects	Not reported
Behrendt [28] 2017	Not reported	It is not possible to conceive of Aboriginal health determinants without appreciating the inseparable connection between wellbeing and Country	Valuing Aboriginal knowledge and cultural beliefs and practices is necessary for positive cultural identity and social and emotional wellbeing [55]	A link between self-determination and improved health and wellbeing; however, demonstrating this link can be challenging [55]
Ypinazar [29] 2007	Family is considered pivotal to emotional, physical and cultural health [56]	Not reported	A positive sense of identity is connected to individual and community wellbeing [56, 57]	Not reported