One could well argue that the case has already been made for including the study of race and racism within the Indigenous health curriculum. More than a decade ago the Committee of Deans of Australian Medical Schools developed the Indigenous Health Curriculum Framework, which recognised the importance of teaching students about racism. The framework states that health services, systems and professionals should be free of racism (Phillips 2004:7), and that key student attributes and outcomes should include the ability to identify features of overt, subtle and structural racism or discrimination in interactions between patients and health professionals and systems, ways of addressing such occurrences, and the acquisition of skills to advocate both for their resolution and to explain the connection between history and present health outcomes – including the forms and impacts of racism.
In 2011, Universities Australia developed a National Best Practice Framework for Indigenous Cultural Competency in Australian universities and identified key content areas which included:
- concepts of culture, race, ethnicity and worldview
- myths and misconceptions about, and stereotypes of, Indigenous people
- notions of whiteness, white privilege and power
- reflection on cultural identity, whiteness, privilege, values, beliefs, attitudes, prejudices and propensity to stereotype
- racism and anti-racist practices (Universities Australia 2011:72).
Yet there remains a deep level of discomfort among health educators in teaching race and racism, as evidenced in a recent national consultation to develop the Aboriginal and Torres Strait Islander Health Curriculum Framework (Taylor, Kickett & Jones 2014). Commissioned by Health Workforce Australia the consultations revealed significant concerns among health educators with teaching content that included ‘racism’, ‘whiteness’ and ‘stereotyping’ as they were deemed to be ‘negative’ and focused on ‘deficit’ (2014:38). Health education stakeholders expressed their discomfort with teaching the concept of whiteness arguing that it ‘promotes colourism’ (2014:75) and ‘binary or reductionist thinking’ (2014:46). One health education stakeholder pointed out that ‘not all privileged students are white and not all white people are privileged’ (2014:49). Others suggested abandoning the term ‘race’ in favour of ‘culture’ because race is an ‘ideology rather than a biological fact’ (2014:73). Respondents also raised concerns about the student learning experience, suggesting there was a need for ‘moving away from blaming and shaming’ and ‘guilt and berating’ (2014:6), and that educators should ‘keep the politics out of content and education’ (2014:7) and ensure ‘students aren’t polarised’ (2014:12).
Instead, health education stakeholders argued that the curriculum should emphasise ‘good news statistics/positive stories of shared history and programs which have positive outcomes’ (2014:12), and avoid ‘historically polluting’ in favour of ‘recognising – and celebrating history as a shared experience’ (2014:17). Health education stakeholders cautioned about the ‘delicate nature and potentially offensive associations that may occur by using contentious or “coloured” words such as “white” and “black’”’ (2014:14), and expressed concerns with the ‘saturation of too many facts and figures where “white people are seen as evil and Aboriginal people as fragile”’ (2014:21).
While these concerns did not prohibit the inclusion of racism, anti-racism and white privilege as core curriculum themes within the recently released Aboriginal and Torres Strait Islander Health Curriculum Framework (Department of Health 2016), the consultations that led to its development provide revealing insights into the ways in which health educators are thinking about race and racism. We witness in the consultations various attempts by health education stakeholders to minimise race and racism as categories of analysis in understanding Indigenous health inequality through a pedagogical logic of student ‘comfortability’, and more specifically white student ‘comfortability’. Several claims made by health educators demonstrate a lack of conceptual understanding of race, racism and whiteness, which undermines attempts to understand how race works to produce health inequalities.
Rather than make a case for excluding the teaching of race and racism within Indigenous health curricula the Health Workforce Australia consultation findings demonstrate the critical and pressing need to develop race scholarship within health so as to counter the resistance and reticence among many health educators to exploring race and racism. This paper examines some of the claims about race and racism made by health education stakeholders consulted in the development of the Aboriginal and Torres Strait Islander Health Curriculum Framework, and offers three counter-claims that evidence the ‘realness’ of race and racism – as lived, as a field of academic inquiry and as a determinant of Indigenous health inequality.