In Conversation with Dr Brett Shannon

General Sir John Monash Foundation scholarships provide outstanding Australian graduates with support to undergo postgraduate study at the world’s best universities. Successful applicants demonstrate excellence in their field and leadership potential, and are motivated to contribute to a better Australia. Investing in Australians, for the betterment of Australia, is one of the top criteria in the selection process for the Foundation. John Monash scholarships are awarded to applicants who can demonstrate why studying at a particular university abroad is the best place possible to further their research.

Indigenous health expert Dr Brett Shannon is a 2021 John Monash Scholar, currently undertaking a PhD in the Division of Environmental and Occupational Health Sciences at the University of Illinois Chicago (UIC).

Brett is an occupational and environmental registrar, with a particular interest and expertise in Indigenous health issues. He is a proud Ngugi/Quandamooka descendant and has served as chairperson of the Brisbane Aboriginal and Torres Strait Islander Community Health Service. His PhD is focused on occupational injuries, to review occupational injury management and prevention strategies in Indigenous and vulnerable populations.

What learnings are you taking from your studies in Illinois that can be applied in the Australian Indigenous health setting?

My degree in Illinois currently requires me to work across three separate departments at UIC, and this ideally places me to better understand global perspectives in environmental and occupational health. I am currently conducting research with my primary supervisor, Dr Lee Friedman, focused on injury surveillance programs in Illinois where I am concentrating on injury prevention in Indigenous and minority populations.

The other two departments I am working across include the Great Lakes Center for Occupational and Environmental Safety and Health, which delivers an online training program for occupational health professionals globally, and the Black Lung Center of Excellence (BLCE), which conducts extensive international education and outreach programs on risks of injury and illness in the mining industry. The BLCE team already has provided expertise to Australia, particularly through collaborative work evaluating the respiratory component of the Queensland Coal Mine Workers’ Health Scheme.

All three of these departments have acknowledged the paucity of occupational health data on Indigenous populations globally and have not only incorporated ethnicity into current research projects, but are providing opportunities for comparative research between Australia and North America, and assistance in developing methods to incorporate Indigenous occupational health into national research agendas where it has been lacking to date.

In regards to occupational injuries, what specific kinds of injuries are we talking about and why do they need particular attention in the context of Indigenous and vulnerable populations?

In terms of occupational injuries, we are talking about more than musculoskeletal injuries and trauma from body stressing, falls, trips, slips and being hit by moving objects in the workplace. We are still seeing large numbers of occupational diseases from mental stress, chemical and biological exposures, and environmental factors such as heat, electricity and noise.

Indigenous workers are currently strongly represented in hazardous industries such as agriculture, coalmining, construction and community welfare services, and health services. Despite the increasing number of Indigenous staff employed in these settings, we have no understanding of their work-related injuries and illnesses.

Generally, occupational injuries have continued to increase in Australia, with over 100,000 serious claims per year and the median time lost from work currently six weeks per claim. My research shows that historically we have limited research on Indigenous workers who have previously been exposed to physical trauma, uranium and other mining exposures, environmental biological exposures and persistent organic pollutants in various occupational settings internationally.

The work setting for Indigenous populations has changed dramatically and I would suggest that the increases in mental health occupational conditions we are witnessing globally would be reflected in Indigenous communities as well; however, at present we do not have any data to determine the Indigenous occupational injuries in Australia. We need this information to support Indigenous engagement and retention in the workforce and understand a growing problem in the Indigenous context where it has not been reviewed.

How does Australia’s Indigenous health system compare to other countries? What elements could we take from other systems that would work well in Australia?

As a previous non-executive Director of the Institute for Urban Indigenous Health (IUIH) based in Brisbane, I have regularly acknowledged that elements of IUIH were based on the Urban Indian Health Institute located in Seattle. Also, as part of a contingent from IUIH, I visited the Nuka Health System based in Alaska in 2018 to review their model of primary health care for Alaskan natives and bring learnings home to improve our community-controlled health services in south-east Queensland.

From my experience, Australia can translate lessons from international health systems into successful new programs. I see occupational health as another area where we can take lessons from overseas to translate into better data systems, research agendas, educational programs and clinical models of care for Indigenous and non-Indigenous Australians.

Are there any aspects of Australia’s Indigenous health system that you feel could be successfully applied in other countries?

There are successful aspects of Australia’s Indigenous health system, such as our comprehensive primary health care, particularly related to chronic disease management and prevention, and maternal and child health. Australia also has an increasing focus on the unique challenges for both urban and remote Aboriginal and Torres Strait Islander communities, particularly the unique challenges of providing health care in very remote settings, including ensuring continuity of care and appropriate workforce models.

These aspects of Australia’s Indigenous health system have been successful due to the Indigenous-led health service partnerships we have created. I really believe that when exploring opportunities for knowledge translation in an international context, the process used to develop relationships with all stakeholders engaged in the policy, research or clinical service development process is just as important as the output produced.

Are there current themes in terms of the challenges facing Indigenous global populations?

Globally, we have not made significant reductions in the burden of mental health and injuries in Indigenous populations. These are challenging areas in Indigenous health that require significant investment in culturally appropriate research and multidimensional models of care that will hopefully allow for development downstream of researchers and clinicians trained in these areas in the future.

We are also seeing an increasing focus globally on sustainable environments and environmental changes in Indigenous communities and this will be one of the key challenges facing Indigenous people moving forward. In a world that has been ravaged by COVID-19, the prediction is that disparities in socioeconomic and health outcome status between Indigenous and non-Indigenous will potentially widen as the most disadvantaged in society become even more so as we try to recover from the pandemic. As the Delta variant currently spreads through parts of Australia many Indigenous Australians are still unvaccinated and many remote communities continue to be effectively locked away from the rest of Australia. I hope Indigenous communities are prioritised and supported through the recovery of the pandemic as we start ensuring permanent changes are made to the circumstances people are living in day to day to reduce their risk.