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PW 1898 Embedding multi-sectoral solutions to address transport injury and social determinants of health in aboriginal communities in australia
  1. Patricia Cullen1,
  2. Kathleen Clapham2,
  3. Kate Hunter1,
  4. Bobby Porykali1,
  5. Rebecca Ivers1,3
  1. 1The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney Australia
  2. 2Australian Health Services Research Institute, University of Wollongong, Wollongong Australia
  3. 3Flinders University, Adelaide Australia


Aboriginal and Torres Strait Islander people in Australia experience fatal road crashes at 2–3 times the rate of other Australians and sustain serious injuries at a rate about 20% higher. High rates of transport injury have been attributed to reduced driver licence participation in Aboriginal communities. Community-based licensing programs are an innovative multi-sectoral approach to addressing barriers to licensing (identification, literacy, supervised driving and costs) and reducing risks associated with unauthorised driving including transport injury and incarceration.

We review the economic, social inclusion and cultural impacts of embedding a multi-sectoral injury prevention program, Driving Change, in Aboriginal communities in New South Wales, Australia using a social ecology framework. Qualitative methods underpinned by a social ecology approach triangulated in-depth interviews (n=17) and community discussion groups (n=21). Analysis was inductive and deductive.

The data amalgamated into four main themes: 1) Social and economic opportunity; 2) Access to services; 3) Cultural identity; and 4) Autonomy and the justice system. Program impacts were evident at multiple levels of the social ecology; it emerged that licensing greatly impacts the mobility of individuals, families and communities. A driver licence facilitates access to employment, education, healthcare and social activities, which impacts the health and well-being of individuals, families and communities.

The results highlight the value of licence participation for cultural identity and community well-being. Improving licence participation in Aboriginal communities has far-reaching effects that benefit all levels of the social ecology from individuals and families through to government across multiple sectors: health, education, human services, justice. Licensing is not simply a ‘Transport’ problem; addressing this complex issue of safety and social justice is a prime example of the need for multi-sectoral policy action to prevent injury, promote social inclusion and improve health and wellbeing of Aboriginal people.

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