Indigenous peoples in Australia and similar colonised countries are subject to racism and systemic socioeconomic disadvantages, resulting in worse health outcomes compared to non-Indigenous counterparts. Such inequities persist despite governments’ attempts to reduce them. Since 2008, Australian governments have committed to a national ‘Closing the Gap’ (CTG) to reduce inequities in health, education, and employment outcomes between Aboriginal and Torres Strait Islander peoples and other Australians, but with limited success. We applied policy theory and a cultural safety framework developed for the research to analyse stakeholder perceptions of CTG policy implementation between 2008 and 2019. We identified policy-shaping ideas and policy incoherence in the environment surrounding CTG policy that obstructed culturally safe policy. Top-down, prescriptive modes of implementation were also a barrier. However, Indigenous-led policy partnerships and community-controlled services in the health sector have met principles of cultural safety. Identifying these strengths and weaknesses points to ways in which implementation of CTG policies can be improved to achieve cultural safety and reduce Indigenous health inequities. These results may hold lessons for similar countries such as the United States, New Zealand, and Canada.

中文翻译：

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利益相关者对土著健康和文化安全政策实施的看法：澳大利亚“缩小差距”政策的研究

澳大利亚和类似殖民国家的土著人民受到种族主义和系统性社会经济劣势的影响，与非土著人民相比，他们的健康状况更差。尽管政府试图减少这种不平等现象，但这种不平等现象仍然存在。自 2008 年以来，澳大利亚政府一直致力于全国性的“缩小差距”(CTG)，以减少原住民和托雷斯海峡岛民与其他澳大利亚人之间在健康、教育和就业结果方面的不平等，但收效甚微。我们应用政策理论和为研究开发的文化安全框架来分析利益相关者对 2008 年至 2019 年间 CTG 政策实施的看法。我们确定了围绕 CTG 政策的环境中阻碍文化安全政策的政策塑造理念和政策不连贯性。自顶向下，规定的执行模式也是一个障碍。然而，卫生部门中由土著主导的政策伙伴关系和社区控制的服务符合文化安全的原则。确定这些优势和劣势指出了可以改进 CTG 政策实施以实现文化安全和减少土著健康不平等的方法。这些结果可能对美国、新西兰和加拿大等类似国家具有借鉴意义。