A J Clarke, K Radford, C Murrup-Stewart, C Swinton, P Bates-Canty, J McGuinness, L Lavrencic, A Withall, A Brodtmann, J Towney
For Aboriginal and Torres Strait Islander peoples, Place represents a nexus of structural and cultural determinants relevant to brain health. Community-led examination of Place-based exposures extends exposomic frameworks, offering an ethically-grounded foundation for dementia prevention policy with potential relevance for Indigenous populations globally.
BACKGROUND: Dementia prevention is increasingly conceptualised as an exposome issue, reflecting life course eco-psychosocial exposures. For Aboriginal and Torres Strait Islander peoples in Australia, these exposures can be articulated through the Social and Emotional Wellbeing (SEWB) framework and Indigenous conceptualisations of Place. However, dementia research and policy often rely on spatial and socioeconomic proxies that overlook Place-based opportunities for brain health. We employed research yarning to examine how Place influences brain health and inform strengths-based, locally-tailored dementia prevention policy.
METHODS: Data were collected via research yarning across eight urban, regional, and rural/remote Australian sites. Data were analysed using reflexive thematic analysis, combining deductive coding guided by the SEWB framework with inductive analysis centring Aboriginal perspectives.
RESULTS: Thirteen yarns were held with 88 participants from 6 ACCHOs and 7 communities across 8 sites, with 33 additional participants attending feedback yarns. Participants described brain health as supported through everyday relational and cultural exposures accumulating from birth. Connection to Country, Culture, spirituality, family, and Community reinforced brain health through intergenerational continuity and relationship to ancestral lands. Structural factors - educational access, socioeconomic conditions, health system design, and cultural governance - could enhance or disrupt these relationships. Geographic remoteness did not uniformly predict vulnerability; its effects were mediated by kinship and community structures.
CONCLUSION: For Aboriginal and Torres Strait Islander peoples, Place represents a nexus of structural and cultural determinants relevant to brain health. Community-led examination of Place-based exposures extends exposomic frameworks, offering an ethically-grounded foundation for dementia prevention policy with potential relevance for Indigenous populations globally.