How to build health care Aboriginal and Torres Strait men would actually use

Aboriginal and Torres Strait Islander men in Australia face significant health disparities, with a life expectancy 8.8 years shorter than non-Indigenous men. Nearly three times more men under 75 die from potentially avoidable causes. Limited access to culturally appropriate care, language barriers, racism, and discrimination contribute to these disparities.

However, engaging Aboriginal and Torres Strait Islander men in health care is possible when it is accessible, relevant, and delivered in a culturally safe environment where they feel respected.

These men are not simply "hard to reach" or uninterested in their health. Barriers include long waiting times, difficulty obtaining appointments, lack of male health professionals, confidentiality concerns, previous negative experiences, shame or embarrassment, and environments that do not cater to men's needs. The impact varies depending on the individual's location, with remote community members facing longer distances to healthcare and regional towns having clinics that may not feel culturally safe.

Aboriginal Community Controlled Health Organisations exemplify successful service delivery, providing holistic care and reducing barriers. Programs like "Enough Talk, Time for Action," which created a men's group in an Aboriginal primary health care service and a pop-up male-only clinic, have shown promise. These initiatives succeeded due to community control, trusted relationships, cultural safety, flexibility, and continuity of care.

Every health clinic can take practical steps to better engage Aboriginal and Torres Strait Islander men. They should seek local input on service use, employ Aboriginal and Torres Strait Islander health workers and, when possible, male staff, provide cultural safety training for all staff, review patient flow, offer longer appointments, build relationships with local Aboriginal and Torres Strait Islander groups, hold annual health checks, and set up outreach clinics. Success should be measured by repeated use and ongoing care, not just appointment processing.

Governments can also contribute by extending funding times for men's health programs, properly funding male health workforce positions, strengthening Aboriginal and Torres Strait Islander community control in decision-making, and undertaking evaluations that focus on health, wellbeing, engagement, and learning outcomes rather than merely counting activities.