Surveillance to Sovereignty: Indigenous Health Data Shift

This article was originally published by Melissa Sweet, Croakey Health Media on 18 March. Licensed by Copyright Agency. Do not copy this work without permission.

Ahead of National Close the Gap Day on 19 March, the Close the Gap campaign published a statement of intent stressing the importance of self-determination, and of recognising the resilience, innovation and leadership across communities - from Indigenous Rangers programs to Aboriginal and Torres Strait Islander community controlled organisations delivering locally led solutions.

In the article below, Keziah Bennett-Brook and Associate Professor Julieann Coombes, from The George Institute for Global Health, call for the strengths-based focus of the campaign to be upheld, noting that public commentary and institutional responses frequently revert to familiar deficit tropes.

They put forward practical suggestions for how data custodians, researchers, evaluators, policymakers, funders, health services and clinicians can better support Aboriginal and Torres Strait Islander leadership in data governance and a genuine commitment to data sovereignty.

"When data is governed by Aboriginal and Torres Strait Islander peoples and aligned with our definitions of wellbeing, it stops acting as a tool of surveillance and becomes a platform for empowerment and healing," they write.

Keziah Bennett-Brook and Julieann Coombes write:

On Close the Gap Day, Australia becomes fluent in numbers. Again and again, we hear about life expectancy, disease prevalence and service access, yet rarely ask what these numbers do, or who they serve. Each year, the same story is told, that Aboriginal and Torres Strait Islander people are behind. What remains largely unexamined is how this story itself continues to cause harm.

Close the Gap Day was created to galvanise action on health inequity. But over time, the language of "the gap" has come to dominate public conversation, often at the expense of recognising strength, sovereignty and survival. When inequity is all we measure, it becomes all we plan for.

This piece is not a call to abandon data or measurement. It is a call to rethink how data is framed, governed and interpreted, because the categories embedded in our systems shape outcomes long before policies are written or budgets set.

It is important to be clear about what is being critiqued here. The Close the Gap Campaign itself has long championed Aboriginal and Torres Strait Islander leadership, strengths‑based narratives and community‑driven solutions. Each year, the campaign highlights examples of resilience, innovation and self‑determination, and directs its calls to action squarely at governments and institutions.

The problem is not the campaign's intent, but the persistent disconnect between this strengths‑based vision and the deficit‑focused language that continues to dominate government systems, datasets and much mainstream media coverage. Too often, the values articulated by the campaign are lost as data moves through policy pipelines and public reporting.

There is a quiet power in labels and a harm in how these labels travel. For too long, public health and government services have been organised around a deficit discourse that catalogues illness, "risk factors" and "gaps".

In many datasets, Aboriginal and Torres Strait Islander peoples appear as "vulnerable", "non-compliant" or "high risk". These terms are not neutral descriptors. They carry the weight of a colonial history in which Indigenous peoples were counted, classified and controlled, and they continue to shape contemporary policy and practice.

A label like "non-compliant" never stays in a spreadsheet. It travels into funding formulas, program eligibility criteria and frontline practice, where it can justify coercive or paternalistic responses.

A community coded as "vulnerable" may be met with short term, problem fixing interventions that overlook self-determination, cultural strengths and long term capability. When the starting point is deficit, communities are framed as problems to be fixed rather than sovereign peoples with knowledge, agency and strengths.

Data governance and data sovereignty

This disconnect is particularly visible at the moment when the Close the Gap report is released. While the campaign foregrounds Aboriginal and Torres Strait Islander leadership and community‑led solutions, public commentary and institutional responses frequently revert to familiar deficit tropes of who is "behind", who is "failing", and where the "gap" remains.

In doing so, the strengths‑based intent of the campaign risks being overshadowed by the very narratives it seeks to disrupt.

A strength-based approach offers an essential counter narrative. It begins by recognising that Aboriginal and Torres Strait Islander peoples have maintained thriving cultures, sophisticated governance and resilient kinship systems for tens of thousands of years.

For public health, this means shifting from measuring deficits to documenting and supporting the cultural and social determinants that protect and promote health: connection to Country, language, kinship, cultural continuity, community led innovation and local governance.

Importantly, this shift is not merely technical. It requires Aboriginal and Torres Strait Islander leadership in data governance and a genuine commitment to data sovereignty.

This includes co designing data dictionaries and metadata with Aboriginal and Torres Strait Islander governance structures, and removing deficit markers (such as "vulnerable", "non-compliant", "treatment failure" or "non-attendance") from routine reports. These should be replaced with descriptions that reflect context, barriers and systems responsibility.

It also means embedding Indigenous definitions of wellbeing in indicators, not as an add on to biomedical metrics but as anchors for decision making, and ensuring data returns to communities in forms that are useful, safe and owned.

Data sovereignty is often framed as a future aspiration. In practice, it requires institutions to relinquish control over how Aboriginal and Torres Strait Islander lives are described, categorised and judged, and to be accountable for the consequences of those choices.

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