‘We know what our communities need’: What the Indigenous health sector reveals about pandemic preparedness in urban Indigenous communities in Australia


Bronwyn Fredericks, Abraham Bradfield, James Ward, Shea Spierings, Sue McAvoy, Troy Combo, Agnes Toth-Peter

First Nations Health and Wellbeing – The Lowitja Journal, Volume 2, June 05, 2024. DOI: https://doi.org/10.1016/j.fnhli.2024.100019


  • The benefit of systems thinking lies in its capacity not to ‘fix the problem’ but in its ability to provoke new ways of thinking and approaching complex problems to find common solutions.
  • Applying this approach to complex problems like COVID-19 reveals the complex dynamics that influence the outcome of health responses in Indigenous communities, such as infection rates, socioeconomic conditions, age-specific responses, Indigenous participation in the workforce, media and communications, and vaccinations.
  • Addressing issues relating to mobility, incentivising protective behaviours, engaging in coordinated responses, improving cultural literacy, and limiting overcrowding may increase preparedness and responses to COVID-19 and future pandemics.



In 2021, during the height of the COVID-19 pandemic, researchers from the University of Queensland sought greater understanding of how responses to the pandemic impacted the spread or mitigation of virus in Indigenous communities in southeast Queensland, Australia. This article used a systems thinking methodology to critically unpack the strengths and challenges associated with pandemic responses during COVID-19 in urban Brisbane, Australia.


The findings from three Indigenous-led workshops held in 2020 with Indigenous and non-Indigenous stakeholders from the urban health sector were documented. By visually mapping the dynamics that influence the outcomes of health responses, this study found that holistic understandings of complex problems such as COVID-19 can be gained, and more effective policy implemented. Drawing on the insights provided by stakeholders from state, federal and community representative bodies, it discussed how infection rates, socioeconomic conditions, age-specific responses, Indigenous participation and treatment in the workforce, media and communications, and vaccinations are key determinants that shape positive or adverse outcomes during pandemics.

Main findings

This research found by addressing issues relating to mobility; incentivising protective behaviours; engaging in coordinated responses; improving cultural literacy; and limiting overcrowding that preparedness and responses to COVID-19 and future pandemics may improve.

Principal conclusion

This study, led by Indigenous scholars at the University of Queensland, examines the health and social outcomes of Indigenous peoples and health workers during pandemics in urban settings. The study incorporates systems thinking, emphasising new approaches to complex problems. The research highlighted systemic challenges in pandemic responses, emphasising the need for policy reform, particularly in areas like housing. However, applying these insights into practice remains challenging, and further investigation into the practical application of systems thinking in Indigenous health is needed.