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“I can’t do this, it’s too much”: building social inclusion in cancer diagnosis and treatment experiences of Aboriginal people, their carers and health workers

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International Journal of Public Health



Social inclusion theory has been used to understand how people at the margins of society engage with service provision. The aim of this paper was to explore the cancer care experiences of Aboriginal people in NSW using a social inclusion lens.


Qualitative interviews were conducted with 22 Aboriginal people with cancer, 18 carers of Aboriginal people and 16 health care workers.


Participants’ narratives described experiences that could be considered to be situational factors in social inclusion such as difficulties in managing the practical and logistic aspects of accessing cancer care. Three factors were identified as processes of social inclusion that tied these experiences together including socio-economic security, trust (or mistrust arising from historic and current experience of discrimination), and difficulties in knowing the system of cancer treatment.


These three factors may act as barriers to the social inclusion of Aboriginal people in cancer treatment. This challenges the cancer care system to work to acknowledge these forces and create practical and symbolic responses, in partnership with Aboriginal people, communities and health organisations.

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We express our gratitude to the services that supported recruitment of participants and to participants for sharing their stories with us. This research was conducted within a larger project funded by a NHMRC Health Services Research Grant (ID 440202). We thank the rest of the APOCC study team, including from the Cancer Council NSW, Professor Dianne O’Connell, Dr Rajah Supramaniam, Ms Jennifer Rodger and Ms Kristy Weir, and from The University of Sydney, Professor Bruce Armstrong and Dr Anthony Dillon. Other members of the APOCC Advisory Committee include Ms Liz O‘Sullivan, Professor Ian Olver, Dr Jenny Hunt and Mr Michael Langford.

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Correspondence to Carla Treloar.

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Aboriginal members of the writing and research team

L. Clair Jackson is Ugarapul/Githabal (Jagara Nation, SE Qld) on her father’s side and French and German on her mother’s side. She has lived mostly in Sydney, working in education, research and the arts and is now consulting as a Cultural Mentor/Advisor to APOCC and other projects in Aboriginal health at the National Centre in HIV Social Research.

Veronica Saunders is of Biripi country (Taree NSW) and has worked in nursing and Aboriginal education and is now the Aboriginal Liaison Officer on the APOCC project, based at the Cancer Council NSW. She has played leading roles in Local Aboriginal Education Consultative Groups and reconciliation, working closely with Aboriginal and non-Aboriginal people.

Priscilla Johnson is from Cherbourg QLD (Waka Waka and Birri Gubbi) and besides working on the APOCC team, also works in the Aboriginal Mental Health Unit, part of the Camperdown Community Health Centre. Priscilla has directed the focus of her work around grief and loss, through healing and mediation.

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Treloar, C., Gray, R., Brener, L. et al. “I can’t do this, it’s too much”: building social inclusion in cancer diagnosis and treatment experiences of Aboriginal people, their carers and health workers. Int J Public Health 59, 373–379 (2014).

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