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Crime rates are generally decreasing and governments in Australia (as elsewhere) have committed to reducing recidivism. However, incarceration rates of certain groups continue to rise, including Indigenous and racialised peoples, those experiencing poverty, mental health issues, addiction, homelessness and people with cognitive disability. A large proportion are in custody for minor offences and/or not yet sentenced; however, political leaders have continued to defend their detention on the grounds of risk to community safety. The sudden drop in people incarcerated during the COVID-19 pandemic, without a commensurate rise in crime rates, highlighted the degree to which incarceration rates are a matter of policy decisions. For a time, public health priorities dominated criminal legal policies. Evidence on the social determinants of health that people experiencing social, economic, political and environmental disadvantage are more likely to experience poorer health outcomes has led to acceptance globally that public health policies must address systemic factors and not just focus on individual behaviour. In this article, we propose that a conceptual framework of the social determinants of justice could valuably inform efforts to reduce the criminalisation and incarceration of targeted and disadvantaged groups.

There are multiple structural and practical barriers to Aboriginal young people with cognitive disability in remote areas receiving the support and services they need. Multidisciplinary mixed-methods research over the past decade has provided evidence of the ways that many such young people end up with complex support needs and being ‘managed’ by police and justice agencies in the absence of appropriate early intervention, transition support and community-based options. This article presents and synthesises knowledge generated by this body of work and contextualises it within the experiences and trajectory of a young Aboriginal woman with cognitive disability and complex support needs from a remote town. This case study is drawn from a New South Wales linked administrative dataset containing data from health, housing, disability, human services, police, legal, court and justice agencies on a cohort of people who have been incarcerated. The article draws out key principles and strategies to suggest what a community-led, holistic service response could have looked like for Casey.

Background Re-incarceration rates for people leaving prison in Australia are high, particularly so for those experiencing complex needs including mental health and substance use issues, cognitive disability and homelessness. Effective models of reintegration for this group are needed to reduce incarceration and improve health and wellbeing. Objective This article reports on the outcomes of a mixed-methods evaluation of the Community Restorative Centre’s (CRC) model of intensive casework support for people with complex needs exiting prison in New South Wales, Australia. Methods The evaluation took a mixed-methods approach to assessing the effectiveness of CRC’s model of reintegration support which included five studies: (1) an interrupted time series analysis of 483 clients over an 11-year period to examine changes in custody and court outcomes following engagement with CRC; (2) a comparative interrupted time series analysis of 246 CRC clients vs. a de-identified comparison group of 567 individuals that did not receive CRC support; (3) a cost-benefit analysis of criminal justice vs. CRC program costs; (4) analysis of client health and well-being survey data; and (5) semi-structured interviews with 26 individuals including CRC clients ( n  = 14) and CRC staff ( n  = 12). Results After participating in CRC programs, contact with the criminal justice system reduced significantly, including a 66% reduction in days in custody, a 63% reduction in new custody episodes, and a 62% reduction in proven offences. The comparative analysis estimated savings of $10–16 million in criminal justice costs for each annual cohort of new clients. Well-being survey data analysis indicated that clients were consistently managing drug use, self-care, relationships and resources over the time of engagement with CRC. Qualitative interviews highlighted that meeting people’s basic welfare, housing and health needs was fundamental, as was the model of support (flexible, outreach, relational and long-term) and the workers’ approach (respectful, non-judgemental, compassionate, consistent). Conclusions An intensive, flexible, outreach model of community sector reintegration support that meets the basic welfare, housing and health needs of people with complex needs exiting prison can significantly reduce their contact with the criminal justice system and produce economic benefits for government.

People with cognitive disabilities face specific forms of discrimination and disadvantage in the criminal justice system, including in legal proceedings. While unfitness-to-stand-trial provisions are intended to assist in avoiding unfair trials, in application, such laws can exacerbate disadvantage. A recent research project sought to increase the participation of accused persons with cognitive disabilities in legal proceedings by developing, implementing and evaluating a model in which disability support workers were embedded in legal services in three Australian jurisdictions. This paper details the findings of a cost-benefit analysis undertaken of that model compared with the common outcomes for accused persons with cognitive disability, including a finding of unfitness to stand trial. The analysis provides evidence of how a tailored programme intervention at a critical point can provide savings in police, courts and custody costs in addition to improving the timeliness and quality of outcomes for people with cognitive disabilities.

Crime rates are generally decreasing and governments in Australia (as elsewhere) have committed to reducing recidivism. However, incarceration rates of certain groups continue to rise, including Indigenous and racialised peoples, those experiencing poverty, mental health issues, addiction, homelessness and people with cognitive disability. A large proportion are in custody for minor offences and/or not yet sentenced; however, political leaders have continued to defend their detention on the grounds of risk to community safety. The sudden drop in people incarcerated during the COVID-19 pandemic, without a commensurate rise in crime rates, highlighted the degree to which incarceration rates are a matter of policy decisions. For a time, public health priorities dominated criminal legal policies. Evidence on the social determinants of health that people experiencing social, economic, political and environmental disadvantage are more likely to experience poorer health outcomes has led to acceptance globally that public health policies must address systemic factors and not just focus on individual behaviour. In this article, we propose that a conceptual framework of the social determinants of justice could valuably inform efforts to reduce the criminalisation and incarceration of targeted and disadvantaged groups.

BackgroundAboriginal community-led programmes are likely to be most effective in prevention of injury, but more evaluation is needed. This article examined participating family and community stakeholder views of the Child Injury Prevention Partnership (CHIPP) programme delivered within an existing playgroup at the Walgett Aboriginal Medical Service.MethodsThis codesigned, mixed-methods evaluation adopted a decolonising Indigenous methodological approach. Aboriginal staff members provided weekly reflections on implementation, and family participation data were documented. Parents/carers provided regular feedback and, along with community stakeholders, participated in postprogramme research yarning.ResultsDuring 2021, playgroup sessions were facilitated by locally trained Aboriginal early childhood staff, who offered 2 hourly sessions twice a week. CHIPP implemented safety education for both adults and children through safety yarns and resources to take home focused on water, home and road safety. Parent/carer and stakeholder research yarns revealed six themes: CHIPP was feasible and culturally acceptable for families; Playgroup enabled supportive, holistic delivery of safety messages to adults and children; CHIPP provided information and resources to equip parents and carers to help teach safety at home; Approach to teaching infants and preschoolers safety was based on building confidence through fun, engaging, age-appropriate activities; Programme topics and content were relevant for families and COVID-19 impacted programme delivery but pivoted temporarily to remote delivery.ConclusionsThe CHIPP programme was feasible, accessible, acceptable and demonstrated initial beneficial impact, despite implementation challenges during the COVID-19 pandemic, offering suggestions to inform other child injury prevention programmes in Aboriginal community-controlled settings.

Background/Objectives: High sodium consumption increases the risk of hypertension and cardiovascular disease. Although food remains the primary source of intake, elevated sodium levels in drinking water can further contribute to excessive intake, particularly in populations already exceeding recommendations. This review examines the extent to which national drinking water standards account for sodium-related health risks and aims to inform discussion on the need for enforceable, health-based sodium limits. Methods: National standards for unbottled drinking water in 197 countries were searched for using the WHO 2021 review of drinking water guidelines, the FAOLEX database, and targeted internet and AI searches. For each country, data were extracted for the document name, year, regulatory body, regulation type, sodium limit (if stated), and rationale. Socio-geographic data were sourced from World Bank Open Data. A descriptive analysis was conducted using Microsoft Excel. Results: Standards were identified for 164 countries. Of these, 20% (n = 32), representing 30% of the global population, had no sodium limit. Among the 132 countries with a sodium limit, 92% (n = 121) adopted the WHO’s palatability-based guideline of 200 mg/L. Upper limits ranged from 50 to 400 mg/L. Only twelve countries (9%) cited health as a rationale. Three countries—Australia, Canada, and the United States—provided a separate recommendation for at-risk populations to consume water with sodium levels below 20 mg/L. Conclusions: Globally, drinking water standards give inadequate attention to sodium’s health risks. Most either lack sodium limits or rely on palatability thresholds that are too high to protect health. Updating national and international standards to reflect current evidence is essential to support sodium reduction efforts. Health-based sodium limits would empower communities to better advocate for safe water. Amid rising water salinity, such reforms must be part of a broader global strategy to ensure universal and equitable access to safe, affordable drinking water as a basic human right.

The connection between indigenous peoples and Country (a multidimensional concept including land and water) enabled communities to thrive and survive over millennia. This has been eroded by colonisation, dispossession and increasing food and water insecurity due to climate change and supply constraints. Globally, indigenous peoples experience a disproportionate burden of chronic disease and poor nutrition is a major risk factor. Indigenous leaders have been advocating for community-led solutions. The primary aim of this systematic review is to determine what community-led programs have been undertaken to address food and/or water security globally. A comprehensive search of peer-reviewed literature will be performed in EMBASE, CINAHL, PsycINFO, PubMed, Scopus, LILACs, Informit and Business Source Premier. The grey literature search will include grey literature databases, customised Google search engines, targeted websites, and consultation with experts. The search strategy will consist of four concepts, combined as follows: (1) indigenous peoples AND (2) community program AND (3) food security OR (4) water security. Covidence will be used for study screening and data extraction by two authors. A deductive thematic analysis using indigenous-informed methodologies will be used to synthesise data. This review seeks to provide insight on models and mechanisms to encourage action and metrics for quantifying success of indigenous community-led programs to improve food and water security.

Shared Responsibility Agreements (SRAs) are a key instrument of the Federal Government's new arrangements for the administration of Indigenous affairs. SRAs, described by the Government as a form of ‘mutual obligation’, require Indigenous communities to commit to behavioural changes or other actions in order to access ‘discretionary’ government funding for infrastructure or services. There are significant political, moral and practical issues raised by SRAs. In this paper we contend that despite the language of mutuality, flexibility and choice that accompanies SRAs, the approach appears more aptly associated with ‘divide and conquer’ tactics and a subtle shifting of responsibility for problems from governments to Indigenous communities themselves. In this paper we explore the concepts of mutual obligation and reciprocity, the structural biases that favour the state and its agencies over Indigenous communities in the SRA negotiation process, and issues of citizenship entitlements and accountability that are raised. Finally, acknowledging that SRAs can be a means for Indigenous communities to access greatly needed funding, we suggest various strategies and measures that could be taken up to make the SRA framework more equitable and effective.

Australia has no national agreement formally underpinning the relationship between Indigenous and non-Indigenous people - smaller agreements relating to land, health and policy arrangements exist - these formalise relationships between Indigenous groups and governments.