Indigenous communities shoulder a disproportionate burden of ill health compounded by climate change. In Australia, the oldest surviving cultures have adapted their ecological knowledge over millennia and across climatic ages. However, European colonization has severely curtailed Indigenous peoples’ ability to adjust to climate change. An effective response to the climate crisis requires decolonizing processes to reform our relationship with the planet. From an Australian Indigenous perspective, precursors for a self-determined and healthier future are justice, culture, and relationships. We review existing studies on Indigenous-led contemporary climate and health initiatives to assess these precursors. There are examples that highlight the need to attend to issues of restorative justice as the basis for respectful valuing of culture and genuine collaboration to address the climate crisis.

Climate change is exposing populations to increasing temperatures and extreme weather events in many parts of Australia. To prepare for climate challenges, there is a growing need for Local Health Districts (LHDs) to identify potential health impacts in their region and strengthen the capacity of the health system to respond accordingly. This rapid review summarised existing evidence and research gaps on the impact of climate change on health and health services in Northern New South Wales (NSW)—a ‘hotspot’ for climate disaster declarations. We systematically searched online databases and selected 11 peer-reviewed studies published between 2012–2022 for the Northern NSW region. The most explored health outcome was mental health in the aftermath of floods and droughts, followed by increased healthcare utilisation due to respiratory, cardiovascular and mortality outcomes associated with bushfire smoke or heat waves. Future research directions were recommended to understand: the compounding impacts of extreme events on health and the health system, local data needs that can better inform models that predict future health risks and healthcare utilisation for the region, and the needs of vulnerable populations that require a whole-of-system response during the different phases of disasters. In conclusion, the review provided climate change and health research directions the LHD may undertake to inform future adaptation and mitigation policies and strategies relevant to their region.

Rigorous and effective evaluations inform policy and service delivery and create evidence of program impacts and outcomes for the communities they are designed to support. Genuine engagement of communities is a key feature of effective evaluation, building trust and enhancing relevancy for communities and providing meaningful outcomes and culturally relevant findings. This applies to Indigenous peoples’ leadership and perspectives when undertaking evaluations on programs that involve Indigenous communities. This systematic scoping review sought to explore the characteristics of culturally informed evaluations and the extent of their application in Australia, including the use of specific evaluation tools and types of community engagement. Academic and grey literature were searched between 2003 and 2023, with 57 studies meeting the inclusion criteria. Over time, there was an increase in the number of culturally informed evaluations undertaken, predominantly in the health and wellbeing sector. Around a quarter used a tool specifically developed for Indigenous evaluations. Half of the publications included Indigenous authorship; however, most studies lacked detail on how evaluations engaged with communities. This review highlights the need for further development of evaluation tools and standardised reporting to allow for shared learnings and improvement in culturally safe evaluation practices for Aboriginal and Torres Strait Islander communities.