title: Challenges to driver licensing participation for Aboriginal people in Australia: a systematic review of the literature.
abstract: Aboriginal and Torres Strait Islander people are overrepresented in transport-related morbidity and mortality. Low rates of licensure in Aboriginal communities and households have been identified as a contributor to high rates of unlicensed driving. There is increasing recognition that Aboriginal people experience challenges and adversity in attaining a licence. This systematic review aims to identify the barriers to licence participation among Aboriginal people in Australia.
  
  
  
  A systematic search of electronic databases and purposive sampling of grey literature was conducted, two authors independently assessed publications for eligibility for inclusion.
  
  
  
  Twelve publications were included in this review, of which there were 11 reporting primary research (qualitative and mixed methods) and a practitioner report. Barriers identified were categorised as individual and family barriers or systemic barriers relating to the justice system, graduated driver licensing (GDL) and service provision. A model is presented that depicts the barriers within a cycle of licensing adversity.
  
  
  
  There is an endemic lack of licensing access for Aboriginal people that relates to financial hardship, unmet cultural needs and an inequitable system. This review recommends targeting change at the systemic level, including a review of proof of identification and fines enforcement policy, diversionary programs and increased provision for people experiencing financial hardship.
  
  
  
  This review positions licensing within the context of barriers to social inclusion that Aboriginal people frequently encounter. Equitable access to licensing urgently requires policy reform and service provision that is inclusive, responsive to the cultural needs of Aboriginal people and accessible to regional and remote communities.
authors: The George Institute for Global Health, Level 3, 50 Bridge Street, Sydney, NSW, 2000, Australia. pcullen@georgeinstitute.org.|School of Public Health, Sydney Medical School, Edward Ford Building, The University of Sydney, Sydney, NSW, 2006, Australia. pcullen@georgeinstitute.org.
authors: Patricia
authors: 0000-0003-4652-0936
authors: P
authors: Cullen
authors: Australian Health Services Research Institute, University of Wollongong, Building 234, Innovation Campus, Wollongong, NSW, 2522, Australia.
authors: Kathleen
authors: K
authors: Clapham
authors: The George Institute for Global Health, Level 3, 50 Bridge Street, Sydney, NSW, 2000, Australia.|School of Public Health, Sydney Medical School, Edward Ford Building, The University of Sydney, Sydney, NSW, 2006, Australia.|The Poche Centre for Indigenous Health, The University of Sydney, Edward Ford Building, Sydney, NSW, 2006, Australia.
authors: Kate
authors: K
authors: Hunter
authors: The George Institute for Global Health, Level 3, 50 Bridge Street, Sydney, NSW, 2000, Australia.
authors: Rebekah
authors: R
authors: Treacy
authors: The George Institute for Global Health, Level 3, 50 Bridge Street, Sydney, NSW, 2000, Australia.|School of Public Health, Sydney Medical School, Edward Ford Building, The University of Sydney, Sydney, NSW, 2006, Australia.
authors: Rebecca
authors: R
authors: Ivers
mesh_terms: D001315:Australia / Q000453:epidemiology; D001334:Automobile Driving / Q000706:statistics & numerical data*; D006801:Humans; D008004:Licensure / Q000191:economics / Q000706:statistics & numerical data*; D000095283:Australian Aboriginal and Torres Strait Islander Peoples
keywords: Aboriginal; Driver licensing; Social inclusion; Transport disadvantage; Transport injury