The Australian Library & Australian Indigenous Communities urge the U.S. National Library of Medicine to update their MeSH term to reflect the Australian Indigenous population.


(National Library of Medicine response is included at the end of this article).


This proposal is supported by Health Libraries Australia, a group of the Australian Library and Information Association (ALIA), and the ALIA Community on Resource Description (ACORD). The proposal is informed by terminology guidance and usage from the National Indigenous Australians Agency, the Australian Institute for Aboriginal and Torres Strait Islander Studies and the Australian Capital Territory Council of Social Service (ACT CoSS), as well as Aboriginal and Torres Strait Islander stakeholders


The MeSH (Medical Subject Heading) term for ‘Oceanic Ancestry Group’, which ‘Aboriginal Australians’ and a host of other Australian Indigenous terms is mapped to, has been changed to ‘Native Hawaiian or Other Pacific Islander’ in the latest 2022 MeSH update ( 


This decision is confusing, as Australian Indigenous populations of an entire continent are parcelled up with ‘Other Pacific Islanders’, along with the numerous other national and ethnic population groups that this MeSH term spans. Australia is not a Pacific Island (though we have very close ties with various Pacific Island regional organisations and fora). To include the two major groupings of Australian Indigenous peoples (Aboriginal and Torres Strait Islander peoples) under this MeSH heading is not only inaccurate and a misrepresentation, but also deeply harmful.


Use of MeSH terms in Australian catalogues such as ‘Oceanic Ancestry Group’ and now even more unacceptably ‘Native Hawaiian or Other Pacific Islander’ is highly inappropriate and deeply offensive to Aboriginal and Torres Strait Islander people, with the potential to cause real distress to those encountering this term. It will also cause offence and confusion to library users of all backgrounds.


In 2021 Flanagin et al observed that “terminology, usage, and word choice are critically important, especially when describing people and when discussing race and ethnicity. Inclusive language supports diversity and conveys respect. Language that imparts bias toward or against persons or groups based on characteristics or demographics must be avoided.” 


Aboriginal and Torres Strait Islander populations have significant health problems that are poorly researched and are deserving of more focussed attention in their assignment of MeSH indexing. We need to ensure they are more appropriately described in research databases that rely on MeSH indexing.


It appears the National Library of Medicine changed the MeSH terms for ‘racial groups’ in the 2022 release to match the terms used in the US Census, which probably makes some sense for Americans but is far less helpful for the rest of the globe, especially where our ethnic categories don’t match those used in North America. Going by the US Census Bureau’s own definition, Aboriginal and Torres Strait Islander Australians would not fit any of the listed categories.


The indexing of subject matter relating to Indigenous populations is problematic in several databases as indicated by Kelly et al (in the Canadian context) and by Sladek et al: “The extent to which existing and future research can impact on reducing health disparities relates not only to the evidence available, but the ability to find that evidence”. Sladek et al notes that even expert searchers struggle to find the relevant peer-reviewed Indigenous literature in MEDLINE. At the time of publication, the authors stated that the relevant MeSH term of ‘Oceanic Ancestry Group’ was neither intuitive nor specific. The 2022 MeSH term of ‘Native Hawaiian or Other Pacific Islander’ has further widened the gap.


We write to propose a MeSH term change that better describes Indigenous Australians. In doing so we note the precedent set when the MeSH term ‘Indigenous Canadians’ was introduced in 2021. A comparable international thesaurus Emtree uses the inclusive term ‘indigenous peoples’.


However, feedback from local communities and stakeholders has indicated a firm preference for the term ‘Australian Aboriginal and Torres Strait Islander Peoples’ over ‘Indigenous Australians’. The former term is proposed here as a new MeSH heading, with the latter term included as an entry term. 


Proposed term
 Australian Aboriginal and Torres Strait Islander Peoples


Scope note: ‘The two groups of indigenous peoples of Australia. They include Aboriginal Australians and Torres Strait Islanders. These encompass many distinct peoples with unique histories, languages, cultural practices and spiritual beliefs.’


 As per existing terms:


MeSH Tree Structure

Directly under ‘Racial Groups’ [M01.686.508]


Narrower Concepts


Entry Terms


Additional Proposals

Additionally, we urgently and strongly request that the concept ‘Australoid Race’, currently a narrower concept of ‘Native Hawaiian or Other Pacific Islander’, have its scope note updated to reflect the outdated and highly offensive nature of this term, and emphasise that it should no longer be used in active indexing. We are interested in the potential of deleting this heading outright.

We also propose a new narrower concept term ‘Australian South Sea Islanders’ be added to the existing term ‘Native Hawaiian or Other Pacific Islander’. South Sea Islanders are not indigenous to Australia, but are the descendants of Pacific Islanders kidnapped or otherwise coercively brought to Australia in the late 19th century to work as indentured labourers on sugar plantations and in other primary industries.



ALIA Community on Resource Description (ACORD). (2021). ALIA Community on Resource Description. 


ALIA Health Libraries Australia (HLA). (2022). ALIA HLA. 


Australian Capital Territory Council of Social Service. (ACT CoSS). (2016). Preferences in terminology when referring to Aboriginal and/or Torres Strait Islander peoples. 


Australian Institute for Aboriginal and Torres Strait Islander Studies. (2022). Indigenous Australians: Aboriginal and Torres Strait Islander people.   


Flanagin, A., Frey, T., Christiansen, S. L., & Bauchner, H. (2021). The reporting of race and ethnicity in medical and science journals: comments invited. JAMA, 325(11), 1049-1052. 


Kelly, L., & St Pierre-Hansen, N. (2008). So many databases, such little clarity: Searching the literature for the topic aboriginal. Canadian Family Physician, 54(11), 1572-1573. 


National Indigenous Australians Agency. (2022). Homepage. 


Queensland Government, Department of Children, Youth Justice and Multicultural Affairs (2022). Australian South Sea Islanders. 


Sladek, R. M., Tieman, J. J., Tyndall, J., & Phillips, P. A. (2013). Searching MEDLINE for Aboriginal and Torres Strait Islander health literature: questionable sensitivity. Health Information & Libraries Journal, 30(2), 138-148. 

World Health Organisation. (2013). Pacific Island Countries.



National Library of Medicine response:


Thanks for your suggestion on MeSH content related to Australian indigenous population terms. As you noted MeSH terminology related to race/ethnicity has been in flux to better align with other US governmental sources. By doing so we also created some temporary oddity which we are addressing in MeSH 2023.


In summary we separated US-only from the rest of world population descriptors. In addition we created Australian Aboriginal and Torres Strait Islander Peoples per your request along with three other indigenous group terms: Maori People in New Zealand and Navajo People and Pima People in the US.


Your request came into NLM suggestion system right after close of annual descriptor review cycle but MeSH review team took up the request.


Once we are done with more QC activities over the summer we will announce our changes in November.


Thank you,


Dan Cho, Ph.D.

Senior MeSH Analyst

Medical Subject Headings (MeSH)