The impact of social determinants of health on Indigenous Australians

Question:

Discuss about the Determinants Of Indegenous Health for Housing and Employment.

There exists a disparity in health among the Indigenous non-Indigenous Australians which has been under constant highlight by the Australian media. The mass media campaigns previously were majorly focused on the raising awareness among the people while overlooking the negative social determinants of health. However, recent findings show that there are several social determinants that have lead to the generation of health inequality among the Australian aboriginals like of proper hygiene, racism, discrimination and abundance of infectious diseases. Indigenous health outcomes are influenced by a broad range of social determinants including housing, employment, incarceration, racism, education and discrimination, and can be attributed to the impact of colonization (Taylor & Guerin, 2014). This report will analyze four significant media articles that are focused on housing and living conditions in remote Indigenous communities of Australia. The report will also try to evaluate how these factors are proving to be an important social determinant among the indigenous people.

The report sheds light over racism, lack of proper sanitation, overcrowding and spreading of contagious disease and prevalence of high smoking rates and their negative effects on the living condition of the indigenous people in Australia and thus generating health inequalities.

A new policy statement on racism in the health system has been released by the Australian Indigenous Doctors Association (Australia, 2016)

https://ajp.com.au/news/racism-impacts-health-care/

This news article focuses over the new policy that has been frame by the Australian Indigenous Doctors Association (AIDA) upon the impact of racism in health care system on the Australian aboriginals. As per the statement of the AIDA, racism is still prevalent in the health framework of the Australian subcontinent which is creating a steep inequality in the Australian health care system. However, they have agreed that progress has been undertaken in order to curb the racism impact on health but still their lies certain indifference in the behavior and the attitude of the people. There is a firm existence of systemic racism among the Australian socio-economic domain and this lead to increase in stress level followed by poor mental and physical health outcome. Past history of racism has generated a taboo among the Aboriginal and Torres Strait Islander people in Australia. Continuous encounter of racism has hit hard their self esteemed and now they fear of visiting the health care sectors even during emergency. The article also clearly states that racism is the principal social determinant in the sector of health. The policy drafted by the AIDA uplifts an urgent need to identification of racism as a strong barrier against culturally safe health care system. They also stated that the must exist a zero tolerance in the grounds of racism across all the health care sectors in Australia. They also proposed the active preaching of culturally safe health care system for providing promising health backup to the Australian aboriginal via eliminating racism and promotion of universal health care access to all the indigenous people in Australia.

Analysis of media articles on housing and living conditions in remote Indigenous communities

The article here highlights a broad range of health inequality among the Australian aboriginal that are arising out of racism. In the Australian subcontinent, the root cause behind the extreme health disadvantage and socio-economic imbalance among the Australian aboriginal is racism. However, in the majority of the cases, poor health has been considered as an outcome of the locational disadvantage, lack of proper financial backup and lack of proper health schemes or investment in health care plan and other cultural differences. However, racism in the health care sectors has results in poor mental yet physical health condition, bed-delays, and increases in hypertension, blood pressure and smoking (Larson, Gillies, Howard & Coffin, 2007). Improved health care model and initiatives in eliminating the inequalities in healthcare sectors are not enough to curb the affect of racism in health as this will not change the behaviour of the non-aboriginal people towards the aboriginal people. Uprooting racism from the grass root level is the only away out to overcome this situation.

This article raises some interesting points over impact of racism on the health of indigenous people in Australia and how the AIDA is responding to overcome this scenario. However, the article does not take a critical stance and provides no concrete evidence regarding how the Australian government is reacting to this racism impact on the aboriginal people. The author could have also elaborated characteristic of racism which is generating health inequalities like discrimination in physical appearance, hair colour, skin colour, build or voice. Author also failed to highlight other impact of racism apart from mental health like according to the Wheel of Discrimination, as described by McConnochie et al., in the year of 1988, institutional racism results in poor level of child birth, neonatal deformity and imbalance in the health of the mother (Hampton & Maree, 2013).

As per my understanding, this article is a is significant in the grounds of racism and health inequalities in Australia. It gives a detailed insight about the steps or the policies that are needed to be followed in order to overcome this harmful impact of racism in health and in other sectors of life. However, it would have been interesting to learn about how the governmental scenario or the policies have promoted the development of this racist attitude among the Australian descents and government is presently acting to curb this health inequalities arising in term of racist attack.

The health disadvantages of Indigenous Australians caused by lack of access to proper hygiene, racism, discrimination, and infectious diseases

Why the housing shortage exacerbates scabies in Indigenous communities?

https://theconversation.com/why-the-housing-shortage-exacerbates-scabies-in-indigenous-communities-71337

This article is based on exacerbation of the scabies in the Indigenous population of Australia. Scabies is an infection that occurs due to the infestation of the tine mites or parasites called Sarcoptes scabei var hominis. This disease is prevalent in the remote areas of the northern Australia who were termed as the aboriginals or the Torres Strait Islanders. The scabies infection has formed an endemic in these remote regions. As per the recent report of 2016, almost 70% of the aboriginal children are affected by the scabies in their first year of life.

Recent researches from the Medical Journal of Australia estimates that about one in every 100 aboriginals in the Katherine region are affected by crusted scabies and high virus infections. This can be linked with the homelessness and lack of cleanliness. Crusted scabies are communicable diseases and have the potential to infect hundreds of other people (Carapetis et al., 1997).

Crusted rabies had been identified in the list of the noted diseases in the Northern territory in the year 2016 (Gibson et al., 2015).

The key issue of this news is that The chairman of The Northern Territory Department of Health centre for disease control have said that considerable improvements are going on in the field of improving the housing infrastructure and sanitation, although no improvements have been found in the past few years in terms of health.

This article provides with the information there health disparity lies among the Indigenous and the non indigenous Australians. The Aboriginals do not get access to clean infrastructure.  According to the aboriginal fringe dwellers like Bennelong, many of the members of the aboriginal community never had a safe home since they were being ousted from their land by the white Australians (Gibson et al., 2015). And many aboriginals are still working on the development of a proper home.  Most of the aboriginals cannot afford private rental houses and therefore have to depend on the private housing.

It is reported that a person having scabies can have thousands of mites present in the body. The main reasons behind the spreading of scabies are prolonged physical contact, sharing a common bed. All these can link to the lack of cleanliness and overcrowding of the population (Gibson et al., 2015). 

As per the news The Northern Territory Department of Health centre for disease control is currently working in association to the “One disease”, which is a philanthropic organization. According to the board of directors of the organization, they will b able to eradicate this disease in a systematic home. This organization has achieved success to some extent in the past 5 years in the Arnhem Land (Gibson et al., 2015). Australia is the forefront of the scabies research and is therefore having a large scope of researches in order to understand the ways of tackling the disease.

The need for improved policies and initiatives to address health inequalities

The above article gives us an idea about the health status of the Aboriginals. According to me, the government should give in more efforts to make them understand the disadvantaged of remaining overcrowded. It should be mentioned that the indigenous people focuses more on the cultural aspects and are community centered (Gibson et al., 2015). In order to preserve that cultural domain, all the members try to stay together at one place. The article further throws light upon the political forces that are responsible for the deteriorating condition of the aboriginal population. It is necessary for the government to access the conditions of the aboriginals from the grass root level (Taylor & Guerin, 2014). Measures should be taken to mitigate the health disparity among the Aboriginal population.  

Indigenous girls missing school during their periods: the state of hygiene in remote Australia (Nina Lansbury Hall , 2016)

This report states that anecdotal evidence girls from remote Australian communities, went missing from schools during their periods. The reported highlighted that the main reason behind this missing case is, unaffordability of the sanitary products in the remote Australian areas where the aboriginal resides. Women or girls here use toilet papers, rags and socks insteas of sanitary packs due to hike in price. Moreover, even if the products are affordable, girls members of the family are too shameful to visit the shop and but the sanitary products in front any male members of the society. The under wear are also costly, keeping their financial background into consideration. Even if the women make use of under wear, washing and drying the underwear in public is consider shameful. Moreover not only due to the social taboos, there also exists a huge dearth of proper hygiene in the schools of the remote areas of Australia. As per the report, the school girls came up with the complain that the toilet of the school is devoid of soap, dust bins and adequate supply of water, compelling them to stay indoors, generating a lack of proper educational background among them. Moreover, the girls who are found visiting the schools develop infectious disease. This report published coincided with the report published by NAIDOC (National Aboriginal and Islander Day Observance Committee).

This article has rightly updated the correct approach of the health and hygiene condition among the Australian Aboriginal children living in remote communities. There still lies a high burden of infectious diseases among these aboriginal children due to existence of poor hygiene and prevalence of unsanitary living conditions. However, apart from shame, article did not highlight other social taboos that the prevalent among these aboriginals leading to the generation of the infectious disease. The children here do not wash their hands, before and after their meal, leading to the generation of diarrheal disease and infectious diseases. The article however, rightly uplifted the need for adequate access of sanitary pads, water and washing facilities in order to increases the attendance in school and to prevent generation of detrimental infectious disease. However, there exists certain educational, social cultural, financial and logistic barrier behind optimized implementation of the same, as highlighted by the UNICEF as well under the domain of menstrual management campaigns (McDonald, Bailie, Brewster, & Morris, 2008).

The author have used this article to attract the attention of the government to do something need full for the aboriginals residing in the remote areas of Australia. The article has also highlight that how the government has taken initiatives to install taps and showers in 3500 houses under the Housing for Health plan in order to support healthy living. The article also stated that NSW Aboriginal Land Council has joined a partnership with state governments in order to provide proper sewage and water infrastructure for the proper operation of the communities. Article also stated that there is also a need to address other economic and social issues of that are prevalent among the aboriginals in Australia. It highlighted overcrowding as a economic and social links between the health inequalities among Australian aboriginal. Now is this one of the strong point of the article but the article fail to consider other social taboos that is prominent among the aboriginals in Australia (McDonald, Bailie, Brewster, & Morris, 2008; Geelhoed & de Klerk, 2012). 

After reading the article, I want state that hygiene and proper sanitization in school must be strictly taken in consideration in the remote areas of Australia which are crowded with the Australian aboriginals. However, installation of taps and proper supply of adequate water is not enough, there must remain a proper awareness program among the aboriginal people, helping them to understand the requirement of the personal hygiene (McDonald, Bailie, Brewster, & Morris, 2008).

‘Close the Gap’: indigenous urged to quit smoking

https://www.abc.net.au/local/photos/2012/03/27/3464866.htm

Aboriginal smoking is a serious health problem. And from the history of being paid with Tobacco, the rate of smoking in the aboriginal communities has increased from 40 to 80% (Hoy et al., 2012). It has been reported that the aboriginals smoke at the time of pregnancy which can be detrimental for both mother and the child. The rate of smoking had also increased among the teenagers to a considerable extent.

This article focuses on the number of services that had been provided by the government in order to achieve good health and increase the life expectancy in the aboriginals and the Torres Strait Islanders. The occurrence of the chronic diseases like heart diseases and diabetes among the non indigenous has lead to the formation of the “Close gap campaign” in 2006. The campaign aimed at focusing on controlling the dependency of the aboriginal to drugs, smoking and alcohol, provision of opportunities for the tertiary studies. They have organized activities like spear making and tree plantation.  The Pangula Mannamurna Chief Executive Officer, Karen Glover, had said that during the organization of the campaign it was difficult for them to break the fear and the hesitation of the aboriginals in approaching their team.

As Pangula said that there were significant gaps and it was difficult to get gentlemen to their camp that often weren’t looking after their health.

She said that they were trying to increase the access for Aboriginal people to the mainstream health services.

It has been found that more than one person out of three persons in the aboriginal’s smokers. And it has been found to be the leading cause of mortality in the Australian population (Minichiello et al., 2016). Moreover this article focuses on the driving factors for the drug and smoking dependency of the aboriginals.

The article provides us with the aim of the campaign that has been taken up to reduce the habit of smoking in the indigenous population. Focusing on the case smoking, the article provides an overview of the social determinants of poor health care of the aboriginals (Minichiello et al., 2016). The factors which can improve the overall health of the population including the dependency of the teenagers on drugs and cigarettes are cessation of racism, proper education, professional opportunities and accessible health care.

As per the report produced, the organized program led the people enjoy healthy lunch, learning to make fishing spears and more, but whether it could tackle smoking in aboriginals is the main issue. A particular campaign will be able to promote the taste of a better life for just one day, but the conditions would go back to the normal as the once the campaign ends. Therefore it is necessary that some permanent measure have to be taken in for better health outcomes. It can be said that betterment in the physical and spiritual well being of the aboriginals can actually improve the health status of the community (Minichiello et al., 2016).

According to me, various social determinants of the health are not being addressed in this campaign. The organizers should try to understand the reasons why these people are addicted to drugs and other addictives. Prevalent racism, low socio economic status has the teenagers to get susceptible to drug addiction (Panaretto et al., 2014). Lack of education failed to provide bright future the indigenous teenagers, which led to frustration and drug addiction. One thing that should be noted is that the aboriginal pregnant women are also found to smoke (Taylor & Guerin, 2014). Programs should be organized to extend the knowledge to the female population of the aboriginals to fight with the adverse effects of smoking (Panaretto et al., 2014). It should be noted that previously tobacco was used as a method of payment. Therefore there are lots of loops and gaps that have to be addressed in order to improve the health conditions of the aboriginals.

In summary it can be stated that proper government policies, increase in awareness and decrease in the social determinates are the only way out to curb the health inequalities that are prevalent among the indigenous people in Australia.

Conclusion

The following examination on different news articles and blogs ultimately focused on the different social determinants of health. It provided information regarding the impact of racism on the mental health of the aboriginals. The examination also helps to understand the issue regarding the prevalence of scabies and other communicable diseases in the aboriginal community. Keeping an eye to this news, a brief overview about the housing and Australian infrastructure can be got. It can be said that overcrowding, inadequate infrastructure and bad sanitation system leads to communicable disease among the aboriginals. Social factors like lack of education, racism has increased the smoking habits among the Australians. Although this paper had also discussed about the different campaigns and the measures to reduce their distress, none of the campaigns were found to have long term effects. These news can only serve the purpose of increasing public awareness. The mass media campaigns previously were majorly focused on the raising awareness among the people while overlooking the negative social determinants of health.

References

Carapetis, J. R., Connors, C., Yarmirr, D., Krause, V., & Currie, B. J. (1997). Success of a scabies control program in an Australian aboriginal community. The Pediatric infectious disease journal, 16(5), 494-499.  May 1997 – Volume 16 – Issue 5 – pp 494-499

Geelhoed, G. C., & de Klerk, N. H. (2012). Emergency department overcrowding, mortality and the 4-hour rule in Western Australia. The Medical Journal of Australia, vol. 196(2), pp. 122-126. doi: 10.5694/mja11.11159

Gibson, O., Lisy, K., Davy, C., Aromataris, E., Kite, E., Lockwood, C., … & Brown, A. (2015). Enablers and barriers to the implementation of primary health care interventions for Indigenous people with chronic diseases: a systematic review. Implementation Science, 10(1), 71.
https://doi.org/10.1186/s13012-015-0261-x

Hampton, A, F. & Maree T. (2013). Racism, colonisation/colonialism and impacts on indigenous people. Oxford University Press, vol. 196(2), pp. 29

Hoy, W. E., Norman, R. J., Hayhurst, B. G., & Pugsley, D. J. (1997). A health profile of adults in a Northern Territory Aboriginal community, with an emphasis on preventable morbidities. Australian and New Zealand Journal of Public Health, 21(2), 121-126.

Larson, A., Gillies, M., Howard, P. J., & Coffin, J. (2007). It’s enough to make you sick: the impact of racism on the health of Aboriginal Australians. Australian and New Zealand journal of public health, vol. 31(4), pp. 322-329. doi:10.1111/j.1753-6405.2007.00079.x

McDonald, E., Bailie, R., Brewster, D., & Morris, P. (2008). Are hygiene and public health interventions likely to improve outcomes for Australian Aboriginal children living in remote communities? A systematic review of the literature. BMC public health, pp. 8(1), vol. 153. https://doi.org/10.1186/1471-2458-8-153

Minichiello, A., Lefkowitz, A. R., Firestone, M., Smylie, J. K., & Schwartz, R. (2016). Effective strategies to reduce commercial tobacco use in Indigenous communities globally: a systematic review. BMC public health, 16(1), 21. https://doi.org/10.1186/s12889-015-2645-x

Panaretto, K. S., Wenitong, M., Button, S., & Ring, I. T. (2014). Aboriginal community controlled health services: leading the way in primary care. Med J Aust, 200(11), 649-52.

Taylor, K., & Guerin, P. (2014). Health care and Indigenous Australians: Cultural safety in practice. (2nd ed.). Melbourne: Palgrave MacMillan

Walton, S. F., McBroom, J., Mathews, J. D., Kemp, D. J., & Currie, B. J. (1999). Crusted scabies: a molecular analysis of Sarcoptes scabiei variety hominis populations from patients with repeated infestations. Clinical Infectious Diseases, 29(5), 1226-1230.https://doi.org/10.1086/313466

Willis, E., Reynolds, L., & Keleher, H. (Eds.). (2016). Understanding the Australian health care system. Elsevier Health Sciences. https://books.google.co.in/books?hl=en&lr=&id=nIwtDAAAQBAJ&oi=fnd&pg=PP1&dq=indegenous+health+care&ots=vaX1VfYyRT&sig=MFuMDKyhn64-pKvZRCJjWEjKb34#v=onepage&q=indegenous%20health%20care&f=false