Factors Affecting the Health and Well-Being of Aboriginal Women Who Smoke During Pregnancy

The aboriginals and the Torres Islanders have a cultural belief in traditional medicine. A majority of the indigenous communities believe that modern medications disrespect their culture (Kowal, Greenwood, & McWhirter, 2015). The increase in the mortality rates of Aboriginal women who smoke during pregnancy is due to social determinants and social imagination framework. Social determinants of health are parameters that dictate an individual’s quality of life (Mitrou et al., 2014). On the hand, social imaginations are discriminatory cultural factors that influence the health status of an individual (Wain et al., 2016). Examples of social determinants that affect the life of the aboriginal women include income, education, employment, transport, and addictions. The aspects of social imagination are history, culture, structure, and critical factors facing the pregnant women who smoke. This essay will also reflect on my understanding to explanations of the ideas surrounding the two theoretical frameworks.

Fist person language will be applicable in explaining my reflection on the frameworks and suggestions of providing culturally-sensitive care. Third person language will apply when interpreting the concepts of social determinants and social imaginations. This write-up will discuss how the frameworks affect the lives of expectant Aboriginal mothers who smoke. The paper will also explain how the acquired knowledge will change both my personal and professional aspects of practice. Finally, the paper will suggest the policies to rectify the emerging issues.

The first determinant is the income status of the smoking, pregnant Aboriginal women. Recent research has indicated that the indigenous tribes earn less income than the other tribes. The low income is due to discrimination due to the race of the women (Race et al., 2017). The gender bias also contributes to the low pay for the pregnant mothers. The low income has numerous effects that shorten the lifespan of the people. The little earnings bar the mothers from affording three meals a day; therefore, the unborn children suffer from malnutrition. The smoking habit affects the lungs of the women; hence complicating their ability to breath. A smoking woman requires specialized medical attention and counseling to contain the habit. The smoking affects not only the life of the mother but also that of the unborn baby (Gould et al., 2017). However, medical attention towards the effects of smoking is expensive, and the women cannot afford it due to their low incomes. I, therefore suggest that the government should implement the universal income policy to benefit all Australians. It is my duty as an RN to conduct free counseling to the women by advising them against smoking during pregnancy.

Income

The second determinant of health among the aboriginals is the level of Education. Quality education impacts a person with knowledge and skills about matters concerning health. Recent studies have shown that a majority of the aboriginals have little or no educational backgrounds (Shahram et al., 2017). The pregnant indigenous mothers are smoking since they lack knowledge of the impacts of the habit on themselves and their unborn child. Recent research has shown that pregnant women from the majority tribes are less likely to smoke during pregnancy than the aboriginals. The basis of the study is the disparity in education levels between the two sets of individuals. Proper education is a pointer to the appropriate remedy for the effects of smoking (Macniven et al., 2016). Therefore, learned white women understand the health steps to take when they have the smoking habit. On the other hand, little education makes the aboriginal women to lack knowledge of the remedies of their condition. I suggest that the Australian administration should provide quality education to both the indigenous and the majority tribes. The government can achieve equality in education by constructing schools in all parts of the country. Quality education improves the lifespan of individuals.

The third social determinant of health among the indigenous communities is employment. Job security improves the well-being and the health of individuals (Ashman et al., 2016). The elevated rates of unemployment among the indigenous groups have increased the severity of illnesses and mortality rates. The unemployed mothers lack sufficient finances to afford food and cigarette at the same time. Therefore, they use the little money they have to purchase the cigarette and neglect food. The habit leads to malnutrition for the woman and the unborn child. Research has shown that hunger is one of the leading causes of premature deaths among the Aboriginals. The rates of employment are higher in the white majority races than the indigenous communities. Unemployment brings both financial constraints and psychological difficulties among those affected (Marmot, 2017).  Lack of employment makes victims experience mental disorders such as stress, depression, and anxiety. The stressful state of lacking a source of income pushes the women to smoke during critical life stages like pregnancy. The Australian government should implement policies that enhance industrialization in all parts of the country. It is my duty as a nurse to ensure that the aboriginal women access employment opportunities. Employed individuals have better health than the unemployed people.

Education

The fourth factor that influences the health and well-being of the Aboriginals is Transport. The pregnant aboriginal women who smoke cannot afford the cost of transport to the health facilities due to the lack of sufficient finances. The women suffer from the effects of their smoking as they cannot visit the hospital. The government should build health facilities in the rural areas to eliminate the need to travel to the cities for quality treatment (Kildea et al., 2016). I plan to request the health stakeholders to ensure that hospitals and caregivers are present at the indigenous localities. Using public transport, walking, and cycling also boost the wellbeing of the aboriginals (Smylie, & Firestone, 2016). I should conduct an awareness campaign on the need to embrace the three forms of transportation for the betterment of health. Using the public rather than private transport decreases air pollution due to the decrease in the combustion of fuel. The toxic chemicals and gases affect the respiratory system of the mother and the unborn child. Walking to work is a form of physical exercise; thus improving the fitness of the mother. Cycling also enhances social contact between people hence enhancing their well-being and status of health.

The effects of addiction make the pregnant Aboriginal women to smoke during pregnancy despite the harmful effects of the habit. The stressful life of the indigenous communities pushes them to smoke to forget their problems (Purcell, O’Rourke, & Rivis, 2015). The mothers have a dilution that the smoking can solve their social issues; however, it worsens their condition. Cigarette smoking is an essential marker of economic and social disadvantages that the aboriginals face on a daily basis. Smoking addiction can lead to suicide among the addicts (Twyman, Bonevski, Paul, & Bryant, 2014). The pregnant aboriginal women face challenging issues like low income, unemployment, homelessness, and lone parenthood. Additional issues facing the indigenous community are social deprivation and poor transport networks. The smoking intensifies the depression due to the social inequalities. I have the duty of training the women on the effects of smoking and why they should avoid it. Additionally, I plan to mobilize the Australian administration to construct rehabilitation centers for the addicts. The government should solve the social issues affecting the aboriginals to fight off the addiction. The administration can increase the tax levied on drugs such as cigarette to discourage pregnant women from purchasing and using them.

Employment

Aspects of social imagination also influence the health of the pregnant aboriginal women who smoke. The first aspect of social creativity is the historical backgrounds and beliefs of the indigenous community (Dudgeon, & Walker, 2015). Since time immemorial, the rest of Australian tribes have alienated the aboriginals. The alienation has made the indigenous individuals have limited access to essential health facilities like the rest. The minority tribes also have negative histories of unemployment, low income, and other unfavorable conditions. The government should acknowledge the historical differences between the different Australian tribes (Paradies, 2016). The administration should also enact policies that accommodate the heritage of the aboriginals. I plan to ask the health stakeholders to attend to the health concerns of the indigenous groups. Health facilities should incorporate the beliefs of the aboriginals in the treatment methods. The women have a history of smoking when pregnant. Therefore, the health organizations should conduct public awareness on the dangers of smoking. The government should also correct the historical injustices such as high unemployment rates for the people. The administration should encourage industrialization to create employment opportunities for the women. The department of housing should construct proper houses for the aboriginals to eliminate the stress due to lack of shelter.

Culture is another social imagination that affects the health of the pregnant aboriginal women who smoke a cigarette. Culture is a collective term for the beliefs of a given community. The aspect of social imagination dictates how a specific group of individuals undertake their daily activities. The majority of the aboriginals believe that the modern methods of treatment are contrary to their beliefs (Pockett, & Beddoe, 2017). The Aboriginals believe in the healing power of the traditional medicines which the modern health facilities do not apply during medical attention. However, the traditional drugs have numerous limitations; hence endangering the lives of the pregnant smoking mothers. It is my duty as an RN to convince the women to embrace the current methods of treatment that reduce the rates of premature deaths. The government should also carry out an awareness campaign to sensitize the aboriginals on the need to embrace the technological advancements in medical treatment. The language barrier also prevents the aboriginals from receiving conclusive attention from the hospitals. Language is a crucial component of culture, and the indigenous people believe that administering treatment in any other language is contrary to their culture. I must teach the community the language that caregivers use to eliminate the language barrier.

Transport

The structure of the aboriginal community is another aspect of social imagination that affects the well-being of the pregnant women who smoke. The structural orientation of the aboriginals has made them face institutionalized racism (Bodkin-Andrews, & Carlson, 2016). The assimilation policy and the succeeding colonization have affected the ability of the aboriginals to get quality medical attention. The indigenous community has accepted and internalized the discrimination. The vice of racism limited the Aboriginal community to poor social amenities and infrastructure (Gair, 2017). The alienation ensured that there is a lack of schools and health facilities at the local settings. Therefore, the pregnant women resort to smoking due to the stress of the lack of essential services. The aspect of social exclusion has denied the indigenous individuals the chance to participate in Australian life. I have the duty of ensuring social inclusion of the aboriginals in critical aspects such as healthcare. The government should treat every Australian equally and eliminate prejudice that worsens the health condition of the aboriginals. I also plan to request equity in the distribution of essential resources from the Australian administration. A practical solution to the social imagination ensures justice and fairness in service delivery towards the indigenous community.

Conclusion

Social determinants and imagination frameworks affect the lives of aboriginal pregnant women who smoke a cigarette. The low income that the individuals earn limits their capacity to afford proper meals and the costs of medical attention. The government should enact the policy of universal income to ensure equality in Australia. The high rates of unemployment also prevent the indigenous patients from accessing quality treatment. I should mobilize the national administration to construct industries to curb unemployment. The little or no education also increases the chances of premature deaths among the aboriginal women who smoke when pregnant. The Australian administration should sensitize the indigenous community on the essence of walking and the use of public transport. The aspects of social imagination such as history, culture, and structure of the society also affect the quality of medical treatment for the aboriginals.

References

Ashman, A. M., Collins, C. E., Weatherall, L., Brown, L. J., Rollo, M. E., Clausen, D., … & Lumbers, E. R. (2016). A cohort of Indigenous Australian women and their children through pregnancy and beyond: the Gomeroi gaaynggal study. Journal of developmental origins of health and disease, 7(4), 357-368. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/27080434

Bodkin-Andrews, G., & Carlson, B. (2016). The legacy of racism and Indigenous Australian identity within education. Race Ethnicity and Education, 19(4), 784-807. Retrieved from: https://www.tandfonline.com/doi/full/10.1080/13613324.2014.969224

Addiction

Dudgeon, P., & Walker, R. (2015). Decolonizing Australian psychology: Discourses, strategies, and practice. Journal of Social and Political Psychology, 3(1), 276-297. Retrieved from: https://journalindigenouswellbeing.com/media/2018/07/81.64.Editorial.pdf

Gair, S. (2017). Pondering the color of empathy: Social work students’ reasoning on activism, empathy, and racism. The British Journal of Social Work, 47(1), 162-180. Retrieved from: https://academic.oup.com/bjsw/article/47/1/162/2622278

Gould, G. S., Bovill, M., Clarke, M. J., Gruppetta, M., Cadet-James, Y., & Bonevski, B. (2017). Chronological narratives from smoking initiation through to pregnancy of Indigenous Australian women: A qualitative study. Midwifery, 52, 27-33. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/28570858

Kildea, S., Gao, Y., Rolfe, M., Josif, C. M., Bar-Zeev, S. J., Steenkamp, M., … & Barclay, L. M. (2016). Remote links: redesigning maternity care for Aboriginal women from remote communities in Northern Australia–a comparative cohort study. Midwifery, 34, 47-57. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/26971448

Kowal, E., Greenwood, A., & McWhirter, R. E. (2015). All in the blood: A review of Aboriginal Australians’ cultural beliefs about blood and implications for biospecimen research. Journal of Empirical Research on Human Research Ethics, 10(4), 347-359. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/26376752

Macniven, R., Richards, J., Gubhaju, L., Joshy, G., Bauman, A., Banks, E., & Eades, S. (2016). Physical activity, healthy lifestyle behaviors, neighborhood environment characteristics and social support among Australian Aboriginal and non-Aboriginal adults. Preventive medicine reports, 3, 203-210. Retrieved from: https://www.sciencedirect.com/science/article/pii/S2211335516000097

Marmot, M. G. (2017). Dignity, social investment, and the Indigenous health gap. Medical Journal of Australia, 207(1), 20-21. Retrieved from: https://www.mja.com.au/system/files/issues/207_01/10.5694mja17.00297.pdf

Mitrou, F., Cooke, M., Lawrence, D., Povah, D., Mobilia, E., Guimond, E., & Zubrick, S. R. (2014). Gaps in Indigenous disadvantage not closing: a census cohort study of social determinants of health in Australia, Canada, and New Zealand from 1981–2006. BMC Public Health, 14(1), 201. Retrieved from: https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-14-201

Paradies, Y. (2016). Colonization, racism and indigenous health. Journal of population research, 33(1), 83-96. Retrieved from: https://books.google.co.ke/books?isbn=1315462605

Pockett, R., & Beddoe, L. (2017). Social work in health care: An international perspective. International Social Work, 60(1), 126-139.Retrieved from:  https://anzasw.nz/wp-content/…/SWR-Issue-24-1-Articles-Beddoe-and-Deeney.pdf

Purcell, K. R., O’Rourke, K., & Rivis, M. (2015). Tobacco control approaches and inequity—how far have we come and where are we going?. Health promotion international, 30(suppl_2), ii89-ii101. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/26420813

Race, D., Dockery, A. M., Havas, L., Joyce, C., Mathew, S., & Spandonide, B. (2017). Re-imagining the future for desert Australia: designing an integrated pathway for enhancing livability. International Journal of Sustainable Development, 20(1-2), 146-165. Retrieved from: https://www.inderscienceonline.com/doi/abs/10.1504/IJSD.2017.083492

Shahram, S. Z., Bottorff, J. L., Oelke, N. D., Dahlgren, L., Thomas, V., & Spittal, P. M. (2017). The Cedar Project: Using Indigenous-specific Determinants of Health to Predict Substance use among Young Pregnant-Involved Indigenous Women In Canada. BMC women’s health, 17(1), 84. Retrieved from: https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-017-0464-1

Smylie, J., & Firestone, M. (2016). The health of indigenous peoples. D. Raphael (3rd ed.) Social determinants of health: Canadian perspective, 434-469. Retrieved from; https://www.canadianscholars.ca/books/social-determinants-of-health-3rd-edition

Twyman, L., Bonevski, B., Paul, C., & Bryant, J. (2014). Perceived barriers to smoking cessation in selected vulnerable groups: a systematic review of the qualitative and quantitative literature. BMJ Open, 4(12), e006414. Retrieved from: https://bmjopen.bmj.com/content/4/12/e006414

Wain, T., Sim, M., Bessarab, D., Mak, D., Hayward, C., & Rudd, C. (2016). Engaging Australian Aboriginal narratives to challenge attitudes and create empathy in health care: a methodological perspective. BMC medical education, 16(1), 156. Retrieved from: https://bmcmededuc.biomedcentral.com/articles/10.1186/s12909-016-0677-2