Health Disparities between Indigenous and Non-Indigenous Australians

The indigenous people in Australia experience worth health as compared to the non-indigenous Australians. The gap in the health has been noticed yet less progress has been made in contemplating the effects of the reasons on the size of the gap.

The aboriginal people have a life span that is ten years less than the non-aboriginal people. For the men in the population, the conditions have even worsened. This issue can be clarified with the help of analyzing the social determinants of health such as accesibility to affordable house, income, age, stress and racism (Williams, 2012).

There has been a greater impact of the inadequate distribution of the social determinants of health on the indigenous people. There has been severing impacts of crowded housing on their health. This has also resulted in problems in the middle ear. These are very common amongst the aboriginal people (Bourke, Humphreys, Wakerman & Taylor, 2012).

This paper analyses the problems faced by the aboriginal people due to the inadequate distribution of the social determinants of health and the factors associated with them. Four media articles would be summarized and they would be linked to various indigenous models and current related debate topics, along with the personal reflection on each of them.

Nogrady, B.(2015).The Indigenous health gap: social factors hit hard. Retrieved 9^th October 2018 from https://www.abc.net.au/health/features/stories/2015/07/07/4268380.htm

The article highlights the association between the overcrowded housing, infections in the ear and confinement amongst the aboriginal people resulting in the social and health issues in the indigenous communities.

It has been analyzed that the indigenous Australians have a ten-year low life span as compared to the non-indigenous people. The social determinants of health pertaining to the situations, in which the aboriginal people are born, live, work , grow and age. These are influenced by dissemination of monetary resources and power at the national, international and local levels (Nogrady, 2015).

The key issues highlighted in the articles are the impact of inappropriate distribution of social determinants on the wellbeing of aboriginal people. Overcrowding in the houses has led to infections in the middle ear which is a very common childhood problem amongst the aboriginal people.

Some of the infections persist long after the illness has been recovered. It has permanent effects on the life of the children and proves to an obstacle for them in schools and job. It can also have an influence on their mental health, wellbeing and management of anger (Kingsley, Townsend, Henderson-Wilson. & Bolam, 2013).

Impact of Inadequate Distribution of Social Determinants on Indigenous Australians

The gaps in life expectancy of indigenous and non-indigenous Australians have been worsened during the time. The babies born to the aboriginal mothers are underweight than the babies who are born to the non-aboriginal mothers.

The major reasons for this gap are due to chronic disease. It occurs more often and at a younger age amongst the aboriginal people as contrasted with the non-aboriginal people. The other factors being racism pertaining to not getting proper treatment in the hospital. It has a clear and negative physiological outcome through its influence on hormones of stress (Hall & Patrinos, 2012).  

In order to curb this problem, Closing the Gap program has been initiated by the Federal Government. It has formulated a policy framework which is concerned about the social determinants of health. It is an action plan which informs about how to act for improving the life expectancy of indigenous people and their chronic illness ( Ottersen et al.,2014).

In my opinion, the article has described the impact of the unequal distribution of social determinants on the health of the aboriginal people. Their problems have well discussed in the article by providing proper evidence of the impact of imbalance in social determinants on their health resulting in infections in the middle ear due to overcrowding in the homes.

It can cause permanent problems to the indigenous children thereby posing a threat to their future. The article has well explained that racism can also affect the health of the indigenous people and can be detrimental for them. As per my opinion, the impact of poor education, unemployment, lack of monetary resources, discrimination and poor housing quality can also affect the health of aboriginal people (Christian & Blinkhorn, 2012).

I believe that if a person who is not able to afford good health services faces inequality in the hospital can increase his risk of death or permanent disability. The imbalance of the social factors can also increase the risk of being engaged in unhealthy behaviors like smoking and consumption of alcohol thereby deteriorating his quality of life.

Gooda, M. & Huggins, J. (2016). Our national shame: Closing the gap for Indigenous Australians is more important than ever. Retrieved 9^th October ,2018 from https://www.smh.com.au/opinion/our-national-shame-closing-the-gap-for-indigenous-australians-is-more-important-than-ever-20160316-gnkquf.html 

This article highlights the fact that institutional racism in the medical facilities continues to be the main barrier to the Aboriginal and Torres Strait Islander who seek for medical help.  This article is about a registered nurse and midwife Ms. Lynore Geia who is committed to the development of the medical professionals of the next generation.

Role of Chronic Diseases and Racism in Health Disparities

Her experience has been illustrated in this article when she met the team from the Close the Gap campaign. She has been working for closing the gap and to provide better outcomes of health for the indigenous people (Gooda & Huggins, 2016).

This article is about her experience regarding the development of better health outcomes amongst the indigenous people. According to her, the life expectancy of the people of Palm islands have improved but still, they die at a very young age.

The key issue highlighted in this article is that although progress has been made over the past decade concerning the improvement of the health of the infants and children along with a minor decrease in the smoking rates of the people.

There are significantly more checkups and the immunization rates have also been increased. There has been greater access to the medical facilities due to improved resourcing for the aboriginal people. In spite of all this, the life expectancy of the indigenous people is 10 years less as compared with the non-indigenous people (Steenkamp, Rumbold, Barclay & Kildea, 2012).

Progress has been made in the past decade regarding the improvement in the living standards and life expectancy of the aboriginal people but it is sad to say that still, they live 10 years less as compared with the non-aboriginal people.

This article insists that closing the gap campaign needs remarkable efforts. It requires the commitments of redoubled and renewed resources. It also requires strong, selfless and impartial political will and frameworks which would extend beyond the three year election time periods.

There is an urgent need to increase the resources for the development of the health of Aboriginal and Torres Strait Islander people in the percentage of the size of the population, their need for service and demands (Anderson et al., 2016).

In this regard, the service models of core health and associated workforce along with proper funding arrangements should be developed in a prioritized manner. It should focus on areas with poor health and improper levels of service.

The Aboriginal and health services controlled by the community should be the chosen model for investments. The health services for the aboriginal people are best placed for delivering the primary health care for the aboriginal people (Shepherd, Li & Zubrick, 2012).  

As per my opinion, the status of health of the Aboriginal and Torres Strait Islander people has been imporved . The people’s movement was established in the year 2006 under the leadership of Aboriginal and Torres Strait islander people. It is now supported by more than 220,000 Australians who signed the pledge to achieve the equality of health of the aboriginal people by the year 2030.

Closing the Gap Program and Its Framework

It has been observed that progress has been made in the field of improvements in the health of infants and children and there has been a gradual closing in the gap of rates of smoking. The rates of health checkups have been increased and the vaccination rate has also been increased. There has been a greater access to the medicines due to the better resourcing for the health of the aboriginal people.

However, in spite of all the changes introduced in the health sector of the aboriginal people, there is a reality that the life expectancy of the indigenous people is 10 years shorter as compared to the non-indigenous people (Zhao, You, Wright, Guthridge & Lee, 2013).

Divi (2017). Aboriginal Poverty & Inequality. Retrieved 11^th October, 2018 from https://www.uowblogs.com/ajs069/2017/04/20/aboriginal-poverty-inequality/ 

This article highlights the issue of poverty in the Aboriginal and Torres Strait Islander people. It is the most crucial disadvantaged group in Australia. These are the most disadvantaged and underprivileged communities in the world.

As per the views presented in this article, there is a huge inequality between the indigenous and non-indigenous communities in Australia regarding health and lifespan. It has been observed that the aboriginal people are confronted with the problems of high rates of unemployment, the shorter expectancy of life, high infant mortality rates and confinement (Divi, 2017).

They have low levels of education and health. They live almost 10 years shorter as compared to the non-aboriginal people. This injustice is prevalent amongst the Australian society and it has been felt by the indigenous people from the time the land was declared ‘terra nullius’.

Furthermore, the article describes the reasons for such disparities. It has been due to racism and dispossession occurring since decades. The successive governments also failed to listen to the woes of aboriginal people. It has led to these equalities and disadvantages.

In the past, they were treated horribly by the Britishers. Human destructions were common in those days and the aboriginals were offered the food laced with poison such as arsenic. The population of aboriginals was destroyed up to 90 % between the period of 1788 to 1900(Brinkman et al., 2012).

This article has linked itself to the approach that in the recent days the aboriginal people are struggling to establish their identity in the society. They have lost their culture and traditions and they did not fit with culture and heritage of Australia.

There are certain organizations and institutions who have been working for the upliftment of the aboriginal society. Oxfam Australia and Australians Together have been working to develop solutions for the problems faced by the indigenous people.

Media Articles Summarization on the Issue

They have been working to promote their culture and wellbeing on the international level along with advocating for the policy to diminish the inequality in Australia. The awareness of these issues should be spread in the society so that everyone is aware of the racism and discrimination which has been accepted in the society (Jorm, Bourchier, Cvetkovski & Stewart, 2012).

In this regard, Close the Gap campaign has been initiated by the 2008 Council of Australian Governments (COAG) with the target for achieving the life expectancy equality by the year 2030. In this regard, 10 years after its commencement, the critical reflection suggests that the government of Australia has not yet been able to achieve its target to close the gap related to health.

It was also been perceived by the Australian Institute of Health and Welfare report that the gaps in mortality and expectancy of life have been widening because of accelerating growth in the rate of population amongst the indigenous people.

As per my opinion, the Close the Gap approach has been partially implemented to date. There is a need to formulate an operative health equality plan which was not in place till the release of National Aboriginal and Torres Strait Islander Health Plan Implementations Plan in the year 2015 but sadly it has never been supported monetarily (Mitrou et al.,2014).

A national plan addressing the infrastructure for health and housing and the social determinants needs to be implemented and funded as well. The strategy should also focus on maternal and child health along with addressing the risk factors related to chronic diseases.

 I believe that there is no organized focus on creating the capability for building the primary health service as per the need to address a preventive footing instead of responding to the crisis arising after the event. There is a need to formulate a refreshing strategy to implement the Close the Gap Statement of Intent Commitments (Australian Institute of Health, 2012).  

As per my opinion, the strategy must target to deliver the equal opportunities relating to goods and services pertaining to health. The primary health facilities should be in accordance with necessity relating to the infrastructure of health i.e. formulation of a proper workforce for health, food and housing facilities.  The social determinants of health must also be addressed at the basic level (Baum & Fisher, 2014). 

Daley, P.(2017). It’s 50 years since Indigenous Australians first ‘counted’. Why has so little changed? Retrieved 11^th October, 2018 from https://www.theguardian.com/inequality/2017/may/18/50-years-since-indigenous-australians-first-counted-why-has-so-little-changed-1967-referendum 

Development of Health Services Controlled by the Community

This article suggests that the Citizenship Referendum made the existence of the aboriginal people in Australia in the year 1967. The former Rugby player Sol Bellear who played for South Sydney Rabbitohs and is also an activist for the Aboriginal rights is of the opinion that Australia had voted in a referendum to include the aboriginal people in its census in 1967.

The year marked the end of the fight. After that, the High Court passed the Native Title Land Rights Act. After that, the Prime Minister of Australia Mr. Paul Keating in his landmark ‘Redfern speech’   in the year 1992 had acknowledged the sickness, dispossession, oppression and violence which the colonization imposed on the indigenous people (Daley,2017).

The article describes the misery of aboriginal people by stating the fact that yet a quarter of a century has passed but still the country remains deaf to the reports generated by the non-government organizations and the Commonwealth policies purported to make the lives of the indigenous people better.

These reports describe the intensity of crimes done against the aboriginal people. They explain the rates of child removal in the indigenous community, confinement and the lack of commitment of the government towards their education, employment and health (Durey & Thompson, 2012). 

This article explains the approach and model formulated by the successive governments since 2008 which are used to determine the progress of the indigenous people. The annual report of Close the Gap strategy generated by the Federal Parliament of Australia has not succeeded to recognize its first people.

It has been established that the Aboriginal and Torres Strait Islander people die earlier as compared to the other Australians. They have the worst conditions related to health, education and employment. Closing the Gap was formulated to finish the inequality. As per the last report, Australia has not succeeded to improve on the critical measures.

The Aboriginal and Torres Strait Islander people constitute 3% of the overall population of the country. In the year 1991, 14% prisoners of Australia were aboriginal and after a quarter of a century, it has been raised to 27 %. It has also been found that more than 150 people died while remaining in the custody in the last 25 years (Australian Human Rights Commission, 2018).

After the census of 2011, it was determined that the number of aboriginal people has increased by 20% during five years. The statistics is expected to increase than the population which was in 1788. Despite this positive growth, the government has failed to make policies to the lives of Aboriginal and Torres Strait Islander people.

Aboriginal Poverty and Inequality

Most of the aboriginal people are not even willing to align themselves in the mainstream health services as they had bitter experiences with racism which arises due to the assumptions about their way of leading life (Priest et al.,2013).

As per my opinion, it is sad to say that after so many years, the aboriginal people suffer rather than seeking mainstream health treatment. They believe that racism makes them sick and this service was established to encourage racism.

People are not sympathetic towards the aboriginal people rather they are curious to know that how they were left to die in the emergency departments and they were not seen at all or were told to come the other day (Lawrence, Hancock  & Kisely, 2013).

I insist to the fact that although Closing the Gap Strategy has led to some improvements but as per the national statistics, there is a long way to go. In the year 2017, the government was pressurized to add a target for lowering the confinement rates. Moreover, there is a concerning gap between the aboriginal and non-aboriginal people with reference to child removals and violence in families and the community.

The deterioration of the social and cultural determinants of health convey that the ways of living, working and playing affect the health. It pertains that racism and discrimination and lack of employment and education along with cultural isolation impact the health of the person.

Lastly, I believe that high rates of violence in the communities of aboriginal people are impacted  by factors such as alcohol and illegal use of drugs along with the issues associated with  mental health and childhood experience. There is a lot of scope for improvement to be done so that the aboriginal people enjoy the life expectancy and health in Australia (Di Cesare et al.,2013).

Conclusion

Hence to conclude, it can be said that although Closing the Gap strategy has made some improvements to the health of indigenous people with its introduction in 2008 but only one of the targets has been achieved till the year 2016.

The disparity is associated with inequalities in the life expectancy and health  between indigenous and non-indigenous people of Australia. It comprises a shorter life, poor health and higher levels of infant mortality along with less education and employment.

References

Anderson, I., Robson, B., Connolly, M., Al-Yaman, F., Bjertness, E., King, A. & Pesantes, M. A. (2016). Indigenous and tribal peoples’ health (The Lancet–Lowitja Institute Global Collaboration): a population study. The Lancet, 388(10040), 131-157.

Australian Human Rights Commission (2018) . Close The Gap – 10 Year Review (2018). Retrieved 11^th October, 2018 from https://www.humanrights.gov.au/our-work/aboriginal-and-torres-strait-islander-social-justice/publications/close-gap-10-year-review 

Australian Institute of Health (2012). Australia’s Health 2012: In Brief. Canberra : AIHW. 1-10.

Baum, F. & Fisher, M. (2014). Why behavioural health promotion endures despite its failure to reduce health inequities. Sociology of health & illness, 36(2), 213-225.

Bourke, L., Humphreys, J. S., Wakerman, J. & Taylor, J. (2012). Understanding rural and remote health: a framework for analysis in Australia. Health & Place, 18(3), 496-503.

Brinkman, S. A., Gialamas, A., Rahman, A., Mittinty, M. N., Gregory, T. A., Silburn, S. & Hertzman, C. (2012). Jurisdictional, socioeconomic and gender inequalities in child health and development: analysis of a national census of 5-year-olds in Australia. BMJ open, 2(5), e001075.

Christian, B. & Blinkhorn, A. S. (2012). A review of dental caries in Australian Aboriginal children: the health inequalities perspective. Rural & Remote Health, 12(4). 1-10.

Daley, P.(2017) . It’s 50 years since Indigenous Australians first ‘counted’. Why has so little changed? Retrieved 11^th October, 2018 from https://www.theguardian.com/inequality/2017/may/18/50-years-since-indigenous-australians-first-counted-why-has-so-little-changed-1967-referendum 

Di Cesare, M., Khang, Y. H., Asaria, P., Blakely, T., Cowan, M. J., Farzadfar, F. & Oum, S. (2013). Inequalities in non-communicable diseases and effective responses. The Lancet, 381(9866), 585-597.

Divi (2017) . Aboriginal Poverty & Inequality. . Retrieved 11^th October, 2018 from https://www.uowblogs.com/ajs069/2017/04/20/aboriginal-poverty-inequality/ 

Durey, A. & Thompson, S. C. (2012). Reducing the health disparities of Indigenous Australians: time to change focus. BMC health services research, 12(1), 151.

Gooda, M. & Huggins, J.(2016). Our national shame: Closing the gap for Indigenous Australians is more important than ever. Retrieved 9^th October, 2018 from https://www.smh.com.au/opinion/our-national-shame-closing-the-gap-for-indigenous-australians-is-more-important-than-ever-20160316-gnkquf.html 

Hall, G. H. & Patrinos, H. A.  (2012). Indigenous peoples, poverty, and development. England: Cambridge University Press. 1-10.

https://www.abc.net.au/health/features/stories/2015/07/07/4268380.htm

Jorm, A. F., Bourchier, S. J., Cvetkovski, S. & Stewart, G. (2012). Mental health of Indigenous Australians: a review of findings from community surveys. Medical Journal of Australia, 196(2), 118.

Kingsley, J., Townsend, M., Henderson-Wilson, C. & Bolam, B. (2013). Developing an exploratory framework linking Australian Aboriginal peoples’ connection to country and concepts of wellbeing. International journal of environmental research and public health, 10(2), 678-698.

Lawrence, D., Hancock, K. J. & Kisely, S. (2013). The gap in life expectancy from preventable physical illness in psychiatric patients in Western Australia: retrospective analysis of population based registers. BMJ, 346(2013), f2539.

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.

Nogrady , B.(2015) .The Indigenous health gap: social factors hit hard. Retrieved 9^th October, 2018 from https://www.abc.net.au/health/features/stories/2015/07/07/4268380.htm

Ottersen, O. P., Dasgupta, J., Blouin, C., Buss, P., Chongsuvivatwong, V., Frenk, J. & Leaning, J. (2014). The political origins of health inequity: prospects for change. The Lancet, 383(9917), 630-667.

Priest, N., Paradies, Y., Trenerry, B., Truong, M., Karlsen, S. & Kelly, Y. (2013). A systematic review of studies examining the relationship between reported racism and health and wellbeing for children and young people. Social science & medicine, 95, 115-127.

Shepherd, C. C., Li, J. & Zubrick, S. R. (2012). Social gradients in the health of Indigenous Australians. American journal of public health, 102(1), 107-117.

Steenkamp, M., Rumbold, A., Barclay, L. & Kildea, S. (2012). A population-based investigation into inequalities amongst Indigenous mothers and newborns by place of residence in the Northern Territory, Australia. BMC pregnancy and childbirth, 12(1), 44.

Williams, D. R. (2012). Miles to go before we sleep: Racial inequities in health. Journal of health and social behavior, 53(3), 279-295.

Zhao, Y., You, J., Wright, J., Guthridge, S. L. & Lee, A. H. (2013). Health inequity in the Northern territory, Australia. International journal for equity in health, 12(1), 79.