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Enhancing Health Care Equity with Indigenous Populations




Three moments in time.

Social determinants.

Historical and cultural factors.

Health issues faced by Indigenous Australians in 21st century.


Introduction to Indigenous' Health Issues

The main aim of this Indigenous health reflective essay is to illustrate the health issues in the Indigenous community. Further, over the centuries, great importance has been given to the good health and results associated with good health. Good health is the results of an interaction between the cultural statuses and various biological factors that aids in sharing the feelings and thoughts of the people. Though, in the present situation, it has been evident that the Indigenous people have changed their outlook towards the healthy lifestyle and achieve considerable growth in the health condition (Browne et al., 2016). However, still, the gap is not fulfilled. Hence, this reflective essay aims to effectively annotate and locate the philosophies of the Indigenous community and health. This essay would demonstrate the social and cultural factors that can create health issues amongst indigenous people. Further, a thorough discussion of current health issues of Indigenous people would be included in this essay.

Discussion on Indigenous' Health Issues

Three Moments in Time

People are well versed with the Indigenous and the Aboriginal people’s history. I had gained an understanding of various aspects of Indigenous people’s culture and health issues, by working for them. I had gained my first experience when I was posted in the rural area to render holistic care to the aboriginal children. During that posting, I had come to know that aboriginal kids are mostly facing health issues due to low immunity and low birth weight. Therefore, I had rendered special care and medical solutions to these kids.

Additionally, the second time I was allotted as the nurse in the Aboriginal region to evaluate the health conditions of the pregnant females. I had found that aboriginal women are suffering from adverse events due to lifestyle factors, for instance, poor physical activity, smoking, alcohol intake and poor nutrition. Additionally, few of the women were suffering from a poor mental condition, diabetes mellitus and cardiovascular disease. During my second posting, I had offered practical solutions and advice to women and their family members.

My third experience of working for the aboriginal people made me realise that indigenous people are in dire need of medical education regarding lifestyle modification. I came to know that people are suffering from poor mental health due to discrimination and racism incidences and to overcome the stress and anxiety feeling, maximum youth are into smoking and alcohol intake habit. Therefore, I started the monthly health education and health camp for the indigenous communal, that is budget effective. The cultural gap between the indigenous people and non- indigenous people is the barrier to gain trust and living skill that leads to poor health condition amongst the Aboriginal people (Goldberg et al., 2018).

Social Determinants

Social determinants are closely interlinked with the health outcomes of the people. Working and living conditions have a tremendous effect on the health condition of the people. Social determinates can be defined- condition in which the people are work, grow, born and live. Paramount determinants of Aboriginal people health inequality include the lower health infrastructure standards, for instance, sanitation, food and health housing etcetera and access to basic health care (Butler et al., 2019). During my posting in the rural area, I had found that the living condition of the aboriginal people is lower than other Australians. I realised that the indigenous people have a very low standard of housing as 7-8 people are living together in a small house.

Additionally, as accord to the national census 2001, the regular salary for the native people was 364 dollar in a week, whereas other Australian people’s income rate was 585 dollar a week. Literature has confirmed that poverty is directly proportional to the deprived health condition as people are unable to reach for the proper health care services. Poor literacy and education are directly associated with poor health (Harriss et al., 2018). I feel the same that indigenous people are not willing to join health education sessions due to poor literacy rate.

Unbalanced infant diet can be associated with poverty. I had experienced the same in my first posting, the children were not able to access balanced diet and suffering from various disease due to low immunity. High-risk behaviours, for example, smoking, alcohol intake and substance abuse are associated with the low socio-economic condition of the people (AIHW, 2020). Poor people have less control on their lives and directly linked to unhealthy stress. Long-lasting stress can lead to a hazardous influence over the immune system, metabolic function, circulatory system and mental health. Indicator of high stress in the indigenous people is the high incidence of substance abuse, smoking and alcohol consumption (Lines & Jardine, 2019). Moreover, in contemporary society, racism and discrimination towards the indigenous community people by the non-indigenous people have a deleterious effect on the psychological health of the victims of racism. Many youths have developed high-risk behaviour due to stress that arises because of the feeling of low self-esteem associated with discrimination evident. Young aboriginal people are into substance abuse to reduce their chronic stress level (Dudgeon & Walker, 2015).

Historical and Cultural Factors

In accord with a various piece of literature, numerous factors can be responsible for varied health issues amongst Indigenous people (Taylor & Guerin, 2019). As accord to my research, I have found that ecological imbalance is the prime factor that is responsible for the various health issues in the Indigenous community. Therefore, it is paramount to restore the ecological balance as it is prime social determinant. The foremost aspect I want to highlight in this essay is that there is a strong connection between the health and social connection to the family amongst Indigenous people. Further, it can be characterised by the clear magnification of various cultural compulsions that historically responsible for healthcare issues. I feel that persistent desire to retain the cultural identity and distinctiveness have both negative and positive outcomes and that can influence health menace behaviours. Additionally, my understanding helped me to appreciate the separation between the non-indigenous and indigenous people and that separation had tended to nurture racism and marginalisation (Ford et al., 2018).

 The communication gap between the native and other Australian people is about to be the historical factor. Indigenous people are not able to share their issues and health concern with the doctors of non-indigenous origin that this can contribute to health problems. Another obvious outlook that comes into consideration is the Aboriginal people live in the rural and/ or remote areas. The communication gap and living in remote areas make them more prone to health issues and disadvantaged them as they are not able to access the health-care amenities (Velásquez et al. 2018). Further, the lifestyle including alcohol intake and poor physical activity can cause cardiovascular disease, Diabetes mellitus and hypertension. Aboriginal people usually take alcohol less than the other Australian people, though those consume, they are more like to consume alcohol at dangerous levels. Additionally, Aboriginal and Torres Strait Islander community people celebrate their major and/or minor events with taking alcohol (Shepherd et al., 2018).

Health Issues Faced by Native Australians in The 21st Century

In 21 century, Native people that live in isolated or rural area experiences high mortality rate, psychological distress, cardiovascular disease, stroke, heart failure, hypertension and low birth rate. Further, cardiovascular illness is the major cause of death in the Aboriginal community. Following 2012-2013 Australian Aboriginal and Torres Strait Islander Health Survey, every 8th indigenous person was suffering from heart disease. Further, indigenous people living in the rural area are suffering from obesity type II diabetes, tooth decay and malnutrition due to poor nutrition. Additionally, their food choices are limited due to food cost, transportation issue and distance to dealers (Cianconi et al., 2019).

Fresh food in the rural area costs approximately 180 per cent price of the food items in the cities. Nevertheless, the healthiness of the indigenous people has improved because of territory, commonwealth and state government initiatives. Though, dissimilarities sustained to exist between the Aboriginal and non-Aboriginal people. Moreover, Indigenous people are reluctant to take medical help until their health condition had declined. The general approach to fulfil the gap is to render the job opportunity, education and easy access to health care services and food items. Moreover, the frequent health education session and medical camps can be effective steps to reduce the health issues amongst the Aboriginal people (AIHW, 2020).

Conclusion on Indigenous' Health Issues

It can be concluded from this reflective essay that cultural and historical events have a persistent influence over the overall well-being of Native Australians. Racism, discrimination and communication gap are some of the factors that are responsible for high risk-behaviour, for instance, smoking, substance abuse and alcohol intake. Moreover, social determinants including poor standard of living, poverty, low literacy and unemployment are some of the factors that create a health gap among the native and non-Indigenous people. In 21 century, Aboriginal people that live in isolated or rural area experiences high mortality rate, psychological distress, cardiovascular disease, stroke, heart failure, hypertension and low birth rate. Therefore, Indigenous people require proper support and care from the government and private agencies.

References for Indigenous' Health Issues

AIHW,. (2020). Alcohol and Aboriginal and Torres Strait Islander peoples.

AIHW,. (2020). Coronary heart disease.

Browne, A. J., Varcoe, C., Lavoie, J., Smye, V., Wong, S. T., Krause, M., ...&Fridkin, A. (2016). Enhancing health care equity with Indigenous populations: evidence-based strategies from an ethnographic study. BMC Health Services Research, 16(1), 544.

Butler, T. L., Anderson, K., Garvey, G., Cunningham, J., Ratcliffe, J., Tong, A., ... & Howard, K. (2019). Aboriginal and Torres Strait Islander people's domains of wellbeing: A comprehensive literature review. Social science & medicine233, 138-157.

Cianconi, P., Lesmana, C. B. J., Ventriglio, A., & Janiri, L. (2019). Mental health issues among indigenous communities and the role of traditional medicine. International Journal of Social Psychiatry65(4), 289-299.

Dudgeon, P., & Walker, R. (2015).Decolonising Australian psychology: Discourses, strategies, and practice.

Ford, J. D., Sherman, M., Berrang-Ford, L., Llanos, A., Carcamo, C., Harper, S., ... & Edge, V. (2018). Preparing for the health impacts of climate change in Indigenous communities: The role of community-based adaptation. Global environmental change, 49, 129-139.

Harriss, L. R., Kyle, M., Connolly, K., Murgha, E., Bulmer, M., Miller, D., ... & Campbell, S. (2018). Screening for depression in young Indigenous people: building on a unique community initiative. Australian journal of primary health, 24(4), 343-349.

Lines, L. A., & Jardine, C. G. (2019). Connection to the land as a youth-identified social determinant of Indigenous Peoples’ health. BMC public health19(1), 176.

Shepherd, S. M., Delgado, R. H., Sherwood, J., & Paradies, Y. (2018). The impact of indigenous cultural identity and cultural engagement on violent offending. BMC public health18(1), 1-7.

Taylor, K., & Guerin, P. (2019). Health care and Indigenous Australians: cultural safety in practice. Macmillan International Higher Education.

Velásquez, C. N., Meza, M. D. R. G., Ukhova, D., Xinico, S., Palma, S., & Simpson, S. (2018). Making the health system work by and for Indigenous women in Guatemala: a community led multisectoral collaboration. bmj, 363, k4677.

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