A health issues blog

According to a new report, relased in 2007 by the World Health Organisation (WHO), the health of Australian aboriginals are 100 years behind that of the rest of the population.  The report by researchers at the University of New South Wales shows that Aboriginal Health lags a full century behind that of other Non-indigenous Australians. Indigenous people, which account for about 2.4% of Australians, are plagued by health problems that have not affected the rest of the country’s population for many years, Lisa Jackson Pulver at the University of New South Wales in Sydney, and colleagues carried out the study. “Leprosy, rheumatic heart disease and tuberculosis haven’t been experienced in Non-Indigenous populations for decades, but they are still problems for some indigenous communities,” Jackson Pulver says. An Aboriginal male’s life expectancy is 59.4 years, compared with an average 76.6 years for the total male population in Australia. For indigenous women, life expectancy is 64.8 years, compared with 82 years for all Australian women. In some parts of the state of New South Wales, the average age of death of Aboriginal males is just 33 years.

Health experts at a Melbourne conference have stated that “it’s the richest and healthiest Australians who have the best access to medical services” (SBS, 2010). I believe this quote is quite true as the Australians that can afford to pay for medical services and health resources are the healthiest and richest and do not often need these services. For Indigenous Australians, however, this is not the case as most cannot afford to go to the doctor or have access to good health resources. The article Call for equality in health services talks about how the Government is not doing enough to ensure that everyone is equal and how the social justice principles are not being met. This has led to poor health status among Indigenous Australians.

The three social justice principles (diversity, equity and supportive environments) are not being met at all in Australia with our health care system and Indigenous Australians. The values, beliefs, attitudes and behaviour of the Indigenous differs from non-Indigenous and this is often shown in their health outcome as it is much lower than non-Indigenous people and also in their life expectancy with Indigneous being about 10-17 years less. Indigenous people are not always treated the same and are not treated equal to everyone else which is very unfair and not just and often results in bad health outcomes for the Indigenous people affected. They do not have the same health resources or medical services as non-Indigenous Australians have and most of the time they live out in rural places which are far away from any towns or hospitals. Indigenous Australians have less access to essential health services and do not get the health care they need when they need it. They do not have a very good supportive environement, often due to cultural beliefs.

Close the Gap is a national health strategy that aims to achieve Indigenous health and life expectation equality by 2030. Although this is a step in the right direction, there still needs to be a lot done before the social justice priciples are met.

Close the Gap 2007, Together we can end the Indigenous health crisis, 4 April, viewed 6 July 2010, <http://www.closethegap.com.au/>.

 SBS 2010, Call for equality in health services, 7 June, viewed 6 July 2010, <http://www.sbs.com.au/podcasts/Podcasts/world-view/episode/89212/Call-for-equality-in-health-services>.

Those who have a say in the Indigenous population are pleading with the Australian Government to improve Indigenous health outcomes. Close the Gap is a campaign consisting of 40 health and advocacy groups working together in order to close the life expectancy gap between non-Indigenous and Indigenous Australians.

Mick Gooda, Close the Gap committee co-chair stated that ”today’s events send a clear reminder to government that closing the gap must remain one of its top priorities, people do not want the government to take the foot off the pedal.”

Research has found that:

• Indigenous babies die twice the rate compared to other babies
• Indigenous men experience heart disease three times the rate of other Australians
• Indigenous women die from cervical cancer at a five times higher
• The life expectancy gap between non-indigenous and indigenous Australians is 11.5 years for men and 9.7 for women

Recognition and awareness has occurred and Federal Indigenous Minister, Warren Snowdon has put forward $4 million towards research teams that will work together to improve health literacy of indigenous Australians with heart disease, improve doctor training, tackle chronic dental disease and many more ongoing  problems amongst the indigenous population.

It is obviously clear that the Indigenous health status lacks equality. A significant contribution to this is the difference between non-Indigenous and Indigenous Australians in life expectancy; although this is not the only contribution. This statistic is very clear and has been for many years.

As a whole, when other aspects in Australia’s health lack, the government either takes immediate actions to make a difference, or at least takes the initiative to fight for advertising, funding and research that will help in the needed area. Although the Close the Gap campaign has recently been made a priority, already it seems to be slipping down the ladder of importance.

Not only is the Indigenous population suffering physically, but also emotionally. For too long there has been prolonged racism and discrimination. In 2008 we witnessed the apology to the stolen generation made by the then Prime Minister, Kevin Rudd. While these words meant well, it’s the actions that mean the most to Indigenous Australians. Actions speak louder than words. After suffering without the feeling of equality and supportive environments, the government owes the Indigenous people a long term program that will continue for as long as there is a need. This is not a problem that can be solved within just a few years. What the indigenous need is to feel they are considered a priority in our country in terms of their health.

AAP (2010) ‘Do more’ to improve indigenous health, March 24, Sydney Morning Herald, viewed 7 July 2010,  <http://news.smh.com.au/breaking-news-national/do-more-to-improve-indigenous-health-20100325-qx08.html>

Within Australia, the Indigenous population has ‘The Worst Indigenous Health’ compared to those who are Indigenous in New Zealand, Canada and the United States of America. Although, this title is unwanted, there is clear evidence as to why it is there.  The Indigenous population of Australia “suffers a higher infant mortality rate and lower life expectancy than those from the other three counties” (Rose, 2009).  The report from the AIHW also states that ”significant health disparities exist between Indigenous and non-Indigenous population in Australia”(Rose, 2009). Just from these few statement we can see that there are an obvious gap in between Indigenous populations and non-Indigenous populations. This can be backed up by the fact that ”Australian Aboriginal and Torres Strait Islanders die 17 years earlier than the non-Indigenous population” (Rose, 2009).

The Indigenous people should not have to deal with these appalling statistics. So, why are these figures so shocking? Maybe it’s because of a lack of knowledge? NO, but it can be related to the social justice principles. The social justice principles examine the regularity and justice of health for individuals, groups and communities. These principles can be broken down into three categories: diversity, equity and supportive environments.  Diversity is very important when it comes to closing the gap between Indigenous and non-Indigenous health.  If the diversity was recognised, then health systems might change their ways to encompass the Indigenous peoples’ values, beliefs, attitudes, behaviors and attachments.  Therefore, creating equality between the two populations. This leads to the Equity category, which is showing concern for the health, wellbeing, rights and dignity of all people, irrespecitive of their decent or economic position. If equality was acknowledged, this can create new opportunities for Indigenous people to get health care; that will hopefully start to close the gap. The other category that may possibly be affecting Indigenous heath is supportive environments.  This includes the understanding of the person’s cultural beliefs and their physical, political, emotional and educational surroundings. If this was effectively understood, it could in turn lead to more education and the acceptance of their way of life. The social justice principles can lead to more medical help in areas more accessible for Indigenous people and as a result improve the overall health of Indigenous health.  But how will these messages get across to the public?     

Rose, Danny  2009 ‘Australia has worst indigenous health ‘, The Age, 20th March, viewed 4 July 2010, <http://news.theage.com.au/breaking-news-national/australia-has-worst-indigenous-health-20090321-94m8.html>.

The Australian health status and service needs for Indigenous people differ from non-Indigenous people in a large way. The development, efficiency and evaluation of health policies which impact Indigenous Australians must take differences into account. These policies also need to take into consideration the history of the difficult relationship the governments and Aboriginal people have previously had. In an attempt to close the gap between Indigenous people and non-Indigenous people, there is an aim for greater understanding. Aboriginal health principles that should be applied are a whole of life view of health, efficient exercise of Aboriginal self determination, partnership, understanding the culture and recognising loss and trauma. The negotiation and consultation processes that have occurred with the Aboriginal stakeholders has been not so effective in the sense that defective time and resources are committed to these particular process which means that they are delivered and managed poorly. Many people have been left disappointed, frustrated and cynical but also concerned for the future of Aboriginal people. To conduct a successful consultation and negotiation the process should be open to transparency, integrity, partnership, trust and mutual respect. If non-Indigenous people are going to become a part of these processes, they should very much so consider participating in Aboriginal awareness training programs so they develop a deeper understanding of the Aboriginal culture and can be a lot more considerate towards them (Government of Western Australia Department of Health, 2005).

In relation to the social justice principles, diversity is not recognised in this situation, as the non-Indigenous people are not considering the Aboriginal people ‘a part’ of Australia and do not consider different viewpoints and beliefs. To me, this is really disheartening to hear because despite our skin colour or background, I think Australians should look out for other Australians especially considering Aboriginals are the original inhabitants of Australia. It would be very worthwhile for non-Indigenous health professionals to undertake an Aboriginal awareness culture course because it will help improve the health outcomes for Aboriginals. Equity is a main point that needs to be addressed appropriately. Even though there are campaigns such as Close the Gap, if the The Prime Minister and State Premier commit to policy changes, then bigger differences in health outcomes can be made. Although it will take some time, true cultural understanding can only predict a better future for Indigenous Australians.

The Government of Western Australia Department of Health (2005), WA Aboriginal Health Impact Statement and Guidelines, retrieved on July 4, 2010 from <http://www.aboriginal.health.wa.gov.au/docs/Impact_Statement.pdf>

In 2007, a report was released at the WHO Commission on the Social Determinants of Indigenous Health in Adelaide, South Australia. Some shocking results were uncovered, most of which can be erased through equality in access to health care. The report of the study conducted by Lisa Jackson Pulver from the University of NSW, revealed that the health of Aboriginal Australians is one-hundred years behind the rest of the nation. Diseases that haven’t been experienced in the non-Indigenous population for a long time such as Leprosy, rheumatic heart disease and tuberculosis are still major health problems for Aboriginals. In addition to this, it was revealed that the life expectancy of an Aboriginal male and female is 59.4 years and 64.8 years compared with 76.6years and 82 years in Australian males and females respectively.

There is clearly a large gap in between the health of Indigenous and non-Indigenous Australian’s which is unacceptable. It is apparent that there is not true equality in health status amongst all Australian’s if at least 2.24% of the population have very poor health. The good news is, there is a way out. On April 4, 2007, the Close the Gap campaign was launched. The aim of this campaign is to close the life expectancy gap between Indigenous and non-Indigenous Australians.  The Indigenous health crisis needs more than a quick fix; long term help needs to be put in place so that there is equity among all Australians.

The idea of social justice principles is that the concept of justice is met on a social scale. In terms of health, this means that all of the population has equal access to health care and resources as required and no minority should be excluded from this. Diversity refers to recognising the cultural and social diversity of society. In order for changes to occur, Australians need to understand the differences between Indigenous and non-Indigenous populations and work together to make a difference. Suppotive environments need to be created so that Indigenous people can feel safe and be cared for in the way that they need i.e. creating greater networks between Indigenous and non- Indigenous people, support for those who are suffering and positive environments for children to grow up in. By providing supportive environments, big changes can occur such as promotion of good health, quit smoking campaigns, rehab facilities for those suffering from substance abuse which all leads to positive change within the Indigenous community.

A United Nations report claimed that Indigenous Australians have the worst life expectancy rates of the 90 countries that were tested. Indigenous Australians and Nepal’s Indigenous people both have a life expectancy that is 20 years less than those countrie’s non-indigenous residents. Australia and Nepal tie for having the largest gap in life expectancy. John Paterson, chief executive officer of Aboriginal Medical Services Alliance of the Northern Territory (AMSANT) said that research mirrored these findings, and “to improve the status of Aboriginal health, one key measure or approach is for Aboriginal people to become more involved in decisions around strategies, programs in primary healthcare.”

“According to the UN report, indigenous peoples experience disproportionately high levels of maternal and infant mortality, malnutrition, cardiovascular illnesses, HIV and other infectious diseases such as malaria and tuberculosis”. Although the Australian Government has recognised the large “gaps” between indigenous and non-indigenous populations, there is still the need for sustained action. Which is why the Australian Government has allocated nearly $1 billion from the 2009-2010 budget to improve Indigenous health.

We definitely need to consider Social Justice Principles when dealing with the health of Indigenous Australians. There are no “health” reasons that would mean the life expectancy Indigenous Australian’s should be so low (meaning there is no medical problem that Indigenous Australians have and non-indigenous Australians do not). This also means that one of the main reasons for the large “gap” in the life expectancy of Indigenous and non-Indigenous Australians must lie in other causes. For example, an inequity between the two populations and a lack of a supportive environment among Indigenous Australians. This means that most (if not all) the reasons for the lower life expectancy of Indigenous Australians are preventable.

Diversity refers to circumstances, experiences and characteristics of stakeholders. One of the reasons why so many Indigenous Australians do not get health care may be that they choose not to. Equity refers to fairness i.e. all Australians shoud have access to health care and resources. One obvious reason behind the large “gap” between Indigenous and non-Indigenous Australians may be that Aborigines do not have access to resources such as hospitals and health professionals, which is definitely not fair or just. Supportive environments relates to not just physical but also cultural, political, social and economic environments). I feel that there is a definite lack of supportive environments for the Aboriginal community, making it hard for them to maintain good health and gain access to health resources. However, it is not enough to just say that these supportive environments do not exist so that is why they have a low life expectancy. Now that the Close the Gap program is in place, people have started to make the connection between health status and the importance of supportive environments, especially amongst Indigenous populations.

Bibliography:

 Statham, L, January 15 2010, ‘Aborigines have ‘worst’ life expectancy,’ The Sydney Morning Herald, viewed 4 July 2010, <http>://news.smh.com.au/breaking-news-national/aborigines-have-worst-life-expectancy-20100115-mber.html

The rate of young children being diagnosed with pneumonia is the highest in the world, with approximately 78.4 cases per every 1000 Central Australian children. A new study has found that these numbers are climbing, especially in children under the age of one. As well as chest infections, the study has uncovered that decayed teeth were more prevalent in Aboriginal communities, and untreated teeth problems was 3.1 times higher than in urban townships. Menzies School of Health Research in Darwin post-doctorate, Kerry-Anne O’Grady, has deemed her findings “unacceptable in a wealthy country like Australia”, and that programs into improving indigenous health should be a “national health priority”.

The Health Impact Assessment of Intervention has labelled outside leadership of indigenous communities such as restrictions on the purchase of alcohol and intervention by government, as doing “more harm than good”, by damaging the psychological, social and cultural health of these communities. The Australian Indigenous Doctors’ Association president has even stated that these reports are conclusive that Aboriginal health is “the sickest in the country” and Australia is “a long way off having equality in healthcare at the moment.”

This issue presents many different problems when related to the social justice principles. Firstly, the Aboriginal culture is a very diverse and unique lifestyle, and extreme caution must be taken when government intervention occurs, as you may damage the community more than improving it. Equity is obviously a strong issue when considering this problem, as the healthcare system in rural and indigenous areas of Australia is considerably poorer than other areas of Australia where citizens have access to better care, and the opportunity for more choices when concerning their health.

The supportive environments of Aboriginal children is not adequate. The social, physical, educational and economical surrounds of these children does not support positive health outcomes. Living conditions may be significantly poorer, and necessities such as fresh food and water may not be accessible. The overcrowding of homes, and the hygiene kept by Aboriginal children is potentially very detrimental to their health.

If the social justice principles are not addressed adequately, the health outcomes of Aboriginal children will not be of the same standard of non-indigenous children that receive better health care, and more positive health outcomes.

REFERENCES: The Australian 2010, Indigenous pneumonia rates top world, viewed 6th July 2010, http://www.theaustralian.com.au/news/nation/indigenous-pneumonia-rates-top-world/story-e6frg6nf-1225867469886