Multiculturalism Health Disparities In Australian Healthcare - Report Example

Introduction Grief and loss has been integral part of thousands of indigenous people across Australia. Majority of indigenous children have been forcibly separated from their families and communities since European colonization (Van Krieken, 1991). The conflict for land, capital and power saw kidnapping and exploitation of indigenous children as labours in Australia. National Governments have targeted indigenous children for removal from their families (Reynolds, 1990). The motive was to ‘inculcate European values and work habits in children, who would then be employed in service to the colonial settlers’ (Ramsland, 1986). The initial co-operative step towards the development of indigenous children taken away from families due to colonisation was in 1814 when Governor Macquarie funded the first school for Aboriginal children. In nineteenth century the protectorate experiment had failed and the very survival of indigenous people was being questioned. Forced off their land to the edges of non-Indigenous settlement, dependent upon government rations if they could not find work, suffering from malnutrition and disease (Van Krieken, 1991). The national government of Australia started treating indigenous people as nuisance in end of 19th century. The government sentiments drastically changed in 1911 when rules & regulations were passed related to land reservation for the exclusive use of indigenous people (Ramsland, 1986). On the other hand, end of 19th century saw protectionist legislation passed in Australia for indigenous children development and welfare (Reynolds, 1990). As parents of indigenous children were sketched as nuisance the government started removing children from their mothers at about the age of four years and place them in dormitories away from their families and to send them off the missions and settlements at about 14 to work (Haebich, 1988). Bottom-line: Australian government took a neutral stance till 19th century to control the reproduction of indigenous people with a view to ‘merging’ or ‘absorbing’ them into the non-indigenous population (Haebich, 1988). The bottleneck of neutral absorbing strategy of Australia government saw greater numbers of Indigenous children were removed from their families to advance the cause of assimilation (1950-1960). Not only were they removed for alleged neglect, they were removed to attend school in distant places, to receive medical treatment and to be adopted out at birth (Haebich, 1988). The cause-effect analysis of Australian government forced movement of indigenous children from parents could be seen from the below statistics of 1994 Census. Educational Qualification (1994)       Taken Away Not Taken Away Higher 1.90% 2.00% TAFE 1.90% 1.80% Other 0.60% 1.00% None 95.60% 94.80% Source: 1994 ABS National Aboriginal and Torres Strait Islander Survey According to national survey of Indigenous health in 1989 found that almost one-half (47%) of Aboriginal respondents of all ages had been separated from both parents in childhood. On the other hand, the most recent survey showcased the following: 10% of indigenous children aged 25 and above had been removed in childhood across Australia (Australian Bureau of Statistics survey of Aborigines and Torres Strait Islanders, 1994). Almost 60% of indigenous children taken away from parents for decades in Australia were unemployed. This was similar to indigenous children not taken away from parents post friendly regulations. Thus overall it could be seen that unemployment is high amongst indigenous people even after absorption with non-indigenous population. On the other hand, those indigenous children separated from families earned lower than average ($19,4001 in 1994). Employment Status (1994)       Taken Away Not Taken Away Employed non-CDEP 22.80% 25.00% Employed CDEP 8.20% 8.50% Unemployed 22.20% 20.00% Not in labour force 46.80% 46.50% Source: 1994 ABS National Aboriginal and Torres Strait Islander Survey Income Status (1994)       Taken Away Not Taken Away $0-16,000 88.00% 87.00% $16,000-30,000 17.00% 17.00% $30,001-40,000 3.00% 3.00% $40,001 plus 2.00% 2.00% Source: 1994 ABS National Aboriginal and Torres Strait Islander Survey Thus from the above initial analysis it could be seen that removal of indigenous children from parents served as bottleneck for the Australian government in long run. Overall indigenous children suffered to larger extend (separated and non-separated from families). Thus in 1994 the government passed recommendations to reduce income and unemployment between indigenous and non-indigenous children on long term basis. Research Question Did recommendations of national government of Australia in 1994 improved quality of life and standard of living for indigenous people and Torres Strait Islander population? In the research note we would be analysing the 5-6 recommendations and impact of those on indigenous people and Torres Strait Islander population in recent years (2005-2008). Recommendation 1: The national government should enhance the funding of Indigenous language, culture and history centres to ensure national coverage at regional level (Carrington et al., 2007). Where ever the Indigenous community so determines, the regional language, culture and history centre be funded to record and maintain local Indigenous languages and to teach those languages, especially to people whose forcible removal deprived them of opportunities to learn and maintain their language and to their descendants (Carrington et al., 2007). Impact Analysis: In Australia it was estimated that there were 250 Indigenous languages at the time of European settlement or colonisation2. As per the survey report in 2005: Only 18 Indigenous languages are now considered strong and have speakers across all age groups primarily in 25 years age children (www.immi.gov.au). Around 110 Indigenous languages are still spoken by older people but can be considered endangered (www.immi.gov.au). On broader term across Australia as nation, Australians speak over 200 languages in 2008. In 2008, Italian was the most popular language other than English spoken at home followed by Greek, Cantonese, Arabic and Mandarin (www.immi.gov.au). Thus the indigenous language and culture as recommended to be preserved and enhanced as language and values no longer stands in 2008 (www.immi.gov.au). At the beginning of the 20th Century, Christianity was the dominant religion in Australia, peaking at 96.9 % of total population in 1921 (Carrington et al., 2007). Christianity declined rapidly as per 2008 census due to higher mobility and immigration and stood at 63.9% of total population (www.hreoc.gov.au). In 2008, Catholics were the largest religious group in Australia at 27.8%, of the total population, while Anglicans were the second largest at 21.7%. The next largest religious groups were: Uniting Church at 4.7% and Presbyterian and Reformed at 3.0% (www.hreoc.gov.au). The religious discrimination stood at moderate range in Australia on overall basis in 2008.   Federal NSW QLD VIC SA WA ACT TAS NT Religious Discrimination No* No** Yes Yes No Yes Yes Yes Yes Religious Vilification/Hatred No No Yes Yes No No No Yes No Source: www.hreoc.gov.au A total of 121,221 persons were bestowed with Australian citizenship in 2007-08. Migrants from the United Kingdom (22%), India (7%), China (6%), New Zealand (5%), South Africa (4%), Iraq (3%), and the Philippines (3%) together comprised 50% of total population in 2007-08. Bottom-line: From the above analysis it could be seen that there has been religious discrimination and higher concentration of religious sects such as Christianity and Anglicans across the nation. Non-indigenous language, religion and population has grown to larger extend due to immigration and government rules & regulation related to economic development. The development of indigenous culture, language and historical centres has declined sharply post 1994 recommendation. Recommendation 2: That monetary compensation is provided to people affected by forcible removal under the following heads. The criteria for receiving monetary compensation are as follows: Racial discrimination. Arbitrary deprivation of liberty. Pain and suffering. Abuse, including physical, sexual and emotional abuse. Disruption of family life. Loss of cultural rights and fulfilment. Loss of native title rights. Labour exploitation. Economic loss. Loss of opportunities. Impact Analysis: The average weekly household income for indigenous peoples (A$460) was only 62% of that for non-Indigenous people (A$740) in 2008. On the other hand, land ownership for indigenous people and children deprived from parents stood as 62% (2006: 63%) rental accommodation 10% (2006: 12%) own houses upfront and finally 18% (2006:24%) own their homes with a mortgage. There were mere 40% (2006: 43%) of indigenous households consisting of internet facilities as compared to 78% (2006: 64%) of non-indigenous ones in Australia in 2008. The homelessness of indigenous people has rapidly increased in majority of neighbourhoods across Australia in 2008. NSW Vic Qld WA SA Tas. ACT NT no. No. no. no. no. no. no. no. No conventional accommodation 1250 55 2469 1402 152 24 4 927 Hostel, refuge, night shelter 1206 38 1198 1176 39 9 14 82 Friends/ relatives 1315 70 1352 171 67 43 19 134 Total number 3771 163 5019 3749 258 76 37 1 143 Source: Australian Bureau of Statistics (April 2009). The pain and suffering hasn’t much decreased for indigenous households post drafting of 1994 resolution by Australian government. This could be seen from the following rationale as per Australian Bureau of Statistics in April 2009: Many Indigenous families and communities live under severe social strain, caused by a range of social and economic factors. Alcohol and substance misuse, and overcrowded living conditions are just two of the factors that can contribute to child abuse and violence. In 2008-2009, indigenous children were nearly six times as likely as other children to be the subject of abuse or neglect. Adult imprisonment is also high with indigenous population in Australia. In 2009, indigenous prisoners represent 27% (2007: 24%) of the total prison population in Australia. Bottom-line: As per the recommendation monetary compensation should be provided to indigenous population facing pain and suffering, Abuse, including physical, sexual and emotional abuse, disruption of family life etc. From the above analysis it could be seen that indigenous population are suffering higher emotional pain, abuse and racial discrimination in 2008-2009. There has been low development by national government in Australia with respect to the recommendation. Recommendation 3: The Commonwealth and individual State and Territory Government institute traineeships and scholarships for the training of Indigenous population on regular basis to reduce income and unemployment gap with non-indigenous population across Australia. Impact Analysis: Eight new Aboriginal and Torres Strait Islander Health Worker qualifications were approved and funded by Education Ministers in March 2007 for scholarships in specialisations such as archivists, genealogists, historical researchers and counsellors. The Australian Government is working in close collaboration with Australian Indigenous Doctors’ Association, the Congress of Aboriginal and Torres Strait Islander Nurses, and the Leaders in Indigenous Medical Education Network to develop and implement strategies to increase the Aboriginal and Torres Strait Islander health workforce (www.health.gov.au). In 2008, strategic partnership with the Australian Government the SA Department of Health was signed in order to implement an Aboriginal Program of Experience in the Palliative Approach (PEPA). This care workforce development and education initiative is aimed to enhance the skills and expertise of health care providers in providing care for Aboriginal peoples with a life-limiting illness and their families (www.health.gov.au). In Victoria province the state government have included scholarship programs across a range of areas including alcohol and drug training, recruitment and curriculum, Home and Community Care training and development and rural training programs for indigenous children taken away from parents (www.health.gov.au). Bottom-line: As per the recommendation individual State and Territory Government institute are offering aggressive commitment towards traineeships and scholarships for Indigenous population. There has been high development by national government in Australia with respect to the recommendation. Recommendation 4: The Commonwealth Government should closely work in partnership with the national Aboriginal and Torres Strait Islander Health Council in consultation with the National Aboriginal Community Controlled Health Organisation (NACCHO) to devise a program of research and consultations to identify the range and extent of emotional and well-being effects of the forcible removal policies. Thus this recommendation is highly aligned with health is wealth policy. Impact analysis: The expenditure on Indigenous primary health care (as measured by funding of Aboriginal community-controlled health services and Aboriginal and Torres Strait Islander access to MBS and PBS) has sharply increased by 82% and 55% respectively between 2000-2001 and 2007-2008 (Australian Institute of Health and Welfare, 2008). However, the significance of such increases is mainly attributed to increased health care costs, an increasing Indigenous population, and continuing excess rates of morbidity and mortality in the Indigenous community (Australian Institute of Health and Welfare, 2008). There have been aggressive healthcare reforms related to indigenous population across the nation such as the Medical and Pharmaceutical Benefits Schemes (MBS and PBS) to ensure that funding reached Aboriginal communities. The medical funding for aboriginal communities has been increased from A$248 per person in 2000-2001 to A$412 in 2007-2008, with CAGR of 10% on year-on-year basis (Australian Institute of Health and Welfare, 2008). The funding for Aboriginal community controlled health services increased from A$241 per person in 2001 to A$438 per person in 2008 (in constant 2005-06 dollars). Bottom-line: As per the recommendation Commonwealth Government is closely working in partnership with the national Aboriginal and Torres Strait Islander Health Council to enhance health is wealth concept across the indigenous population. There has been sharp rise in healthcare expenditure for indigenous population in Australia in past 6-7 years (2001-2008). There has been high development by national government in Australia with respect to the recommendation. Recommendation 5: The Council of Australian Governments should ensure the provision of adequate funding to Indigenous health and medical services and family well-being programs to establish preventive health programs on long-term basis. Impact Analysis: There has been sharp increase in contagious dangerous epidemics such as HIV in the Aboriginal and Torres Strait Islander population increased from 4.0 per 100,000 in 2001 to 7.3 per 100,000 in 2008 (Department of Health and Community Services, 2009). On the other hand, it could be seen that rate of hepatitis C notifications in the Northern Territory, South Australia and Western Australia is more than double that in the non-Indigenous population as compared to indigenous base (Department of Health and Community Services, 2009). Further, on country basis, experimental Indigenous life expectancy at birth for 2004-2008 is estimated at 56.4 years for males and 65.8 years for females. This is well below the 72.8 years and 89.8 years for total males and females respectively, for the same period. Source: Territory Health Departments Finally, it could be seen that the rate of diagnosis of chlamydia in Aboriginal and Torres Strait Islander people in the Northern Territory, South Australia, Victoria and Western Australia rose from 751 per 100,000 populations in 2004 to 1,111 per 100,000 populations in 2008 (Department of Health and Community Services, 2009). The rate of diagnosis of Chlamydia almost doubled in the non-Indigenous population, and is twice that of non-indigenous population across Australia in 2008 (Department of Health and Community Services, 2009). Bottom-line: As per the recommendation the government should ensure optimal funding for enhance preventive healthcare programmes for indigenous population. The preventive programmes has been lacking as rates of HIV, Chlamydia and other diseases is sharply increasing in the indigenous population base across the national and neighbouring territories. There has been low development by national government in Australia with respect to the recommendation. Proposition Thus it could be seen that out of five recommendations sketched in Bringing Them Home report in 1997 the government has performed low-moderate on year-on-year basis (rating on scale of 1-5 i.e. 2). Recommendations on healthcare expenditure and skill set development in niche market such as archivists, genealogists, historical researchers is taken seriously and acted upon by Australian government. The government lacks actions on preventive healthcare programme implementation along with reduction of pain and proper compensation and overall economic development for indigenous population whose children were taken away post colonisation. It is long-term process of implementing and performing moderate-high on all 54 recommendations drafted in Them Home report in 1997 but it has performed fairly well and implemented core strategies to enhance living standard and improve quality of life for grief stranded indigenous population whose children were forcefully taken away in 1900’s. References The Committee on Economic, Social and Cultural Rights, General Comment No. 13, (1999), para 6(a). Vos T, Barker B, Stanley L, Lopez AD (2007). The burden of disease and injury in Aboriginal and Torres Strait Islander peoples. Brisbane: School of Population Health, The University of Queensland Victorian Aboriginal Community Controlled Health Organisation (2007) Communities Working for Health and Wellbeing: Success stories from the Aboriginal Community controlled health sector in Victoria. Victorian Aboriginal Community Controlled Health Organisation and Cooperative Research Centre for Aboriginal Health. Thomas, D. P., J. R. Condon, et al. (2006). "Long-term trends in Indigenous deaths from chronic disease in the Northern Territory; a foot on the brake, a foot on the accelerator." MJA 185: 145-149. Panaretto, K., M. R. Mitchell, et al. (2007). "Sustainable antenatal care services in an urban Indigenous community: the Townsville experience." MJA 187: 18-22. Hill, K., B. Barker, et al. (2007). "Excess Indigenous mortality: are Indigenous Australians more severely disadvantaged than other Indigenous populations?" 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Canberra: Centre for Aboriginal Economic Policy Research, Australian National University. http://www.dpac.tas.gov.au http://www.closethegap.com.au/ http://www.pc.gov.au http://www.health.nsw.gov.au http://www.hreoc.gov.au http://www.humanrights.gov.au/ Read More