Impact of Racism and Discrimination on Health in Australia - Example

Running Header: Impact of Racism and Discrimination on Health in Australia SOCIOLOLOGICAL THEORETICAL PERSPECTIVE: How racism and discrimination impact on access to health services in Australia. Your Name: Course: Institution: 23/04/2011 Introduction Marginalized and vulnerable social groups bear insurmountable health problems as many health disparities are embedded in fundamental social structural inequalities, which are inextricably related to racism and other forms of discrimination in society. Health and mortality in general rarely diverge far from economics and social relations, which leads to the conclusion that to eliminate differential in health outcomes requires addressing the underlying social inequalities that so reliably produce them. The right to health is a fundamental human right that all living souls are entitled to. The practice of racism and discrimination in healthcare, inter alia sectors is a factor of outstanding prevalence amongst the Aboriginals and the non-Aboriginals in the Australian fraternity. Racism is herein perceived as a fundamental social determinant of health. It is the most universal and persistent inequality in the provision of multi tiered or differential treatment. Racism and discrimination are an extreme health disadvantage affecting not only the Australian society but the world at large. “A state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmary” - World Health Organization (1946) definition of health This essay will begin by providing a brief overview of racism and discrimination and how these two factors have affected the provision and distribution of health care services and facilities. The reasons why the indigenous Australian communities are almost neglected in terms of health provision as compared to other non-indigenous Australian communities will be adequately explored in this essay. This essay also supports the concept of race as a social construction that is evasively shaped and reshaped. Individuals identify themselves by being socialized within ideologies of race where specific social groups define boundaries of inclusion and exclude those who do not meet their conditions. The dilapidated health status of the Aboriginal and Torres Strait Islander health and the 17-year expectancy gap are vividly depicted in the Australian lifestyle. It is postulated that the Aborigine and the Torres Strait Island as the minority, registers the highest death toll, simply because of discrimination in health care. According to recorded findings, racism occurred both interpersonally and institutionally, with the latter encapsulating discrimination in health care institutions. Despite the 2007 rights ratification of the UN Declaration on the Rights of Indigenous people, racism still lingers in Australia. There are two notions of racism relevant to this essay: institutional racism and symbolic violence. According to (Henry et al 2004, pp 171-179) institutional racism refers to the ways in which the racist beliefs or values have been inculcated into the social institutional operations with the aim of discriminating against, controlling and oppressing various minority groups, say Aborigine. The Australian Medical Association (AMA) Aboriginal and Torres Islander Health Report Card in 2007 found that the Aboriginals were worse in some specific health areas. The AMA president acknowledged that there were still ‘’too many barriers’’ stopping Indigenous patients getting access to better health care, and institutionalized racism as one of the key contributor to this scenario. A lot of institutional racism is arch diving in Australia and the world over, posing a threat to the co-existence in both local and global diversity. The paper herein takes a keen look at prevalence of this vice in Australia. Symbolic violence plays a significant role in the analysis of domination. (Connelly, P and Healey, J 2004, pp 15-33) perceive symbolic violence in a two-fold spectrum; first it is seen as an act of violence since it leads to the constraining and subordination of persons. From a symbolic perspective, Connelly and Healey perceive it as a sense that can be achieved indirectly without need to use energy or plead or coax. In any social setting, lack of reflection and interrogation with regard to the existing system only serves to breed more discriminatory opportunities. Pursuant to the launch of a state protection of the affected persons, the Aboriginal Community Controlled Health Services (ACCHS), was established a time when most Australian Aborigines were handled with a racist attitude, cost of the services notwithstanding. With the ACCHS had the great onus of integrating the clinical paradigm in a holistic healthcare system. In the heart of an Aborigine society, cultural safety is indeed a lacking agenda. (Coffin, J 2007, pp 31(3): 22-24.) perceives cultural security as an amalgamation of cultural awareness and cultural safety; both of which are pertinent in a socio-cultural setting. Kleinman, A and Eisenberg,L 1978, pp. 251-258.) Postulate that biomedical diagnosis has got a cultural parameter that must be brought to book for logical examination to be executed. Healthcare can be culturally multifaceted herein to mean; the care that is culturally appropriate, culturally aware, cultural safe, culturally responsive, culturally congruent et cetera. A short in any of the above stated therefore result to some form of discrimination. The fact that the Indigenous people of Australia do not have an understanding of the English language renders communication a hurdle, hence further culminating in cultural discrimination. Organizations have been tailored by the government to address the Aboriginal and Torres Strait islander people from such discriminative attack. In recent years, it has been observed that racism and its effects have greater impact on health status. The experience of racism by indigenous people every day can directly contribute to poor physical and mental health. There is a connection between racism and mental health conditions such as psychological distress, anxiety and depression. Racism is also consistently associated with health risk behaviors such as alcohol, smoking and substance abuse. There is also a link between heart disease and depression and psychosocial stress brought about by the isolation, poverty, lack of empowerment and a feeling of hopelessness and control over life opportunities (Commission on Social Determinants of Health 2007, 29-30 April.). In Australia, Indigenous people actually receive less specialized healthcare both as patients and outside hospitals. Indigenous patients are less likely than other patients to receive a major procedure even after adjusting for patient, episode and hospital characteristics. There are also discriminative treatment for cancers and unequal access to cardiovascular healthcare. There are confirmed reports that the Aboriginal people with lung or prostrate cancer are less likely to receive a surgical procedure than their non-indigenous counterparts. (Australian Institute of Health and Welfare 2006) Fewer and poorer health care services for racial and ethnic minorities exist in Australia. Many health care systems are also affected by cultural and linguistic barriers and fragmentation of care-providers. Uncertainty and stereotyping influence the behaviors of doctors and other health care providers when attending to people from racial and ethnic minorities. These stereotypes do influence doctor’s interpretation of patient symptoms and communications and therefore make biased clinical decisions to the detriment of minority group patients. Even though these stereotypes may not make the minority patients have hatred or open contempt, they may make them have anxiety and discomfort which may eventually lead to avoidance. There is immense workforce shortage experienced in the entirety of the Australian health system. The fact that there is limited number of suitably trained and experienced indigenous professionals but more non-indigenous professionals compounds the limited provision of health services provided to Aboriginal and Torres Strait Islander communities. The lack of sufficient health service delivery increases the negative impact on health status and wellbeing. Indigenous health professionals play a unique and critical role in achieving positive health outcomes for the Aboriginal and Torres Strait Islander people but unfortunately they are under-represented in the Australian health workforce. Statistics show that for instance in the year 2006, the Aboriginal and Torres Strait Islander health workforce comprised of 100 medical practitioners, 53 midwives, 1107 registered nurses and 965 health workers. A culturally competent and clinically qualified health workforce is crucial in ensuring Australia’s health system has the capacity to effectively meet the health needs of the Aboriginal and Torres Strait Islander communities (Green, J, 2007, pp. 11-14). Most government policies in indigenous affairs reflect the failure of the government to apply even the most basic principles of social problems and what can be done to reverse them. Concepts like locus of control, learned helplessness, self fulfilling prophecies and attributive theory would help in devising better policies not only in health but to other human aspects. External locus of control affects those who experience discrimination and powerlessness and it relates to poorer health care and academic performance. Learned helplessness widely suggests that when people frequently experience unpleasant events which they have no control over, they will experience trauma and also believe that it is impossible to exercise control in any situation and that whatever they do is futile. Consequently, they will be passive even in dire or harmful circumstances. A self fulfilling prophecy is realized when expectations about an individual’s behavior cause that individual to act in ways which confirm the expectation. Minority groups in any society are the most vulnerable to such effects, probably if the expectations are negative and constantly repeated. So when indigenous Australians hear that they are lazy, sick and unproductive, they internalize what they have heard and hence get convinced of their own ‘unfitness’ (Coffin, J 2007,31(3):22-24). Possession and access to land is a key determinant of health and wellbeing of the Aboriginal and Torres Strait Islander people. The eventful displacement of these communities since colonization has fatally caused cultural disruption, increased feeling of stress, decreased sense of identity, social exclusion, social and political oppression. It is no doubt that Aboriginal and Torres Strait Islander people live in overcrowded and unacceptable housing conditions, try illicit drugs, drink to excess, smoke tobacco, have higher levels of obesity and have poor nutrition (Commission on Social Determinants of Health 2007). Hence most of them die at a tender age in addition to experiencing disabilities and a reduced quality of life than other Australians. For instance, in the year 2001, the median age for indigenous communities was 21 years compared to other Australians whose median age was 36 years; life expectancy of 59 years for males, 65 years for females compared to 77 years for males and 82 years for females of other Australians. These statistics reveals a disparity that is glaring indictment of health inequality in Australia. The discriminations and racism that followed colonization and that exist to the present day impact heavily on stress levels and contribute to greater feelings of social exclusion (Australian Institute of Health and Welfare 2006). Access to appropriate and linked health services impacts immensely on the experience of good health. Access to basic health care facilities is crucial in offering preventative health care such as child immunization and targeted health promotions. According to (Australia’s Health Report 2006), people who live in deprived areas are still overrepresented in morbidity and mortality figures. The report farther found out that infants living in disadvantaged areas of Australia had double the death rate of those in more privileged areas. The non-urgent surgery booking lists reveal that people from disadvantaged areas are overrepresented on surgery waiting lists. This is demonstrative of the effects disadvantage has on the health of individuals and on access to health services in lower socioeconomic areas. A good education supplies us with the foundations for the future ability to make decisions and choices concerning occupation, consequently providing us with greater control and influence over our future level of income, dwelling place, our health and wellbeing for the remaining part of our lives. The level of education attained by individuals is inextricably linked to the social gradient. A recent survey by the Australian Bureau of statistics showed startling results regarding the literacy skills of Australians: only 54% of Australians aged 15 to 74 years had literacy skills required to meet the complexity demands of everyday life and work. Education is one of the key determinants of health. Health literacy is important for consumers to access, utilize and understand health related information; make informed decisions and choices regarding their personal health and empowering people around them to self manage safe health practices (Green 2007, Number 92, pp. 11-14.) The greater the level of personal income, the higher the social ladder an individual will be. Individuals in the higher social ladders access good health care, nutrition and often live longer than individuals in the lower rungs of the ladder. Social and economic disadvantage impacts upon people across the social divide with those down the social ladder having the double risk serious illness and premature and untimely deaths than those in the higher rungs of the ladder. There is also a connection between low levels of income and chronic diseases such as malignant cancer, heart disease and infant deaths. The social gradient and effects that income, advantage and social involvement have over the experiences of health and wellbeing is a discrepancy demonstrated and replicated across any society (Wilkinson 2003, p 78). In conclusion, confronting the harmful effects of racism and discrimination on Aboriginal health and reducing health disparities between the Indigenous and non-indigenous Australians is a precedence that requires a multi-tiered dedication to action. The political goodwill to change race based inequities in health care systems is crucial to facilitate culturally appropriate health service provision across the board in line with Article 24 of 2007 United Nations Declaration on the Rights of Indigenous People. Therefore, there is need to come up with a program located with a broader systemic anti-racist framework aimed at eliminating ideological and structural aspects of racism on health care practices. It of utter importance to have collaboration between policy makers, mainstream inter-disciplinary health services, academia and key indigenous stakeholders if equitable health services are to be provided in Australia. References Australian Institute of Health and Welfare 2006, ‘australia’s health: The tenth biennial health report of the Australian Institute of Health and Welfare’, Viewed 23 April 2008. Bourdieu, P & Passeron, J 1977, Reproduction in Education, Society and Culture. London, Sage. Coffin, J 2007,’Rising to the challenge in Aboriginal health by creating cultural security’, Aboriginal and lslander Health Worker Journal, 31(3):22-24. Commission on Social Determinants of Health (2007), ‘Social Determinants of Indigenous Health: The International Experience and its Policy Implications’, International Symposium on the Social Determinants of Indigenous Health Adelaide, 29-30 April. Connelly, P & Healey, J 2004, ‘Symbolic violence, locality and social class: The educational and career aspirations of 10-11-year-old boys in Belfast’ pedagogy, culture and Society 12(1):15-33. Green, J, 2007, ‘health literacy: Terminology and trends in making and communicating health related information’, in health issues 2007, Number 92, pp. 11-14. Henry, B.R, Houston,S. & Mooney,G 2004, Institutional racism in australian healthcare, Gavin H, Medical journal of Australia, vol.180(10) p.171-179. Kleinman, A & Eisenberg, L 1978, ‘Culture, illness and care’, clinical lessons from anthropologic and cross-cultural research, Ann Intern Med., pp. 251-258. Wilkinson, R & Marmot, M 2003, ‘Social Determinants of Health’: the Solid Facts. 2nd edition, World Health Organisation, Denmark. Read More