Improvement of Health Care Services Received by Indigenous People in Australia - Essay Example

?Do Indigenous groups in Australia receive a fair allocation of health resources? Potential policy changes that might improve health outcomes for theIndigenous population Contents Introduction …………………………………………………2 Indigenous health…………………………………………….3 Economics and Health Policy..………………………………4 Health programs………………………………………………6 Potential Policy changes...............……………………………9 Conclusion. …………………………………………………..11 Reference .................................................................................12 Introduction Health care is an indispensable part of any country’s growth and development since it indicates a health care system that makes health care facilities accessible at affordable prices to all citizens. Health care system provides beneficial packages to every member of the society with the objective of providing quality health care services to ensure enhanced health outcomes (World health report, 2013). The health care industry is always undergoing changes and is under constant pressure to deliver the best services. Public demand of quality health care services is increasing and at the same time the cost involved in providing these services is also increasing. Moreover, there is scarcity of resources, and government and insurers are demanding their money’s worth. Health pattern is also changing with increasing population with chronic diseases becoming more common and more difficult to manage. Traditional medical services need to be replaced with modern and more effective services. Constant medical innovations have increased the expectation levels of both consumers and health professionals. The need is a broader system with adequately skilled professionals and new technologies to deal with the challenging environment (Harris, 2006, p.xvii). One long term challenge for the Australian governments is to enhance the health profile of Indigenous people in the country. There is wide disparity in the health conditions between the Indigenous and non-Indigenous Australians. This has been accepted by the United Nations committees as part of their human rights issues and is also accepted by the Australian governments (Dick, 2007). This paper focuses on health care services received by Indigenous Australians and necessary policy changes to improve health outcomes for this population. Indigenous health In Australia, there are two groups of Indigenous population who have been in the country for more than 60,000 years: Aboriginal people from the Australian continent and the island state of Tasmania, and Torres Strait Islanders. These groups together comprise up to 2-4 percent of the total Australian population (Anderson et al., 2006, p.1776). Research has proved that the standard of general health of Indigenous Australians is much lower than that of the majority of Australians, and this would have been revolutionary matter if it had existed in the broader community. Periodically various reports are released regarding the appalling health conditions of the Aboriginal communities that create shock waves and induce demands for appropriate actions. However, such reports seem to have little impact on health policies for the Aboriginals and very soon the gravity of the situation is forgotten till the next report is released (Saggers & Gray, 2007, p.1). The differences in health conditions arise from social inequalities. Although some important elements are differences in accessibility of health services as well as differences in lifestyle, but major factors that determine unequal health status between Indigenous and non-Indigenous Australians are the circumstances under which they are born, grown up and work (Marmot, 2011, p.512). General population studies have proved that Indigenous Australians have greater mortality and disability rates at every phase of life than non-Indigenous Australians. This is because the former suffer more from chronic heart and renal diseases for which they are hospitalized. Such differences are mostly caused by a ‘wide range of biological, socio-cultural, political and economic determinants of health’ (Rosenstock et al., 2013, p.356). The wide inequity in health conditions between and within countries is an issue of major concern globally. Research has proved that many social factors contribute towards such health inequities. Therefore the need is that health issues must be the subject of not only health policy makers but also policy makers in every sector. According to WHO (World Health Organization) the definition of health inequity is ‘difference in health which is not only unnecessary and avoidable but, in addition, is considered unfair and unjust’ (Carter-Pokras & Baquet, 2002, p.427). One of the most prominent examples of health inequity exists in Australia. In this country, Indigenous population has 20 year lower life expectancy than the other Australians according to 1998-2000 reports. Australian Indigenous population experiences poor health and negative birth outcomes like low birth weight and premature birth much more than the general population. Also, more people from Indigenous population needs to get admitted to hospitals than other Australians (Turrell et al., 2006, p.2). The life expectancy in men of Indigenous population is 56.3 years while in women it is 62.8 years. The reason behind poor health and low life expectancy cannot be attributed only to poverty and child deaths since infant mortality is mere 12-7 per 1000 births. Major factors that contribute towards low life expectancy are ‘non-communicable disease and injury’ (Marmot, 2005, p.1100). Infant mortality rate is considered as a major parameter for assessing the health standards of a community. During mid 1960s, this rate was as high as 100 per 1000 births among the Indigenous population in Australia. However, there has been a constant rate of decline in the rate and by 1981 it was 26 per 1000 births. Since then the rate has declined more because of improvements in ‘post-neonatal mortality’. Also, development of Indigenous health programs in the 1970s along with improvement in the community infrastructure has contributed towards the declining infant mortality rate (Gray et al., 2002, p.7). Economics and health policy The links between economics and health policy are myriad in any country. In the 1960s, only 5 percent of the GNP (Gross National Product) was spent on health care by the Australian governments and in the early 1990s as high as 8.5 percent of national income of the country was consumed by health policies. The major concern here is not whether the amount is sufficient for nation wide health care, but whether the funds are spent in appropriate manner under right conditions and on the right people. With constant innovations in the medical sector, people’s expectations on quality health care have increased as well as the demand for health resources (Mooney & Scotton, 1999, p.xiii). The impact of the global financial crisis has been strong on the Australian government. In response to the crisis the government has made considerable one-time payments to many families and has enhanced expenditure on infrastructure related to education and transport. On the contrary health has been considerably ignored in budget sessions, and expenditure in this sector has been constrained to make savings in the national fund (Gool, 2009). It has however been observed that improving health conditions of Indigenous Australians does not only mean that the national wealth should be spent only on medical issues like hospitals and doctors’ charges (Leeder, 1999, p.2). There are other barriers that this population face while accessing to health care services. Such barriers include ‘distance, availability of transport, access to GPs and pharmaceuticals, the proximity of culturally appropriate services, proficiency in English, the extent of the involvement of indigenous people in the delivery of health services, private health insurance cover and economic disadvantage’ (Palmer & Short, 2000, p.281). Adequate investment on transport facilities like railways can do more good than spending on medical technologies as the former can enable people to reach medical service centers conveniently. Moreover, creating more employment opportunities for indigenous population can increase their economic stability thus enabling them to spend more on their medical needs. Also, proper education can make the aboriginal communities more health literate thus can create awareness among them to choose the right kind of health care system and to lead a healthy lifestyle (Leeder, 1999, p.2). So far the education services for the Indigenous people are replete with ‘expensive failures and placebo policies’ (Penfold, 2013). Although billions of dollars are spent on education programs every year, it is however been observed that the programs are structured in inefficient manner, funds are being wasted, education services are not implemented properly and resultant outcome is poor. This scenario is consistent in studies conducted by governments every year (Penfold, 2013). Health programs An interview conducted on people responsible for resource allocation in Australian health care system revealed a number of facts. An economic assessment of health resource allotment is encouraged by a number of factors like benefit to the department, easy accessibility of information, and treatment processes that are compatible with the patients’ needs and widely acknowledged. Some discouraging factors that are interpreted are tight schedules regarding designing policies, budgetary constraints, impractical savings and slow movement of finances from one department to the other (Baghbanian et al., 2011, p.280) Although paucity of resources is a common problem faced by health decision makers, it is however seen that decision makers look upon various other factors before making economic assessment while making decisions regarding health resource allotment. High prevalence of mental problems and psychological distress is a major contributor towards physical illness and high mortality rates among Indigenous Australians. In spite of this high occurrence of mental illness, only one third of the population has access to any kind of mental health services especially in remote areas of Australia. For any kind of health services to be effective it is required that the services be culturally compatible with Indigenous Australians. For this purpose, community people should be participating in designing and promoting health programs. A study conducted on 21 people involved in health services has revealed that there has been decline in the rate of smoking and alcohol consumption since the development of SEWBS (social and emotional wellbeing service). For further development of the program it is recommended that the staff be well trained and supervised, community people become involved in making decisions and proper research be done to adapt the programs to changing circumstances (Carey, 2013, p.1). The Minister for Indigenous Health, Warren Snowdon has launched the Health Heroes campaign which is focusing on bringing more Indigenous workforce in the health sector for the community (New National ‘Health Heroes’ Campaign....., 2013). Racism has a major contribution towards discrimination in health services between Indigenous and non-Indigenous Australians. Current health policies are designed in the manner that reflects the White people’s perspective of convenience. The policies carry a stamp of their sense of superiority and the health resources are effectively managed and used by the Whites for their advantage. The major concern is that such racist attitudes remain unreported in health care matters in spite of the appalling effects on the health of the Indigenous population (Durey & Thompson, 2012, p.153). People from ethnic minorities get fewer opportunities to avail themselves of health care and as a result chronic diseases like diabetes or heart disease are common among this population (Eliminate health disparities, 2013). A survey conducted in 2003 revealed that 40 percent of the Australian Indigenous population experiences discriminations regarding medical treatments because of their race (Paradies et al., 2008, p.6). It has also been reported that Indigenous people has three times less chance of kidney transplant than the non-Indigenous Australians. Such experiences increase psychological disorders and drug consumption in the community (Smiles, 2008). Other than racism, there are other factors like ‘quality of early years of life, education/ employment levels, income/social status, social support networks, cultural influences, government policy/intervention, access to services like public transport, health clinics, supermarkets, discrimination and social exclusion’ (Health inequities in Australia, 2012). In recent years there has been development in the overall health matters of the general Australian population; however there has been almost no advancement in the health of the Indigenous population who suffers from higher rates of chronic diseases and lower life expectancy as compared to the general Australians. According to Ring and Brown (2002), the need is to provide adequate financial support to the Primary Health Care Access Program. This program aims at providing health services to reduce the number of hospitalization cases among the Indigenous people, and also provides treatment at early stage to ensure good health in later years of life. It is also needed to establish a National Training Plan to prepare efficient workforce for health services. The Indigenous people suffer from shortage of supply of water, electricity and sewerage services, and so the third requirement is to implement a National Infrastructure Plan to ensure continuous supply of water, sanitation and other basic services including proper education (Ring & Brown, 2002, p.629). In 1926, the Federal Health Council was established whose membership included ‘Commonwealth Director General of Health and the Chief Health Officer of each State’. In February 1937, the first meeting of NHMRC (National Health and Medical Research Council) was held mainly to discuss various research activities on medical issues (History of the NHMRC, 2013). The principle objective of the Council is to enhance the health system of the Indigenous population in Australia. There are a number of responsibilities and the Council members strive to fulfill all of them which includes performing functions that will increase the health standard of both general and Indigenous population across the nation, maintain consistency and equity in the health system of both states and territories, support all kinds of research activities related to medical and public health, prepare staff for the health services, and promote ethical issues in health matters. In order to achieve the necessary target of maintaining proper health standards among Indigenous population, NHMRC endeavours to spend 5 percent of funding under MREA (Medical Research Endowment Account) on Aboriginal and Torres Strait Islander health every year (Indigenous Health, 2013). Since 2003, there has been a constant rise in the proportion of MREA funds on research activities of Indigenous health issues and this is shown in the following table :- Year Expenditure ($) Proportion 2003 9,389,167 3.0% 2004 11,619,028 3.4% 2005 17,613,996 4.3% 2006 20,021,823 4.5% 2007 22,745,583 4.3% 2008 31,155,736 5.0% 2009 36,113,332 5.1% 2010 41,685,595 5.7% 2011 44,304,234 5.6% 2012 46,754,663 5.9% (Source: Indigenous Health, 2013) Potential policy changes In order to eliminate health inequities the Australian health policy makers should focus on factors that are avoidable like racism and socioeconomic disparities rather than just discussions on health inequalities. Considering the known elements that trigger health inequities, discussions should be on avoidable and unjust factors. It is not just sufficient to make broad statements about decreasing or eradicating health inequities since there may always be disagreements regarding avoidable and unavoidable factors. Therefore, the priority of research studies should be hitherto unknown means of eliminating health disparities. Research should also focus on the elements that will act as proper intervention methods, and to make the environment favorable for proper health (Carter-Pokras & Baquet, 2002, p.432). An all round development in the health sector is needed to meet the needs of both general and Indigenous population of Australia, and to achieve this end it is needed to alter Australia’s ‘tight- fisted and mean- spirited approach to aid’ (Toby & Shahar, 2007, p.426). For an efficient development of a health research program it is required that ethical issues be duly considered. For this purpose, ethics related information must be collected and accordingly the health research program must be planned and designed. In case of research regarding the health of Indigenous population in Australia, there is often a high level of mistrust that exists between researchers. This is because researchers often attempt to comprehend and assume from their own cultural perspective the cultural values, beliefs and practices of Aboriginal and Torres Strait Islanders. The Indigenous people in Australia often express increasing concern that there is lack of proper communication between different health researchers. They also remain concerned that their values are undermined or ignored because of absence of sensitivity towards their culture, and for this reason they believe that research results are often not compatible with their health requirements. For maintaining growth in the process of developing Indigenous health projects that will meet the health requirements of the Aboriginal and Torres Strait Islander people, it is needed that researchers hold consultations on regular basis with the Indigenous communities. From such consultations broad ethical matters must be properly understood before passing all information to other researchers. Researchers who are concerned with health issues of general Australian population often remain unaware how to deal with Indigenous health matters, and these researchers may even show reluctance to embark on Indigenous health research. This is not a fair attitude as this will rather increase the growing concern of the Indigenous people and will also continue to have negative impact on the trust level between the health researchers and the Indigenous population (Wand & Eades, 2008, p.584). To prevent racism from negatively affecting the health of the Indigenous people, it is needed that the community people be trained to become doctors or nurses so that they can play a direct role in the health services (Nakata, 2001, p.223). Conclusion Indigenous health research can be a promising field considering there is efficiency and fairness in the research activities to improve medical services for the Aboriginal people. There should be sufficient planning and preparation, and also the researchers should be communicating with the Indigenous communities and should work in collaboration with the people to ensure that research outcomes are practical, ethical and culturally sensitive. Since the objective of collecting Indigenous health information is for the advantage of the Indigenous people, so the need is to make strategies to distribute the results among the community. It is not required that new policies are designed or new strategies are made; instead the focus should be on executing the current Indigenous health programs in a more efficient and ethical manner. Focus should also be given on education to Indigenous people to enhance health awareness. References 1. Anderson, I. et al., 2006. Indigenous Health in Australia, New Zealand, and the Pacific. Lancet, Vol.367, pp.1775-85 2. Baghbanian, A., Hughes, I. & F.A. Khavarpour, 2011. 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