Indigenous Australians and Diabetes - Essay Example

Introduction Diabetes is a global epidemic and in most cases, the indigenous people carry a disproportionate burden .The indigenous people in Australia have among the highest prevalence of this disease and they get it at much earlier age (Dunstan et al, 2000). For instance, the prevalence of diabetes in indigenous Australians is five to ten times greater than that of non-indigenous Australians. They also have much earlier age for onset of diabetes with about 13% prevalence compared to 0.3% for other Australian population in the 25-34 year age group (Burke et al, 2007). Thus, the indigenous people have a much greater burden as compared to non-indigenous population. This article involves an assessment of diabetes in indigenous Australians; its impact on individual; family; and population. It also assesses the implication of these impacts for the role of nurse in Australian health care system. Impact on individual Based on low income on indigenous Australians, a typical diet for an individual is high salts and fats as well as low in fruits and vegetables. As a result, an indigenous Australian is at an increased risk of developing more related complications such as cardiovascular disease among others. In addition, due to poor conditions where most of them live in remote or congested areas, there is poor management of individual health leading to functional limitations, loss of working days or loss of employment as well as undergoing extraordinary medical costs. With the poor life that an individual is experiencing, diabetes leads to anxiety and stress. As a result, an indigenous Australian is at an increased risk of depression (Taylor, & Borgnakke, 2008). The complications of diabetes also affect an individual in many ways. Making changes in lifestyles is a great burden to individuals for instance, managing hypertension and other complications, paying for drugs and supplies as well as losing time from school or work. Among individuals with diabetes, there are high mortality rates which results to a decrease in life expectancy in regard to all ages as compared to non-indigenous people. In regard to morbidity burden that indigenous individuals with diabetes experience, the health adjusted life expectancy at birth was lower in comparison to other population at all ages. This leads to significant loss of years. Since the past, there has been a reluctance to recognise the expertise, wisdom and knowledge of an indigenous person. This has resulted to more harm based on the essence of the injury of colonisation which has been lived and re-lived through successive generations. Due to this, individuals with diabetes experience poor psychological wellbeing and they feel burned-out in regard to coping with diabetes. Such complications affect the overall health of an individual and the quality of life (Coffey et al, 2002). Impact on families Poverty is directly linked to ill health and by comparing with other families; indigenous families earn less money, have lower educational levels, are less likely to own homes and are more likely to be unemployed. This makes families to struggle financially when diabetes strikes. Culturally, diabetes presents various challenges to the health of the family. For instance, attitudes to personal health; the connections of indigenous people to the family or the wider community are very essential in regard to their choices about all features of their lives. Such attitudes affect the health of the family in various ways such as the importance of sharing meals in the family as a way of strengthening ties. For instance, if the meal for a family is junk foods, a person with diabetes within the family will prefer taking such foods to improve their family ties instead of being isolated in by making choices on healthier foods. Importance of relationships is also essential to indigenous people especially with the family and loved ones. In this way, a diabetic indigenous person may prefer not doing exercises as this may prevent one from joining the loved ones and the family and spending time with them, an issue that can be seen as shameful to indigenous people (Magliano et al, 2009). Diabetes has also created an emotional impact on families especially the members that are closely related to the diabetic person. With their previous records of earning low income, the family may decide not to spend their limited income on health. Due to their remoteness, the information on health for indigenous families is also limited. For instance, a diabetic indigenous person in a remote area has lower opportunities to various healthcare professionals as compared to non-indigenous people in urban areas (Coffey et al, 2002). Impact on population There have been significant variations between the indigenous population and others in regard to history, the effect of colonisation, preservation of culture, social, legal, institutional rights as well as their access to territories and lands. As a result, the indigenous people have experienced more challenges than other people as they represent the most marginalised and poorest communities in their states. Their risk to health increases with more risk factors. In comparison to other population in Australia, the indigenous people and mostly the great percentage which lives in remote areas drinks more alcohol, are more likely to exposed to various issues such as violence, they usually eat a nutritionally poor diet, have higher rate of smoking cigarettes and have a higher likelihood of being obese as well as higher mortality rates (Gregg, & Albright, 2009). In addition, the rate at which indigenous population experience racism is twice than that of non-indigenous Australians and this affects their participation and development in various areas crucial to their health such as sports among other activities. For indigenous people that live in remote areas, the diabetic people have challenges in accessing transport as well as other important facilities that are importance for improvement of their health (Trewin, & Madden, 20005). Implications for the role of healthcare professionals Traditionally, the view of indigenous in regard to health as well as illnesses is based on hunter-gatherer ways of being. On the other hand, the western views are based on industrialised state cultures. Although the two inhabit common space and time, there are various challenges in regard to the illness and health and the indigenous and western views of health professionals (McDonald, 2006). In the practice of public health, culture has contributed to various challenges as it have been more focused on production of negative stereotypes as well as lists of health behaviours and risks. With such understandings, there are more difficulties in acknowledging the real culture but focusing on racist assumptions. As Brough (2003) states social determinants of health such as social status, support and isolation are important in understanding the concept of culture especially in understanding the indigenous people as a factor of improving the health. Based on biomedical model of healing and illnesses, the ideology is based on the western concept where an individual is defined independently of the community or family (Taylor, 2003). In this way the treatment is individual focused where the health of the body is give priority over the health of the society. However, in the treatment of indigenous people such as the case in diabetes, their first priority is focused on social health rather than individual bodily health. This is one of the main reasons why the diabetic indigenous people find it difficult to adhere to individualised treatment based on their strong family and community bond. In such a way, they may be seen as not looking after their own bodies as well as failure to comply with recommendations provided by health care professionals. Thus, the distinction between the biomedical required of indigenous people with diabetes is mainly based on the relational nature of the cultures of indigenous people. According to the medical services alliance of the aboriginal people in Australia (AMSAT, 2001), use of biomedical model gives a health professional the privilege as an expert on the health of the patient and teaches diagnosis and treatment in an isolated way from historical, social, political and economic considerations. Thus, based on indigenous diabetic people, the framework tends to put little or no emphasis to global relational-moral casualty. For instance, more challenges are based on the effects of economic globalisation, which further relates to the low economic and social status on the health of indigenous people. Based on the ANMC national competency standards, health professionals have a significant role by ensuring that they demonstrate ethical, legal and professional responsibilities in addressing the issue of diabetes in indigenous Australians. Practising within the ethical and nursing framework is crucial in order to ensure that regardless of culture, race, gender and physical or mental state, the indigenous people with diabetes are accepted as individual and as a group. In addition, nurses have a great responsibility of addressing this issue while acknowledging the values, beliefs, dignity and rights of indigenous diabetic people as individuals or group. This ensures compliance with the codes of ethics and conduct in the nursing profession (ANMC, 2010). It is also important to note that though the indigenous people have been able to claim their self-determination right successfully in regard to who is indigenous as well as the basis of legitimising their claims, they way their issues of health are addressed shows the difference in legitimising their claims (Stewart, 2003). As a result, this is why there are challenges in addressing the issues of diabetic indigenous people especially in rural or remote areas. For instance, if aboriginal people the same materials benefits in individual or community level that the non-indigenous wants, they are assumed not to make claim in regard to being in different cultural needs and cultural distinctiveness. However, although they may require same materials or facilities, their cultures; that is the relationship within the community is very different. Failure to recognise this act as the main source of challenges experienced by diabetic indigenous people based on psychological damaging. This is due to failure for medical professionals and key stakeholders in medical sector in bridging the gap between traditional and modern connection in accessing better healthcare. In this case, socialisation of health care professionals is essential in order to make the indigenous diabetic people confident as well as making healthcare professionals to be aware of socialisation in their roles. This is important in addressing the issues of indigenous diabetic patients irrespective of age, sex, colour, social, religious belief or political status that seems to vary greatly between indigenous and non-indigenous population (Eckermann et al, 1992). Based on this argument, the priorities of the indigenous diabetic people are seen to be harmed because they do have different needs in regard to their culture and beliefs among other factors. As a result, when health care professionals gains the ability to treat every individual, community or population the same regardless of colour and gender among others, health becomes the symptoms of the disease that is being treated instead of people. This explains the need for healthcare professionals to engage in cultural dialogue as well as switching between indigenous and western modes of practice and knowledge. Some of the issues on diabetes in indigenous people are also based on horizontal violence in mainstreaming services towards indigenous health workers. According to Winsor (2001), there is usually control, humiliation as well as denigration of dignity which continuously occur within the place of work where health care professionals act as professional oppressors and opponents. Thus, behavioural changes seem to be an important requirement in order to ensure the confidence and equality of indigenous people. As a result, the co-workers’s behaviours must change to respect and that of indigenous people must also change to self-respect. This calls for realisation of indigenous relational values especially by non-indigenous healthcare professionals. Promotion of health in regard to this situation is a crucial factor as impediment to good health for diabetic patient is based on cultural difference. Their health and survival is an indication that express and cultural identity is very important to the well being. One way of ensuring that there is flow of western health profession to a culturally different indigenous diabetic patient is through institutional racism (Garcia, 2001). If the beliefs and values of indigenous patients will not be taken into account, this means that they are being excluded and their values are diminished. Such a situation will lead to more deterioration in the quality of their life. For instance, a sickness in indigenous people such as diabetic one, they perceive its source as due to antisocial actions or malignant outside forces. Effects of colonisation are one of such believed forces or actions. The impacts can be reduced by understanding the culture of indigenous people such as their concepts of strength and weakness, and cultural images. Self-determination also works out as one of the best means for indigenous people to regain control in crucial matters that affect them directly while preserving their cultural identities. Based on such statement, the field of health and education as well as partnering with various institutions such as health and wellness programs, clinic and universities is essential the indigenous people in promoting their health and learning. Conclusion Indigenous people have been presented as one of the marginalised and poorest communities in various nation states. As a result, issues such as diabetes are very common on these communities. This is associated with psychological, social and cultural impacts at individual, family and community levels. Due to this, indigenous people experience the highest infant and premature adult mortality, lowest life expectancy as well as occupying the lowest social strata as compared to non-indigenous population. The concept of people on health and illnesses is related to their ways of being into this world. As a result, there is a big difference in regard to the concept of illness and health between indigenous people and western health care professionals. This is irrespective is their current inhabiting of common space and time. This means that more understanding of the concept of culture based on social determinants such as social status, cultural identity and support among others. 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