Aboriginal Health and Wellbeing - Term Paper Example

Name: Topic: Aboriginal Health and wellbeing Institution: Date of submission: Instructor: Table of content Introduction 3 Health and history in Australia 3 Health, care, and well-being of the Aboriginal people and communities 5 Common diseases among the indigenous people 5 Contemporary issues in health and well-being 7 Social determinants of health status 7 Mental health of the aboriginal people 8 Underlying factors of mental health disorders 9 The changing policy on mental health 12 Conclusion 13 Bibliography 15 Introduction Enhancing the health of the Aboriginal people and communities has been a longstanding issue for the Australian government for decades now. While there are some improvements witnessed in some areas since early 1970s especially regarding infant mortality, the overall progress seems to be much slow and inconsistent compared to other regions in the country. According to Williams and Chapman (2012, p. 188), the inequality gap between the indigenous communities and other Australians continues to be wide with little support from the Australian government to narrow the gap. Furthermore, with a significant increase in the population of Aboriginal and communities in all age groups, there is an additional challenge to both services and programs that match the burgeoning number of the Aborigines (Lin et al., 2012, p. 103). This paper examines the history of the Aboriginal people and communities. It will also explore the health, care, and well-being of the indigenous communities in Australia. It will further tackle the contemporary issues in the health care systems by examining their health. I will later conclude by summing up the key points concerning the health care and well-being of the well-being of the Aboriginal people in Australia. Health and history in Australia The 1960s is recognized as a time in which Aboriginal and Torres Islanders were identified as Australian citizens. It marked a decade of major social change for the indigenous communities whereby the people could receive their right to equal treatment without any facing any discriminatory behaviors. Consequently, it is significant to note that the poor state of Aboriginal and communities today are because of historic context of broader policies, beliefs and attitudes about indigenous people that were facilitated by state and territory governments (Kulchyski, 2013, p. 100-102). Medicare began in 1984 with the intent of providing a simple, fair, as well as affordable system that offered basic health cover to every Australian, building on the fee-for-service billing arrangements. In addition, a universal Medicare scheme in conjunction with commonwealth initiatives began in 1990s with an aim of providing episodic health care to Australians. Medicare Agreements with territories and existing states had a less decentralized model by 1981 that rolled out communal health funding into given block health grants, hence terminating the involvement of the commonwealth initiatives in the program. The commonwealth initiatives took up the responsibility of ensuring equitable as well as timely access to reasonable specialist services. They also had the mandate of assisting in lessening pressure on hospital emergency sections through provision of additional funding for the existing primary health care service Isaacs (Maybery & Gruis, 2012, p. 93). In considering the current issues surrounding the health care system in Australia, it is important to understand the how the care health system has developed over the years. Although the average Australians enjoys good health today, the reported average expected period of life of Native Australians is about 56 compared to the average life expectancy for non-indigenous Australians that are about 20 years longer. Now, the health system is primarily funded by the private health insurers, national and territory governments. Individual Australians make their contributions to health services by making health insurance, paying tax among others. In general, people with lower revenues often benefit from government support by receiving free medications for primary health care. The health services are often distributed through a decentralized way with clients identifying their General Practitioners including a hospital. Additionally, there are public health services that are continuously offered through the federal governments (Williams & Chapman, 2012, p. 88). Health, care, and well-being of the Aboriginal people and communities Health is an essential aspect of people regardless of their origin, ethnicity, or social background. It is the state of complete social, mental, and physical wellbeing and not just the absence of illnesses or infirmities. Attaining good health stands as one of the most important universal goals. This aspect is reaffirmed by the United Nations Declarations of the indigenous regarding their rights to life. The article states that every indigenous person has a right to life, physical well-being, liberty, security, and mental integrity. Archaeological evidence proposes that aboriginal people and societies have been Australian inhabitants for the past 50,000 years. For decades, the indigenous people have suffered from poverty and unemployment leading to poor access to appropriate health care services. Furthermore, most of the aboriginal and communities have poor education and literacy skills that are associated to poor health status. The aboriginal people also live in over-crowded and run-own housing often associated with poverty, thus contributing to the spread of communicable illnesses among these people. Common diseases among the indigenous people Cardiovascular disorders and diabetes Over 1996-2011, reports have estimated difference of about 17 years between the Aboriginal people and non-ingenuous life expectancy. According to Helps and Kowanko (2011, p. 110), life expectancy at birth of the indigenous people was approximated to be 59.4 years for the male sex as well as 64.8 years for the female sex compared to the period between 1998-200, which indicated 76.6 an 82.0 years for all males and females respectively. In 1999-2003, about two out of three leading causes of mortality for the indigenous people in Queensland, Southern Australia, and Northern region and Western Australia indicated high rates of chronic illness of the circulatory system. Many of these people had cancer and ischemic heart disorders, statistics indicated that the number of males suffering from such disease was twice that of the females. In addition, hospitalizations for hypertensive disorders were relatively higher. Health reports of the Aboriginal people and communities show high rates of chronic illnesses such as diabetes, cardio-vascular disorders, and renal failure among others. Basing on various studies, it is also evident that there are continued high rates of poor health among the Aboriginal infants along with frequent occurrences of otitis media and eye conditions including trachoma. This has had high impact on the educational attainment and employment rates of the indigenous people. Furthermore, the indigenous people continuously lack primary healthcare, as verified by the high prevalence of sexually transmitted infections such as HIV/AIDS. The indigenous people have also shown high rates of unhealthy as well as risky behaviors including the heightened prevalence of substance abuse including alcohol and tobacco use. Communicable diseases In 2003, many indigenous people indicated high rates of communicable diseases compared to other non-indigenous Australians. Rates of gonococci, syphilis and chlamydia infections among the indigenous people were up to more than 93 times the rates of other non-indigenous Australians. Furthermore, child survey reported that about 18 percent of Aboriginal children report recurring ear infections, around 12 percent show recurring chest infections, about 9 percent indicated a recurring skin infection while 6 percent of the children showed recurring gastrointestinal infections. Mental health Health surveys between 2003 and 2004 also showed that indigenous people are twice likely to suffer from mental and behavioral disorders compared to other non-indigenous Australians. In 2003-04, indigenous males were seven times probably suffer from mental health problems than other non-indigenous Australians were. Similarly, females from the indigenous groups are more 31 times more likely to suffer from mental disorders than their female counterparts from non-indigenous communities are. Contemporary issues in health and well-being Social determinants of health status For decades, social inequalities have been associated with health inequalities among different communities. In Australia, both World Health Organization and Royal Australia College of physicians have proposed the use of social determinants for identifying health inequality among the indigenous communities. Aboriginal and communities disadvantage is also ostensible in other social indices. Poverty, as well as racism also offers a framework for the high statistics of poor health status including mental illnesses witnessed between the indigenous people. Most of these communities live in absolute poverty disadvantaged of basic essentials such as clean drinking water, health, shelter, education, and sanitation facilities. Given this ongoing trend, the aboriginal and communities are continuously dying from water-borne disorders such as diarrhea and typhoid among other illnesses. The challenge of indigenous poverty is mostly apparent in rural areas. Additionally, failure of plethora policies to enhance aboriginal health is attributed to a ubiquitous culture of welfare colonialism, an element of continuing poverty. Furthermore, Welfare colonialism has highly affected the aboriginal communities that often rely heavily on the provision of public sector resources. For many decades, the reliance on these customary methods of governance has led to the decrease of their capacity to develop leadership in the solution to their existing problems. The Royal Australian College of Physicians indicates that poor health care among the indigenous communities is a key example of the existence of negative social determinants of people’s health status in Australia. Mental health of the aboriginal people Traditional aboriginal culture held a number of strong reinforcing elements that defined a sense of self in terms of a collective sense that is intimately interconnect to all aspects of life, spirituality, culture, state, and community. In the context of general mental health, reports indicate that severe mental disorders often existed among the aboriginal people in the traditional social settings. According to Kulchyski (2013, p. 78) cases of schizophrenia and mood disorders were reported among the indigenous people living in Central Desert cultures as early as 1972. Pike and Strehlow (2013, p. 89) also argue that Aboriginal people are greatly susceptible to psychosis and delusional disorders due to severe social practices such as early marriages among the young girls. As a result, aboriginal society carried substantial conviction within the their culture by providing protection for those who suffered from moderate neurotic and adjustment disorders by ascribing unusual events such as sorcery that eventually led to premature death(Earle, 2013, p. 71). Underlying factors of mental health disorders Reports of occasional mental illness disorders in Aboriginal and communities culture are often common notwithstanding, the extinction of the Aboriginal populations, marginalization, and destruction of their cultural norms following the colonization of Australia by the British. This influenced to widespread, devastating impacts on both the physical and mental health of these indigenous individuals. The matter of the Stolen Generations is a good example of physical and psychological deprivation imposed on Aboriginal children separated from their parents. Additionally, the perception of safety also forms a key aspect of well-being. Surveys show that the indigenous people aged above 18 years are twice more likely to become victims of violence compared to other non-indigenous Australians (Pike & Strehlow, 2013, p. 103-104). Further disturbing statistics concerning child safety indicated that the rate of child protection per 1000 was 32 for the indigenous children compared with six for other non-indigenous children. Given the above, a national report conducted between 2004 and 2005, indicated that about fifty percent of the indigenous people reported at least not less than two stressors within year, and while about 27 percent reported at least four stressors over the same period. Reports also showed that more multiple stressors were majorly experienced in rural areas. Among the common stressors indicated included death of a close family member, friend, overcrowding in homes, substance or alcohol related problems, severe illnesses or disability , or even having a close family convicted and sent to jail. The profound impact of stress on Aboriginal children is also of great concern that highly contributes to mental disorders among children. The Australian Aboriginal Child Health Survey (WAACHS) revealed that a large proportion of children from the Aboriginal origin aged between 4 and 17 years were living in families with about seven or more major life-stress events had occurred within a period of one year((Horton, 2013, p. 201). These refers to the aspect of ‘‘malignant life’’ being the result of obstinate stress experienced among the indigenous people. Malignant grief refers to a process of collective, cumulative, as well as irresolvable grief that often affects indigenous communities. This grief causes individuals and communities to progressively to become worse and to lose function, ultimately leading to death. Pike and Strehlow (2013, p. 123) further argues that the grief has invasive features, spreading throughout the body and that many of the indigenous individuals often die from this grief. Reports from WAACHS also show that affiliates of the stolen Generations are less likely to have long-standing relationship build on trust and were more likely to have been convicted for offences. Moreover, it is evident that affiliates of the stolen Generation are probably admitted in the mental health centers following their exposure to numerous stressful life events than other groups. In fact, mortality rates in the indigenous community population secondary to drug-abuse and mental behavioral disorders due to excessive use of psychoactive substance abuse in about 12 times higher than in non-indigenous Australian men and in about 20 times higher than in non-indigenous women. Additionally, the rates of mortality due to suicide for the Aboriginal people and communities are almost more than three times the rate of all Australian people. The way forward Helps and Kowanko (2011, p. 108) argues that enlightened government policies and heightened control of socioeconomic factors of the Aboriginal people and communities with respect to their health can eventually lead to enhanced outcomes. Moreover, I believe that enhancing community capacity with improved civic participation, stronger inter-organizational relationships, as well as leadership resources will result into enhanced health within the indigenous communities. For many years, Aboriginal people have continued to articulate, recognize, and request more culturally acceptable and holistic policy projects that govern the indigenous and community’s social, mental, and emotional wellbeing. This has resulted into identifying of mental health services that appropriately depicts Aboriginal peoples’ philosophies and views. The mental health programs have continuously undergone a constant process of change and there has been a greater emphasis on the prevention as well as promotion in mental health policy (Pike & Strehlow, 2013, p. 79-80). Oxfam family projects located in the Gulf of Carpentaria focuses on enhancing community resilience against the impacts of substance abuse by creating safe family place homes. A similar community project known as Domestic Violence –It is Not Our Game, are increasingly fighting against domestic violence among the Gulf Communities by using sportsmen as key role models. On the other hand, Djirruwang Aboriginal Health Program majorly focuses on treating mental illness and psychiatric care by underlying issues such as discrimination, domestic violence, and early marriage. It emphasizes on adopting an innovative and community-based solution that focuses on improving coping skills that will help reduce the increasing mental health disorders (Scambary, 2013, p. 90). The program has greater recognition of the positive mental health behaviors that tend to lay emphasis on the social wellbeing that promote mental wellbeing among the indigenous communities. It clearly identifies different determinants that tend to influence the social, mental, and emotional wellbeing about mental health. They include grief, loss, discrimination, domestic violence, cultural dislocation, and forcible removal of children, racism, substance abuse, and enduring disadvantage (Place, 2013, p. 88). This program has also had profound impacts on the lives of the indigenous individually and collectively. It ensures that the Aboriginal and Torres Islander people gain direct access to mental health services without facing any form discrimination. In conjunction with other programs, Djirruwang Aboriginal Health Program empowers the indigenous communities by providing employment and education among these people. Furthermore, the Australian policy on the environment also holds a number of innovative solutions in facilitating the welfare of the indigenous people (Horton, 2013, p. 55). The changing policy on mental health The last decade has seen an increasing policy focus on the indigenous people’s social as well as emotional well-being through the implementation of several policy frameworks. They include the national Aboriginal Health Strategy (NAHS), The National, and Strategic Framework for Aboriginal and Torres Strait Islander people’s Mental Health and Social Well Being as well as the National Strategic Framework for Aboriginal and Torres Strait islander Health (NSFATSIH). Similarly, the Aboriginal along with the Torres Strait Islander Health Performance framework was implemented under the help of the Australian health Ministers Advisory Council continuously monitor progress in Aboriginal people and communities (Earle, 2013, p. 120-121). It encompasses of 71 performance indicators including a given indicator on both social and emotional well-being. Progressively, these policies extend beyond the effect of health and mental health systems to include other sectors including education, law, and justice, Naïve Title, communities, families, and human rights. They also cut across multiple sectors in order to help guide planning and providing services for Aboriginal people and communities. While there are continuous efforts to widen community understanding on the promotion of mentally healthy behaviors and the prevention of mental illness, indigenous people suffering from mental health disorders still experience discrimination in the health system (National Aboriginal Economic Development Board, 2013, p. 75-76). Therefore, programs such as Djirruwang Aboriginal Health Program are continuously working on a holistic approach that could transpose the current negative attitudes on mental health practices into the existing indigenous health services that are often widely resisted. Conclusion The traditional life of the Aboriginal people and communities was affected by the arrival of the British settlers. For many years, the aboriginal and Torres Strait Islander people have been exposed to stressful events including high poverty, discrimination, racism, and unemployment. This among others has resulted to increased health issues including mental disorders. Thus different policies as well as programs such as Djirruwang Aboriginal Health Program is constantly working on a holistic approach that could help tackle the underlying causes of mental health disorders among the indigenous communities. In broad terms, economic, opportunity, social conditions, as well as physical infrastructure were among the key factors that negatively influenced the health of many individuals, communities, as well as societies at whole. These features are profoundly seen in education systems, housing, social networks, racism, incarceration and access to basic health services of many Australians especially the indigenous people. Bibliography Earle, L. (2013). Traditional Aboriginal diets and health. Prince George, B.C., National Collaborating Centre for Aboriginal Health. http://site.ebrary.com/lib/celtitles/docDetail.action?docID=10633524. Helps, Y. L. M., & Kowanko, I. (2011). Riverland Aboriginal Chronic Disease Support Group: community storybook 2011. Adelaide, Flinders University, and the Aboriginal Health Council of South Australia. http://www.lowitja.org.au/announcements/new-chronic-disease-community-storybook. Horton, D. (2013). Aboriginal Australia. Isaacs, A. N., Maybery, D., & Gruis, H. (2012). Mental health services for Aboriginal men: Mismatches and solutions. International Journal of Mental Health Nursing. 21, 400-408. Kulchyski, P. K. (2013). Aboriginal rights are not human rights: in defence of indigenous struggles. Lin, I., O'sullivan, P., Coffin, J., Mak, D., Toussaint, S., & Straker, L. (2012). ‘I am absolutely shattered’: The impact of chronic low back pain on Australian Aboriginal people. European Journal of Pain. 16, 1331-1341. National Aboriginal Economic Development Board. (2013). The Aboriginal economic benchmarking report. Gatineau, Que, National Aboriginal Economic Development Board. http://site.ebrary.com/lib/celtitles/docDetail.action?docID=10652238. Pike, A. N., & Strehlow, C. F. T. (2013). Aboriginal traditional ceremonies sourcebook. Place, J. (2013). The health of Aboriginal people residing in urban areas. Prince George, BC, National Collaborating Centre for Aboriginal Health. http://site.ebrary.com/lib/celtitles/docDetail.action?docID=10666898. Scambary, B. (2013). My country, mine country: Indigenous people, mining, and development contestation in remote Australia. Williams, K. A., & Chapman, M. V. (2012). Unmet Health and Mental Health Need Among Adolescents: The Roles of Sexual Minority Status and Child-Parent Connectedness. American Journal of Orthopsychiatry. 82, 473-481. Read More