Causes of Health Inequalities - Essay Example

Inequalities and Health Name Presented by Department Institution Lecturer Inequalities and Health Causes of Health Inequalities of Aboriginal People in the Northern Territory: Gates and Barr [1] define health inequality is the variation in the health status that exists between groups within a population. In addition, they define health inequality as the way in which health determinants are distributed between different groups within a population. There are various causes of health inequalities between groups within a population. This section focuses on the causes of health inequalities of aboriginal people in the Northern Territory of Australia. The causes identified include poor living conditions of the Aboriginal people, racism, and alcohol consumption among the aboriginal people. In addition, it is acknowledged that availability and accessibility to adequate, effective and quality health services contribute to health inequalities of aboriginal people in the Northern Territory. 1. Harmful Alcohol Consumption among Indigenous People in Australia: Alcohol is considered the psychoactive drug that is widely used in Australia [2]. In 2007, it was estimated that only about 10.1% of Australians above 14 years old had never consumed alcohol in their lives [2]. It was also found out that about 20.4 percent of Australians (17.2 females and 23.7 males) was involved in risky alcohol consumption with respect to the Australian Alcohol Guidelines of the 2001 [3]. Australian Aboriginal people are more affected by the social and health issues arising from the alcohol consumption problem than the non-aboriginal people (AIHW). In fact, Stanley et al. [4] indicate the health and social consequences of alcohol consumption among the aboriginal people is about twice as much as in non-Aboriginal people. In the year 2003, alcohol contributed to about 6.2 percent of the disease burden among the aboriginal people, of which 0.8 percent of the burden was prevented [4]. Between 2002 and 2004, risky alcohol consumption among the aboriginal people increased from 15 percent to 16 percent [5] [6]. A study conducted by the Australian Institute of Health and Welfare [2] between 2004 and 2007 indicated that the aboriginal population were more affected by the risky consumption of alcohol, and the related problems (39 and 23 percent respectively) than the non-aboriginal population (21 and 10 percent respectively). The health and social consequences of alcohol consumption include: deterioration in physiological and physical health among the consumers; child neglect and abuse by the severe alcohol consumers; interpersonal violence among consumers; and suicidal deaths among the severe alcohol consumers. 2. Racism: Bonilla-Silva [7] describes racism as the segmentation of a population in terms of races, which define or directs the distribution of resources. Racism mainly lies on the ideology of superiority that ranks some cultures (or groups of people) as being superior to others to the extent of supporting social norm that contribute to the implementation of the ideology [7]. Racism, when applied in health, has a myriad of negative consequences. Wiliams and Mohammed [8] outlines one of the negative consequences of racism in the health of aboriginal people, unavailability and/or poor access to adequate, effective and quality health services. This is usually coupled by the fact that aboriginal people are, in general, poor since they have lower income than the non-aboriginal people in Australia [9]. The poverty aspect implies that the aboriginal people are socially disadvantaged, and their living conditions are, in general, poor. Consequently, this contributes to health inequalities among the aboriginal people in the Northern Territory. Research studies indicate that racism leads to poor mental health among the minority groups [9]. A research study on the impact of racism on the aboriginal population in Australia indicated that racism leads to poor mental health, especially among the aboriginal youth and children [10]. Mental health issues include depression, anxiety and psychological distress, which result into health inequalities among the aboriginal people. In addition, mental health may result into physical harm, such as suicide and other injuries, which lead to health inequalities of the aboriginal people in Australia. Paradies, Anderson and Harris [10] also indicates poor mental health leads to substance abuse, including risky alcohol consumption, which may serve to explain the reason behind risky alcohol consumption by the aboriginal people of Australia. This ultimately results into health inequalities of the aboriginal people. Strategies being used in the Emergency Measures in the Northern Territory of Australia: 1. The National Alcohol Strategy: Taking into consideration the role of alcohol consumption and abuse in health inequalities of the aboriginal people, it is very important to implement strategies to either minimize or completely eradicate alcohol consumption among the aboriginal people. The 2006-2009 National Alcohol Strategy aims to minimize or prevent the health issues related with risky use of alcohol, especially by the aboriginal people and instead develop safe and healthy alcohol drinking habits [11]. This strategy involves a combination of primary, secondary and tertiary strategies, all of which aim at minimizing harms arising from the misuse of alcohol. The primary strategies are aimed at preventing non-drinkers from taking alcohol through informing them the alcohol related health and social issues, and the prevention factors that they can consider. The primary strategies include programs that are designed to educate pregnant women about the risks associated with alcohol consumption, especially to the unborn child while providing support to new mothers so that they do not engage in alcohol abuse [12]. In addition, the primary strategies include programs that ensure a smooth transition of children to schooling so that they do not engage in alcohol abuse [13]. Evidence from research studies indicates that the early years of a person (including the antennal period) are crucial in determining the health and social life of the person during his/her later years [13]. Accordingly, interventions aiming at positive development during childhood are essential in preventing risk factors during childhood, which makes individuals vulnerable to use of risky substances during their teenage and adult life [13 14 15]. Primary intervention strategies also include programs that provide activities serving as alternatives to alcohol use. These include activities such as sporting activities. Another strategy aiming at reducing alcohol abuse involves limiting alcohol supply, especially in places where aboriginal population is high [16]. Such strategies include restricting the sale of low cost alcoholic drinks, especially those containing high alcohol content, restricting the alcohol drinking time, and banning alcohol consumption in some locations [16]. Following such strategies, there has been a reduction in problems associated with alcohol abuse, as well as delayed use of alcohol by young people [17 18]. Secondary strategies aim at preventing risky alcohol use [19] they prevent alcohol users from becoming risky user. The secondary interventions are provided to the aboriginal people through services that substance-specific, and ones that are controlled by the aboriginal community. Secondary interventions include, for example, programs that give advice and support to alcohol user, who would wish to abstain or reduce alcohol use [12]. Tertiary interventions aim at reducing the harms arising from alcohol abuse, or enabling users to cease alcohol use [19]. Accordingly, tertiary interventions are aimed at treating the effects of alcohol abuse. Programs under the tertiary intervention include, for example, inpatient detoxification, withdrawal management and residential rehabilitation [12]. 2. Child Health Checks strategy: This strategy was established as an intervention for child maltreatment, a key cause of health inequality of aboriginal people in the Northern Territory [20]. A study conducted by the Australian Institute of Health and Welfare (AIHW) indicated that the aboriginal children aged below sixteen years are neglected [21]. For instance, AIHW found that, between 2005 and 2006, about 29.4 for every 1000 aboriginal children were neglected [21]. The neglect rate for the non-aboriginal children was far much lower (6.4 out of every 1000 children) than that of the aboriginal children. This implies that the chance that an aboriginal child will be neglected is about six times higher than is the case with a non-aboriginal child. Similarly, according to Foster [22], the aboriginal children are at a higher risk, than the bon-aboriginal children, to experience child maltreatment. In the Northern Territory, a significant number (about 34 percent) of maltreatment substantiations in the aboriginal children results from child neglect [21]. In the same region, about 22 percent of child maltreatment substantiations in the non aboriginal children arise from child neglect. Child maltreatment notification is essential in addressing the issue of child maltreatment [21]. Child maltreatment notifications have significantly increased in number [21]. However, increase in child maltreatment notifications in the Northern Territory has not increased has not been impressive as in other states, in Australia [20]. This implies that child maltreatment still remains to be a key cause of health inequality in the aboriginal children of the Northern Territory. First, majority of the aboriginal people do not have trust with the government, taking into consideration that the Australian Government is known to have practiced racism against the Aboriginal people [23]. Mistrust also arises from the fact that the Australian government has a history of forcefully taking aboriginal children from their parents and placing them in missions; to work as domestic workers; to make them apprentices; or to work in white farms [24]. This implies that the aboriginal people will not be ready to disclose maltreatment cases. In the Northern Territory, child maltreatment is highest in Australia since the aboriginal people do not have confidence with the child protection system of the Northern Territory [25]. In fact, the aboriginal consider the child protection system as one that does not have the resources, is unpredictable and does not respond to cases of Aboriginal child neglect [25 26 27]. Child mistreatment, therefore, is a key health inequality issue of the aboriginal people in the Northern Territory, and Child Health Checks strategy is a justified strategy for dealing with child mistreatment among the Aboriginal people in the Northern Territory. Strengths and Weaknesses of the aforementioned strategies: The National Alcohol Strategy: The national alcohol strategy involves primary, secondary and tertiary interventions. The three strategies strive to reduce or curb the health risks associated with risky alcohol abuse. This strategy for minimizing or eradicating health inequalities of aboriginal people in the Northern Territory is associated with various strengths and weaknesses. Aboriginal people have already realized that the various programs in this strategy, especially those serving as alternative to alcohol use, are crucial in developing the self esteem of the young people [16 28]. In addition, the aboriginal people have already realized that these programs are important in connecting the aboriginal culture and developing self-worth among the aboriginal people [28]. This is an essential strength of the strategy, which will ensure its adoption by the aboriginal people. There is available evidence, which indicates that limiting alcohol supply to a population is effective in reducing or curbing health and social issues associated with alcohol abuse [13]. In addition, the strategy is strengthened by the fact that alcohol sale and consumption in Australia is usually subjected to various territory and state restrictions [16]. These restrictions are usually based on the time of selling alcohol, place of selling and consuming alcohol and the minimum age of a person to qualify to drink alcohol [16]. This implies that the strategy is already supported by territory and state restrictions. Therefore, implementing the strategy will not be difficult since it has already been preceded by territory and state restrictions on alcohol sale and consumption. However, the strategy has various weaknesses, which may serve to limit its full implementation and adoption in the Northern Territory. In an ideal situation, the aboriginal people in Australia should have access to similar services accessed by the non aboriginal people. Taking into consideration that the aboriginal people are more affected by alcohol abuse related issues, there has been debates on whether to provide the aboriginal people with more services than the non aboriginal people [29]. It is, however, unfortunate that there are already identified barriers that limit the provision of treatment services to the aboriginal people suffering from the alcohol abuse. In particular, it has already been identified that early intervention pharmaco-therapies, which are helpful in reducing relapse, as well as in the aftercare services, are limited in the Northern Territory and other places with high populations of aboriginal people [16 29]. This is a considerable weakness of the strategy, which may limit the full potential of the strategy to treat health and social issues arising from alcohol abuse. As already noted, substance abuse, especially among the youth and children, is usually associated, or results from racism and poor living conditions [30]. This means that the strategy to reduce or eradicate the health and social risks associated with alcohol abuse will not be effective if it fails to address the racism and social aspects of the aboriginal people. This strategy does not address these crucial issues, implying that they may not be effective in curbing or minimizing alcohol use by the aboriginal people. Child Health Checks strategy: Collaboration between the government and the aboriginal people is very crucial towards the realization of the strategy’s objectives [26]. Indeed, any initiative requires collaboration between the local community and the initiator in order to ensure it is successful. This strategy, according to Libesman [31], involves a strong collaboration between aboriginal leaders, health agencies working within the Aboriginal communities and Aboriginal child protection systems. In addition, the child health check is usually conducted by a health worker or nurse from the aboriginal community [31]. It is worth considering the negative perception developed by the Aboriginal people about the non-Aboriginal people and Australian Government [24]. Therefore, this particular strategy (of involving people from the Aboriginal community) is a crucial strength that will ensure the success of the Child Health Check Strategy. This strength is seen from the fact that the Aboriginal people will easily allow their children to undergo the Child Health Check upon realizing that it is conducted by their own people. Further, the aboriginal nurses or health workers will easily convince the Aboriginal people to allow for Child Health Check, which will aid in making the health strategy successful. The inclusion of Aboriginal health workers, nurses, agencies and leaders will not only convince the Aboriginal people to allow for Child Health Check strategy, but will also convince them provide the required information for the success of the strategy. As aforementioned, the aboriginal people do not have confidence with the Australian Government [24]. This fact is a major weakness of the Child Health Check Strategy. Specifically, the strategy requires that Aboriginal parents give some information regarding the health of their children [31]. It is very likely that the Aboriginal will not provide all the relevant information fearing that the information might be used to discriminate them further. In addition, it is worth noting that aboriginal people are characterized by the need for confidentiality [33]. This implies that they do not like giving out personal information, and would rather keep it secret. Taking into consideration that the strategy requires the Aboriginal people to give some information regarding the health of their children during the health check [31], it is very likely that they will not give any or all the relevant information. This will hinder the strategy from realizing its full potential of addressing health inequalities among the Aboriginal people from the Northern Territory. Other measures that may be useful in improving the health of Aboriginal people: 1. Poverty reduction strategy: It appears that health inequalities among the Aboriginal people, in general, are caused or fueled by poverty. This is supported by Lynch and Kaplan, who points out that poverty is a key contributor of health inequality. In Australia, majority of Aboriginals, especially the ones living in remote communities, are subjected to poverty [34]. The Aboriginal people, in general, are considered to be disadvantaged group of people in the affluent Australian population [35]. This is mainly because the income level for the Aboriginal people is generally lower than that of the non-Aboriginal people [9]. These factors lead to poor living conditions among the Aboriginal people [9]. Dealing with the income issue (as a first step towards dealing with other health inequality issues) has been considered by Smith [36] as an effective strategy of combating health inequalities in a community. Accordingly, this strategy will not only eliminate health inequalities in Aboriginal people but will also facilitate other strategies, such as alcohol restriction strategy. For instance job creation, accompanied by training and education, will draw the attention of the Aboriginal people (especially the youth) into jobs, which will prevent them from risky alcohol consumption. This will also reduce or curb other risky activities such as substance use by the youth, which contributes to health inequalities in the Aboriginal people. Poverty reduction, through job creation, will also improve the living conditions of the Aboriginal people since their disposable income will increase. 2. Addressing Structural Power Imbalances and Increasing the Sense of Control of Circumstances among the Aboriginal people in Australia: This strategy will aim to address all the factors that contribute towards structural imbalances between Aboriginal and the non-Aboriginal people in Australia, which contribute towards health inequalities in the Aboriginal people. In a hierarchical structure, people belonging to a low social status are, in most cases, denied a chance to control their circumstances [37 38]. Consequently, these people will experience poorer health than those belonging to higher social statuses [37]. This is usually fueled by the fact that people with a diminished sense of control over their social and health circumstances usually have poor health status [38]. Social (and racial) discrimination is one of the identified results of structural power imbalances in a community, which contributes towards a lack of sense by the minority group that they have control of their circumstances [38]. In the context of Aboriginal people, circumstances include the life and health of the Aboriginal people. Racism has also been identified as the leading cause of substance abuse among the Aboriginal people, which leads to poor mental health and social related health problems [7]. For a long time, there has been the assertion, by the Aboriginal people, that there is a linkage between their health and their ability (and freedom) to control their circumstances, including their cultures and lives [39]. In addition, it has been established that the health of that Aboriginal people is very much affected by their recognition of their rights [39]. Accordingly, addressing the structural power imbalances between Aboriginal and non-Aboriginal people will address racism and the health inequalities arising from it. This will also make the Aboriginal people have a sense that they have control over their social and health circumstances, which will contribute towards the improvement of their health status. References 1. Gates, B., and Barr, O., (Ed). Oxford Handbook of Learning and Intellectual Disability Nursing. Oxford, New York: Oxford University Press. 2009. P 142. 2. Australian Institute of Health and Welfare (AIHW). Child Protection and out-of-home Care Performance Indicators. Canberra: AIHW. 2007. 3. National Health and Medical Research Council (NHMRC) Australian alcohol guidelines. Health risks and benefits. Canberra: National Health and Medical Research Council. 2004. 4. Stanley, L., Barker, B., Vos, T., and Lopez, A., Burden of Disease and Injury in Aboriginal and Torres Strait Islander Peoples: 2003. Brisbane: Centre for Burden of Disease and Cost- Effectiveness. 5. Brady, M., and Chikritzhs, T., Fact of Fiction? A Critique of the National Aboriginal and Torres Islander Social Survey 2002. Drug and Alcohol Review. 25(3), 277-287. 2006. 6. Australian Bureau of Statistics (ABS). The Health and Welfare of Australia’s Aboriginal and Torres Strait Islander Peoples 2008. Canberra: ABS and AIHW. 2008. 7. Bonilla-Silva, E., Racism without Racists: Color-Blind Racism & Racial Inequality in Contemporary America, Third Edition. Playmouth, United Kingdom: Rowman & Littlefield Publishers, Inc. 2010. p 2. 8. Williams, D., and Mohammed, A., Discrimination and Racial Disparities in Health: Evidence and Needed Research. J Behav Med. 32, 20-47. 2009. 9. Waldram, B. J., Herring, D. A., and Young, K. T., Aboriginal Health in Canada: Historical, Cultural, and Epidemiological Perspectives, Second Edition. Toronto, London: University of Toronto Press. 2006, p 1. 10. Paradies, Y., Anderson, I., and Harris, R. The Impact of Racism on Indigenous Health in Australia and Aotearoa: Towards a Research Agenda Melbourne. Cooperative Research Centre for Aboriginal Health. 2008. 11. Ministerial Council on Drug Strategy (MCDG). National Alcohol Strategy 2006-2009: Towards Safer Drinking Cultures. Canberra: MCDG. 2006. 12. Saggers, S., Wilkes, E., Gray, D., and Atkinson, D., Substance Misuse. In Murray, R., and Couzos, S., (Eds). Aboriginal Primary Health Care: an Evidence-Based Approach, Third Edition. Oxford University Press. 2000. p 782. 13. Haines et al. The Prevention of Substance Use, Risk and Harm in Australia: A Review of the Evidence. Canberra: Department of Health and Ageing. 2004. 14. Dalby et al. The Social and Emotional Wellbeing of Aboriginal Children and Young People: Summary Booklet. Perth: Telethon Institute for Child Health Research. 2005. 15. Northern Territory Board of Inquiry into the Protection of Aboriginal Children from Sexual Abuse. Children are Sacred. Northern Territory Government. 2007. 16. Wilson, M., Gray, D., Doyle, M., and Stearne, A., Indigenous-Specific Alcohol and other Drug Interventions: Continuities, Changes and Areas of Greatest Need. Canberra: Australian National Council on Drugs. 2010. 17. Togni, P., and d’Abbs, P., Liquor Licensing and Community Action in Regional and Remote Australia: A Review of Recent Initiatives. Australian and New Zealand Journal of Public Health. 24 (1), 45-53. 2000. 18. Muller, R., Ypinazar, A., and Margolis, A., The Impact of Supply Reduction through Alcohol Management Plans on Serious Injury In Remote Indigenous Communities in Remote Australia: A Ten-Year Analysis Using Data From The Royal Flying Doctor Service. Alcohol and Alcoholism. 43(1), 104-110. 2008. 19. Toumbourou, W., and Rowland, B., Preventing Drug-Related Harm in Indigenous Australian Communities: Prevention Research Evaluation Report; Prevention Research Summaries: Reading and Resource List. Australia: Drug Info Clearinghouse 20. Hunter, S. V., Child Maltreatment in Remote Aboriginal Communities and the Northern Territory Emergency Response: A Complex Issue. Australian Social Work. 61(4), 372-388. 2008. 21. AIHW. A Picture of Australia’s Children. Canberra: AIHW. 22. Foster, A., Reframing Public Discourse on Child Abuse in Australia. Child Abuse Prevention Newsletter. 13, 22-26. Australian Institute of Family Studies. 2005. 23. New South Wales (NSW) Aboriginal Justice Advisory Council. Submission to the Review of the Children and Young Persons (Care and Protection) Act 1988. [Web]. Retrieved 6 Jan. 2012. 24. Bird, C., (Ed). The Stolen Children: Their Stories Including Extracts from the Report of the National Inquiry into the Separation of Aboriginal and Torres Strait Islander Children from their Families. Random House. 1998. 25. Pocock, J., State of Denial: The Neglect and Abuse of Indigenous Children in the Northern Territory. The Secretariat of the National Aboriginal and Islander Child care. 2003. p 9. 26. Libesman, T., Not One without the other: Human Right and Aboriginal and Torres Strait Islander Children’s Well Being go Hand in Hand. In Lawrence, M., (Ed). Remember Me Commemorating the Tenth Anniversary of the Bringing them Home Report. 2007. p 25. 27. Tomison, A., Stanley, J., and Pocock, J., Child Abuse and Neglect in Indigenous Australian Communities. Canberra: Australian Institute of Family Studies. 2003. 28. Clough, R., Lee, S., Rawles, J., Silins, E., Conigrave, M., and Wallace, C., Evaluation of a Community-driven Preventive Youth Initiative in Arnhem Land, Northern Territory, Australia. Drug and Alcohol Review; 27(1) 75-82. 2008. 29. Lintzeris, N., Haber, P., Lopatko, O., and Proude, E., Guidelines for the Treatment of Alcohol Problems. Canberra: Department of Health and Ageing, Australia. 30. Paradies, Y., Anderson, I., and Harris, R. The Impact of Racism on Indigenous Health in Australia and Aotearoa: Towards a Research Agenda Melbourne. Cooperative Research Centre for Aboriginal Health. 2008. 31. Libesman, T., Indigenizing Indigenous Child Welfare. Indigenous Law Bulletin. 6, 17-19. 2007 32. Human Rights and Equal Opportunity Commission (HREOC). Ending Family Violence and Abuse in Aboriginal and Torres Strait Islander Communities – Key Issues: An Overview of Research and Findings by HREOC, 2001-2006. Canberra: HREOC. 2006 33. Tomison, A., Current Issues in Child Protection Policy and Practice: Informing the North Territory Department of Health and Community Services Child Protection Review. Casuarina: NT Department of Health and Community Services. 34. Toumbourou, W., Williams, J., McDonald, M., Moore, T., and Jones, S., A Sea Change on the Island Continent: Frameworks for Risk Assesment, Prevention and Intervention in Child Health in Australia. Children and Society. 19, 91-104. 35. Williams, D., and Mohammed, A., Discrimination and Racial Disparities in Health: Evidence and Needed Research. J Behav Med. 32, 20-47. 2009. 36. Smith, D. G. (Ed). Health Inequalities: Life course Approaches. Bristol, United Kingdom: The Policy Press. 2003, p xv. 37. Marmot, G., Bosma, H., Nicholson, C., Hemingway, H., Stansfeld, A., and Brunner E., Low Job Control and Risk of Coronary Health Disease in Whitehall II Study. BMJ. 314(7080), 558-565. 1997. 38. Tsey, K., Gibson, T., Deemal, A., and Whiteside, M., Social Determinants of Health, ‘The Control Factor’ and the Family Wellbeing Empowerment Program. Australian Psychiatry. 11, 34-39. 2003. 39. National Aboriginal Health Strategy Working Group. National Aboriginal Health Strategy. Canberra: AGPS. 1989. Read More

Following such strategies, there has been a reduction in problems associated with alcohol abuse, as well as delayed use of alcohol by young people [17 18]. Secondary strategies aim at preventing risky alcohol use [19] they prevent alcohol users from becoming risky user. The secondary interventions are provided to the aboriginal people through services that substance-specific, and ones that are controlled by the aboriginal community. Secondary interventions include, for example, programs that give advice and support to alcohol user, who would wish to abstain or reduce alcohol use [12].

Tertiary interventions aim at reducing the harms arising from alcohol abuse, or enabling users to cease alcohol use [19]. Accordingly, tertiary interventions are aimed at treating the effects of alcohol abuse. Programs under the tertiary intervention include, for example, inpatient detoxification, withdrawal management and residential rehabilitation [12]. 2. Child Health Checks strategy: This strategy was established as an intervention for child maltreatment, a key cause of health inequality of aboriginal people in the Northern Territory [20].

A study conducted by the Australian Institute of Health and Welfare (AIHW) indicated that the aboriginal children aged below sixteen years are neglected [21]. For instance, AIHW found that, between 2005 and 2006, about 29.4 for every 1000 aboriginal children were neglected [21]. The neglect rate for the non-aboriginal children was far much lower (6.4 out of every 1000 children) than that of the aboriginal children. This implies that the chance that an aboriginal child will be neglected is about six times higher than is the case with a non-aboriginal child.

Similarly, according to Foster [22], the aboriginal children are at a higher risk, than the bon-aboriginal children, to experience child maltreatment. In the Northern Territory, a significant number (about 34 percent) of maltreatment substantiations in the aboriginal children results from child neglect [21]. In the same region, about 22 percent of child maltreatment substantiations in the non aboriginal children arise from child neglect. Child maltreatment notification is essential in addressing the issue of child maltreatment [21].

Child maltreatment notifications have significantly increased in number [21]. However, increase in child maltreatment notifications in the Northern Territory has not increased has not been impressive as in other states, in Australia [20]. This implies that child maltreatment still remains to be a key cause of health inequality in the aboriginal children of the Northern Territory. First, majority of the aboriginal people do not have trust with the government, taking into consideration that the Australian Government is known to have practiced racism against the Aboriginal people [23].

Mistrust also arises from the fact that the Australian government has a history of forcefully taking aboriginal children from their parents and placing them in missions; to work as domestic workers; to make them apprentices; or to work in white farms [24]. This implies that the aboriginal people will not be ready to disclose maltreatment cases. In the Northern Territory, child maltreatment is highest in Australia since the aboriginal people do not have confidence with the child protection system of the Northern Territory [25].

In fact, the aboriginal consider the child protection system as one that does not have the resources, is unpredictable and does not respond to cases of Aboriginal child neglect [25 26 27]. Child mistreatment, therefore, is a key health inequality issue of the aboriginal people in the Northern Territory, and Child Health Checks strategy is a justified strategy for dealing with child mistreatment among the Aboriginal people in the Northern Territory. Strengths and Weaknesses of the aforementioned strategies: The National Alcohol Strategy: The national alcohol strategy involves primary, secondary and tertiary interventions.

Read More