Persistent health inequalities between the native and non-native populations in Australia

There have been discussions on why there are persistent health differences in Australia between native and non-native populations. As a result of the various studies, the focus has shifted to social factors as the primary causes of rising health disparities. Discrimination, lack of access to primary health care, and inadequate health facilities among the indigenous population have all been significant contributors to recognizing inequality. As a result, addressing social factors to enhance the health conditions of the indigenous community has become critical, necessitating an enabling climate to improve healthcare. To establish innovative strategies, various healthcare stakeholders have concentrated their efforts towards understanding the diverse reasons for health inequalities to develop effective policies geared towards ensuring effective healthcare delivery. Therefore, this paper will examine the various reasons for the inequalities in healthcare provision between native and non-native populations in Australia despite the prospect of government funding.

Social determinants have become the focal point towards understanding the prevalence of health disparities between the two populations. In a society that prides itself in ensuring quality healthcare, the persistence of health inequalities has led to the need for the development of effective strategies to mitigate the issue (Paradies, Harris & Anderson, 2013). The government has acknowledged that social issues have led to disparities in health quality among the indigenous and non-indigenous population.

Social, Economic Disparities

An evaluation of the current status of the health of the native Australians indicate that their access to healthcare is of poor standards compared to the rest of the Australian population. According to Stephens, Porter, Nettleton & Willis, (2016), there remains a wide inequality gap across the diverse statistics. As a clear example, Jamieson, Elani, Mejia, Ju, Kawachi, Harper & Kaufman, (2016) record a 17-years life expectancy gap between the two populations. Accordingly, from the analysis of all the diverse age groups below sixty-five years, the age-specific death rates of the two populations are estimated to have a constant differential of two; whereby the natives are thought to be twice as prone to age-related illnesses compared to the non-natives. Therefore, in the analysis of the first reason for the disparities, there is the persistence of social-economic disparities that have been fueling the increasing inequalities. Jamieson et al., (2016) assert that the indigenous population does not have an equal opportunity to be healthy as compared to the non-indigenous people living in Australia. There is the persistence of socio-economic disadvantages that prevail in regards to their exposure to both behavioural and environmental risk factors. Jamieson et al., (2016) emphasises that the socio-economic environment of the indigenous population entails that they have a higher exposure to the risk factors as a result of their living conditions. As a clear example, the Torres Islander people live in places whereby the risk factors to their health are extensive such as exposure to venomous animals, poisonous plants, and the general living condition. Their living conditions, as per Stephens, Porter, Nettleton & Willis, (2016) are not enabling to support good health, therefore; it is a daunting environment to necessitate accessibility to primary health care. As such, the living conditions of the indigenous entails that the accessibility to primary amenities such as housing, drinking water, and sewerage systems catapults their exposure to health hazards extensively. Stephens, et al., (2016) believe that despite the increasing government funding, there are significant challenges to ensure that the indigenous population access the primary health infrastructure. Admittedly, some of the indigenous tribes adopt a nomad way of life, which makes it challenging for the government to implement any form of sewerage system or standard housing to ensure a healthy environment prevails. Further, in development of health care policies such as immunisation, the way of life of the indigenous population has made it challenging for the government to implement the diverse measures successfully. Accordingly, the use of various approaches such as educational empowerment campaigns to ensure information relay prevails on the need for immunisation has not been successful due to the nomadic way of life and suspicion and reluctance emanating from the indigenous population.

Further, there is the prospect of remote locations, Wright, Wahoush, Ballantyne, Gabel & Jack, (2016) emphasise that majority of the indigenous populations live in remote towns whereby the accessibility to the healthcare products and services is a challenge for the government. Remote locations serve as a barrier to ensuring quality health care for the indigenous population due to the extensive costs of service delivery. As an example, if the service is far away from an individual, the travel costs may be too exorbitant (Wright et al., 2016). The cost of services can be equally expensive for individuals in the payment process. Aspects such as lack of healthcare insurance, inadequate finances, and personal beliefs regarding healthcare are equal challenges in meeting the healthcare needs of the indigenous population in the remote locations.

Racial Discrimination of the Indigenous Population

The Australian perception of the indigenous population has become a facet of concern translating to health care inequalities. Accordingly, the first aspect of concern is treating the indigenous population as backward, ignorant, and are not well-learned to meet their healthcare needs. The prevalent misconceptions about the indigenous cultures have led to the increasing discrimination and inaccessibility to healthcare (Marmot, 2011). The healthcare policy makers have been reluctant in adopting various initiatives to empower the indigenous population to meet their healthcare problems. There is little or no consultation of the indigenous population in the provision of healthcare services, which has led to further escalation of the healthcare problems experienced. There is the prevalence of systemic discrimination, which has led to the indigenous population ignoring the positive and innovative approaches by the government to promote their healthcare. According to Bramley, Hebert, Jackson & Chassin, (2014) from a historical standpoint, the indigenous population has not been exposed to equal living standards as the non-natives, which are responsible for promoting proper and healthy living conditions. Inaccessibility to the amenities and the focus on developing healthcare policies that are discriminatory have further increased the healthcare inequality. The belief of the non-indigenous population about the indigenous ought to be eliminated to develop a mutually cohesive initiative towards handling the health care issues.

Ineffective Health Policies to Address the Health of the Indigenous Population

Bramley, et al., (2014) assert that there is the scarcity of information about the health of the natives. As such, prior and after the colonisation of Australia in 1788, there has been little or no interest in understanding the health of the indigenous population. What has been actually determined is the declining health of the indigenous population after the arrival of the European settlers. The indigenous population, before the arrival of the Europeans, was deemed to be extensively healthier than the settlers in the first years of settlement, which translated to an increase in their numbers. The little contact with the outside world entailed that the indigenous population were not prone to the numerous infectious diseases. The introduction of new illnesses emanating from the colonisers saw the indigenous population begin to decrease in number (Wright, et al., 2016). Further, it was common for the indigenous women to contract sexual ailments from the colonisers. In the analysis of the indigenous population, there was equally no research and evaluation of the implications of the change of diet on their well-being. Before European settlement, Bramley, et al., (2014) emphasise that the indigenous population had been used to a diet of either proteins or vegetables due to ease of availability of both animals and plants. Further, there was extensive exercise due to their hunting and gathering way of life. Nonetheless, after colonisation, there was a radical shift in the diet, which entailed high-fat foods that led to the increase in diabetes, heart diseases, and obesity. Marmot, (2011) believes that apart from the introduction of new diseases and diet change, the relocation of the indigenous population led to their current health status. Admittedly, land was an important facet of the indigenous population and was an influential aspect towards determining their livelihood. However, with the relocation of the indigenous Australians to the reserves, there was the deterioration of their lifestyle; hence, their wealth. With the various issues circumventing the lives of the indigenous pundits such as King, Smith & Gracey, (2011) emphasise that it was and still is the reduced focus on the plight of the individuals that have led to the increasing inequalities in health. Accordingly, in the present environment, the lack of understanding of the indigenous Australians has been fueling the increasing myriad of health problems. The policies set forth by the government have not been focusing on addressing the problems experienced by the indigenous population, which ought to be handled effectively. As a clear example, the first policy to address the health problems of the indigenous population was established in 1968. The failure of the policy was evident from the numerous amendments made between 1968 and 2006. King, Smith & Gracey, (2011) assert that the health policy makers realised the futility of the policies since it did not address the problems of the indigenous population adequately. Further, the changes in the governments also dealt a huge blow in addressing the plight of the indigenous population. As such, the change in governments translated to an environment whereby changes in health issues progressed rapidly as compared to the policies set forth due to the increasing bureaucracy. Till to date, there has been little progress towards establishing policies that comprehensively address the indigenous population. In the attempts to establish effective policies, there has not been in-depth comparative analysis to determine how the various health issues can be addressed (Paradies, Harris & Anderson, 2013). Accordingly, whereas there have been some levels of analysis and policy formulation, the policies set have not fully met or suited the situation of the indigenous population.

Differences between the Native and Non-natives in Addressing Health Issues

The policy formulation process is complex and has been challenging towards addressing the plight of the indigenous population. Accordingly, the indigenous population, in most instances, has been expressing concerns about the non-indigenous population being involved in formulating health policies to address their issues (Paradies, Harris & Anderson, 2013). Therefore, there has been the increasing disparities in views about how the health issues of the indigenous people ought to be addressed. As a clear example, the closing down of the Aboriginal and Torres Islander Commission (ATSIC) in 2004 was a significant aspect of concern about the health of the indigenous population (Gracey & King, 2012). The ATSIC had been tasked with the role of formulating indigenous health policies to address their issue. Nonetheless, the act of eradicating the commission translated to the shift in responsibility from the indigenous to the non-indigenous population. Therefore, the mainstream departments were charged with the daunting role of handling the health concerns of both the indigenous and non-indigenous populations, which led to significant shortcomings. Gracey & King, (2012) emphasise that the action of the government to close down ATSIC was a critical setback to the health of the indigenous population, which led to winding back the progress made in addressing the health issues of the indigenous population. The government’s perception of the indigenous population, as a culture, that was not suited to handle their issues translated to increasing differences in views and opinions about the health of the indigenous population. There was the extensive failure of the government to acknowledge the need for input by the indigenous policy makers in handling the specific health concerns.

Conclusion

Despite Australia maintaining a top rank globally in healthcare service delivery, there still prevail various aspects of concern in addressing healthcare inequalities between the indigenous and non-indigenous population. From the above analysis, it is evident that the indigenous population faces myriads of challenges in accessing health care. Social, economic disparities, ineffective policies and discrimination are aspects of concern that require direct government involvement to ensure an enabling healthcare environment prevails. The indigenous population is part and parcel of the healthcare industry. Therefore, the Australian government, despite the funds allocated should adopt a radical shift in the healthcare policies. Encompassing the indigenous population in the healthcare policy making is one of the approaches towards minimisation of the health inequalities.

References

Bramley, D., Hebert, P., Jackson, R. T., & Chassin, M. (2014). Indigenous Disparities in Disease-Specific Mortality, A Cross-Country Comparison: New Zealand, Australia, Canada, and the United States.

Gracey, M., & King, M. (2012). Indigenous Health Part 1: Determinants and Disease Patterns. The Lancet, 374(9683), 65-75.

Jamieson, L. M., Elani, H. W., Mejia, G. C., Ju, X., Kawachi, I., Harper, S., & Kaufman, J. S. (2016). Inequalities in Indigenous Oral Health: Findings from Australia, New Zealand, and Canada. Journal of dental research, 95(12), 1375-1380.

King, M., Smith, A., & Gracey, M. (2011). Indigenous Health Part 2: The Underlying Causes of the Health Gap. The Lancet, 374(9683), 76-85.

Marmot, M. (2011). Social Determinants and the Health of Indigenous Australians. Med J Aust, 194(10), 512-3.

Paradies, Y., Harris, R., & Anderson, I. (2013). The Impact of Racism on Indigenous Health in Australia and Aotearoa: Towards a Rresearch Agenda. Cooperative Research Centre for Aboriginal Health.

Stephens, C., Porter, J., Nettleton, C., & Willis, R. (2016). Disappearing, Displaced, and Undervalued: A Call to Action for Indigenous Health Worldwide. The Lancet, 367(9527), 2019-2028.

Wright, A. L., Wahoush, O., Ballantyne, M., Gabel, C., & Jack, S. M. (2016). Qualitative Health Research Involving Indigenous Peoples: Culturally Appropriate Data Collection Methods. The Qualitative Report, 21(12), 2230.

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