In essence, culture as a foundation of resilience, strength, confidence, identity, and happiness is inseparably connected to the wellbeing and health of Aboriginal people. Nonetheless, the ordeals of colonization keep on significantly affecting the promotion and maintenance of culture through racist practices and policies that are part of the daily experience of Aboriginal individuals in Australia even today (Durey, 2010). Tragically, even in this day and age racism is still entrenched in the health system and among healthcare professionals. Thus racism keeps on causing the unacceptably vast health gap between Australia's non-Indigenous and Indigenous people. This health gap has contributed much to the Aboriginal population’s deaths every year. This discussion will look deeply into how racism manifests itself in the Australian health system by looking at two important areas, first, on healthcare outcomes for Aboriginal population and secondly, on the medical workforce.
The manifestation of racism in the healthcare outcomes
Racism essentially manifests itself in stereotypes, beliefs, discrimination, and prejudices. Racism may be internalized or exist on a systemic and institutionalized level and affects the health of Aboriginal population from many perspectives, however, for this discussion, we will focus on Systemic or potentially institutionalized racism in medical facilities and services (Willis, 2009). It is worth noting that, racism on an interpersonal level increases the exposure to discrimination and prejudice, indifference and devaluation, disrespect and mistrust (Aubusson, 2018). Internalized racism propagates negative self-assessments through resignation, hopelessness, helplessness, self-devaluation and sadly the acceptance of reinforced and perceived insufficiency.
In today’s Australia's health system, racism exists and it adversely affects the Aboriginal doctors, medical students and the general health outcome of Indigenous people (NACCHO Aboriginal Health News Alerts, 2018). Healthcare provider racism always prompt to lower perceived quality of care, poorer self-reported wellbeing status, delays in seeking care, underutilization of health services by the indigenous people, inability to follow recommendations, interruptions in care, distrust within the society, evasion of health care system due to the existence of mistrust of providers and the whole system.
Systemic racism in the system has caused adverse impacts on the Indigenous Australians' access to and quality of healthcare services (Caac.org.au, 2018). The adversity of this effect causes an increase in levels of emotional stress, which is firmly connected to poorer physical and mental health outcomes for indigenous people. Racism does not only create a huge barrier to Aboriginal populations access to healthcare services, but also creates a barrier to receiving a similar quality of medicinal services administrations accessible to non-Indigenous population(Keleher, 2009).
Research that was carried out in 2015 on more than 250 international and national students on the issue of racism in the healthcare system established a reasonable connection between poorer mental health and racism, including anxiety, psychological stress and depression, and poorer physical and general health (Australian Medical Association, 2018). These discoveries are affirmed by a study carried out which focused particularly on the effect of racism on Torres Strait Islander and Aboriginal health.
Moreover, a lot of experiences of racism in the healthcare system in the past have been a contributing fact to the Torres Strait Islander and Aboriginal individuals sidestepping those settings and situations because of fear of undergoing the prejudice once more (Ziersch et al., 2011). This also impacts their access to healthcare. Studies have proposed that there is a link between poorer psychological health, the regularity, and seriousness of racist experiences. In medical institutions, Indigenous patients are treated with suspicion and denied pain relief. Indigenous cancer patients have even had pain relief denied to them (Russell and Dawda, 2014). This may occur for a few reasons. In the first place, it is due to the notion that Indigenous people can withstand more pain than their non-indigenous counterparts which is an ethnocentric view that isn't right. Another view is that indigenous people are "faking it" to get drugs.
In Australian healthcare setting, Torres Strait Islander and Aboriginal population have poorer health than the non-Indigenous people. Aboriginal people are the majority underprivileged and poor, characterized by lower life expectancies and limited success in improving (Eckermann, Sheridan and Ivers, 2015). Researchers have for the most part centered on the marginalized and disadvantaged population in trying to address this issues, however, offering a just fractional understanding of influences behind the slow advancements. One thing that is evident is that an analysis is critically needed of those with the ability to improve or perpetuate health inequalities.
The life expectancy of Torres Strait Islander and the Aboriginal population is about 10 years lower than that of the non-indigenous people (Kelaher, Ferdinand, Paradies, " Warr, 2016). Notably, in some parts the gaps reach as far as 26 years, and children of Indigenous people as young as seven years of age were developing diabetes type 2, likely the Youngest on the planet to develop this type of diabetes. Consequently, healthcare services for the Torres Strait Islander and Aboriginals have been hit by Government budget cuts and uncertainty over any possible future funding (Russell and Dawda, 2014). The AMA, in its Key Health Issues for the 2016 Federal Election document, has requested a termination of what it pointed out to be an unending under-funding of the healthcare sector and a boot on investment in an indigenous community controlled health organizations.
Manifestation on medical workforce
Systemic prejudice and in addition to xenophobic behavior or remarks, an inadequate reporting and mechanism for follow-up adversely impact the growth of the Torres Strait Islander and the Aboriginal medical workforce (Gabb, 1998). This phenomenon is in essence demonstrated by the accessible Australian data which features the impact of medical students’ and doctors racists’ experience.
Research has demonstrated that Indigenous doctors are reporting bullying or harassment as the major source of stress and racism at almost twice the rate of their non-Indigenous colleagues. A similar report additionally demonstrated that 27% of students of Indigenous decent pointed out that they are stressed by racism significantly (Payne, 2018). Basically, discrimination including bullying, sexual harassment, and racial discrimination is common and widespread all through the health system than expected.
Conclusion
As can be seen, racism surfaces as a critical issue, driving us to deeply question the part that 'Whiteness' plays in Australian health care system. While Whiteness can allude to skin color, it also represents a social structure radicalized and where Indigenous beliefs, values and knowledge are subject to western biomedical model in practice and policy. Racisms towards Torres Strait Islander and Aboriginal patients in services provisions in health facilities are interpersonal and institutional (Gelber and McNamara, 2015). Racism on an internalized level manifests itself when Torres Strait Islander and Aboriginal patients incorporate racist beliefs and attitudes into their experiences which lower their self-worth and their expectations. Existing health practices and policies support standardized care where the voice of the marginalized is regularly lacking. However, looking at the adequacy of such models in diminishing the disparities in healthcare provision requires providers of healthcare to deliberate on whether the health care practices and policies compromise or promote health which is an imperative step in transforming the dialogue that has, in essence, placed the Torres Strait Islander and Aboriginal communities at the center of the issue.
References
Aubusson, K. (2018). Racism in the health system plagues efforts to close the gap for
Indigenous Australians, report shows. [online] The Sydney Morning Herald. Available at: https://www.smh.com.au/healthcare/racism-in-the-health-system-plagues-efforts-to-close-the-gap-for-indigenous-australians-report-shows-20170315-guyhz4.html [Accessed 22 Apr. 2018].
Australian Medical Association. (2018). ‘Elements’ of racism in how health system treats
Indigenous. [online] Available at: https://ama.com.au/ausmed/%E2%80%98elements%E2%80%99-racism-how-health-system-treats-indigenous [Accessed 22 Apr. 2018].
Caac.org.au. (2018). Racism is a significant barrier to Aboriginal health improvement | CAAC.
[online] Available at: https://www.caac.org.au/news-events/media-releases/2015/8/racism-is-a-significant-barrier-to-aboriginal-health-improvement [Accessed 22 Apr. 2018].
Durey, A. (2010). Reducing racism in Aboriginal health care in Australia: where does cultural
education fit?. Australian and New Zealand Journal of Public Health, 34, pp.S87-S92.
Eckermann, S., Sheridan, L. and Ivers, R. (2015). Which direction should Australian health
system reform be heading?. Australian and New Zealand Journal of Public Health, 40(1), pp.7-9.
Gabb, D. (1998). Commentary: Australian Psychological Society Position Paper on Racism and
Prejudice. Australian Psychologist, 33(3), pp.183-186.
Gelber, K. and McNamara, L. (2015). Evidencing the harms of hate speech. Social Identities,
22(3), pp.324-341.
NACCHO Aboriginal Health News Alerts. (2018). NACCHO Aboriginal Health and #18C :
Racism in Australia’s health system. [online] Available at: https://nacchocommunique.com/2016/12/07/naccho-aboriginal-health-and-18c-racism-in-australias-health-system/ [Accessed 22 Apr. 2018].
Payne, S. (2018). Stan Grant’s ‘Racism is Destroying the Australian Dream’ speech. NEW:
Emerging scholars in Australian Indigenous Studies, 2(1), p.84.
Russell, L. and Dawda, P. (2014). Lessons for the Australian healthcare system from the
Berwick report. Australian Health Review, 38(1), p.106.
Ziersch, A., Gallaher, G., Baum, F. and Bentley, M. (2011). Racism, social resources and mental
health for Aboriginal people living in Adelaide. Australian and New Zealand Journal of Public Health, 35(3), pp.231-237.
Kelaher, M., Ferdinand, A. S., Paradies, Y., " Warr, D. (2016). Exploring the mental health benefits of participation in an Australian anti-racism intervention. Health Promotion International, daw048. doi:10.1093/heapro/daw048
Keleher, H. (2009). Primary health care system. Understanding the Australian Health Care System, 33-43. doi:10.1016/b978-0-7295-3861-9.10004-3
Willis, E. (2009). The Australian health care system. Understanding the Australian Health Care System, 3-13. doi:10.1016/b978-0-7295-3861-9.10001-8
