The Close the Gap Campaign: Bridging the health and life expectancy gap between Indigenous and non-Indigenous Australians
Australians are enjoying the longest lifespan compared to most of the countries in the world. But this is not the case for all Australian. There exists an unacceptable wide gap between Indigenous and non-indigenous population in Australia. Australian Government has launched a Close the Gap Campaign since 2007 to bridge the health and life expectancy gap between Aboriginal and Torres Strait Islander people and non-indigenous people. The main target of this campaign is to achieve health equality within a generation. With the launch of this campaign, the Australian Government has committed to work collectively to systematically address the social determinants that impact on achieving health equality for Aboriginal and Torres Strait Islander people. Social determinants theory recognises that population health and inequality is determined by many interconnected social factors. Important determinants of Indigenous health inequality in Australia include lack of primary health care access and the lower standard of health infrastructure in Indigenous community (healthy housing, food, sanitation, etc.) compared to other Australians (Australia, 2013).
Housing is one of the most important social determinants which is fundamental to physical, mental and social well-being and quality of life. According to ABS 2011 census data, overcrowding rates among non-indigenous Australians (6.1%) are considerably low compared to the Indigenous Australians (23.4%) (James, 2016). Better home environment can have positive outcomes for Aboriginal and Torres Strait Islander Australians. Reducing overcrowding can have positive effects on health, family relationship and children’s education of Aboriginal communities. Similarly, improvements in environmental health can help reduce the spread of diseases that are linked to environmental causes; and clean water, functional sewerage and electricity services and housing of an acceptable standard can certainly encourage and support healthy living practices for Aboriginal communities. While fundamental to improving the Indigenous health outcomes, the impact of poor housing on the Indigenous health have been explained in this paper by analysing 4 media items that focus on housing and living conditions of Indigenous people.
In this article, the author talks about housing conditions in crisis situation in the remote areas of Northern Territory. A survey report on indigenous housing condition revealed 10% improvement on overcrowded conditions of indigenous housing and one-third of Indigenous people in remote areas (38%) were still found to be living in overcrowded situation. However, the NT service providers find it hard to believe the survey report because according to them, there is no sign of improvements as the remote communities’ houses are hard to find that are not over-crowded. They termed this condition as a crisis until this is addressed (James, 2016).
Housing as a significant social determinant of health
The second half of the article talks about major structural problems with indigenous houses making the houses hazardous to live-in. According to Dr Paul Jelfs from the ABS population and Social Statistics Division, when surveying 11,500 indigenous people, 36% were found to be living with major structural problems with their houses and 28% with basic problems of household facilities such as cooking, washing, sleeping and safe waste removal. Dr Jelfs considered major structural problems, poor household facilities and over crowdedness as ‘triple-whammy’ and very difficult to live-in with. Similarly, Ms Collins was concerned about dangers of overcrowding where up to 30 people live in some small dwellings such as spread of diseases.
Similarly, the article talks about Government failing to provide houses for more than half of remote communities (57/73) resulting into critical shortage of affordable and public housing which is primarily driving to worsen overcrowding and increase homelessness. According to 2011 ABS census data, more than 7% of Indigenous people in NT are homeless which is about 15 times the national average and 85% of these people are living in severely crowded dwellings (James, 2016).
In the Module 2 Topic 1 (HSC203 learning materials, 2017) the demonstration of housing crisis have been included. According to the available evidences, the issue has been raised since colonization and affected significantly the indigenous population’s health. On the other hand, Griffiths et al., (2016) identified that only overcrowding is not the issue, rather the whole concept of housing needed to be changed. It is needed to be considered that the model and urban style of western constructs are not suitable for most indigenous social organization. Thus, the overcrowded houses lead to the increased health issues of population. Thus, indigenous population’s living standards should be designed according to their physical environment. These are also demonstrated in the above media article. It has been claimed that government has not adequately understood their roles and responsibility related to outstation community build up, which is urgent for improving the current status.
This article provided significant information regarding the indigenous housing crisis in Northern territory. The article provided adequate sources of statistical data for ensuring the authentication of the information provide in the article. The article represented the housing crisis of indigenous population along with the effects of the issue on their lives. In this context, author also represented a negligence of government and other social welfare communities to mitigate the issues. A significant discrimination between the rural and urban society has also been represented, which is enhancing the health issues among the indigenous people living in the remote areas with housing crisis. Thus, the article claimed that government should take more active initiative to address the issue, for reducing health issues related gap in the society. In addition, non-government organizations should also take some initiatives to promote governmental efforts to mitigate the issues, for improving indigenous people’s lifestyle and health disparities. gudd3d.html
Overcrowding and low standard of health infrastructure in Indigenous communities
This article talks about critical stage of housing shortages in remote NT Aboriginal communities making the wider gap between Indigenous and non-Indigenous. People are living under tents pitched on verandas during monsoon rains, elderly people are sleeping on kitchen floors and are experiencing violence due to poor housing. According to the article, 4000 additional houses are required immediately to overcome the housing shortage but then over the past 8 years, only minimal investment has been done in remote housing under the National Partnership Agreement on Remote Indigenous Housing, which is a drop in the ocean compared to the need (Shannon, 2016).
The second half of the article focuses on housing being the fundamental pillar of the close the gap campaign. It talks about the housing conditions being the primary driver for poor health of Aboriginal people. Proper housing is one of the fundamental human rights which plays a vital role in people’s physical and mental health allowing people to participate and contribute to the society. Poor housing does not only hinder good night sleep but also increases the health risks such as unhygienic food preparation, increase use of drugs and alcohol, increase rate of physical violence, etc. Impact of poor housing with disability becomes worse. Overcrowding is not a part of the Aboriginal or their choices but the consequence of chronic underfunded investments. Australian Government should collaborate with remote indigenous housing need to address the housing shortfall. For breaching the gap, Government need to take urgent action on this matter and certainly requires greater investment (Shannon, 2016).
According to the Module 2 Topic 1 (HSC203 learning materials, 2017) the history of indigenous colonisation have significantly influenced social gap among the indigenous and non-indigenous population, which is in turn influenced by dominant political ideology of the government of that time. In the article this social gap has been demonstrated, as result of homelessness and health issues among the indigenous people. Tom (2016) argued that political pressure and actions by the indigenous organizations have significantly responsible for the improvements done for them. However, one problem that has been identified for failed government initiative is that the key focus of these government policies are to change the indigenous society instead of embedding structural changes within the dominant non-indigenous society. However, indigenous population are not able to fit in the non-indigenous society.
In this article also, the housing crisis of indigenous people in Northern territory has been reflected, with a demonstration of increased gap between indigenous and non-indigenous people. Being a human right, indigenous people deserve proper housing, but there are significant gap in the society in terms of gaining human rights among indigenous and non-indigenous people. Therefore, significant need for government initiative has been seen in North territory to promote the social well being of indigenous people. Author highlighted that overcrowding is negative consequence of chronic unfunded investments. Author also highlighted the need for collaborating with remote indigenous housing need for addressing the housing shortfall. Unlike the previous article, author has mentioned the need for urgent investment by the government for addressing and mitigating the housing issue, as the housing issue is significantly contributing to the increased social gap in health issues and reducing the overall growth and sustainability of the country.
Government’s inadequate response to Indigenous housing crisis
The key issue of this article is homelessness as a health issue for Indigenous people. After colonisation, the Indigenous people have been displaced internally and have lost connection to their own land. Stolen Generation has affected the Indigenous family culture, community and the physical land. The Northern Territory Emergency Response Act (NTERA) 2007 well-known as The Intervention further impacted on the autonomy of Indigenous people causing fear, humiliation and confusion leading Aboriginal people to leave their communities and land. The article talks about Warlpiri town camps near Katherine where currently a large number of homeless indigenous people live in. The condition in there is said to be miserable due to overcrowding and lack of security causing unhealthy life and high rate of violence such as murder. The article is concerned about lack of future for Indigenous people who wanting to move Katherine because of prolonged waiting time for public housing and end up homeless. The Indigenous people are experiencing from refugee-like condition who are displaced in their own land because remote communities are hard to live in due to poor housing conditions and town camps are dangerous and contribute homelessness (Quilty, 2017).
The last but important part of the article is about concerns of Indigenous people attending the hospital very frequently due to homelessness. A paper was published where it was revealed that some people attended emergency department for non-medical conditions as frequently as every two weeks. The people who frequently presented in emergency department for non-medical conditions were found 16 times more likely to be living in temporary accommodation or homeless. Majority of the admissions were alcohol linked, however the main driving factor was considered as homelessness. The six of ten regions with the highest rate of homeless are in Northern Territory along with Katherine has 12% homeless Indigenous population. The article describes the local level approach of Katherine team to address this problem. A social care pathway has been implemented which is culturally appropriate as well. With this, Katherine hospital expects to reduce unnecessary hospital attendance to an already over-burdened system (Quilty, 2017).
Samson and Gigoux (2016) argued that a human rights approach would recognise the link between health status and systemic discrimination. However, the government policies were not able to mitigate the issue from the root, as a significant discrimination is visible in the organization. In addition, there is a lack of awareness among the policy developers regarding the key holes in these policies. In addition, as the impact of homelessness and housing is significantly affecting the health of these people, the health and social care practitioners are also need to have more understanding upon the broad issue. Therefore, along with increased investment, government should also need to understand the proper solution of mitigating the issue, instead of continuously trying to integrate these indigenous people in the non-indigenous lifestyle.
The impact of poor housing on Indigenous health: An analysis of four media items
In the third article, author specifically focused upon the association between the homelessness and health issues of indigenous people. This article also provided information regarding the indigenous culture and history linking with their current status, regarding how they are experiencing humiliation and discrimination through the society. Author attempted to make the paper more relevant by concentrating upon specific incidents including Warlpiri town camps near Katherine, where a large indigenous population resides in overcrowded tents, with lack of security and high rate of violence. Author highlighted that the hospital visit rate is high among indigenous people. It has also been revealed from a survey that the rate of harsh lifestyle including alcohol addiction is high among the hospitalized individuals; the key reason is homelessness. Finally, authors demonstrated local initiatives for improving the situation, highlighting that there is an urgent need for local and national level approach aligning with the cultural consideration to mitigate the issue. However, instead of highlighting the key issue, author has focused more on the burden of NT hospital.
This article talks about endemic scabies infection in Aboriginal communities the far remote Northern territory due to poor housing. According to the article, 70% of the Aboriginal children were infected with scabies in their first year of life. Similarly, Medical Journal of Australia found that at least 1 in 100 suffer this infection in a severe form (highly virulent and crusted scabies) which is linked with homelessness and remote living. Crusted scabies can be very dangerous as this can potentially spread among hundreds and thousands of others very easily. Scabies is caused by tiny mites in the inner layer of the skin. It is highly contagious when its crusts start to fall and can spread to everyone who have a direct contact with the infected person, such as bus seats, in the cinemas, on mattresses, lounge chair, footpath. In case of excessive itching, the infection can cause streptococcal infection resulting into sever disease such as Rheumatic Heart Disease (Ross & Walters, 2017).
The article describes how poor housing condition can spread scabies and how it can be addressed. As many as one in four Indigenous people in Katherine are homeless because of unaffordable private rental market and public housing takes a five-year waiting time. Many remote-living people wanting to move to the bigger cities like Darwin and Katherine have to embrace homelessness and live in the bushes and riverside fringe dwelling camp with no sanitation, running water or secure shelter. Many houses in Katherine are overcrowded with four generations sharing the same roof. In such an overcrowded condition, if a scabies-infected relative unknown of his condition comes for visit, everyone in the house get infected in no time. Even if that visitor relative luckily get to treat scabies in the hospital, he is likely to catch it back when he returns to his place where the scabies rate is high. Northern Territory 2016 has added scabies in the list of notifiable diseases to treat identified cases systematically. However, great distance of remote areas, tropical weather and mobile population make it challenging to eradicate scabies. Poor social and health outcomes are the result of colonisation creating homelessness and unsafe livings (Ross & Walters, 2017). The fundamental solution to homelessness should be done to enhance Aboriginal people’s health condition.
Indigenous population’s living standards should be designed according to their physical environment
In the above article, the key focus was upon scabies endemic among the aboriginal population. Here, along with the need for policy change, highlighted in Module 2 Topic 3 (HSC203 learning materials, 2017) for improving the health disparities among the homeless indigenous population, a need for educating the health and social care workforce has been mentioned, for identifying and understanding the key requirements of indigenous population to improve their health status (Taylor & Guerin, 2014). Therefore, the educational policies for health and social care workforce should be embedded along with the improved affordability of health care service for the indigenous population.
Here author discussed about the scabies endemic in Aboriginal community in Northern territory, which is the consequence of housing crisis. The disease is highly contagious and needs to be prevented with high level of hygiene practices. However, due to homelessness and overcrowding, the rate of this infection is higher among indigenous people than the non-indigenous children. Author significantly demonstrated the influence of their social condition on homelessness. The private rent is higher to be afforded by these poor indigenous population, thus most of them have became homeless and waiting for government’s help for their public housing. On the other hand, the distance of remote areas from the health care centre is also hindering this population to get adequate treatment. Therefore, government and non-governmental organization should undertake urgent and appropriate steps to address the downturn of their health condition.
Reference List
Australia. (2013). Footprints in time: The Longitudinal Study of Indigenous Children : report from Wave 4. Canberra: FAHCSIA.
Griffiths, K., Coleman, C., Lee, V., & Madden, R. (2016). How colonisation determines social justice and Indigenous health: A review of the literature. Journal of Population Research, 33(1), 9-30. doi: 10.1007/s12546-016-9164-1
James, F. (2016). NT Indigenous housing crisis continues despite national improvements: agency. ABC News. Retrieved 27 May 2017, from https://www.abc.net.au/news/2016-05-01/nt-remote-housing-crisis-continues-despite-national-improvement/7373656
Quilty, S. (2017). Why the housing shortage exacerbates scabies in Indigenous communities. NITV. Retrieved 27 May 2017, from https://www.sbs.com.au/nitv/nitv-news/article/2017/02/07/why-housing-shortage-exacerbates-scabies-indigenous-communities
Ross, D., & Walters, A. (2017). The gap grows wider for remote communities struggling with severe overcrowding. The Sydney Morning Herald. Retrieved 27 May 2017, from https://www.smh.com.au/comment/the-gap-grows-wider-for-remote-communities-struggling-with-severe-overcrowding-20170215-gudd3d.html
Samson, C., & Gigoux, C. (2016). Indigenous peoples and colonialism: Global perspectives.
Shannon, G. (2016). Refugees in their own land: how Indigenous people are still homeless in modern Australia. The Conversation. Retrieved 27 May 2017, from https://theconversation.com/refugees-in-their-own-land-how-indigenous-people-are-still-homeless-in-modern-australia-55183
Taylor, K., & Guerin, P. (2014). Health care and Indigenous Australians: Cultural safety in practice (2nd ed.). Australia: Macmillan Education Australia.
Tom, C. (2016, October 26). How discrimination and stressful events affect the health of our Indigenous kids. (n.d.). Retrieved from https://theconversation.com/how-discrimination-and-stressful-events-affect-the-health-of-our-indigenous-kids-67548
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