Statistics on the Health Gap between Indigenous and Non-Indigenous Australians
The poorer health of the Indigenous-Australians when compared to that of the non- Indigenous-Australians has become one of the most important issues in the nation. Present statistical data shows that the life expectancy of the Indigenous-Australian is much lower than that of the non Indigenous-Australians (Clifford et al. 2015). The males have low life expectancy of about 69.1 years to that of 79.7 years of the Indigenous-Australians males and the females have low expectancy rate of the 73.7 years to that of the 83.1 years in females. This health gap has become a rising concern and different types of campaigns had been developed like “closing the gap “to mitigate the issues (Hunt et al. 2015). However, very few had been successful which results in increased responsibility of the government to look into the matter with urgency”.
While closely analysing the root causes, one of the most important arena that needs to be considered for providing holistic care is considering the social determinants of health. Holistic care is the form of care that ensures physical, mental, social as well as spiritual needs of the persons. Only pitting importance to physical healthcare of the Indigenous-Australians may not bring out best outcomes. Different social determinants like poor education levels, poor employment rates, poor sanitations and housing properties, low access to healthcare organisations, poor culturally incompetent services are some of the factors that result in poor quality lives of the Indigenous-Australians (Lin et al. 2017). Therefore, this has been one of the governing concerns as to why the Indigenous-Australians are suffering massively in different aspects of their health although they are the first people of the nation. Research has shown its roots in the colonisation era in the nation.
Aboriginal people are the ancestors of the original population of the nation. Studies have found that their understanding of the water as well as land is the living cultural knowledge that is passed on from generation to generation. This has helped in the forming of rich and even a significant matrix with the different types of people, totemic, economic as well as spiritual connectedness with the nation. The connectedness is seen to extend from the past and helped in shaping the present and future of the land and natural resource management (Gibson et al. 2015). They had developed their own systems of knowledge as well as understanding of their ecology which is actually the representative of the living symbiotic relationship with both their lands and water of their traditional homeland estates. Different researchers are of the opinion that this knowledge includes different widespread systems of the knowledge that incorporates the biodiversity, culture, climate, land, and people. Therefore, this had made me understand the deep ingrained emotions, love and dependency that the Indigenous-Australians had developed with their motherland. They have shared a living culture with their environment since the time immemorial.
However, the period of colonisation by the European settlers had modified the living conditions of the Indigenous-Australians in their own nation. The horrific history about how the Indigenous-Australians were treated, tortured, oppressed and humiliated by them and the ways the government and the church sanctioned systems perpetuated the trauma in the 20th century had been one of the main cause of the poor living condition of the Indigenous-Australians in the present day (Hart et al. 2015). There have been evidences where the Indigenous-Australians had been forcibly removed from their own land making them homeless and destroying their kinship structures by causing destruction of the communities. With them, they brought many disorders like influenza, flu, chicken pox and many others which were not previously predominant in the nation (Jongen et al. 2018). Diplomatically, they had introduced alcohol consumption in the nation but had not made them aware about the harmful effects it causes and ways to overcome them. There had been instances of various on-human policies which degraded the respect of the Indigenous-Australians to the minority group in the nation. Even evidences speak about of stolen generations where children were removed from their parents forcibly with rationales of making their future bright in the western mode of living. This attempt of destroying the culture of the Indigenous-Australians had highly impacted the Indigenous-Australians. Including them in the flora-fauna act or poisoning their water and food resources had impacted a huge number of populations and degraded their living conditions (Lorie et al. 2017).
Importance of Social Determinants of Health for Holistic Care
The horrors of this form of oppressions had passed on from generation and generation with the degradation of their life quality. For too long, they had been governed by the western government which had taken their rights for self-determination about their own decisions and responsibilities towards their own lives as well as towards their motherland. For too long they have survived in a state of oppression. Four main values have been attacked by the colonisers. These are the identity, responsibilities, relationships as well as spirituality. On close analysis, it can be seen that all the four core values are associated with their cultural identity (Johnstone et al. 2016). Therefore, I believe as healthcare professionals, attending to the social determinants and developing strategies for developing and respecting the four core values of the Aboriginal culture would help them revive their self-determination and alter their quality of life towards betterment.
Nursing professionals need to develop cultural safety in their practice so that the care they provide to the Indigenous-Australians aligns with their cultural traditions, preferences and inhibitions. Nurses should be aware of their own values, traditions, beliefs as well as their own cultural perspectives to understand how their own work will affect the care to the patient. Cultural awareness of one important part where nurses need to be aware about the cultural backgrounds of the people they care for, so that their interventions align with the patient’s expectations (Kendall and Barnett 2015). Cultural sensitivity or ensuring care to the patients aligning with their cultural traditions makes them satisfied and dignity and autonomy are also respected (Campbell et al. 2017). I am from Nepali background and can absolutely understand the love shared by the Indigenous-Australians with their motherland. My nation and my culture are based on centuries old traditions as well as customs. Such traditions are very important for me and I try my best to follow them as a part of respecting my motherland. I am highly compassionate towards their emotions and can feel the depth of their spirituality with the nation as I am myself a spiritual person. My culture has taught me to be respectable to other cultures and never judge any aspect of other cultures in the light of my own culture. It has taught me the importance of respecting the diversity in every culture for that would only result in developing a loving world. Therefore, I believe that the values and beliefs ingrained in my own cultural foundation will help me to be culturally unbiased, develop cultural awareness and cultural sensitivity while caring for them. I would consider each Indigenous-Australian as a unique individual, try to understand their mental and emotional conditions, make them comfortable and then proceed with the treatment.
I have learnt that only caring for the biological determinants of health in the Indigenous-Australians would never provide them quality life. I will collaborate with them, engage them in decision making about their own health and maintain cultural safety. This will make them feel respected and I will be able to maintain their dignity and autonomy as well. Therefore, such culturally competent care will make them comfortable with the western healthcare systems and they will overcome nay negative feelings about the western healthcare system. I will ensure that I am providing them culturally competent and person centred care that aligns with their cultural preferences. This will help in overcoming the gap that exists in health status in the nation between the Indigenous-Australians and the non Indigenous-Australians.
References:
Campbell, S., Roux, N., Preece, C., Rafter, E., Davis, B., Mein, J., Boyle, J., Fredericks, B. and Chamberlain, C., 2017. Paths to improving care of Australian Aboriginal and Torres Strait Islander women following gestational diabetes. Primary health care research & development, 18(6), pp.549-562.
Clifford, A., McCalman, J., Bainbridge, R. and Tsey, K., 2015. Interventions to improve cultural competency in health care for Indigenous peoples of Australia, New Zealand, Canada and the USA: a systematic review. International Journal for Quality in Health Care, 27(2), pp.89-98.
Gibson, O., Lisy, K., Davy, C., Aromataris, E., Kite, E., Lockwood, C., Riitano, D., McBride, K. and Brown, A., 2015. Enablers and barriers to the implementation of primary health care interventions for Indigenous people with chronic diseases: a systematic review. Implementation Science, 10(1), p.71.
Hart, B., Cavanagh, M. and Douglas, D., 2015. The “Strengthening Nursing Culture Project”–an exploratory evaluation study of nursing students’ placements within Aboriginal Medical Services. Contemporary nurse, 51(2-3), pp.245-256.
Hunt, L., Ramjan, L., McDonald, G., Koch, J., Baird, D. and Salamonson, Y., 2015. Nursing students’ perspectives of the health and healthcare issues of Australian indigenous people. Nurse education today, 35(3), pp.461-467.
Johnstone, M.J., Hutchinson, A.M., Redley, B. and Rawson, H., 2016. Nursing roles and strategies in end-of-life decision making concerning elderly immigrants admitted to acute care hospitals: an Australian study. Journal of Transcultural Nursing, 27(5), pp.471-479.
Jongen, C., McCalman, J., Bainbridge, R. and Clifford, A., 2018. Health Organisation and System Cultural Competence Interventions. In Cultural Competence in Health (pp. 99-113). Springer, Singapore.
Kendall, E. and Barnett, L., 2015. Principles for the development of Aboriginal health interventions: culturally appropriate methods through systemic empathy. Ethnicity & health, 20(5), pp.437-452.
Lin, I.B., Ryder, K., Coffin, J., Green, C., Dalgety, E., Scott, B., Straker, L.M., Smith, A.J. and O’Sullivan, P.B., 2017. Addressing disparities in low back pain care by developing culturally appropriate information for aboriginal australians:“My Back on Track, My Future”. Pain Medicine, 18(11), pp.2070-2080.
Lorié, Á., Reinero, D.A., Phillips, M., Zhang, L. and Riess, H., 2017. Culture and nonverbal expressions of empathy in clinical settings: A systematic review. Patient education and counseling, 100(3), pp.411-424.
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