Indigenous Australians and Health Disparities
Indigenous health refers to the all-around development of the native people of Australia. Indigenous Australians suffers from poorer health than other Australians. They are more likely to die younger. They generally suffer from respiratory diseases, poor mental health, diabetes, kidney and heart disease. The government has taken numerous initiatives for increasing the health condition of indigenous Australians. They are primary health care services, improving access to those health care services and targeted health activities etc. Health care professionals can remove the existing disparities in health care and become a part of an effective solution (Berglund, 2012). Nurses could also play an important part in removing cultural barriers. To narrow down the gap aboriginal nurses, doctors, midwives and staffs could be employed, the doctors should disclose to the aboriginals regarding their disease in their own language and educate them regarding the gravity of the disease, they should be offered treatment at a very low price, staffs should be recruited who are aware of the culture of aboriginals, awareness should be spread among the aboriginals regarding the benefits of regular health checkups.
Hospitals staffs should be well equipped to deal with the aboriginals effectively. Hospital staffs should have long working hours to cater to the needs of the aboriginals. The prevailing discrimination between the aboriginals and other Australians should be stopped. Normative need can be defined as acceptable standards in health care based on special expertise (Berridge, Gorsky& Mold, 2011). The normative needs at an individual level can be assessed by using standard assessment tools. Comparative need can be defined as a method that is applied to access the health status of people belonging to different communities or population groups. A region is said to be in comparative need of health services if that region has more health problems and lesser access to health services than any other region. Comparative needs are also measured by standard assessment tools at the individual level. Expressed need can be defined as an inference drawn on the basis of observing the services used by a community or person. The expressed need is also influenced by the availability of the services in that particular community. Expressed need vary from region to region and by the number of services received by the individuals. Felt need recognizes the subjective element of need. It is defined in term of what the individuals say they want. The range of felt needs can be decided by a mixed consumer at a different level. The level could be local, state or national level.
Initiatives by the Government
The aboriginals of Australia do not trust the white peoples and hospital environment reminds them of racism and mistreatment. They fear that hospitals staffs will not treat them well. They are deeply traumatized by the behavior of the hospital staff and the white doctors. For the aboriginals, a hospital is a place from where no one comes back alive. When they have bad experiences regarding health services they do not complain they stay away because of the fear of racial discrimination prevents them from speaking up. The way in which they are treated by the hospital staffs makes them feel uncomfortable and undeserving (Carnevale, 2012). In order to improve indigenous health, it is necessary to develop skilled indigenous health workforce. If the hospital would allow traditional healers the number of aboriginal patients visiting the hospitals would have increased. There are limited doctors in the remote areas and hospitals are situated far away. Due to lack of infrastructure, their access to pharmaceuticals is also limited. The main drawback of indigenous people to access the healthcare service is the lack of any indigenous doctor. Some young doctors have opined that it is tough to maintain the balance between the western medical system and aboriginal culture. The issues that do not receive adequate attention are mental health, oral health, and dental health. Infant mortality rates are also high among aboriginals. There is an inadequate distribution of primary health care and health infrastructure in terms of formal equality (Lisa Zamosky., 2013).
Health inequality is present between aboriginal Australians and Torres Strait Islanders. Indigenous people experience high prenatal mortality, child mortality and low birth weight. They are even prone to chronic diseases, cardiovascular diseases, diabetes, and sexually transmissible diseases. It is important to narrow this gap and ensure that everyone gets full health care despite their social position.
Health care providers with better cultural competency can reduce disparities. The nurses and other health staffs should also be empathetic towards those who have less access to healthcare facilities. Alcohol and other drugs treatment approach should be taken to reduce the impact of AOD related diseases as AOD use is higher among indigenous peoples (Duckett&Willcox, 2015). The harms caused by AOD are mental health problems, violence, and blood-borne diseases.
The obstacle of cultural and linguistic barrier should be removed to get satisfactory results in health care service among Aboriginal Australians and Torres Strait Islanders. The literature shows that different beliefs, faiths, and understanding of health make them unwilling to use western health care facilities. Cultural difference plays a key role in the unequal outcome of health care services. The absence of speech-language pathologists in the rural territories who can understand the language of the aboriginals only increases this problem (Slottje, Tchernis, Baltagi&Sadka, 2010). Communication difference can cause misdiagnoses. The biological and physical difference also prevents the aboriginals from participating in the treatment. It is difficult to create a comfortable environment with one from a different cultural group. The life expectancy of indigenous men and women are 56 and 63 years respectively. The leading cause of death is cardiovascular disease, neoplasm, respiratory and metabolic diseases. Due to having children at a young age, the birth weight of babies is lower than non- indigenous babies.
Challenges for Health Care Professionals
The theme for the development of indigenous peoples should be a partnership between locally run services and mainstream services where a large number of indigenous health personnel work. The indigenous health personnel must spread awareness among the community members about the benefit of regular medical checkups and how that can help them to be fit.
The unavailability of adequate health services can create huge problems for the indigenous people and government of the country. Indigenous people may start to move to metropolitan cities for better healthcare facilities that can lead to increase in the crowd in the hospitals. Apart from this, the healthcare professionals may also face huge pressure for managing the patients.
The National Health and Medical Research Council (NHMRC) had laid down certain guidelines for the ethical conduct of indigenous research. Those guidelines have adhered throughout the planning, analysis, and implementation of the research. The healthcare provider priorities should be to respect the privacy of indigenous people, uphold their opinion correctly and provide them an opportunity so that they can express their opinion in a non-judgmental way. The discussion not only focused on one type of health behavior but a range of behaviors like smoking, alcohol consumption, physical activity, and dietary habits. Broader social factors like culture, history, racism, socio-economic circumstances, personal circumstances and psychological factors that influence the health behavior were also taken into consideration. The communication gap between the indigenous and non- indigenous persons is more in remote areas, where the cultural difference is more (Dunbar, Reddy & May, 2011). An understanding of the indigenous language can play an important role in improving the communication gap. Studies have revealed that indigenous people withheld information when under treatment which leads to the assumption that aboriginal people do not want to know what they are suffering from or that they do not experience pain. Effective communication method and the use of interpreters are underutilized. Let’s give an example a doctor told a patient that he is not sure how his heart got enlarged. The patient assumed that the doctor had no idea and discontinued treatment.
Failure to develop an understanding can result in grave problems. Indigenous people are full of superstitious beliefs. They believe in the black magic theory. For them, even serious accident or diseases are due to the application of magic on them. Immune system and germ theory are alien concepts for them. They have traditional knowledge of human anatomy but that does not means they know about the detailed functioning of human organs and how medicines work. The establishment of an effective doctor-patient relationship is the only way to narrow the communication gap. The hospitals in the remote areas are always overcrowded; more health care clinics have to be opened in order to improve health in rural populations. Indigenous people have more incidents of liver cancer and cervix cancer and fewer incidents of breasts cancer, colon cancer, rectum cancer, and lymphomathan non- Indigenous persons.
The state should concentrate on improving the relationship between white doctors and indigenous patients by reducing the communication gap. More health care officials should be appointed from indigenous communities. The outside of the ambulance can be painted with the drawings from aboriginal cultures so that the indigenous patients could relate. The health care staffs have to be gentle towards indigenous patients. Lastly, awareness could be spread regarding the benefits of regular health checkups (Neblett& Roberts, 2013).
The healthcare professionals have to develop appropriate communication skills in order to develop relationship with the patients. The priority is important because it will assist the healthcare providers to understand the issue of the patient and provide adequate care. The indigenous people will be benefited because they could communicate appropriately with the healthcare professionals.
References
Berglund, C. (2012). Ethics for health care (2nd ed.). South Melbourne, Vic.: Oxford University Press.
Berridge, V., Gorsky, M., & Mold, A. (2011). Public health in history (4th ed.). Maidenhead: Open University Press.
Carnevale, A. (2012). Healthcare (4th ed.). Washington, D.C.: Georgetown University, Georgetown Public Poicy Institute, Center on Education and the Workforce.
Duckett, S., &Willcox, S. (2015). Australian Health Care System (3rd ed.). Sydney: Oxford University Press.
Dunbar, J., Reddy, P., & May, S. (2011). Deadly healthcare (6th ed.). Bowen Hills, Qld.: Australian Academic Press.
Lisa Zamosky. (2013). Healthcare (6th ed.). Apress.
Neblett, E., & Roberts, S. (2013). Racial identity and autonomic responses to racial discrimination. Psychophysiology, n/a-n/a. doi: 10.1111/psyp.12087
Slottje, D., Tchernis, R., Baltagi, B., &Sadka, E. (2010). Current Issues in Health Economics(4th ed.). Bingley: Emerald Group Publishing Limited.
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