Defining Racism and Types of Racism
According to Paradies et al. (2015), racism is defined as discrmination, bias or antagonism which is focused against a certain individual or group of another race anchored on the belief that an individual’s race is superior to a different race. It is vital when reflecting on debate of racism that a concise and clear distinction is made between the various types of racism, that is, individual racism and institutional racism. Individual racism is described by overt acts carried out by an individual that result in death or injury of the victim. It can also cause assaults, destruction of property as well as verbal abuse. Systemic racism is concerned with the way racism is built or engraved right into every level of society. Institutional or systemic racism can also be described as racist policies as well as discriminative practices in institutions like healthcare centers, governments agencies which routinely creates unjust outcomes for the individuals of color. The Aboriginal and Torres Strait Islander people have been subjected to personal and systemic racism especially in healthcare delivery (Hussain, Katzenellenbogen, Sanfilippo, Murray & Thompson, 2018). Thus, they do not receive adequate and quality health care as compared to their non-indigenous counterparts in Australia (Priest, Paradies, Stewart & Luke, 2011).
There is no denying or dispute that the Aboriginal Australians’ health is both worse and very poor as compared to that of the non-Aboriginal people (Durey, 2010). The life expectancy of the aboriginals at birth is approximately twenty-one years less for male and nineteen years less for female as compared to the non-aboriginals. The disparity in healthcare provision in Australia can be attributed to racism and discriminative practices especially by the white people who consider themselves superior to the indigenous people (Australian Government, 2013). The Aboriginal Australians have been disadvantaged across a myriad of health, economic, social, political indicators. Such underprivileges expose them to racism across all sectors of modern-day society leading to concomitant deleterious impacts on their wellbeing and health. With the concept of whiteness, practicing nursing in Australia has been pegged on the color of the skin of an individual (Shute, 2017). For instance, it is very difficult for an Aboriginal nurse to have the same opportunities in healthcare as compared to non-Aboriginal nurses. The institutional and personal racism practiced by the ‘white’ Australians has broaden the equality gap between the aboriginal and non-aboriginal nurses.
Cultural safety is the ability to evaluate power imbalances, colonization, institutional discrimination, and acceptable to the differences. Cultural safety is normally concerned with offering quality health care which fits with the familiar and known cultural norms and values of an individual accessing the services, which may differ from other individual’s own and the dominant culture. Cultural safety has an aim to promote the delivery of care services by the identification of power relationship between the person receiving the services and the healthcare professional, and empowering the service user to maximize the services provided fully. Addressing the various cultural inequalities through the lens of cultural safety allows healthcare providers to enhance healthcare access for populations, aggregates and populations, acknowledge and recognize we come from different cultures and expose the historical, political, and social contexts of healthcare. Cultural competence defined as the ability to effectively relate with individuals of various cultures, aids to ensure the needs of people in the community are addressed. In practice, both organizations and individuals can be effectively culturally competent (Hill & Mills, 2013). It is significant to state that the concept of cultural competence means to be responsive as well as respectful to the health practices and beliefs, cultural as well as linguistic needs of the diverse population groups. Cultural competence is viewed as independent inputs while cultural safety is the dependent outcome (Dolan & Kawamura, 2015). Thus, whether an individual feel culturally safe is highly dependent in part on whether the healthcare provider is culturally competent.
Healthcare Disparities among Aboriginal Australians
Reporting; Inequality has existed between the Aboriginal and non-Aboriginal Australians especially in the healthcare sector. I can reportedly and empirically state that the Aboriginals have structurally and institutionally been abandoned when it comes to equitable distribution of resources in the health sector. Responding; I feel that this is not morally, ethically and culturally since everybody has an inherent right to be treated equally and justly without any form of prejudice and discrimination. Relating, reasoning and reconstructing; As a student of nursing who is guided by the nursing code of ethics, professionalism, and principles it is prudent that the government of Australia reduces the gap of inequality between the indigenous and non-indigenous population.
Disparities in mortality and morbidity rates between the indigenous and non-indigenous are well documented and are increasing at an alarming rate (Möller et al. 2016) even though these statistics is not new and is been subject to inquiry for numerous years, the Aboriginals are underprivileged across an array of health, political, economic, social determinants. These entail exposure to racisms like systemic and institutional racism across every domain of contemporary Australian society. Racism is a fundamental social determinant of social factors like education and health in which institutional and interpersonal racist behaviors, as well as attitudes, are normally ingrained in political, structural, and social contexts. Institutional racism can be attributed to the increased and glaring disparity between the aboriginals and non-Aboriginal Australians (Came & Humphries, 2014). Due to rural geographic and remote conditions and the social and economic disparity as well as cultural differences, the indigenous populations normally tend to face a significantly greater rate of child and infant mortality, lower birth weight, perinatal mortality, and standardized death rates. The rates of chronic diseases like cardiovascular disorders and infectious diseases like hepatitis and HIV/AIDS are high among aboriginal Australians.
The existing institutional and structural policies and practices have not been formulated to bridge the gap of inequality between the aboriginal and non-aboriginal Australian (Marrie, 2017). In present years, interest in both the practice and concept of institutional racism has increased. For instance, in the United Kingdom, it was started by the inquiry of Stephen Lawrence in 1999. In Australia, institutional racism has been a constant attribute of their history, from the designation of the country as terra nullius by the British via the convention of Federation of 1897 to the stolen generation as well as misgivings of the federal government to render an apology. I do believe that any healthcare system is a public institution which is established on the cultural stance of the people it serves. Between the aboriginals and non-indigenous Australians, there is not a variation in culture but a clash of it. In the country, little has been done in health policy to recognize the cultural difference between white and black. There is a lack of respect by the white Australians for the values of the aboriginals. The aboriginals have, thus, lost their trust in major social institutions of the government like the healthcare sector (Conway, Tsourtos & Lawn, 2017). It is important that cultural differences be celebrated instead of being denigrated. The government needs to formulate laws that champion equal distribution of resources as well as equal treatment of every individual in the country.
Cultural Safety and Competency in Healthcare
The concept of cultural safety is currently gradually being accepted in many fields of service provision and policy that impact on the aboriginal population in Australia. Cultural safety has a basic and fundamental principle which can inform and guide nursing practice in healthcare delivery in the country. The cultural safety framework is underpinned by aboriginal self-determination, reciprocity, transparency, accountability, sustainability, equity justice, social restoration and cultural contextuality (McGough, Wynaden & Wright, 2018). The mentioned cultural safety principles are the prerequisite for ensuring sustainable and effective transformational change in the healthcare sector. Cultural safety is anchored on the care recipient experience and entails effective care of an individual or a family from a different culture by a nurse who has gone through a process of reflection on his or her own cultural distinctiveness as well as know the effect his or her own culture has on his or her practice. As a nurse respecting one’s culture is one way of ensuring that institutional racism is eliminated in the healthcare system in Australia. Cultural sensitivity by nurses is important in reducing personal and structural racism which can ensure that the aboriginal population receives equitable health care services just like the non-aboriginal Australians (Dudgeon, Kelly & Walker, 2010).
It should be noted that a culturally responsive and safe work environment is one which recognizes and acknowledges, accommodate, and respect the difference in culture. Cross-cultural programs and training, strategies as well as other transforming workplace techniques and tools have gradually gained attention in the public and private healthcare workplace domain. Nurses have the role in offering equitable and just healthcare resources to all the people in the country.
Reporting; it is clear that Aboriginal and Torres Strait Islander still experience relatively poor health outcomes as compared to other Australians. The inequalities in the health care sector is a result of the colonization process as well as the numerous discriminatory policies in which the Aboriginal people are subjected to as well as the ongoing experience of the current discrimination. All the healthcare professionals and leaders have a greater role to play in bridging the gap of inequality (Sweet, 2010). I have analyzed the inequality gap between the indigenous and non-aboriginal Australians, and it is prudent that we come up with sustainable measures that can bridge the gap of inequality.
Responding; As a nurse, I have worked as a community nurse in the Aboriginals, and I can say that the discrimination that exists majorly due to racism against the aboriginals is worse and have a deleterious effect. I have noted that the aboriginals have been living in a world of neglect, especially by the government. Enhancing the health status of the Aboriginal people has been established as a longstanding problem in Australia (Delany et al. 2018) Even there have been significant and notable enhancements in certain areas since the 1970s, mostly in reducing high levels of infant mortality, overall improvements have been inconsistent and slow.
Institutional and Structural Racism
Relating; It should be noted that the inequality gap between the Aboriginal population and other population has remained high and little effort has been made to reduce that gap. Unless prudent and sustainable steps are taken, there is a real chance that the health status of the Aboriginal and Torres Strait Islander people could become worse. An incremental, steady will not solve or reduce the glaring disparities that exist between the Aboriginal and Torres Strait Islander and other population. There is an urgent need for obligations to a course of action integrated with significant financial backings to realize equality in healthcare in the country (Shepherd, Li & Zubrick, 2012). We as nurses must be at the forefront of fighting injustices at the institutional level to ensure that equality is achieved in the healthcare sector.
Reasoning; the inequality in health care sector has existed among the aboriginal Australians because of the structural and institutional failures (Bourke et al. 2017) The weak government policies have propagated the failures. As a nurse, I have observed that white nurses have better opportunities in their workplaces. The situation has exacerbated as the white Australians consider themselves more superior than the aboriginal Australians. As nurses, we should appreciate and respect different cultures among ourselves and those of the patients.
Reconstructing; given the knowledge I have gained in my workplace and in literature, I can moot effective laws and policies which if implemented can reduce racism and inequality in Australia. Some of the policies include respect to one’s culture, awareness programs, and capacity building.
References
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Dolan, S. L., & Kawamura, K. M. (2015). Cross-Cultural Competence: A Field Guide for Developing Global Leaders and Managers. Bradford, United Kingdom: Emerald Group Publishing Limited.
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