Education and Indigenous Health
Social determinants contribute significantly to the health outcomes of individuals and communities and, in fact, “social, economic and educational disadvantages result in whole of life poor nutrition, systemic infections and …poor access to primary health care awareness” (Zhao & Dempsey, 2006, p. 30). This report discusses the impact of the social factors of education, healthcare system and culture of Indigenous Australians which can be identified as a contributor to the current life expectancy gap that is experienced between indigenous and non-indigenous Australians. This gap is “estimated to be 10.6 years lower than that of the non-indigenous population” (Australian Institution of Health and Welfare, 2018, p.6).
Education is a contributing factor to the current life expectancy gap that’s experience between indigenous and non-indigenous Australians. Education has a direct link to health literacy, “People with no education or lower secondary schooling have a 46% higher probability of dying prematurely than people who have achieved a high school or higher education level” (Hart, Moore & Laverty, 2017, p. 3). It can be concluded that higher levels of education generate the ability of higher cognitive skills which create a more balance lifestyle of healthy awareness choices, education is a detrimental factor to indigenous Australians with only 27 % of indigenous Australians to have completed year 12 compared to 54 % in non-indigenous people (Department of the Prime Minster and Cabinet, 2014, p.1).
The importance of education is interconnected with lower life expectancy. It is therefore important that educators target health information to the indigenous communities through health promotion programs in schools that are constructed with both input from medical experts and indigenous Australians to identify and rectify any cultural learning barriers that potentially exist.
School promotion programs inform students and their families on health care issues and raise awareness of improvements such as 99.5% Aboriginal primary health care services now offer health promotion/education programmes (Department of the Prime Minster and Cabinet, 2014, p.1).
Higher education being a major factor in increasing life expectancy it is imperative that the education barriers of identified and resolutions to be made to increase overall indigenous people’s level of education.
The health care system in Australia can be classified as one of the social determinants of health that contributes to the difference in life expectancy between Indigenous and non-Indigenous Australians. The indigenous Australians are reported to have twice as more health risk factors than the general population statistics (Australian Institute of Health and Welfare, 2015).
Importance of Education in Improving Health Outcomes
The notion that the healthcare system determines the health of Australian indigenous groups is deeply rooted in the structure and policy of the existing healthcare system (Human Rights and Equal Opportunity commission, 2005, p. 65). In developed nations, the governments are working hard for enhancing the health care system’s performance. It is major priority of the government and is defining the agenda of the policies related to health (Gottwald & Lansdown, 2014, p. 67). Most of the systems for healthcare have found clinical governance as a major aspect of achieving their health agenda. It is done with the help of developments in patient safety and quality of healthcare (Gottwald & Lansdown, 2014, p.23). However, if a certain population, in this case, the indigenous community has low health outcomes, it can be stated that the system is not doing enough.
The indigenous population experiences poor self-management of their health conditions, stress among the indigenous health workers, and discrimination towards the population are some of the primary barriers that impede the process of delivery of health quality services to the target population (Department of Health, 2009, p.18).
Culture is a key social determinant of indigenous health. Culture is the “basis for …[a]…healthy identity” (King, Smith & Gracey, 2009, p78), which underpins good “mental and physical health” (Dept. of Health, 2017, p.7), and is central to indigenous “wellbeing and needs” (Dept. of Health, 2017, p. 5). As such, the loss of cultural language and traditions (King, Smith Gracey, p. 78) and spiritual, emotional and mental disconnection (King, Smith Gracey, p. 77) due to European colonization (King, Smith Gracey, p. 78) has had great impact on indigenous health. In addition, non-indigenous culture has had an impact on indigenous health, particularly in the health services sector. Non-indigenous health culture is based on the understanding of health as “the absence of illness or disease” (King, Smith & Gracey, 2009, p77) whereas the indigenous equivalent is “the absence of wellbeing or balance”. This can lead to non-indigenous health professionals not understanding the “complexities of indigenous health” King & Gracey (2009, p.70), such as families being present during clinic visits (King & Gracey, 2009, p73) and indigenous healing involving a public consultation process (King, Smith & Gracey, 2009, p77). As a consequence there can be a “perceived hostility or indifference” (McBain-Rigg & Veitch, 2011, p.73) by indigenous Australians, further impacting indigenous health management (McBain-Rigg & Veitch, 2011, p.73).
The Importance of Educating Indigenous Communities
However, by recognising these impacts, culture can also improve indigenous health gap by way of reinforcement of indigenous cultural identity (King, Smith & Gracey, 2009, p77), increasing the cultural education of non-indigenous health professionals, and with greater integration of indigenous medical professionals in health services (Dept. of Health, 2017, p. 5).
Conclusion:
With social determinants playing a significant role in the health gap and life expectancy of indigenous Australians (Dept. Of Health, 2017, p. 6) it is important to understand where and how social determinants play this role, but also identify what influence they have on closing the health gap. This paper has discussed three social determinants: education, health services and culture and concluded that each determinant impacts indigenous Australians’ health separately and collectively. As a result, the discussion has identified the following recommendations for where changes in three social determinates may increase the life expectancy of indigenous Australians.
- Education: The increase and development of rural Aboriginal facilities and infrastructure and to address the teacher number crisis in central Australia aboriginal communities.
- Culture: strengthening indigenous cultural identity, educating non-indigenous medical professional in indigenous health culture and customs, and increasing the number of Indigenous medical professionals working in the health services area.
- Health Services -Stakeholders in the health system should work towards engaging the indigenous community to develop essential qualities such as trust and open communication in understanding and resolving the problems that face this community.
- Creating awareness of the collective impact of social determinants on the health of indigenous Australians.
- Ensuring indigenous Australians are engaged in policy and planning process by developing decision-making structures that include the leaders of indigenous communities, as the voice of the indigenous community, in the areas of education, health services and cultural awareness.
References:
Australian Institute of Health and Welfare. (2015). The health and welfare of Australia’s Aboriginal and Torres Strait Islander peoples 2015. Retrieved from https://www.aihw.gov.au/reports/indigenous-health-welfare/health-welfare-australias-indigenous-peoples-1999/formats/the-health-and-welfare-of-australias-aboriginal-and-torres-strait-islander-peoples.
Australian Institute of Health and Welfare. (2018). Deaths in Australia. Retrieved from https://www.aihw.gov.au/reports/life-expectancy-death/deaths/contents/life-expectancy
Department of Health. (2009). Development of a new national women’s health policy consultation discussion paper 2009. Retrieved from https://www.health.gov.au/internet/main/publishing.nsf/Content/38FF434F5AE683E3CA257BF0001E72E7/$File/cons-dis-paper2009-no-graphics.pdf
Department of Health. (2017). My Life My Lead – Opportunities for strengthening approaches to the social determinants and cultural determinants of Indigenous health: Report on the national consultations December 2017. Retrieved from https://www.health.gov.au/internet/main/publishing.nsf/Content/D2F6B905F3F667DACA2580D400014BF1/$File/My%20Life%20My%20Lead%20Consultation%20Report.pdf
Department of the Prime Minster and Cabinet. (2014). Aboriginal and Torres Strait Islander Health Performance Framework 2014 Report. Retrieved from https://www.pmc.gov.au/sites/default/files/publications/indigenous/Health-Performance-Framework-2014/tier-2-determinants-health/206-educational-participation-and-attainment-adults.html
Gracey, M. & King, M. (2009). Indigenous health part 1: Determinants and disease patterns. The Lancet, 374(9683), 65-75. doi: 10.1016/S0140-6736(09)60914-4
Gottwald, M., & Lansdown, G. (2014). Clinical governance: improving the quality of healthcare for patients and service users. McGraw-Hill Education (UK).
Hart, M., Moore, M., & Laverty, M. (2017). Improving Indigenous health through education. The Medical Journal of Australia,207(1), 11-12.
Human Rights and Equal Opportunity commission. (2005). Social justice report 2005. Retrieved from https://www.humanrights.gov.au/sites/default/files/content/social_justice/sj_report/sjreport05/pdf/SocialJustice2005.pdf
King, M., Smith, A., & Gracey, M. (2009). Indigenous health part 2: The underlying causes of the health gap. The Lancet, 374(9683), 76-85. doi: 10.1016/S0140-6736(09)60827-8
Mcbain-Rigg, K., & Veitch, C. (2011). Cultural barriers to health care for Aboriginal and Torres Strait Islanders in Mount Isa. The Australian Journal of Rural Health, 19(2), 70-4. doi: 10.1111/j.1440-1584.2011.01186.x
Zhao, Y., & Dempsey, k. (2006). Causes of inequality in life expectancy between Indigenous and non-Indigenous people in the Northern Territory, 1981–2000: a decomposition analysis. The Australian Medical Journal, 184(10) 490-494. Retrieved from https://www.mja.com.au/journal/2006/184/10/causes-inequality-life-expectancy-between-indigenous-and-non-indigenous-people#
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