Wk 3: Indigenous health

  1. What is acknowledgment of country?
    What is welcome to country?
    • Acknowledgement: by non-indigenous people, designed to show respect for traditional owner
    • Welcome: provide by indigenous, dancing, singing
    • Why important?: addressing colonisation of australia
  2. Who is indigenous?
    Aboriginal and torress strait
  3. CLosing the gap
    • 2005: life expectancy of ind aus 17 years lwoer
    • Ave age for ind women: 64.8
    • Ave age for ind men: 59.4
    • Goal by 2030 to close this gap
  4. Stats
    • Make up 2% of population (0.3% in vic vs 22.4% in NT)
    • In 2005-2007 men 67years
    • Women 73 years
    • During 07-09, 1.7 times more likely to be hospitalised for cardiovascular diseases
    • Rate of hospitalisation of indigenous for mental health problems was nearly twice
  5. Indigenous health across lifespan:
    • Babies twice as likely to be low birth weight/
    • ATSI chldren 0-14 2x more likely to die
    • In 2008, 1/3 16-24 had high/v high psychological distress. 2x rate of non ind
    • Much higher proportion with dementia were aged less than 75
  6. Closing gap report
    • No progress in raising life expectancy
    • targets:
    • close life expectancy gap within a generation
    • Have gap in mortality rates of children under 5 within a decade
    • Ensure access to early childhood education for4yo within 5 years.
    • Halve gap in literacy and numeracy for children within a decade
    • Halve gap for y12 attainment rates by 2020
    • Halve gap in employment outcomes within decade
  7. What are the key determinants of health and wellbeing in Aus indigenous communities?
    • Theoretical modelling predict that either psychosocial factors or broad economic and political influence are most significant impact on health.
    • WHO modelling found social inequality is primarily responsible for inequality in physical and mental health
    • WHO recognise the role of racism in social inequality
    • WHO published empirical evidence that policy interventions addressing social factors can reduce incidence of disease and improve health.

    Williams identifies history and culture as a key determinant of health in indiginous people.
  8. COntinuum of health
    Positive state of physical, mental and social wellbeing
  9. Risks for ind social and emotional well being
    • Life stress
    • SOcial inclusions
    • Economic and social diasadvantage
    • Incarceration
    • child remonal
    • family violence
    • substance use
    • Physical health problems
  10. effects of colonisation
    • Loss of hunter gatherer lifestyle
    • Leads to poor nutrition (low birth weight, hypertension, cardio diseases)
    • Also leads to marginalisation from white society, poor comunication, discrimination (unemployment outcomes, substance abuse, violence)
    • Also leads to fixed settlements, fringe camps, urban ghettos (poor housing, poor hygiene, overcrowding (leads to respiratory diseases, renal disease, ear disease)
  11. Paridies "colonisatio, racism and indigenous health"
    • Determine why colonisation leads to disparities in health between indigenous and non popu.
    • Col. responsible for historical war, displacement, forced labour, removal of children, relocation, ecological destruction, massacres, genocide, slavery, spread of of deadly disease, banning ind. languages, regulation of marriage, assimilation and eradication of social, cultural and spiritual racism.
  12. Paridies hostorical trauma as indigenous ill health
    Historical trauma- contemporary reminders (eg. public- structural inequalities, public symboms and personal- perceived historical loss, discrimination, microaggressions, personal trauma) -> narrative salience
  13. Paridies: colonial trauma transmission is transgenerational
    Colonial injury-> cumulative effects -> cross generational impact -> stress created for subsequent geenrations -> health related issues
  14. Aboriginal aus expe racism at 3 levels
    • Institutional racism: practices, policies or processes that are experienced in everyday life and maintain and reproduce avoidable and unfair inequalities across ethic/racial groups
    • 2. Interpersonal: in interactions between individuals either within 
    • 3. Internalised
  15. Racism and health
    PAthways multiple and complex
  16. case study Ziersch
    Insights on how racism can damage health from a urban study of aus aboriginal people
    • Findings:
    • Majority (93%) had experienced racism and 63% experienced racism on regular basis
    • They perceived this racism as negative impact on their health
    • Participants were self aware of the health deterriorating from complex pathways

    • Maladaptive responses: anger, frustration, substance,
    • Positive responses: talking to tohers, confrontation, bystander intervention, cost and benefits of social support

    • Limitations:
    • Study relies on subjective meaning in a qualitative rather than quantification
    • Sample was deemed not representative
    • Strategies used by participants in response to racism no exhaustive

    • Conclusion:
    • reponses to racism are subjective and difficult to label and protective or harmful to health
    • Interventions would need to tackle white privelege and the way its codified in structures and institutions in society
  17. Case study Mcabe: ecological model of australian indigenous men's health
    • Aim: assess ind aus men's lifestyle and societal systems in relation to bronfen's ecological model to dtermine how each of the systems interact to affect health
    • Sample: 150 abo men 18-35yo WA and VIC interviewed
    • Key findings: Community, societal networks and culture and crucial to improving ind men health.
    • His sense of community influence all other systems that shape his health behaviour. 
    • Lack of employment influenced perception of responsibiltiy for family, comm, healthy eating

    • Conclusion:
    • health programs should focus on social, relational and family factors (community) rather than the individual.
    • Limitations: difficult to generalise to wide ind comm
    • Research difficult to distinguish rural, remote and urban comm
  18. Cultural factors protecting aboriginal SEWB
    • Connection to land
    • Kinship
    • Self-determination
  19. Culturally appropriate model for mental health care
    • Ind ppl reluctant to access health care due to lack of cultural competence and cultural security
    • Need for cultural considerations in interventions to address psychosocial determinants of health.
    • Propose replacing traditional doctor centred model of healthcare with community controlled health cares, more hoolistic
  20. Summary
Card Set
Wk 3: Indigenous health
Wk 3: Indigenous health