The Principles Of Public Health Intervention

▪ Increasing the number of Indigenous people working in the health sector (Aboriginal, health workers, social workers, doctors, dentists, nurses, etc);

Australian government today recognises that educational policies regarding Aboriginal people cannot be made without considering social and economic policies aimed at improving outcomes for Aboriginal communities in general (TICHR, 2006). Main contemporary issues facing Aboriginal communities are proving land ownership, remoteness, health status, education and employment status and social attitude of Non-Aboriginal population towards the Aboriginal communities (Challenges facing the Indigenous communities today, n.d.). Tackling this issue is not a simple task: the document “National Indigenous Reform Agreement” (2010) which aims to improve outcomes for all Indigenous Australians recognizes that this process needs approach from different aspects, taking into account “seven key building blocks: Early Childhood, Schooling, Health, Economic Participation, Healthy Homes, Safe Communities, and Governance and Leadership” (as cited in DET Queensland,

Critical factors, highlight why things are as they are and if there are possible alternatives (Germov 2011, p.9). Institutionalized racism is a critical reason for the disadvantages indigenous people face that could be expressed implicitly or explicitly (Larson, 2007). The Indigenous population directly experiencing racism through social and political institutions, is critical and a determining factor for their current state (Larson, 2007). Institutional racism is measured through the socio- economic status of certain minorities (Larson, 2017). Although racism is mostly implicit nowadays, it is still overall evident in the social health and wellbeing of Indigenous Australians today (Jackson 1999).The gap between the health statuses of Indigenous Australians as opposed to non-indigenous people are high (Darren, 2007). There is an estimated gap of 17 years between indigenous and non-indigenous life expectancy in Australia (Darren, 2007). This could be due to the absence of equal public health resources in primarily remote areas (Darren, 2007). There is Lack of Access to safe drinking water, effective sewage systems and healthy housing in indigenous neighborhoods (Darren, 2007). This further impacts Indigenous socially as many of them are subjected to poor living standards due to the inability from the government to provide the

Sherwood & Edwards (2006) cite that the worldview of health is in direct conflict with the Indigenous worldview and the way health and wellbeing are considered by Aboriginal people. Aboriginal health, care and wellbeing is not just the physical well-being of the individual but includes the social, emotional and cultural wellbeing of the individual and community (Sherwood & Edwards, 2006). Rather than focusing on isolating the specific cause of illness, health initiatives for Aboriginal communities look beyond the traditional biomedical model and adopt a model that incorporates the broader social determinants of health, which focus on Aboriginal societal structures and psychosocial factors (Dudgeon, 2014). Hence Aboriginal people view health differently, their concerns for health issues are diverse requiring a holistic and informed response.

Inequality in health is one of the most controversial topics within Australian Health Care. Inequality in relation to health is defined as being “differences in health status or in the distribution of health determinants between different population groups” (World Health Organization, 2012). Within Australia inequality affects a wide range of population groups; however Indigenous Australians are most widely affected therefore this paper will focus on how inequality has impacted their health. Research shows that Australia’s Indigenous people suffer from a multitude of social and economic inequalities such as inadequate access to nutritious food and health care, being socially and

Among Aboriginal peoples, there are a number of similar historical and contemporary social determinants that have shaped the health and well-being of individuals, families, communities and nations. Historically, the ancestors of all three Aboriginal groups underwent colonisation and the imposition of colonial institutions, systems, as well as lifestyle disruption. However, distinctions in the origin, form and impact of those social determinants, as well as the distinct peoples involved, must also be considered if health interventions are to be successful. For example, while the mechanisms and impact of colonisation as well as historic and neo-colonialism are similar among all Aboriginal groups. The contemporary outcome of the colonial process

The poor health position of Indigenous Australians is a contemporary reflection of their historical treatment as Australia’s traditional owners. This treatment has led to Indigenous Australians experiencing social disadvantages, significantly low socio-economic status, dispossession, poverty and powerlessness as a direct result of the institutionalised racism inherent in contemporary Australian society.

“However, Aboriginal people still struggle for more than words on paper. They require the enactment of visible justice, where aboriginal people have a pride of place and heritage that can be shared as well as respected.” (king, 2010, p.216).

“Structural inequities produces suffering and death as often as direct violence does, though the damage is slower, more subtle, more common and more difficult to repair” (Indigenous politics, 2005). The overt difference in health between aboriginal and non-aboriginal

In relation to Aboriginal health, this will require nurses to develop greater awareness of culture and the influences that affect it including racism, colonialism, historical circumstances, and the current political climate in which we live. Nurses working with aboriginal communities need to understand the history, socio-political climate and culture within the specific community (Foster, 2012). Nurses must emphasize the need for solutions that will strengthen cultural identity, identify and promote both existing and traditional sources of strength within First Nations communities, incorporate traditional healing methods, and rely on local control and self-direction by First Nations communities (Mareno & Hart, 2014). In addition to placing a high priority on cultural awareness, nurses should also understand the concept of respect in aboriginal terms and apply respect in all their encounters. Self-awareness of their own beliefs and assumptions are important in order for nurses to have an effective relationship with the community (Foster, 2012). It is important for nurses to reflect on their own cultural knowledge, awareness, skills, and comfort in encounters with a diverse population of

The social determinants of health are described as the condition of daily living in which determines the individual’s chances of maintaining optimum health (Department of Health and Human Services 2015). In Australia, the health inequality between indigenous and non-indigenous Australians is noted by the World Health Organization (WHO) to have the largest disparity in the world (Markwick et al. 2014). Statistically, the life expectancy for indigenous Australians who are born in 2010-2012 is estimated to be 10.6 years lower when compared to non-indigenous Australians (Markwick et al. 2014). Social determinants such as employment and social exclusion may contribute to the major difference in the health status between the indigenous and non-indigenous Australians (Markwick et al. 2014). This essay will focus on discussing how having employment and social exclusion has led to the health inequalities between indigenous and non-indigenous Australians, and how indigenous healthcare nurses can address these determinants in the care they provide in the indigenous community setting.

These groups are different to other indigenous groups around the world. Among Aboriginal peoples, there are a numerous amount of similar historical and contemporary social determinants that have shaped the health and well being of individuals, families, communities and nations. However, distinctions in the origin show and give impact on social determinants and impact on health interventions to make sure they are successful.

Indigenous peoples have occupied Australia for more than 60, 000 years, so why are they among the most disadvantaged in our health system? The right to a ‘standard of living adequate for … health and wellbeing’ was established as a basic human right in Article 25.1 of the 1948 Universal Declaration of Human Rights (The Universal Declaration of Human Rights). However, it is evident that the standard of health for Indigenous Australians is well below non- indigenous Australians with their average life expectancy being around 20 years younger than the rest of Australia. It is evident that the health of indigenous Australians prior to 1967 was drastically influenced by the European settlement and ever since their health has not been at the same standard as non-indigenous Australians despite recent introductions of health programs, reconciliation between indigenous and non-indigenous Australians cannot be achieved until health standards are equal for both groups.

“The land is my mother. Like a human mother, the land gives us protection, enjoyment and provides our needs – economic, social and religious. We have a human relationship with the land: Mother, daughter, son. When the land is taken from us or destroyed, we feel hurt because we belong to the land and we are part of it.” This quote was written by Djinyini Gondarra, an Aboriginal that is working to towards enhancing the health and well-being of his fellow aboriginal people. Over the years, aboriginal people have been mistreated and have experienced a large magnitude of discriminations that range from health to social inequalities, which have led to many health-related issues that have made it very difficult for Aboriginal people to break the stigma and prejudice they continue to experience.

I agree with Michael Dodson through establishing the twin projects for Aboriginal people. The first twin project is self identification which is essential that the Aboriginal people to self identify themselves and to actually break away from the representations that the colonisers’ gave implied on them. Michael Dodson argues that one has the right to control their identity to broader the right to self identification ( Dodson 2003, pg 22) that he is trying to make the Aboriginal people to develop an identity of their own. A Positive reinforcement that Dodson has placed that is found in the article is the Un study that gave recognition for aboriginal people’s right and that they are being heard an has made an impact for Aboriginal people to find their own self identity and It is a way to ensure that Indigenous peoples can direct their cultural, economic and social development and participate fully in the democratic life of the entire community