Contemporary Indigenous Health and Wellbeing

Trauma can be referred to as single event or chain of events that may affect the psychological and emotional experience of a person. These are the situations which are emotionally and psychologically overwhelming for them. Because of the presence of a stressor, they may also be diagnosed with Acute Stress Disorder (ASD) or even Post-Traumatic Stress Disorder (PTSD) (Atkinson et al., 2014). To understand the trauma in the population which is colonised that is Aboriginal and Torres Strait Islanders, it is necessary to look at the past and sociological perspective. Transgenerational trauma in indigenous people is connected to psychological and emotional scarring with growing disparities in the health status which is further expanded by racism, sexual or physical assault, natural disasters and other problems which involve social injustice faced by Aboriginal and Torres Strait Islanders communities (Carlson et al., 2017).

The recent incident which happened in the United States of America against an African American man has evoked anger in people’s heart worldwide. The man was murdered by a white police officer in cold blood and no one stopped him from doing the injustice. The event highlighted racial injustice and discrimination in the legal system and also how police misconduct these citizens. For Aboriginal and Torres Strait Islanders communities this incident is closely related to the processes which are still ongoing with them. These events of misconduct with them as lead to disparities and a large gap between the non-indigenous community and indigenous community. The gap is created in the communities’ health status, power base, resources, opportunities, capacities. There is also a very large difference in their religions, culture, value and ethics. This has also caused Aboriginal and Torres Strait Islanders people to develop many mental and psychological illnesses. Therefore, it can be said that transgenerational trauma has affected many indigenous people and it is necessary to close the gap between the differences that are created with the help of governmental policies and also with healthcare professional like nurses (Paradies, 2018).

It can be seen that transgenerational trauma has very poorly impacted the Aboriginal and Torres Strait Islander people not only physically but mentally too. There are higher rates of mental problems in these communities’ people. The poor mental health of the mothers can have severe health implications on the child and entire family too. These factors impact the emotional wellbeing, behavioural and cognitive growth of the child. With that other risks are also associated such as the neurological and immune-related impact on the mother, preterm birth, birth weight less than expected, the increment of depression in postpartum and additional mental health problems related to postpartum which could adversely affect the child’s cognitive and behavioural growth. These problems can also risk families’ wellbeing and put the child at greater risk of developing mental health problems later in his/her life (Roy, 2014).

Aboriginal and Torres Strait Islander people are often found outliving their life in distress. This could also be linked with problematic policies and guidelines set by the government in the past like removing indigenous people children. People who survived through the trauma in their childhood experience trouble in making and maintaining relations with their partners whom they are married to, with their friends and also with their care providers. Adults whose traumas are unresolved most likely to grow diseases like cancer, skeletal fractures, heart-related diseases, strokes and disease of the liver. They also enter the police justice system and remain there for most of their time. In the research, it was also found out that indigenous people who have to face criminal justice because of their violent acts which have been registered with the police have themselves experienced violent and traumatic events in their youth and their childhood. Strong connections have also been found out between transgenerational trauma and its transfer due to displaying PTSD symptoms. Due to normalising violence in the family and high rates of grief, substance use and loss have to lead to traumatic stress in Aboriginal and Torres Strait Islander people. 

The Strategy of Closing the Gap is implemented by the Australian Government which has goals to decrease the disadvantages between Aboriginal and Torres Strait Islander people. They basically aim to reduce the gap within the life expectancy between non-indigenous and indigenous people. They also want to cut down the child mortality rates in these communities. They want to provide education from early childhood and chances for building their career and gain employment. It is a commitment which is taken by the government to make all Aboriginal and Torres Strait Islander people health position equal to non-indigenous within the time span of 25 years. This operation was started as a response to a report which was printed in 2005 which mentioned social justice and also because of a campaign known as close the gap.

Therefore, in 2008 March, it was collectively decided by Aboriginal and Torres Strait Islander people and the Australian government to work for acquiring equality in the ratio of life expectancy and health position between non- indigenous and Aboriginal and Torres Strait Islander Australians. For checking the changes that have been made, Council of Australian Government (COAG) made some targets so as to evaluate the improvements made in the wellbeing and health of Aboriginal and Torres Strait Islander people. The targets were to bridge the life expectancy gap till 2031, to cut the gap into half by 2018 in numbers of child mortality rates, to make sure that 95% Aboriginal and Torres Strait Islander children who are more than four years of age are gaining their education by 2025. It also aims towards bridging the gap between the reading and writing capability in addition to numeracy by 2018. Another goal was to remove the gap in attendance of the school by 2018 and to eliminate the gap by 2018 in the employment of Aboriginal and Torres Strait Islander people (Australian Government, 2020).

Closing the Gap which is now implemented has progressed in Australia. And according to the report which was published in 2018, much information can be accessed about the set targets and their achievements. Therefore, the progress report states that the aim to bridge the gap between child mortality rates by 2018 is on track for Aboriginal and Torres Strait Islander people. It was found out the rate has reduced by 32% from the year 1998 to 2016. This was possible by improving maternal and child health over these years. Another target was to give early education to 95% Aboriginal and Torres Strait Islander children who are above four years of age. It was mentioned in the report that the progress is on track. It was estimated that 91% of Aboriginal and Torres Strait Islander children, that is 14,700 children were enrolled in the education program.

However, to cut down the gap in attendance in schools and to eliminate the gap in reading and writing capabilities by the year 2018 is not on track. The goal to give employment to Aboriginal and Torres Strait Islander people and to reduce the gap area by 2018 is also not on track. Most importantly, the aim to lessen the gap between life expectancy by the year 2031 is not going according to the original plan. Between the years 2005-2007 and also in 2010-2012 a small amount of decrement can be seen by 0.8 years for indigenous men and 0.1 for indigenous women. By looking at the time span of more years, it was stated that 14% mortality rates have dropped in Aboriginal and Torres Strait Islander people since 1998. Because of this policy, smoking rates have also reduced by 9%. The incident of drinking while being pregnant also cut short in half by the year 2015 (Department of the Prime Minister and Cabinet, Australian Government, 2018).

The strategy to use as a registered nurse for recovering the health outcomes for Aboriginal and Torres Strait Islander people who have experienced transgenerational trauma is to work with indigenous people by undertaking their cultural influences. It is important for the nurse to understand their background and their history and what are the implications they have to face because of this. Nurses also need to value the patient culture so that care which is culturally safe can be provided to him/her. The nurse needs to follow all the codes of ethics which is set for registered nurse practitioners by the Nursing and Midwifery Board of Australia (NMBA). They should respect the patient and work within their scope of practice. They should keep in check that patient doesn't face any problem which can more complicate the patient’s trauma. Nurses should know what might trigger the patient so that all those factors could be avoided while treating him. They should also maintain sensitivity towards the patient and his problems and should work towards finding a solution to help him overcome his trauma and the disease which he/she is suffering. Nurses could also prevent any misconduct against the patient that might be not appropriate and could further deepen his trauma. They should acknowledge the Aboriginal and Torres Strait Islander people’s struggle plus difficulties and moreover should treat them fairly and in a respected manner.

References for Transgenerational Trauma in Aboriginal and Torres Strait Islanders

Atkinson, J., Nelson, J., Brooks, R., Atkinson, C., & Ryan, K. (2014). Addressing individual and community transgenerational trauma. Working Together: Aboriginal and Torres Strait Islander Mental Health and Wellbeing Principles and Practice2, 289-307.

Australian Government ( 2020). Closing the gap. Available at https://healthinfonet.ecu.edu.au/learn/health-system/closing-the-gap/#:~:text=Closing%20the%20Gap-,Closing%20the%20Gap%20is%20a,%5B1%5D%5B2%5D.&text=and%20employment%20outcomes.-,It%20is%20a%20formal%20commitment%20made%20by%20all%20Australian%20governments,health%20equality%20within%2025%20years.

Carlson, B. L., Jones, L. V., Harris, M., Quezada, N., & Frazer, R. (2017). Trauma, shared recognition and indigenous resistance on social media. Australasian Journal of Information Systems21.

Department of the Prime Minister and Cabinet, Australian Government. (2018). Closing the gap, Prime Minister’s report 2018. Available at https://www.pmc.gov.au/sites/default/files/reports/closing-the-gap-2018/sites/default/files/ctg-report-20183872.pdf?a=1

Paradies, Y. (2018). Racism and indigenous health. Oxford Research Encyclopedia of Global Public Health.

Roy, A. (2014). Intergenerational trauma and Aboriginal women: Implications for mental health during pregnancy. First Peoples Child & Family Review9(1), 7-21.

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