Australian Indigenous Community Case Study Sample

• Subject Name : Public health

Introduction to Australian Community

Australia is a diverse country with an involvement of a number of different communities (Whittaker et al 2019). Even though Australia have a number of health programs that promote health equity but there are still a number of communities that lacks behind in terms of health, equality and social justice. The Indigenous people in Australia are vulnerable to severe health disparities, inequalities and discrimination. These people have been under the influence of traumatic history, tremendous stress and social exclusion which has made them to experience an unhealthy and socially inactive lifestyle. These people prefer to live in remote areas in established colonies of their own race and avoid interactions with someone from the Non-Indigenous background. This assignment will develop a case study in context to the “the Australian Indigenous community living in rural and remote areas. The assignment will primarily describe the state of people living in these communities, followed by their health status in terms of inequalities. The assignment will then provide a detailed discussion and analysis of the communication and cultural factors of the Indigenous Australians followed by the development of a public health program for addressing their cultural and communicative needs.

Status of The Australian Indigenous Community Living in Rural and Remote Areas

According to a research conducted by Callander et al (2019), approximately 65% of the Indigenous people live in remote areas in comparison to 29% of the Non-indigenous people. Moreover, only 35% of the Australian Indigenous people live in major cities in comparison to 71% of the Non-Indigenous Australians. The status of the Aboriginal and TSI people living in the remote areas is even lower than the status of the Aboriginal and TSI people living in major cities (Tervonen et al 2016). Even though both the Indigenous people living in major cities and remote areas have to bear the burden of inequalities but the burden for the Indigenous people living in remote areas is always higher. The Australian Indigenous population living in remote areas face a number of health based challenges. This is mainly because of their geographic isolation and lack of accessible services. A research conducted Azzopardi et al (2018), compared the health and wellbeing outcomes of the Indigenous and the Non-indigenous people living in remote areas and evaluated that the health and wellbeing status of the Indigenous people are lower than the Non-Indigenous people.

These people are highly engaged in behaviors such as excessive alcohol consumption, smoking, and sedentary lifestyle which impart greater health risk to these people. Factors such as disadvantage in terms of education, income and employment have impacted their health status (Psaltopoulou et al., 2017). Moreover, the people living in remote areas are also influenced by lack of access to healthcare which is a subject to both inequality and inequity. According to Wylie and McConkey (2019), lack of access to healthcare for the Indigenous people is one of the most influential cause of health disparities. It has been seen that the Indigenous Australians have greater risk of both physical and mental health conditions such as diabetes, cardiac failure, depression, anxiety and COPD (Eton et al 2019). This is mainly because of their poor living conditions and lifestyle. Indigenous people living in remote location do not get timely diagnosis which makes their condition even worse and ultimately leading to greater mortality and morbidity. Although a research conducted by LoGiudice et al (2020), have indicated greater live satisfaction in Indigenous people living in remote areas of Australia. But, their health status is significantly lower than other people of Australia in addition to severe inequalities and social injustice.

Health Status of The Community

According to Fast and Collin-Vezina (2019), the Indigenous people of Australia have a stressful history and these people are influenced by severe culture and health based disparities. This inequalities and disparities have made them to live a less fulfilling and stressful life. Therefore, these people have lower health outcomes then the Non-Indigenous people. According to Stone and Waldron (2019), the Aboriginal and TSI people living in the remote areas of Australia have greater health risks because of their reduced health access and poor living standards. According to the health statistics developed by AIHW (2020), the indigenous people have greater health burden in comparison to the Non-Indigenous people because of severe health based inequalities. As per the reports published by AIHW (2020), IN year 2014-15, 1 in 3 Indigenous youth experienced greater level of emotional distress in comparison to 1 in 8 Non-Indigenous youth. Remoteness if one of the most common factor the produce inequalities for the people. For example: people living in remote areas are more vulnerable to cut off during a natural calamity such as flood in comparison to people living in metropolitan areas.

Characteristics of the population have a significant impact over their health status. People living in remote areas get fewer employment opportunities and healthcare access and education. According to Yragui et al (2017), employment is directly linked with health outcomes. Greater employment rate lead to greater socioeconomic status which ultimately lead to greater health outcomes. The Indigenous people living in remote areas get fewer employment opportunities and they indeed have lower socioeconomic status. According to Goodman, Geiger and Wolf (2017), lower socio economic status brings up health conditions such as tuberculosis, diabetes and obesity. Moreover, a reduced socio economic status also contribute to greater physiological distress and conditions such as depression.

The Indigenous people are most likely to live in remote areas which put them at greater risk of disadvantage and inequalities. According to Dunn et al (2017), a majority of the Indigenous people live in the remote areas and they are thus expected to have greater burden of health conditions. The Indigenous people living in remote conditions have greater risk of chronic and preventable conditions. The reported poorer health conditions and lower health statistics have contributed to a decline in the health status of the Aboriginal and TSI people. Remoteness have contributed to development of severe risk factors such as daily smoking and obesity. These people have contributed to conditions such diabetes mellitus, stroke and vascular disease with greater psychological distress. Moreover, lack of service use in terms of hospital administration and consultations have resulted in poor diagnosis of the disease and this have thus contributed to greater health inequalities and health burden (Goodman, Geiger and Wolf, 2017).

Communication and Cultural Factors

According to Doval (2017), the TSI and Aboriginal people have maximum health burden in terms of non-communicable diseases. There is almost 70% health burden among the Aboriginal and the Non-Aboriginal people living in remote areas in respect of diseases such as cardiovascular diseases, respiratory diseases, and diabetes and metal disorders (Doval 2017). According to Griffiths et al (2016), the health risks in the TSI and Aboriginal people are highly impacted by their communication and cultural patterns. The people living in remote areas uses conventional indigenous language and they perform their traditional cultural choices. These people feel it difficult to understand English and hence it become difficult for them to interact with the nurses or physicians with different cultural patterns and language groups. According to

Taylor and Guerin (2019), language plays an important role in the interactions of a person. A person will feel more likely to converse with people of similar language group in comparison to people having different language and cultural choices. Language and culture act as an important factor while determining the status of disparities and inequalities (Taylor and Guerin 2019). People are more considerate toward people of similar language and cultural choices. Similarly, the TSI and Aboriginal people feel greater healthcare disparities and inequalities because they are incapable of relating with the Non-Aboriginal health professionals. Lack of cultural awareness and cultural safety is one of the common cause of healthcare disparities because of language and cultural difference.

According to Lozano and Escrich (2017), every culture have different beliefs and ideologies which can be accepted in one culture and unaccepted in another culture during the same time same situation. According to Belon et al (2016), the Indigenous people loves to live in large communities and celebrate every occasion with unhealthy food practices. Moreover, they have a sweet tooth in terms of eating habits. Practices such as eye contact, use of slang, and touch during conversation can be considered as unacceptable and disrespectful by the Indigenous people. Difference in cultural patterns and lack of cultural safety in healthcare settings have led to healthcare inequalities which thus prove to have a disadvantage on the Indigenous people (Belon et al 2016). Failure to be recognized as individuals in the healthcare setting is one of the most common cultural malpractice practiced in the healthcare setting and it thus make the Indigenous people feel unsafe and uncomfortable. This lead to reduced healthcare outcomes and greater healthcare burden in the Indigenous people on the basis of their language and cultural choices.

Addressing the Communicative and Cultural Needs Through a Public Health Program

A public health program is basically an intervention that works to fight inequalities, disparities and inequities to a person or a group of person in the healthcare setting. It is proved to be effective in building up societies that values the rights and individuality of every person in the society. The Indigenous people living in remote areas of Australia are highly impacted by inequalities in the health care because of their communicative and cultural needs. Factors that develop cultural understanding among the healthcare services must be developed and promoted in the healthcare organisation. It is important for the healthcare organisation to include the concept of cultural safety in the healthcare. According to Mkandawire-Valhmu (2018), cultural safety is the practice that is performed to make the people from different culture feel respected and included in healthcare irrespective of their language and cultural beliefs. Incorporation of cultural safety in which the rights and health of every individual is respected can be effective part of the public health program and it can definitely reduce healthcare inequalities from the society. Moreover, proper implementation of the program can lead to greater healthcare equity.

The program can include strategies and services that uplift the status of Indigenous people living in remote areas. Since the Indigenous people of Australia living in remote locations so they feel it difficult to communicate their needs. So services set to identify their needs and provide relevant resources for their health improvement can certainly benefit the people of Indigenous groups. The communicative needs can be fulfilled by educating them about common language. Appointing an Indigenous trainer for the purpose can be effective for the program. Moreover use of cultural safety and cultural awareness can manage the cultural needs of the people (Wheeler et al., 2018). Remoteness is a major factor that lead to lack of understanding among the people and this in turn lead to greater instability in their health. However, promotion of proper healthcare access with greater awareness about the Indigenous language can culture can uplift their standard and reduce healthcare inequalities.

Conclusion on Australian Community

In conclusion, the Indigenous people have experienced a number of healthcare differences that have led to their reduced health status. The Indigenous people living in remote location of Australia are under tremendous stress, inequalities and discrimination because of their geographical and environmental isolation. These people are victims of lower healthcare access and delayed diagnosis which have increased their incidents of poor health outcomes. The Indigenous people have a greater health burden in terms of non-communicable diseases such as cardiac failure, diabetes and COPD. Moreover, these people are influenced by lower socio-economic status which have led to reduced employment, education and awareness. This in turn have reduced the healthcare setting. The Indigenous people have different language and cultural patterns then the Non-Indigenous people and this indeed reduce their health outcomes further. It makes it difficult for the physicians as well as the patients to understand each other and lack of cultural safety can also lead to conflicts. A public health program sufficed with recognition to rights of the Indigenous people can be effective in uplifting the health status of the Indigenous people.

Reference for Australian Community

AIHW. (2017). Remoteness and the health of Indigenous Australians. Available at {https://www.aihw.gov.au/getmedia/3fae0eb7-b2be-4ffc-9903-a414388af557/7_7-indigenous-health-remoteness.pdf.aspx} {accessed on: 1 may 2020}

Azzopardi, P.S., Sawyer, S.M., Carlin, J.B., Degenhardt, L., Brown, N., Brown, A.D. and Patton, G.C., 2018. Health and wellbeing of Indigenous adolescents in Australia: a systematic synthesis of population data. The Lancet, 391(10122), pp.766-782.

Belon, A.P., Nieuwendyk, L.M., Vallianatos, H. and Nykiforuk, C.I., 2016. Perceived community environmental influences on eating behaviors: A Photovoice analysis. Social Science & Medicine, 171, pp.18-29.

Callander, E., Bates, N., Lindsay, D., Larkins, S., Topp, S.M., Cunningham, J., Sabesan, S. and Garvey, G., 2019. Long-term out of pocket expenditure of people with cancer: comparing health service cost and use for indigenous and non-indigenous people with cancer in Australia. International Journal for Equity in Health, 18(1), p.32.

Doval, H.C., 2017. Lifestyle Changes Are Needed to Eliminate Cardiovascular Diseases. Revista Argentina de Cardiología, 85(3), pp.287-293.

Dunn, J., Garvey, G., Valery, P.C., Ball, D., Fong, K.M., Vinod, S., O’Connell, D.L. and Chambers, S.K., 2017. Barriers to lung cancer care: health professionals’ perspectives. Supportive Care in Cancer, 25(2), pp.497-504.

Eton, D.T., Anderson, R.T., Cohn, W.F., Kennedy, E.M., Sauver, J.L.S., Bucknell, B.J. and Ruddy, K.J., 2019. Risk factors for poor health-related quality of life in cancer survivors with multiple chronic conditions: exploring the role of treatment burden as a mediator. Patient Related Outcome Measures, 10, p.89.

Fast, E. and Collin-Vézina, D., 2019. Historical trauma, race-based trauma, and resilience of indigenous peoples: A literature review. First Peoples Child & Family Review, 14(1), pp.166-181.

Goodman, W.K., Geiger, A.M. and Wolf, J.M., 2017. Leisure activities are linked to mental health benefits by providing time structure: comparing employed, unemployed and homemakers. J Epidemiol Community Health, 71(1), pp.4-11.

LoGiudice, D., Josif, C.M., Malay, R., Hyde, Z., Haswell, M., Lindeman, M.A., Etherton-Beer, C., Atkinson, D., Bessarab, D., Flicker, L. and Smith, K., 2020. The Well-Being of Carers of Older Aboriginal People Living in the Kimberley Region of Remote Western Australia: Empowerment, Depression, and Carer Burden. Journal of Applied Gerontology, p.0733464819898667.

Lozano, J.F. and Escrich, T., 2017. Cultural diversity in business: A critical reflection on the ideology of tolerance. Journal of Business Ethics, 142(4), pp.679-696.

Mkandawire-Valhmu, L., 2018. Cultural safety, healthcare and vulnerable Populations: A critical theoretical perspective. Abingdon: Routledge.

Psaltopoulou, T., Hatzis, G., Papageorgiou, N., Androulakis, E., Briasoulis, A. and Tousoulis, D., 2017. Socioeconomic status and risk factors for cardiovascular disease: impact of dietary mediators. Hellenic Journal of Cardiology, 58(1), pp.32-42.

Stone, L. and Waldron, R., 2019. Great expectations and e-mental health:'The role of literacy in mediating access to mental healthcare'. Australian Journal of General Practice, 48(7), p.474.

Taylor, K. and Guerin, P., 2019. Health care and Indigenous Australians: cultural safety in practice. Macmillan International Higher Education

Tervonen, H.E., Aranda, S., Roder, D., Walton, R., Baker, D., You, H. and Currow, D., 2016. Differences in impact of Aboriginal and Torres Strait Islander status on cancer stage and survival by level of socio-economic disadvantage and remoteness of residence—A population-based cohort study in Australia. Cancer Epidemiology, 41, pp.132-138.

Wheeler, A.J., Spinks, J., Kelly, F., Ware, R.S., Vowles, E., Stephens, M., Scuffham, P.A. and Miller, A., 2018. Protocol for a feasibility study of an Indigenous Medication Review Service (IMeRSe) in Australia. BMJ Open, 8(11).

Whittaker, A., Lohm, D., Lemoh, C., Cheng, A.C. and Davis, M., 2019. Investigating Understandings of Antibiotics and Antimicrobial Resistance in Diverse Ethnic Communities in Australia: Findings from a Qualitative Study. Antibiotics, 8(3), p.135.

Wylie, L. and McConkey, S., 2019. Insiders’ insight: discrimination against indigenous peoples through the eyes of health care professionals. Journal of Racial and Ethnic Health Disparities, 6(1), pp.37-45.

Yragui, N.L., Demsky, C.A., Hammer, L.B., Van Dyck, S. and Neradilek, M.B., 2017. Linking workplace aggression to employee well-being and work: The moderating role of family-supportive supervisor behaviors (FSSB). Journal of Business and Psychology, 32(2), pp.179-196.

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