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Abstract on Closing the Gap Policy

This case study report is a reflection of the reciprocal relationship between culture and health for the aboriginal Australian population. In the past 12 years there has been a lack in the reform to close the gap on health differences. For the aboriginals their culture is important for their wellbeing and health. Self governance and indigenous participation in decision making is crucial for formation of better reforms and policies for the aboriginal communities. Aboriginal Controlled Health Organizations and the Coalition of Peaks is a good example of aboriginal leadership and government working together. The historical trauma of cultural uprooting, government distrust, removal of indigenous children from homes, stolen wages, and suppression had a terrible influence on the health of the aboriginal population. Racism in the health centers has maintained that trauma. This study is a evaluation of success and problems of the close the gap project undertaken for removing the health differences for the aboriginal population.

Table of Contents

Abstract

Introduction

Analysis

Discussion and Conclusion

Recommendations

References

Introduction to Closing the Gap Policy

Closing the Gap is a strategy undertaken by the government whose aim is to reduce the gap between indigenous and non indigenous population of Australia in terms of health and education. It is a commitment made by the Australian government for the well being of indigenous people. Targets relating to child mortality, life expectancy, education for children, employment opportunities are part of this strategy. Closing the Gap strategy came into reality as a response to social justice report released by the social justice commissioner in 2005 as well as the close the gap social campaign. In 2008, the aboriginal communities agreed to work together with the government to achieve equality with the non indigenous Australians by the year 2030 (CAG, 2009).

Under this strategy certain specific targets were formed

  • Life expectancy gap closed by 20131
  • Child mortality reduced by 2018
  • Ensuring aboriginal children are enrolled in schools by 2025
  • Reduce the gap in half in numeracy, reading and writing by 2018
  • Reduce the gap in employment by 2018 (DPMC, 2018).

The progresses in achieving these targets are mentioned in a report card which is released by the prime minister in the parliament every year.

The achievement of these targets depends on the implementation of these targets. Closing the gap strategy faces many challenges which called for improvements for long sustainable changes.

In December 2018, COAG released a draft of new and improved targets for closing the gap strategy

These new targets were bases on partnership of indigenous and the government. The new targets are:

Families, children and youth:

  • enrolling 95% of aboriginal children in schools by 2025
  • significant reduction in the over representing out of home care aboriginal children
  • significant reduction in domestic violence against aboriginal women and children

Health:

  • Life expectancy gap between aboriginals and the non indigenous Australians within a generation by 2031.
  • Ensuring healthy weight of 90-92% new born by 2028 (DPMC, 2018).

Close the Gap: a social justice campaign developed in response to social justice report 2005 highlighting major difference in equality among various aspects of life for aboriginal Australians. This report is a case study done on close the gap project to meet health targets for the indigenous population of Australia. It is based on effect of culture on the health of indigenous people. Aboriginal people have a culturally centered definition of health. This has been documented by the aboriginal people in policy documents. Such a culturally centered view on health was recognized by the national consultations. The strong connection of culture and the role it plays in the health of aboriginal people was recognized (Holland, 2016).

Analysis of Closing the Gap Policy

Section A: Success

  • 1970s: a period of beginning of cultural renaissance for the people of Aboriginal and Torres Strait Island. This was due to lifting of severely oppressive laws of segregation and assimilation, Indigenous writers, musicians, philosophers and artists of indigenous origin emerged (Parbury, 1986).
  • In 2020 a resurgence of culture related knowledge and practices continued to gain momentum. Hidden cultural practices which were once laid dormant due to colonial laws of assimilation are now being revived
  • The Firesticks Alliance responsible for projects such as Ngunnawal language revival project and the language program (ALNF). these programs has helped re-invigorate revival of cultural burning, rebuilding languages and Birthing on Country practices
  • indigenous communities across Australia are leading the way to shape the vision of health and well being formed on the foundation of culture
  • The Lowitja Institute in 2014 held a discussion to promote appreciation and understanding of aboriginal culture , also to understand the relation between aboriginal culture and their health , provided evidences to policy

Australian Indigenous Psychologists Association (AIPA) (Gee et al, 2014) and Australian Indigenous Doctors’ Association (AIDA) (Milroy, 2010) and Yawuru19 have provided a framework that emphasis on culture in relation to health of aboriginal communities in Australia

Section B- Problems

  • Australian government has failed repeatedly to address the health discrimination that takes place which inhibits the growth of a culture and a failure of reforms to adopt a culturally centered approach. There is a struggle to decide how culture could be utilized in order to improve individual as well as community health ( Lowitja Institute, 2014).
  • Closing the gap strategy is target driven which focus on statistical deficit instead of cultural approach to well being and health (Forgarty et al, 2018). The reason for this approach is that the government relied on easily tractable parameter in its knowledge and statistical resources instead of focusing on understanding what the inherent elements of health and wellbeing are for the aboriginal people 
  • According to Coalition of Peaks, closing the gap 2020 was a failure as it was developed without the inputs from indigenous communities. It was acknowledged by the prime minister that the strategies framework excluded and was missing the inputs from the indigenous communities when closing the gap report card 2020 was released
  • Doctors at Aboriginal Health Service, which works on the traditional land of the Gimuywalubarra yidi, peoples had witness that their worries related to reclaiming wages lost for a decade affected their health. Major cause of this cause for this worry is due to historic distrust in the government. The health impact noticed were anxiety and high blood pressure from not knowing how to navigate through the legal process to claim their wages other issues affecting health are stress from needing to visit court, eyesight problems which hinders their response to demand letters, meaning they would later have to pay the fine etc. can affect their health and wellbeing.
  • Aboriginal communities are often subject to unfair practices for example in remote communities indigenous people are sold expensive mobile plans which lands them in debt which ultimately cause them anxiety and mental stress. Children are separated from their families as they were seen as not thriving where as they had medical issues which went unrecognized as they were not using translator

Section C:- Solutions

  • Aboriginal organizations have called for better reforms which can supports indigenous thinking and ways of being into the health: these are the approaches which focuses on the self determination and respecting the choices of indigenous people.
  • Protocols of Aboriginal community controlled organizations, Indigenous g practices, community based reforms to services and systems, and through partnerships. Formal alliance aboriginal controlled managements and organization with government policy making would be a successful step. Considering the role of aboriginal views in the decision making is a need at local, regional, state and national level. Aboriginals should be informed of the decisions made for them and who made them as well as the participation of aboriginal organizations from their behalf. Not only would it give better health results but also empower aboriginals knowing their needs and viewpoints have been heard. Reason for this solution is taking inputs from aboriginal communities into consideration is an important step since for Aboriginal people having control over their health has always been important (AIGR, 2020).

COAG and coalition of peaks came together in partnership in 2019 in order to work together for the coming ten years to close the gap.

  • The issue of health of elders of aboriginal origin affected due to legal matters could be solved with the help of formation of alliance between health justice initiatives and law. Helping the elders who arrive at the clinic in solving their legal issues and paperwork. Historical injustices faced by indigenous communities should be heard and solved in order to give them a sense of justice for promotion of their good health.
  • issues such as removal of aboriginal children from their homes can be solved with the help of translators at the clinics to reduce misinterpretations:

 NAAJA and the Miwatj Health staff together in collaboration health workers also help aboriginal families and individual to solve their legal issues. They help the indigenous communities with issues such as discrimination, housing and child protection. These two communities work for the health justice for the indigenous people

 Use of interpreters in the clinics, cultural based training to all staff, being attentive towards cultural protocols followed in the communities and work in respectful manner towards the elders. Take orders and advise from the aboriginal management.

Discussion and Conclusion on Closing the Gap Policy

Close the gap project has its own positives and negatives in results and the implementation of reforms. Despite the recognition of importance of involvement of aboriginal views in the policy making and decision making, their views were not taken onto consideration significantly up until 2019.There are no additional findings made to further progress the campaign. The health targets undertaken by close the gap campaign although have a simple appeal however they become complex when trying to implement and achieve them as factors such as socioeconomics, underlying trends and patterns etc are considered.

There are several positives of this project such as the formation of alliance of aboriginal controlled organization and government to work for the well being and health of the aboriginal population. Many researches are encouraged, unfair practices against aboriginals are recognized and they are given assistance to solve their legal matters. The project needed to emphasis on resolving the past historical trauma from the time of colonization leading to culture uprooting in order to reduce their distrust in the government and seek help for better health. Efforts and reforms are needed which focus on the restoration and importance of aboriginal population so their stresses can be reduced and their health can be influenced positively. It is a strong believes that the most effective method of achieving targets and creating sustainable, long-term changes is through community-led development model and work according to the needs of different aboriginal communities. This would ensure that each community is supported in developing and achieving their own health goals. Listening should be the core approach to build trust and better relationships which leads to achieving goals and creating sustainable changes.

Recommendations on Closing the Gap Policy

1.) The alliances and all partner ships are needed to be supported to develop the next agreement on closing the health gap between indigenous and non indigenous population. Much significance and importance should be given to the participation of health organizations controlled by aboriginal communities in the Australian health system and policy making.

2.) Aboriginal communities' calls for a representative in the parliament should be supported and actions should be taken to elect an aboriginal representative. This will help make reforms which will empower the aboriginal population by giving them power over their health and restoring their rightful place in the system.

3.) The system responsible for developing and implementing reforms needs to take cultural and social determinants of health. This includes funding made for the development of aboriginals and makes the process more collective in decision making.

4.) Positive results are being noticed from partnership formed between government and aboriginal controlled health organizations. Working together to embed the cultural determinants into the health affairs of indigenous population is important.

References for Closing the Gap Policy

Australian Indigenous Governance Institute and Reconciliation Australia, Indigenous Governance Fact Sheets (6), Nation Building and Development. Retrieved from: https://www. reconciliation.org.au/wp-content/uploads/2018/07/ nation-building.jpg.

Council of Australian Governments. (2009). National Indigenous reform agreement (closing the gap). Council of Australian Governments.

Department of the Prime Minister and Cabinet. (2018). Closing the Gap Prime Minister's report 2018. Department of the Prime Minister and Cabinet.

Department of the Prime Minister and Cabinet. (2018). Closing the Gap Prime Minister's report 2018. Department of the Prime Minister and Cabinet.

Fogarty, W., Bulloch, H., McDonnell, S. & Davis, M. (2018), Deficit Discourse and Indigenous Health: How narrative framings of Aboriginal and Torres Strait Islander people are reproduced in policy, The Lowitja Institute, Melbourne

Gee, G., Dudgeon, P., Schultz, C., Hart, A & Kelly, K (2014), Aboriginal and Torres Strait Islander social and emotional wellbeing, in Dudgeon, P., Milroy, H., Walker, R., (ed), Working together: Aboriginal and Torres Strait Islander mental health and wellbeing principles and practice (2nd ed., pp. 55-68). Department of the Prime Minister and Cabinet, Canberra; Commonwealth of Australia (2017), National Strategic Framework for Aboriginal and Torres Strait Islander Peoples’ Mental Health and Social and Emotional Wellbeing, Department of the Prime Minister and Cabinet, Canberra

Holland, C.. (2016). Close the Gap: progress and priorities report 2016. Canberra: Close the Gap Campaign Steering Committee.

Lowitja Institute (2014), Cultural Determinants Roundtable, 26 November 2014: Background Paper. Retrieved from: https://www.lowitja.org.au/content/ Document/PDF/Cultural-Determinants-RoundtableBackground-Paper.pdf

Milroy, H. (2010), ‘The Dance of Life’ Concept Framework applied in the Australian Indigenous Doctors’ Association and Centre for Health Equity Training, Research and Evaluation, UNSW. Health Impact Assessment of the Northern Territory Emergency Response, Australian Indigenous Doctors’ Association.

Parbury, N. (1986), Survival, a history of Aboriginal life in New South Wales, New South Wales Ministry of Aboriginal Affairs, Sydney

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