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
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
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:
Health:
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).
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
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.
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.
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.
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.
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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