2. The indigenous population in Australia has faced racism and discrimination since historic times and continues to do so in the present times as well (Fast & Collin-Vézina, 2019). In healthcare, racism can be attributed to the lower socio-economic status, stereotypical attitude or professionals. There are multiple pathways which link racism to health outcomes and can affect health outcome directly and indirectly. Directly affecting path is a biopschosocial process which connects racism induces stress due which there is oxidative stress which induces metabolic disease like diabetes (Lee et al., 2018). Racism is considered stressful and harms the health of a person. In healthcare, there is past perception of race and class which determines the current behaviour of healthcare professional as a result it is more profound in healthcare compared to other settings as healthcare professionals are in direct contact with patients (Vina et al., 2015).
3. One of the policies that are in effect post-colonial is to reduce the gap and reduce health inequality. The main aim of the policy is that the Aboriginal and Torres Strait Islander people can enjoy that highest possible level of health that is available to the non-indigenous population as well (Amin‐Korim et al., 2018). The short-term goal is to identify the existing challenges which stand in the way to achieving the highest possible level of health. The long-term goal is to reduce health disparity which exists and the indicators of health and life expectancy of the indigenous and non-indigenous population difference are reduced.
4. The intergenerational effect is the effect of trauma which is seen to be transmitted from one generation to the other among children, grandchildren and great-grandchildren (Menzies, 2019). The effect can be seen in the form of physical, psychological, emotional and even spiritual. This kind of intergeneration trauma can affect the older generation as well as the present generation. Removal of children can result in stress due to separation and result in self-destructive activities and some of the life-style diseases can be seen to be more prevalent (Yehuda & Lehrner, 2018).
6. ACCHOs or ACCHSs have formed under the closing the gap framework which has been formed to make sure that the health disparity between the indigenous population and mainlanders is reduced (Panaretto et al., 2014). One of the reforms that have been made in the Aboriginal Community Controlled Health Organization is the provision of primary health care centers. The main drawback which is seen that the people are not able to access the healthcare facility by the people who require it. That makes adequate access to healthcare as one of the main concerns. This is because the health problems can be identified earlier and similarly the progression can be halted and has a positive health outcome because there are less barriers due to language (Panaretto et al., 2014).
7. Mainstream services are mostly rigid in practice and do not accept other forms of treatment which can help a person (Gainsbury, 2017). It does not take the other aspects or determinants of health are a required factor for the betterment of a person’s health it includes cultural, spiritual and other needs. To make sure that culturally safe care is provided to a person in mainstream, it is required that there are policy norms for the same. Provision of culturally safe care is such that the people involved in the care provision have cultural identification, reflection and the care should culturally safe and sensitive (Henderson et al., 2018).
8. As per the definition of health, as developed by the World Health Organization, it is the complete wellbeing of a person in terms of physical, mental and social aspects and not just the absence of disease or infirmity (World Health Organization, 2019). The healthcare of Aboriginal and Torres Strait islanders is such that it caters to the holistic concept of health and by the inclusion of the same in the mainstream healthcare cultural safety can be ensured (Browne et al., 2017). This integration can help in preservation of culture by upholding the medicine; there is increase in compliance and development of faith in mainstream healthcare.
Amin‐Korim, R., Legge, D., & Gleeson, D. (2018). PHAA's Health Equity Policy. Australian and New Zealand Journal of Public Health, 42(5), 421-423. https://search.proquest.com/openview/f252ab6a4435e4b94da8166b1bf6e02b/1?pq-origsite=gscholar&cbl=37917.
Browne, J., de Leeuw, E., Gleeson, D., Adams, K., Atkinson, P., & Hayes, R. (2017). A network approach to policy framing: A case study of the National Aboriginal and Torres Strait Islander Health Plan. Social Science & Medicine, 172, 10-18. https://doi.org/10.1016/j.socscimed.2016.11.011.
Fast, E., & Collin-Vézina, D. (2019). Historical trauma, race-based trauma, and resilience of indigenous peoples: A literature review. First Peoples Child &Family Review, 14(1), 166-181. https://fpcfr.com/index.php/FPCFR/article/view/379.
Gainsbury, S. M. (2017). Cultural competence in the treatment of addictions: Theory, practice and evidence. Clinical Psychology & Psychotherapy, 24(4), 987-1001. https://doi.org/10.1002/cpp.2062.
Henderson, S., Horne, M., Hills, R., & Kendall, E. (2018). Cultural competence in healthcare in the community: A concept analysis. Health & Social Care in the Community, 26(4), 590-603. https://doi.org/10.1111/hsc.12556.
Lee, D. B., Peckins, M. K., Heinze, J. E., Miller, A. L., Assari, S., & Zimmerman, M. A. (2018). Psychological pathways from racial discrimination to cortisol in African American males and females. Journal of Behavioral Medicine, 41(2), 208-220. https://doi.org/10.1007/s10865-017-9887-2.
Menzies, K. (2019). Understanding the Australian Aboriginal experience of collective, historical and intergenerational trauma. International Social Work, 62(6), 1522-1534. https://doi.org/10.1177/0020872819870585.
Panaretto, K. S., Wenitong, M., Button, S., & Ring, I. T. (2014). Aboriginal community controlled health services: Leading the way in primary care. Medical Journal of Australia, 200(11), 649-652. https://doi.org/10.5694/mja13.00005.
Vina, E. R., Hausmann, L. R., Utset, T. O., Masi, C. M., Liang, K. P., & Kwoh, C. K. (2015). Perceptions of racism in healthcare among patients with systemic lupus erythematosus: A cross-sectional study. Lupus Science & Medicine, 2(1), e000110. http://dx.doi.org/10.1136/lupus-2015-000110.
World Health Organization. (2019). Global action plan on physical activity 2018-2030: More active people for a healthier world. World Health Organization.
Yehuda, R., & Lehrner, A. (2018). Intergenerational transmission of trauma effects: putative role of epigenetic mechanisms. World Psychiatry, 17(3), 243-257. https://doi.org/10.1002/wps.20568
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