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Cultural safety is the framework for delivering health services involving all the deprived populations like Aboriginals and Torres Strait Islanders. At the time environment is spiritually, socially, physically, and emotionally safe and there is no assault or denial of the identity of the people, then the environment is said to be culturally safe (Alcalá, Sharif & Samari, 2017). Cultural safety is not only for the Indigenous people but also relates to sharing respect, knowledge, meaning, and experiences of other people from various other backgrounds as well. This includes actions and that help in identifying the culture of others and safely meeting the needs, rights, and expectations of others (Hatzenbuehler & Pachankis, 2016). The unsafe cultural practices are those that disempower, demean, and diminish the cultural identity of others. The principles of cultural safety allow people to work on culturalism and harmony in the country more than being conservative. Open-mindedness and flexibility in views allow people in identifying and measuring attitudes of culture towards people than their own (Martinez, Artze-Vega & Wells et al., 2015). Cultural safety helps in understanding the culture, and its influence on how it should be thought, to feel, and behave in all matters. The strategies enhance the ability to be culturally safe by reflecting the culture, beliefs, and attitudes of others. Cultural safety allows us to be prepared and engaged in two-way dialogue by sharing knowledge. Trust building in cultural safety is very important to avoid and recognize stereotypical barriers. An increase in the sense of multicultural environment, helps to gain the importance of cultural safety, and the need is never underestimated (Sharma, Pinto & Kumagai, 2018).
Interpersonal power has an impact on health as equality and inequality are the attributes of the healthcare system. Interpersonal power is complex, multidimensional, and proposed through social exchange theory, interdependence theory, and communication theory. Conflicts arise in the healthcare system as it operates under the surface and communication choices are definite to be same. In healthcare institutions like hospitals, the medicine prescribed by the doctor doesn't need to be agreed by nursing professionals (Hicken, Kravitz-Wirtz & Durkee et al., 2018). Here in these types of situations, the chances of conflicts are high even though the nurse does not say anything, share opinions, conformation of expectations from others, and behavior to enact. The ways should be found in the healthcare system to eliminate the confusion and differentiate from others. The process behavior and outcomes relationship are known as an interpersonal relationship of the way professionals react with the patients. The variety of factors such as demographic and environmental are found beyond control in ensuring quality care to patients by adopting specific attitudes and behavior (Waterworth, Dimmock & Pescud et al., 2016). This helps in the increase of knowledge and good behavior by professionals in healthcare institutions in providing quality care. Low interpersonal power in the healthcare system has disadvantages like it is related to low morale, loss of control, and low decision-making between the professionals in institutions. This lifts imbalance between the professionals that is not required by both the parties in the healthcare system. Interpersonal interdependence is the behavior that gives rise to the motives, outcomes, beliefs, and preferences of others in the healthcare service delivery (Forrest, Lean & Dunn, 2016).
The social determinants of health have a great impact on the health conditions of all in the country, be they are Indigenous people or non-Indigenous people. Social determinants of health include the physical environment, economic stability, food, social context, neighborhood, and healthcare system (Kowal, 2015). These factors affect the health system but give shape to practices and policies in promoting the healthcare of people by working on health equity and equality. Social determinants of health are the contributing factors to exercise, diet, economic status, demography, health behavior, and the social context in which people live. Government and politics are responsible for focusing on health sectors, with the focus on social and environmental health (Reid, Cormack & Paine, 2019). Transportation is also included in the social determinants of health for the availability and accessibility that affect healthcare, employment services, and other important drivers. The government has introduced many nutritional programs that are needed for countries like Australia to provide healthy foods to children (Grant & Guerin, 2018). Community programs and school programs are also developed to address and identify the social needs of patients with the multi-layer system of Australia. Hence, many challenges are faced by people in managing the requirements of people. The public health programs and prevention initiatives are taken by the government by providing funding to the country citizens (Alderwick & Gottlieb, 2019).
Culture has no biological bias because human culture encompasses artifacts, behaviors, and attitudes, and ideas that change with time. Natural selection is based on Darwin’s principle for the process of transmission and change. Different languages and species develop the processes that are parallel and underpins scientific barriers. Culture is not a biological process, but it operates through biological mechanisms like hormones, hands, and brains (Cox, 2017). The difficulty faced is through the threads of cultural and genetic influences on human behavior at one point. However, biology is the study of life and it relates to the understanding of nature and evolution of living systems that have to be enriched and extended by discoveries that are introduced. The transmission and social learning of cultural traditions are said to affect the creation of a secondary form of evolution and functional behavior. The scientific approaches prove that human culture has been emerged and became productive in evolution (Sharma, Pinto & Kumagai, 2018). But the evolutions in the system are integrated into both human and nonhuman systems of biology. In a student's life, it enters racism, diversity, and cultural competence that lies with the assumption that race is biological. Racial thinking influences others in a way that experience health, romance, politics, education, religion, and work. The social structures are relatively dependent on occupational status, socioeconomic status, wealth, power, and educational status. Racism as biology is a fiction, however, racism as a social problem is real (Montesanti & Thurston, 2015). This discussion helps in determining that Culture has no biological bias.
Alcalá, H. E., Sharif, M. Z., & Samari, G. (2017). Social determinants of health, violent radicalization, and terrorism: A public health perspective. Health Equity, 1(1), 87-95. https://doi.org/10.1089/heq.2016.0016
Alderwick, H., & Gottlieb, L. M. (2019). Meanings and misunderstandings: Social determinants of health lexicon for health care systems. The Milbank Quarterly, 97(2), 407. https://dx.doi.org/10.1111%2F1468-0009.12390
Cox, L. (2017), Do politicians need cultural safety training, YouTube. Com, Available at https://youtu.be/-bA-UANKSmc
Forrest, J., Lean, G., & Dunn, K. (2016). Challenging racism through schools: Teacher attitudes to cultural diversity and multicultural education in Sydney, Australia. Race Ethnicity and Education, 19(3), 618-638. https://doi.org/10.1080/13613324.2015.1095170
Grant, J., & Guerin, P. B. (2018). Mixed and misunderstandings: An exploration of the meaning of racism with maternal, child, and family health nurses in South Australia. Journal of Advanced Nursing, 74(12), 2831-2839. https://doi.org/10.1111/jan.13789
Hatzenbuehler, M. L., & Pachankis, J. E. (2016). Stigma and minority stress as social determinants of health among lesbian, gay, bisexual, and transgender youth: Research evidence and clinical implications. Pediatric Clinics, 63(6), 985-997. https://doi.org/10.1016/j.pcl.2016.07.003
Hicken, M. T., Kravitz-Wirtz, N., Durkee, M., & Jackson, J. S. (2018). Racial inequalities in health: Framing future research. Social Science & Medicine (1982), 199, 11. https://dx.doi.org/10.1016%2Fj.socscimed.2017.12.027
Kowal, E. (2015). Time, indigeneity, and white anti‐racism in Australia. The Australian Journal of Anthropology, 26(1), 94-111. https://doi.org/10.1111/taja.12122
Martinez, I. L., Artze-Vega, I., Wells, A. L., Mora, J. C., & Gillis, M. (2015). Twelve tips for teaching social determinants of health in medicine. Medical Teacher, 37(7), 647-652. https://doi.org/10.3109/0142159X.2014.975191
Montesanti, S. R., & Thurston, W. E. (2015). Mapping the role of structural and interpersonal violence in the lives of women: Implications for public health interventions and policy. BMC Women's Health, 15(1), 1-13. https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-015-0256-4
Reid, P., Cormack, D., & Paine, S. J. (2019). Colonial histories, racism, and health—The experience of Māori and Indigenous peoples. Public health, 172, 119-124. https://doi.org/10.1016/j.puhe.2019.03.027
Sharma, M., Pinto, A. D., & Kumagai, A. K. (2018). Teaching the social determinants of health: A path to equity or a road to nowhere?. Academic Medicine, 93(1), 25-30. https://doi.org/10.1097/ACM.0000000000001689.
Waterworth, P., Dimmock, J., Pescud, M., Braham, R., & Rosenberg, M. (2016). Factors affecting indigenous west Australians’ health behavior: Indigenous perspectives. Qualitative Health Research, 26(1), 55-68. https://doi.org/10.1177%2F1049732315580301
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