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Aboriginal and Torres Strait Islander Health and Cultural Safety 

The disparity in the system can be evaluated after evaluating the condition before the colonization that changed the life of Indigenous population. The pre-invasion time for the Indigenous population was different from today’s era as they lived in small groups with practising their traditional aspect for livelihood. The health status of the Indigenous population was better than today’s time as they are closer to the environment and involved in the hunting to gather the necessary resources. The era before the colonization was peaceful for them as there were no disparities that lead to the proper distribution of the resources which lead to health complication (Kalinda et al., 2019).

There has been a great disparity when it comes to health care services of the Indigenous population compared to the non-Indigenous population. The health care system after several years of struggle has adopted equality in the system but still their lack of equity that is important for the Indigenous population (Morgan, 2015). The Australian government has presented different initiatives that are important to provide culturally competent care to the Indigenous population. But still due to lack of resources and services distribution in the health care sector increases the vulnerability of the Indigenous population to acquire health-related complication like diseases or lifelong illness (Harfield et al., 2018).

One of the negative impact that has been associated with the colonization which has not only physically but emotionally devastated the Indigenous population is the loss of their traditional practice. The Assimilation Policy of 1961 forced the Indigenous population to think, speck, and practise like white by forgetting their traditional practices and increased discrimination in the system. This has directly impacted their mental wellbeing and they have mentally broken down due to the forced practise they are asked to perform. The policy was lead to the separation of the mixed-blood children from the Indigenous community that lead to the formation of the stolen generation which leads to greater grief to the parents and the children’s (Williams, 2019).

Racism is one of the most negative behaviours that can directly impact the mental as well as physical wellbeing. The racism occurs due to the imbalance of the social and political powers which lead to the favour of one of the communities of the whole population. The racism in the system leads to the in equal distribution of the resources which lead to the poor mental state of the individual in the minority group (Ferdinand et al., 2015). The study presented by Sheppard et al. (2019) discussed that sport is the symbol of unity and brotherhood that should not be spoiled by discrimination and racism. The Australian sports have faced great racism concerning the Indigenous population and their participation in different fields of sports. The racism in the sports not only increases the stress of the players that directly hamper the mental wellbeing of participation but it also increases the distress in the audience as well. The men sports also faced the same discrimination in Australia which directly increase the distress and lead to increased prevalence of the depression in the players. 

Another article presented by Philpott (2016) discussed that from the colonization there has been biased behaviour toward Indigenous population that has been deteriorated the physical as well as mental wellbeing. The racism in the sports affected the participation of the players in the sports and it also decreased the chances of the Indigenous population to attain a good position in the sports like coaches or committee head. The racism has directly impacted over the mental and emotional wellbeing as due to their discrimination there were not able to full fill their ambition. The indigenous population not only faced difficulty while playing the sports but there are lack opportunities that help to enter the mainstream sports which negatively impacted them. The study presented by Evans et al. (2015) the racism faced by the players belong to the Indigenous community not only faced discrimination from the committee end but they also face negative comments from the other participants that are directly demoralized and distress them which lead to decrease mental wellbeing. The racism leads to the anguish in the Indigenous community as it makes them realise that they belong to the minority group having no equal rights and opportunity in any fields. This negative thought process decreases the mental peace and increases the negativity towards the non-indigenous population.

The pregnancy is considered to be one of the happiest phases in the life of the mother as she is being attached to a new being and going to experience a new phase of life. But Indigenous population has all the negative experiences when it comes to pregnancy due to the racism in the health care sector. The racism increases the health disparities which directly decrease the use of right resources to address the issue of the pregnant women which lead to negative health consequence for mother and baby. The racism has increased the mortality and morbidity for the pregnant mother as well as new born for the Indigenous population (Wynn, 2019). According to the Centers for Disease Control and Prevention (2019), 700 women die during the pregnancy due to the racism that leads to the disparity which leads to the pregnancy-related mortality. The racism in the different aspect that leads to the increased mortality of the pregnant women includes decrease health care facility, lack of community services and lack of antenatal care specialist. The lack of resources leads to the ineffective antenatal care which directly deteriorated health of the baby which led to complication after birth.

The racism in the pregnancy increases the chances of the addressed need of the mother which lead to the negative health outcome which also affects the baby during the growth phase. During the pregnancy, the mother has special need concerning the diet, care and mental support but racism decrease the chances of equal distribution of the resource which lead to a low birth outcome in the Indigenous population. The racism directly affects the physical and mental wellbeing which lead to the negative health consequences for the mother and baby lead to preterm birth and low weight of the baby. The inadequate care during the pregnancy can lead to the lifetime illness to the baby which decrease the survival rate and can lead to increase mortality (Alhusen et al., 2016). The racism is directly associated with the increase stressor for the pregnant women which directly negatively influence the mother immune system and increase the risk for the infection which is not good for the baby. The increase in stressor also negatively affects the mental wellbeing of the mother which can lead to a state of depression or anxiety. The pregnant women faced racism during the care is generally birth the baby with cognitive development defect or physical impairment due to right care and nutrition’s (Chambers et al., 2020).

One of the most vulnerable groups in the Indigenous community for racism is the primary school children as the effect is for a lifetime. The racism in the primary school children directly affects their physical and neurological development which leads to a health-related issue. The racism act as a toxic for the development of the children and it retard the normal growth of the children. It acts as a social determinant of the health for the children and decreases the right neurological development. The racism in the adolescent age increases the chances of depression, anxiety issue and isolated behaviour of the children that negatively impact the neurological development (Trent et al., 2019).

The study presented by Bécares et al. (2015) discussed that deteriorated neurological development leads to poor academic performance that leads to decreased self-esteem. The children faced racism have a reluctant attitude toward social gathering and they also produce a sign for impaired cognitive development. The racism can increase or decrease the expression of the children as sometimes they become under confident and do not interact with anybody or they become abusive concerning the colleagues. The stress that is developed by the due to the negative impact of the racism will lead to hormonal changes in the children which lead to a metabolic disorder. The racism leads to the underestimation of the children which lead to the neurological issue in the development of the children. The children faced persistent racism sometimes faced traumatic disorder of the nervous system which can lead to lifetime issue with brain functioning.

The article presented by Macedo et al. (2019) discussed that racism directly increases the production of the stress hormone and cortisol which lead to the increasing prevalence of the inflammatory responses. The increase rate of the inflammatory response increases the risk for the children for the chronic disease that not deteriorates physical but also mental health. The different neurological issue that arises in the children due to the racism includes suicide ideation, attention deficit and hyperactive disorders that lead to the behavioural issue. The neurological development is compromised due to the discrimination faced by the children in the primary school setting which lead to lifetime mental health complication. The emotional and psychological issues are also evident in the children faced racism that leads to the irrelevant behaviour which leads to the negative image of the child.

After reviewing the literature I realised that the main issue in the health care process for the Indigenous community is the lack of consideration of the cultural aspect of the diverse population. This made me realise that care needs to be competent concerning the population preferences and cultural belief. The cultural competency in the care with therapeutic communication will help to improve the care that is culturally safe concerning the Indigenous population. Thus, to improve the equity in the care I will try to improve my cultural competent skills that are important to deliver the culturally competent care which leads to positive influence over the patient wellbeing. The study presented by Jongen et al. (2018) indicates that cultural competency is important to understand and consider the cultural values and belief of the diverse population to deliver culturally safe care. The cultural safe practise will help me to understand their cultural perspective and respect them during the care. The cultural competent care will help to improve the equity which is important to address the specific issue of the patient while considering their cultural belief. The cultural competency includes respecting the cultural values concerning the care which lead to patient satisfaction and positive health outcome. The cultural competency is key skills while caring for the culturally diverse population to address the health issue in cultural safe aspect.

Another aspect that I will adopt in the care to deliver the cultural safe care to the Indigenous population includes therapeutic communication this will help to improve the rapport with the patient. I will utilize my verbal and non-verbal communication skills to improve the understanding of the patient concerning the care. Increasing patient participation in the decision-making process related to the care increase the cultural safe practise. The study presented by Amoah et al. (2018) discussed that therapeutic communication is important to connect with the patient and understand their perspective reading the care. The nurses are expected to use interpersonal skills to communicate with the patient while patiently listening that will improve patient issue expression. Therapeutic communication is important to improve the patient information concerning the care which is important to provide the cultural safe care by partnering with the patient. I will try to improve my interpersonal skills that include effective communication and active listening skills so that can therapeutically communicate with the patient to deliver culturally safe care. These two aspects will help me to improve the cultural competency in the care which is important to decrease the disparity in the care which is important to develop equity. I will try to incorporate these two aspects in my clinical practise in future so that I will be able to deliver culturally safe care. The cultural competency and therapeutic communication help to reduce the racism or discrimination in the care which is important to increase the Indigenous population health status. The health status of the Indigenous population needs to be improved to decrease the health care burden by addressing the issue of the population.

References for Health Status of Australian Indigenous Men

Alhusen, J L, Bower, KM, Epstein, E & Sharps, P 2016, ‘Racial discrimination and adverse birth outcomes: An integrative review’, Journal of Midwifery & Women's Health, vol. 61, no. 6, pp. 707–720. DOI: 10.1111/jmwh.12490

Amoah, VMK, Anokye, R, Boakye, DS & Gyamfi, N 2018, ‘Perceived barriers to effective therapeutic communication among nurses and patients at Kumasi South Hospital’, Cogent Medicine, vol. 5, no. 1, pp. 1-12. DOI:10.1080/2331205x.2018.1459341

Bécares, L, Nazroo, J & Kelly, Y 2015, ‘A longitudinal examination of maternal, family, and area-level experiences of racism on children’s socioemotional development: Patterns and possible explanations’ Social Science & Medicine, vol. 142, pp. 128–135. DOI:10.1016/j.socscimed.2015.08.025 

Chambers, BD, Arabia, SE, Arega, HA, Altman, MR, Berkowitz, R, Feuer, SK & McLemore, MR 2020, ‘Exposures to structural racism and racial discrimination among pregnant and early postpartum black women living in Oakland, California’ Stress and Health, pp. 1-7. DOI:10.1002/smi.2922 

Evans, JR., Wilson, R, Dalton, B & Georgakis, S 2015, ‘Indigenous participation in Australian sport: the perils of the “panacea” proposition’, Cosmopolitan Civil Societies: An Interdisciplinary Journal, vol. 7, no, 1, pp. 53-79. DOI:10.5130/ccs.v7i1.4232 

Ferdinand, A. S., Paradies, Y. & Kelaher, M. 2015. Mental health impacts of racial discrimination in Australian culturally and linguistically diverse communities: A cross-sectional survey. BMC Public Health15(401), 1-10. DOI: 10.1186/s12889-015-1661-1

Harfield, SG, Davy, C, McArthur, A, Munn, Z, Brown, A & Brown, N 2018, ‘Characteristics of Indigenous primary health care service delivery models: A systematic scoping review’, Globalization and Health, vol. 14, no. 12, pp. 1-11. DOI: 10.1186/s12992-018-0332-2 

Jongen, C, McCalman, J & Bainbridge, R 2018, ‘Health workforce cultural competency interventions: A systematic scoping review’. BMC Health Services Research, vol. 18, no. 232, pp. 1-13. DOI: 10.1186/s12913-018-3001-5

Kalinda, G, Clare, Coleman, Fadwa, A, Joan, C, Gail, G, Lisa, W, Jackson, PL, Ian, R & Richard, M 2019, ‘The identification of Aboriginal and Torres Strait Islander people in official statistics and other data: Critical issues of international significance’ Statistical Journal of IAOS, vol. 35, no. 1, pp. 91-106.

Macedo, DM, Smithers, LG, Roberts, RM, Paradies, Y & Jamieson, LM. 2019, ‘Effects of racism on the socio-emotional wellbeing of Aboriginal Australian children’ International Journal for Equity in Health, vol. 18, no. 132, pp. 1-10. DOI: 10.1186/s12939-019-1036-9

Morgan, J 2015, ‘Indigenous Australians and the struggle for health equality’, The Lancet Respiratory Medicine, vol. 3, no 3, pp. 188–189. DOI: 10.1016/s2213-2600(15)00045-4 

Philpott, S 2016, ‘Planet of the Australians: Indigenous athletes and Australian football’s sports diplomacy’, Third World Quarterly, vol. 38, no. 4, pp. 862–881. DOI:10.1080/01436597.2016.1176857 

Sheppard, LK, Rynne, SB & Willis, JM. 2019, ‘Sport as a cultural offset in Aboriginal Australia’ Annals of Leisure Research, DOI: 10.1080/11745398.2019.1635895

Trent, M, Dooley, DG & Dougé, J 2019, ‘The impact of racism on child and adolescent health’, Pediatrics, vol. 144, no. 2, pp. 1-14. DOI:10.1542/peds.2019-1765 

Williams, DV 2019, ‘The continuing impact of amalgamation, assimilation and integration policies’, Journal of the Royal Society of New Zealand, vol. 49, no. 1, pp. 34-47, DOI: 10.1080/03036758.2019.1677252

Wynn, GT 2019, ‘The impact of racism on maternal health outcomes for black women’, The University of Miami Race & Social Justice Law Review, vol. 85.

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