Cultural Effects On Aboriginal Health Essay

Current Issue
Studies have shown Aboriginal health to be much poorer than that of non-indigenous Canadians (Oster, Mayan, & Toth, 2014). This correlates with the skyrocketing rate of diabetes mellitus, which has risen over the past decades because of harmful, dramatic changes in the lifestyle of Aboriginals (Health Canada, 2013b). An increasing number of this aggregate are smoking, eating processed foods, and making other harmful choices towards personal health, all of which are modifiable (Health Canada, 2013b). Other non-modifiable aspects that have also contributed to this increased rate include various psychosocial factors stemming from a history of assimilation, in which cultural values and practices diminished and various barriers Cultural Effects On Aboriginal Health Essay

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When reviewing these determinants, it is noted that many negatively affect the health of this aggregate (Reading & Wein, 2009). This is because many Aboriginals live in poverty and poverty’s effects create tension among various aspects of one’s life (Reading, & Wein, 2009). This tension may lead to the surfacing of many health-related issues, including lack of access to nutrient dense food, decreased health education, minimal recreation opportunities, and lack of social support, each of which can deter those with or are at risk of developing diabetes from proper management and care (Brooks, Darroch, & Giles, 2013). In addition to these aspects, poverty can bring about a sense of losing control over one’s life. This can result in stress, which can accumulate and cause increasing vulnerability towards health-related issues, such as diabetes mellitus  Cultural Effects On Aboriginal Health Essay
Not only can Aboriginal poverty lead to the development of diabetes, but it can also further exacerbate its effects and impact aspects of social and emotional wellness as well as physical health (Anderson 2011). From this, the need for social change in addition to the call to decrease the rate of Aboriginal diabetes were relayed to the Canadian government and acknowledged in 1999 through the establishment of the Aboriginal Diabetes Initiative (ADI) (Health Canada, 2013b). The ADI was developed to advocate for health promotion and diabetes prevention among this aggregate. Initially, this process fell exclusively on the community itself (Health Canada, 2013b). That is, the community and its members were to build upon personal assets and strengths in order to meet community and individual needs (Gottlieb, 2014).Cultural Effects On Aboriginal Health Essay

The health status of Australia’s indigenous people today remains far below that of the general population, with life expectancies comparable to India and Central Africa. Many nurses working in Australia find themselves in remote areas caring mainly for Aboriginal people of whom they have little understanding. It is hoped this paper will provide a basic awareness of indigenous Australians and the reasons for the ill health they experience today.

Indigenous Australians have lived in Australia for over 50,000 years and their culture encompassed over 500 tribes with individual languages and customs, with certain commonalities that could perhaps be compared to the common links between different European cultures.Cultural Effects On Aboriginal Health Essay

In the lifetime of a few generations this distinct culture has had to adapt to changes which took thousands of years to spread in other parts of the world.

When Captain Cook landed in Australia in 1770, despite encounters with indigenous people, he claimed that the land was uninhabited and Britain procured ‘legal’ ownership by classifying Australia as ‘terra nullius’, meaning ’empty continent’.

There was both legal and scientific support for a racist attitude towards the indigenous population, who were used by Charles Darwin and the evolutionary scientists as evidence of a “missing link” between man and the animal kingdom. This resulted in treatment such as hunting, rape and massacre of the Aboriginal people on a huge scale.

It is acknowledged that “few doubted at the time that Genocide was official policy. A government report in the 1850s spoke of the success of poisoning Aborigines; 100 of them laid out at a time”. Although the Aborigines resisted, their population was swiftly decimated by violence, as well as a lack of immunity to introduced diseases.Cultural Effects On Aboriginal Health Essay

Since European colonisation, Australian governments have dominated the lives of indigenous Australians, who are claimed to be the most legislated people in the world. Reserves and missions were set up and Aborigines were forcibly moved to them, where they lived in crowded, dirty conditions, with high morbidity and mortality rates.Cultural Effects On Aboriginal Health Essay

Until the early 1970s an Assimiliation Policy legalised the forcible removal of light skinned children from their darker parents, in an attempt to assimilate these ‘half castes’ into mainstream society. Police were used to find and take the children, with orders not to tell the children or parents where they were being taken. Although there were some exceptions, most parents did not freely give up their children, and usually contact between families was discouraged or prevented. The experiences of these children were varied, from those exposed to various forms of exploitation, to those who found happiness with adoptive families.

Many Australians today will argue that the practises of forcible removal had beneficial outcomes for the children who were taken. Irrespective of the intentions of the policy makers at the time, the National Inquiry into the Stolen Generations found that compared with people who were not removed, these children are in fact not better educated, not more likely to be employed, and not receiving significantly higher incomes. They are twice as likely to have been arrested more than once in the past five years, and twice as likely to assess their own health status as poor or only fair.Cultural Effects On Aboriginal Health Essay

In 1997 the Cooperative Research Centre for Aboriginal and Tropical Health (CRCATH) Board requested a review
of the four subprograms of its Indigenous Health and Education Research program: Health Priorities and Communication of Health Information, Indigenous Education and Health Program, Health Ethics, and Cross-Cultural Education
for Non-Aboriginal People. The review’s fi ndings were to inform decisions about future research directions for the program, and two research fellows were employed to conduct the investigation. The information and the three papers in
this publication report on the review of the two subprograms Health Priorities and Communication of Health Information, and Cross-Cultural Education for Non-Aboriginal People conducted by the author during the fi rst half of 1998.
The scope of the review
The original brief was restricted to a review of the relevant literature. However, particularly in the two subprograms
addressed by this report, the formal literature is limited and refl ects, predominantly, the perspectives of non-Indigenous
researchers. The process was, therefore, broadened to provide an opportunity for the views of stakeholders, particularly
Indigenous and non-Indigenous service providers, to also inform the review. Because of limited resources and time,
the review’s consultation process was not exhaustive, but rather opportunistic: a range of people from different regions
and organisations were invited to participate in informal individual or small group discussions about the subprogram
relevant to their interests. The investigation consisted of four stages:Cultural Effects On Aboriginal Health Essay
• a literature search utilised major health and education databases as well as various internet search
engines, and individuals and organisations were contacted to access published literature and to locate
unpublished information related to the two subprogram areas
• discussions were held in three regions—Darwin, East Arnhem Land and Alice Springs—with a range
of stakeholders, including Aboriginal and non-Aboriginal people working in a variety of health
care settings, and others with expertise in relevant areas (see list of main organisations involved
on next page)
• the synthesis of information from all of the above sources to identify key themes and specifi c project
ideas
• the verifi cation of fi ndings and suggestions with a range of people who were involved in the
consultations, and with others who responded to draft papers
The limitations of the review
There were a number of factors that restricted the extent and depth of the review of the two subprograms Health Priorities and Communication of Health Information, and Cross-Cultural Education for Non-Aboriginal People:
• insuffi cient time to consult all key stakeholders in all regions; an attempt was made to ensure a key
interest group from at least one of each of the three regions was represented Cultural Effects On Aboriginal Health Essay
• support and guidance for the two selected subprograms was limited due to the predominant focus by
the CRCATH’s Indigenous Health and Education Research program reference group and program
management on research in the Indigenous Education and Health subprogram
• a review of literature related to the health priorities aspect of the subprogram Health Priorities
and Communication of Health Information was not conducted even though its aim—‘to promote
Aboriginal participation in the two-way communication of health information and setting of health
service priorities in the context of Indigenous beliefs about personal and cultural wellbeing’ (CRC
Commonwealth Agreement Schedule 1)—was central to the planning and process of the review
• because of the scarcity of published literature, written material was diffi cult and time consuming to
locate, highlighting the serious lack of research which has occurred in this area, despite its central
importance to health service delivery—the amount of useful written information located but no
longer in circulation was also disturbing
“working together…making a difference”
vi
The main organisations involved in the review process
Darwin
Territory Health Services: Darwin Rural (medical and allied health), Darwin Urban, Health Promotion, Aboriginal
Cultural Awareness Program
Northern Territory Department of Education (Student Services, Aboriginal Education)Cultural Effects On Aboriginal Health Essay
Northern Territory University (Faculty of Aboriginal and Torres Strait Islander Studies, Education Faculty, Centre for
Indigenous Natural Cultural Resource Management)
Indigenous Education Council of the Northern Territory
Aboriginal Resource and Development Services
Menzies School of Health Research
Northern Territory Offi ce of Aboriginal Development
Batchelor Institute of Indigenous Tertiary Education
East Arnhem Land
Territory Health Services: management, Aboriginal Liaison, Aged and Disability Services
Aboriginal Resource and Development Services
Northern Territory Department of Education: regional offi ce and community school
Miwatj Health Service
Ngalkanbuy Health Centre
Miwatj Aboriginal and Torres Strait Islander Commission Regional Council
Aboriginal users of health services
Galiwin’ku Community Council
Marthakal Homelands Resource Centre
Galiwin’ku Women’s Centre
Strong Women, Strong Babies, Strong Culture Program
Alice Springs
Territory Health Services: Allied Health, Hospital Liaison Team, Department of Rehabilitation and Physical Therapy,
Aboriginal Cultural Awareness Program
Northern Territory Department of Education
Batchelor Institute of Indigenous Tertiary Education
Institute for Aboriginal Development: Aboriginal Translating and Interpreting Services, cross-cultural training
program, language education program
Aboriginal interpreters and linguists working in various regions
“working together…making a difference”
vii
The outcomes of the review Cultural Effects On Aboriginal Health Essay
An initial draft set of papers, which documented in detail the findings of the review, was presented in May 1998. Based
on this initial draft, three papers reporting the review findings and project suggestions were subsequently developed:
‘Communication in Aboriginal health care: An overview’, ‘Communication in Aboriginal health care: Where are the
interpreters?’ and ‘Cross-cultural education for service providers in Aboriginal health care’. These papers were written
as independent documents; some repetition has resulted from bringing them together in one document.
Specifi c suggestions for possible CRCATH research identifi ed as part of the review process were presented as project
concepts for consideration by the CRCATH’s Indigenous Health and Education Research program reference group.
Some of these suggestions are:
• a research project to identify and document the extent and nature of miscommunication in acute
health care settings
• an evaluation of employment of interpreters in a remote community clinic
• a workshop for the stakeholders in cross-cultural training
• participation in the development of a cross-cultural training program to meet the
specifi c needs of a community-controlled health organisation
• development of multimedia training materials in cross-cultural communication
These and a range of other possible actions to address identifi ed concerns are described in more detail in the papers
that follow.
The three papers in this review were completed and submitted to the CRCATH’s Indigenous Health and Education
Research program leader in October 1998. The purpose of this plain-English publication, which has been delayed for
various reasons, is to provide an overview of the two subprograms—Health Priorities and Communication of Health
Information, and Cross-Cultural Education for Non-Aboriginal People—with a focus on identifying strategic directions for research in these two areas. Since1998, one of the suggestions for research related to miscommunication in
health care has been approved by the CRCATH Board and will proceed early 2001. At the time of publication, none
of the other actions identifi ed through the review had been pursued Cultural Effects On Aboriginal Health Essay

In the 1950s the Australian government sanctioned the testings of nine nuclear bombs by the British government on Australian land in Maralinga, South Australia and Monte Bello, Western Australia. These bombs were twenty times greater than the Nagasaki and Hiroshima bombs. It was known at the time that Aboriginal people were living in these areas. The effects included los of sight, skin rashes, radiation poisoning and hundreds of families forced to leave their homelands due to severe contamination.

Other legislation affecting Aboriginal people has included lack of equal pay, segregation and inequality of health care, curfews from certain towns and cities, and alcohol prohibition.Cultural Effects On Aboriginal Health Essay

The 1991 census counted the indigenous population at 265,459, or 1.6% of the total Australian population. Their unemployment statistics were almost three times those for non indigenous people. 63.5% of Aborigines reportedly earned less than $12,000 p/a, while 2.2% earned above $35,000. Females die 19 years younger and males 18 years younger than their non indigenous counterparts. Hospitalisation occurs at 70% (males) and 57% (females) higher than the national average. 25% of Aborigines live in remote areas, that is towns with less than 1,000 people, limiting their access to various services including health.

Despite these statistics, there is a belief within segments of Australian society, that Aborigines are not disadvantaged, and even that they live privileged lifestyles on government money.Cultural Effects On Aboriginal Health Essay

Alcohol prohibition to Aborigines was enforced in individual states and territories until between 1957-1972. This did not prevent their access to alcohol or other drugs, so they were often arrested for using alcohol. Exemption clauses existed, whereby those who could prove they complied with required standards of hygiene, intellect and good (non indigenous) company, could legally consume alcohol. Like many other indigenous populations throughout the world, some Aborigines now associate ‘drinking alcohol’ with ‘equality and status’. Further causes of alcohol and substance abuse in the indigenous population include low self esteem, depression and alienation.Cultural Effects On Aboriginal Health Essay

Growing use of other illegal substances such as petrol sniffing and kava misuse are creating major social problems in some areas. Related causes of morbidity and mortality include accidental or violent injury, toxicity, epilepsy, heart disease, hypoglycaemia, pancreatitis, cirrhossis and pneumonia.

Aboriginal people are placed in police custody at up to 26 times the rate for non indigenous people. They are over represented for offences of disorderliness, assault and drunkenness, whilst being under represented for homicide, robbery, theft, fraud, sexual offences, driving and drug offences.Cultural Effects On Aboriginal Health Essay

In 1991 the Royal Commission into Aboriginal Deaths in Custody published it’s final report. Despite evidence showing likelihood that a considerable number of Aboriginal deaths in custody between 1982 and 1991 were the result of violence by police or prison officers, investigations into these cases were not recommended and have not taken place. However, the recommendations made did include vetting police and prison officers, abolishing public drunkenness as an offence, and presuming homicide rather than suicide when investigating future cases of Aboriginal deaths in custody.Cultural Effects On Aboriginal Health Essay

Diseases such as obesity, diabetes mellitus, hypertension and cardiovascular disease are causing high rates of premature mortality in the indigenous population. Many Aboriginal people consume large amounts of sugar, meat and tea, which became their staple diet during the days of missions and reserves.

Renal disease is ten times higher in the Aboriginal population than non indigenous Australians. There are a number of reasons, including non insulin dependent diabetes, glomerulonephritis (often resulting from widespread outbreaks of streptococcal skin infections), hypertension and chronic infections.

Malnutrition is experienced by half of the children in some communities. Reasons for this include poor maternal health, low birth weight, diarrhoeal and other diseases resulting in loss of appetite and malabsorption, along with the social issues of family disruption and disintegration.

Although infant mortality has declined since the 1970s, childhood infectious diseases remain rife and are recognised as having a close relationship with standards of living. Diarrhoeal disease is acknowledged as a serious health problem in many Aboriginal communities, especially among infants and children who are at higher risk of associated dehydration and malnutrition. Lack of good quality water, poor hygiene, unsafe sewage disposal and contact with poorly kept animals such as dogs which carry and transmit bacteria and parasites are common reasons. Other conditions resulting from substandard living conditions which are prevalent in Aboriginal children include pneumonia, upper airway infections, otitis media and skin infections.Cultural Effects On Aboriginal Health Essay

Trachoma is disproportionately prevalent in the Aboriginal population. This results in a large proportion of avoidable blindness in Aborigines.

Tuberculosis among Aborigines is 15 to 20 times higher than in non indigenous people. Overcrowding and homelessness combined with diseases such as malnutrition, alcoholism, renal failure and diabetes mellitus are all high risk factors for tuberculosis infection.

Sexually Transmitted Diseases (STDs) are very high among certain Aboriginal groups and can be difficult to diagnose and treat. Whilst HIV is thought to be uncommon in Aborigines at present, the infection rate could change rapidly given it’s history of rapid change in overseas populations, and the high risk factors Aborigines are exposed to.Cultural Effects On Aboriginal Health Essay

Given the disproportionately high rates of hospitalisation occurring in the indigenous population, the overall health care system which serves these people remains dominated by a western, authoritarian approach. It is vital that nurses and other health care professionals working with Aboriginal people educate themselves in the issues specific to Aboriginal health. Understanding the ways in which Aboriginal people view health and illness will provide the health professional with an understanding of why hospitalisation is resisted by many and only used as a last resort.Cultural Effects On Aboriginal Health Essay

Aboriginal people today combine traditional therapies with mainstream health care methods. Traditional healers will sometimes visit patients in hospital to perform or administer therapies, and they are used much more frequently in community settings.

Australians often perceive neglect and vandalism of houses as a form of cultural behaviour inherent in Aboriginal people. However, a publication about health inequalities in Britain noted that bad design of buildings can lead to a lack of respect by some inhabitants. Living in squalid conditions was in turn associated with depression and mental illness.Cultural Effects On Aboriginal Health Essay

A study conducted in a remote Australian community in 1994 negated the theory that lack of respect in Aboriginal housing can be explained by ‘cultural’ behaviour. To the contrary, it was found that when functional houses are provided which are adequately maintained, for example plumbing and electrical faults repaired, Aboriginal people do look after their homes. Poor construction was attributable to 70% of the maintenance costs in this study.Cultural Effects On Aboriginal Health Essay

A survey in 1992 found that over 300 Aboriginal communities nationwide did not have adequate water supplies and 134 did not have a proper sewerage system. In 1991 one third of the Northern Territory’s Aboriginal population were reported to have no access to a safe water supply. Personal accounts are heard of Aboriginal people spending large amounts of their small income on purchasing bottled water for domestic consumption.Cultural Effects On Aboriginal Health Essay

In the 1990s both the Native Title Act and the Wik Decision were passed in Australian courts amidst a frenzy of fear and protest. The Native Title Act overturned the previously held law of “terra nullius” which had stood for 200 years. Indigenous people now had a legal basis to claim ownership of land with which they can prove they have maintained traditional ties. The High Court recognise that Native Title has been extinguished on all freehold and most leasehold land due to dispossession of such land from the indigenous people since European colonisation. As a result, Native Title only applies to a small percentage of Aboriginal people and mainly to remote Australia.

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The Wik Decision 1996 was passed on appeal by the High Court of Australia. It concluded that the Wik and Thayorre people of Far North Queensland had native title of the land on which they live, which is an Aboriginal reserve upon hich their people have maintained continuous occupation. Such title is in co-existence with a pastoral lease of the same land which has never been permanently occupied or fenced, and carries a small number of unbranded cattle. The current lease expires in 2004. However, the High Court ruled that native title rights would be subordinate to those of the leaseholder in any cases of conflict.Cultural Effects On Aboriginal Health Essay

Despite these facts, and although pastoralists have never had exclusive possession of pastoral lease land, the frenzy in the wake of the Wik Decision led to leasehold pastoralists en masse, demanding freehold title to their leasehold land, which Prime Minister Howard is in support of.

Sheryl Kernot, the leader of the Australian Democrat Party, in 1997 called for an “understanding of the way in which traditional and historical connection to land and water and cultural resources is central to the identity of indigenous Australians, to their community, and to their sense of justice”. Land which indigenous people have maintained traditional ties with should, as a basic human right which we are all entitled to, be inherited by it’s inhabitants. Evidence shows that when such land rights are accorded to Aboriginal people, they become capable of self determination and the resulting positive effects include improved health. To this day, mainstream political support for indigenous land rights remains unattainable.Cultural Effects On Aboriginal Health Essay

Conclusion

It is recognised by many that indigenous people themselves need to make positive changes to their circumstances, and take responsibility for their own health status. Aboriginal people are calling for self determination. However, a self determining culture requires the necessary resources, such as educational standards within their own population, and political support, before they can take control of their own situation.

This paper demonstrates the link between Aboriginal culture, Australian history and the ill health of Australia’s indigenous people today. There is an argument for stronger social and political support, for renouncing the dominant ethnocentric view and trying to understand the broader needs of a disadvantaged people. Our association with Aboriginal communities gives health professionals a responsibility to be informed about the wider issues affecting their individual and social health. Nurses have a unique and important role to play in advocating for the needs of indigenous people.Cultural Effects On Aboriginal Health Essay

This assignment will be focusing on indigenous culture and their health. A national strategy ‘Closing the Gap’ will be initially summarised to explore the current gaps and the plans that have been taken by the Australian state and federal governments. The health issues of indigenous Australians will be reviewed in comparison with the non-indigenous population, which will include a discussion about how the European settlers are considered to have contributed to the current health and psychosocial concerns of indigenous people. Additionally, the health of indigenous Australians will be compared with other indigenous groups in the world. Finally, health promotion strategies initiated by the governments to improve indigenous health outcomes will be identified and additional interventions will be proposed.Cultural Effects On Aboriginal Health Essay

Closing the Gap Campaign

Although Australia is considered one of the richest countries in the world, indigenous Australians continue to suffer systematic inequalities and can expect to live 10-17 years less than non-indigenous Australians (Australian Human Rights Commission, 2014). In 2008, a formal apology was made to indigenous Australians and the Government acknowledged, recognised and apologised for their past wrongdoings and committed to taking further steps for indigenous health equality (Australian Government, 2009). This is known as the Closing the Gap Campaign. The goal of the Closing the Gap Campaign is to close the health and life expectancy gap between Indigenous and non-indigenous Australians within a generation. The Australian Governments committed to working towards reaching six targets to reduce the visible gaps in life expectancy, infant and child mortality, childhood education, literacy and numeracy skills, school completion rates and employment rate (Commonwealth of Australia, 2010). The Governments have implemented strategies to the recognised areas, or the Building Blocks: early childhood, schooling, health, healthy homes, safe communities, economic participation, governance and leadership. Also, a report is being published annually on the progress that Australia has made towards this national objective.Cultural Effects On Aboriginal Health Essay

Morbidity and Mortality

In 2006-2010, the mortality rate for indigenous Australians was 1.9 times greater than for non-indigenous people across all age groups. Approximately 50% of indigenous people reported having a disability or long-term health condition and hospitalisation rate for indigenous people were 40% higher than other Australians (Commonwealth of Australia, 2011)

Babies born to indigenous families were twice as likely to be of low birth weight compared to non-indigenous babies, in 2005-2007. The death rate of indigenous infants and children is double the rate of non-indigenous infants. Maternal mortality rates for indigenous women were 2-5 times greater than for the non-indigenous women (Australian Institute of Health and Welfare, n.d).Cultural Effects On Aboriginal Health Essay

In 2008, 32% of young adult indigenous people (aged 16-24 years) reported having high levels of psychological distress, which was 2.5 times the rate for non-indigenous people (Commonwealth of Australia, 2011). Moreover, indigenous young adults died at a rate 2.5 times as high as that of the non-indigenous population. For adults aged 35-45, the death rate was 6-8 times higher than the national average (Australian Indigenous HealthInfornet, 2013a). It was estimated that 12.4% of indigenous people aged over 45 years have dementia, compared to 2.6% of non-indigenous people in that age group (National Aboriginal Community Controlled Health Organisation, 2012). Around 44% of older indigenous adults reported their health as poor and the mortality rate in aged indigenous population is doubled the non-indigenous rate.

Health Issues

For many thousands of years before European settlement in1788, indigenous people enjoyed good health and harmonious existence, relying on a hunter and gatherer life. Connection to the land is fundamental to indigenous wellbeing and the core of all spirituality (Aboriginal Heritage Office, n.d.). Both men and women participated in hunting and they sourced food from the water, hinterlands of the area and the surrounding bush. Since European settlement, indigenous cultural heritage has been broken and indigenous people have experienced disadvantage in aspects of living standards, life expectancy, education, health and employment (Australian Government, 2009).Cultural Effects On Aboriginal Health Essay

Outcomes for education, employment, income and housing are much poorer than that of non-indigenous people (Australian Indigenous HealthInfornet, 2013a). During the 2004-2005 National Aboriginal and Torres Strait Islander Health Survey (Australian Bureau of Statistics, 2006), around 12% of indigenous people reported having long term cardiovascular diseases and this rate was 1.3 times higher than non-indigenous. Many indigenous people experience significantly higher rates of cancer, diabetes, psychological distress, renal disease and respiratory disease than the national average.Cultural Effects On Aboriginal Health Essay

Influence of Non-indigenous population

European settlement has had a devastating impact on indigenous health and psychosocial wellbeing, which can be traced back to the beginning of colonisation. In the time following settlement in 1788, 10 million people have arrived in Australia and made it their home (National Museum Australia, n.d.). In this time, many of the natural resources were affected: fish supplies were depleted, native animal population were reduced and feral animals introduced, land was cleared and waterways were polluted. It is believed that many infectious diseases, such as measles, smallpox, influenza and tuberculosis, were introduced by the new settlers (The Fred Hollows Foundation, n.d.). These diseases caused major loss of life among indigenous populations and resulted in depopulation and social disruption. Direct conflicts and occupation of indigenous homelands meant that indigenous people lost control over many aspects of their lives. This loss of autonomy affected the capability of indigenous people to adapt to changes, which would eventually have consequence in poorer health status (Australian Indigenous HealthInfornet, 2013b).Cultural Effects On Aboriginal Health Essay

From the time European settlers first arrived in Australia, they had attempted to ‘civilise’ the ‘black races’. The Native Institution was designed to educate indigenous children in the European way; the policy of ‘protection’ led to indigenous people being placed on government reserves or in church missions; the policy of assimilation forced indigenous people to live in the same way and hold the same belief and values as the white Australians; many children were forcefully taken away from their families and placed in institutions or white families (Australian Museum, 2009). The children were brought up in Christian way, taught in English and raised to think and act as ‘white’.Cultural Effects On Aboriginal Health Essay

‘Civilisation’ led to a loss of identity and resulted in cultural and traditional practices being destroyed, families bonds being disconnected, and the whole communities being dispossessed.

Dispossession of traditional lands caused loss, emotional distress, trauma and separation and meant that indigenous people were not able to hunt anymore. (Rowena Ivers, 2011). Indigenous people faced discrimination in education and employment (Northern Territory Department of Health, 2007). People became more dependent on welfare and allowances and rations were paid for laboured work. This led to a change of eating habits.

Traditional food were less encouraged and rations and communal feeding were broadly available and convenient (Northern Territory Department of Health, 2007). Under the influence of rations and communal feeding, a transition of meal patterns from traditional diet to ‘westernised’ food has happened. Contemporary indigenous people may not want to resume the traditional hunter lifestyle or they may have lost the skills to hunt. The community store became their only food source. The community store usually stocked a very limited selection of food and popular foods are tinned meat and fruits, biscuits, tea, flour, sugar and tobacco. Fresh fruits and vegetables are less available in stores.Cultural Effects On Aboriginal Health Essay

Indigenous people began smoking when they were paid in tobacco rather than cash. The use of tobacco, alcohol and illicit drugs increases the risk of chronic disease, cancer, as well as other health concerns, such as mental disorders, accidents and injury (Australian Indigenous HealthInfornet, 2013a). Decreased levels of physical activity, less consumption of traditional diet and overeating of high energy foods are risk factors for non-communicable disorders, such as cardiovascular disease, cancer, diabetes and respiratory diseases.

Australian Indigenous vs. Worldwide Indigenous

Indigenous people are the traditional custodians of the land they have inhabited for thousands of years. There are approximately 370 million indigenous people worldwide, living in more than 70 countries (World Health Organisation, 2007). Despite the great diversity of indigenous peoples, many similarities exist between Australian indigenous and other indigenous groups.Cultural Effects On Aboriginal Health Essay

Traditional indigenous people rely on their land for survival and traditional life is linked to the land. Common to many indigenous groups, colonisation negatively affected their physical, emotional, social and mental health wellbeing. Colonisation led to racial prejudice and dispossession of traditional lands which often cause poverty, under education, unemployment and increased dependency on social welfare. The changes of lifestyle caused severe inequalities in indigenous heath status, including emotional and social wellbeing (World Health Organisation, 2007).

Overall, they experience poorer health compared with non-indigenous groups. Their health is associated with a range of environmental and socio-economic factors: poverty, malnutrition, overcrowding, poor hygiene, environmental contamination, and infections (United Nations, 2009). Indigenous people had little natural immunity to microorganisms that were introduced to the land. The devastating infections depopulated indigenous groups.

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Child health is influenced by inadequate nutrition, exposure to infectious diseases and poor living conditions. Childhood health complications are common in Australian indigenous groups as other indigenous groups elsewhere: low birth weight, skin infections, ear disease, dental caries, trachoma, parasite infection and respiratory infections. Although some diseases are prevalent in specific areas, the causes are similar: poor hygiene, malnutrition or water contamination.Cultural Effects On Aboriginal Health Essay

Many indigenous groups both in Australia and elsewhere do not have access to their traditional food and are highly dependent on commercially prepared food. Indigenous adolescents in Australia and other countries experience similar health related problems, such as tobacco and drug use, violence, mental and emotional disorders (Northern Territory Department of Health, 2007). Urbanisation causes rapid changes to indigenous lifestyle, foods high in calories, fat and salt and low in fibre. People live in an overcrowded and unhygienic environments and having less physical activity. The worsening of lifestyles has resulted in chronic diseases, such as obesity, hypertension, cardiovascular disease, type 2 diabetes and chronic renal disease.Cultural Effects On Aboriginal Health Essay

Australian indigenous people in 2001-2004 had the lowest life expectancy for both male and female, compared to indigenous groups from New Zealand, Canada and USA. They also had the highest infant mortality rate and lowest birth weight. When comparing the age standardised mortality rate in 2003, Australian indigenous groups have the highest mortality rate for cancer, cerebrovascular disease, intentional harm, diabetes and HIV.

Health promotion strategies

The Australian Governments have implemented a range of initiatives across the states during 2009 and up to 2014 By recognising the areas that needs to be improved that include improvements to early childhood, schooling, health, healthy homes, safe communities, economic participation, governance and leadership. Delivery of health promotion programs is guided by principles that ensure all programs meet the targets of the Closing the Gap while being appropriate to the communities’ needs. All programs have to engage the local indigenous people and should be time sufficient and accessible to all indigenous residents (Council of Australian Governments, 2009). All initiatives are related to the Building Blocks and best practice has been sought.Cultural Effects On Aboriginal Health Essay

For example, according to the latest Closing the Gap Prime Minister’s Report 2013,

health attention has been focused on implementing health promotions in the following areas that considered could facilitate achieving the goal of closing the gap in life expectancy and child mortality between indigenous and non-indigenous Australians. Areas such as chronic disease, primary health care, health service, food security, oral health, ear and eye health, acute rheumatic fever and rheumatic heart disease, substance misuse, Foetal Alcohol Spectrum Disorders, indigenous sexual health, mental health, aged care, sport and recreation, culture, remote airstrips and road safety (Department of Families, Housing, Community Services and Indigenous Affairs, 2013). Comprehensive strategies have been undertaken to encourage people in communities undergo health checks, provide training of healthcare workers, deliver education on lifestyle change and self-management, provide affordable medicines and fund advertisements to increase awareness.Cultural Effects On Aboriginal Health Essay

According to the Closing the Gap Clearinghouse annual report 2011-12 and 2012-13, some of the strategies work but may only have a short term effect (Closing the Gap Clearinghouse, 2013). However, some interventions trialled in indigenous community were unsuccessful because they were originally designed for non-indigenous populations and were considered culturally inappropriate. Education programs could have a limited impact on indigenous groups and may need to be employed in conjunction with other interventions. Barriers to the effective provision of program may arise due to short term and one-off funding, and the provision of the program may be discontinued due to indigenous groups’ capacity to provide the service. Often the data is incomplete and cannot be assessed for effectiveness.Cultural Effects On Aboriginal Health Essay

Proposal of additional interventions

The traditional indigenous people conceptualise their health as holistic. It encompasses everything: land, environment, family, relationship, community, law and the physical body. Health for indigenous people is the social, emotional and cultural wellbeing of the whole community and the identity of being indigenous (Australian Indigenous HealthInfornet, 2013b). The author’s proposal of interventions to improve indigenous health outcomes is to return to indigenous people the keys elements that have been taken from them: equality with other Australians, their identity, freedom, culture, self-determination and their traditional lands.Cultural Effects On Aboriginal Health Essay

They had good knowledge of their land, sources of water and food, the effects of seasonal cycles on plant foods and animals. Both men and women hunted food, which kept them physically active and emotionally well. The traditional diet had variety and was rich in nutrition: vegetable food provided vitamins and minerals and essential supplements for the body needs; meats were high in quantity and quality (Northern Territory Department of Health, 2007). Health and sickness were shaped by culture beliefs and traditions. Indigenous people believe that the protection of spirituality is fundamental to their health (1). Family relationship is at the core of indigenous kinship systems which is essential to their culture. Kinship helps to define roles and responsibilities for raising and educating children and provides the structure systems of moral and financial support. In indigenous society, family ties are healer to emotional and physical wellbeing.Cultural Effects On Aboriginal Health Essay

Indigenous people had a healthier lifestyle, had pride in their identity and their culture heritage was passed through generations. Their traditional cultures helped them to survive for thousands of years. The crisis indigenous people face today is the consequence of continuous years of inequality, disadvantage, discrimination and disenfranchisement. To close the gap between indigenous and non-Indigenous health, health providers need to consider the determinants of health, including socio-economic and political issues and their impact on indigenous people. It may remind non indigenous Australians to apply some self-criticism: to remember that they equal to us and all can enjoy the right to be free and exercise self-determination.Cultural Effects On Aboriginal Health Essay