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First Peoples Health Outcomes 3


Critical Analysis of Colonization’s effect on Contemporary First People’s Health Outcomes

Indigenous people everywhere have the common signifier of suffering imperialism and subjugation. Indigenous Australians, as well as the Maori, are observed to suffer higher levels of illness and mortality in comparison to the non-indigenous populations (Paradies, Harris, & Anderson, 2008). Nursing professionals need to inculcate a culturally sensitive approach in their practice, where they comprehend the impact of imperialism, colonialism, and policy on Australia’s indigenous people (Edwards & Sherwood, 2006). This paper analyses the impact of history and imperialism on first people’s health outcomes, with specific concern on how specific policy periods affected the indigenous people health outcomes, including the ability of Australia’s first people to develop trustful relationships within the healthcare system.

Impact of Policy Eras on Indigenous People Health Outcomes


The arrival of British colonialists in Australia in the late 1700s marked the beginning of an era for Australia’s indigenous people. The British came with their western knowledge, but at the same time established an era of oppression and dispossession for the First Peoples. Colonialism sought the elimination of the Aboriginal and the Torres Strait Islander people from the land. The colonial policy era sought the vilification and eradication of the aboriginal and the Torres Strait Islander people (Reading & Wien, 2009). During this policy era, the indigenous Australians received minimal attention from the public health system.

Other than the lack of attention, colonialism resulted in the displacement of the Torres Strait Islander people and Aboriginals from their native lands. This displacement resulted in most indigenous people losing their connection to their lands, and families; therefore, had a negative impact on social determinants of health (Australian Indigenous HealthInfoNet, 2015). The displacement from their native lands during the colonial era, still has an impact on Australian first people health outcomes, as they generally report lower quality of life. The loss of connection to land, loss of history, and disintegration of community connections during the colonialism era had and still has a negative impact on the social and emotional wellbeing of Australia’s first peoples (Australian Bureau of Statistics, 2014). Indigenous people report higher instances of psychological distress as compared to other non-indigenous people due to negative historical experiences including displacement during colonisation period.

Protection Through Segregation

The protection era saw the forced seclusion of Australia’s first people into reserves. The period saw the indigenous people live under extremely poor conditions, characterized by low provision of food and other rations (Jacobs, 2009). The segregation of the Aboriginals and Torres Strait Islander people to the reserves and missions resulted in reduced accessibility to health care services. During the protection era, health services in the reserves were limited, which resulted in the deaths of many of the indigenous people. This isolation still has an impact on present indigenous people health outcomes as the majority of this population still has limited access to certain health services (Australian Indigenous HealthInfoNet, 2015). The majority of Australia’s first people still live in rural and remote locations; therefore, access to specialized health services, including cancer treatment, is limited, resulting in poorer health outcomes as compared to non-indigenous people (Shahid, Finn, Bessarab, & Thompson, 2009). The use of tobacco and Opium during the protection era as a control tool also has an impact on current first people health outcomes. Johnston and Thomas (2008) reported the use of tobacco to control indigenous people in the reserves and missions resulted in an increased number of tobacco users among the first people’s population. Although the tobacco use rates have been reducing, indigenous people still account for the highest percentage of tobacco users, which may be an after effect of the protection era.

Impact of Policy Eras on First People’s Ability to Develop Trustful Relationships

These two policy eras also affected the Indigenous community ability to develop trustful relationships with health care professionals. Both the colonialism and protection era involved the separation of Australia’s first people from the non-indigenous population. This separation may have resulted in reduced trust between the indigenous population and non-indigenous community. The displacement and segregation may also have resulted in increased hatred against the non-indigenous population; therefore, impact first people’s ability to develop trusting relationships with health practitioners.

Both the colonialism and protection era involved high instances of social injustices including taking away of half-white children from their families. These instances of social injustice had a negative impact on the emotional and social wellbeing of both the Torres Strait Islander people and Aboriginal people. Most of the indigenous people report higher instances of psychological distress as compared to non-indigenous people. These high instances of psychological distress may limit indigenous people’s ability to develop relationships.

Strengths-Based Approaches Used in Creation of Trustful relationships with Indigenous Communities

The strength-based approach involves cooperation between the individual or group receiving assistance and those offering the help; therefore, allowing them to discover strengths that the person or group in need of help may have. Health care practitioners can employ different strength based approaches in developing relationships with indigenous communities in Australia. Health care practitioners may decide on using a Solution Focused Therapy to help build trusting relationships with the indigenous community. The approach mainly focuses on the development of a solution rather than solving the problem (Pattoni., 2012). This approach focuses on past and present issues with concentration of future plans. Using a solution-focused therapy may assist in understanding indigenous people future goals; therefore, development of a solution meant to solve past problems in the future. A strength based approach would involve the identification of some of the indigenous people strengths; therefore, align them to achieve future goals. A Solution based therapy would result in the development of a trusting relationship between Australia’s first people and health practitioners.

Health practitioners may also choose to use a narrative approach ion the developing trusting relationships with Australia’s first people. A narrative approach involves the reframing of different situations to reveal strengths that may assist to improve resilience (Hall, 2006). Applying a narrative approach would involve a health care professional revisiting problems faced by indigenous populations; therefore, determine strengths that may help ease the problem. Using such an approach would help in the development of a trusting relationship between health practitioners and the indigenous population.

Another approach that may assist in developing trustful relationships with the indigenous population is the use of a Strengths-Based Case Management. The approach involves a consideration of the strengths in combination with supportive networks to help solve the problem. A Strengths-Based Case Management approach mainly focuses on developing a relationship between the case manager and their clients.


The arrival of the British in Australia resulted in an era of oppression for the original inhabitants of Australia. The various policies instituted by the non-indigenous populations further resulted in increased oppression for Australia’s first people which ended in the late twentieth century after it was established that the indigenous people could not be eliminated easily. This change in perspective has resulted in Australia’s first people receiving better treatment from the government. However, despite the change, the various policies instituted as a way of oppression still have an impact on indigenous community health outcomes as well as their ability to develop trusting relationships with health care professionals. However, the use of strength-based approaches may assist in solving some of these issues including the problem of creating trusting relationships between non-indigenous professionals and indigenous people.


Australian Bureau of Statistics, 2014. Australian Aboriginal and Torres Strait Islander health survey: first results, Australia, 2012-13. [Online]
Available at: http://www.ausstats.abs.gov.au/ausstats/subscriber.nsf/0/D95C8DD56A6EDD7DCA257D4E0017034D/$File/4727.0.55.003_7.zip

Australian Indigenous HealthInfoNet, 2015. Summary of Australian Indigenous Health. [Online]
Available at: http://www.healthinfonet.ecu.edu.au/health-facts/summary

Edwards, T. & Sherwood, J., 2006. Decolonisation: A critical step for improving Aboriginal health. Contemporary Nurse, pp. 22(2) 178-190.

Hall, J. M., 2006. Understanding the Person through Narrative. Nursing Research and Practice, pp. 367() 1775-1785.

Jacobs, M. D., 2009. White Mother to a Dark Race: Settler Colonialism, Maternalism, and the Removal of Indigenous Children in the American West and Australia, 1880-1940. Lincoln: University of Nebraska Press.

Johnston, V. & Thomas, D. P., 2008. Smoking behaviours in a remote Australian Indigenous community: The influence of family and other factors. Social Science & Medicine, Volume 67, p. 1708–1716.

Paradies, Y., Harris, R. & Anderson, I., 2008. The Impact of Racism on Indigenous Health in Australia and Aotearoa: Towards a Research Agenda. Casuarina: Cooperative Research Centre for Aboriginal Health.

Pattoni., L., 2012. Strengths-based approaches for working with individuals. iriss Insight, Issue 16.

Reading, C. & Wien, F., 2009. Health Inequalities and Social Determinants of Aboriginal People’s Health, British Columbia: National Collaborating Centre for Aboriginal Health.

Shahid, S., Finn, L., Bessarab, D. & Thompson, S., 2009. Understanding, beliefs and perspectives of Aboriginal people in Western Australia about cancer and its impact on access to cancer services. BMC Health Services Research, pp. 9-132.