CULTURAL DIVERSITY IN HEALTH CARE 1

  • Category:
    Nursing
  • Document type:
    Essay
  • Level:
    Undergraduate
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    2269

Cultural Diversity in Health Care

Cultural Diversity in Health Care

Native people globally have a common characteristic of suffering subjugation and imperialism. The colonial era that ran from the 17th century to the 20th century saw a high number of indigenous people including the Aboriginal Australians experience different hardships including displacement from their native lands, as well as denial of basic services including education and health care. Although the colonization era ended, indigenous Australians including the Aboriginals still experience augmented illness and mortality as compared to non-indigenous populations including the Anglo-Celtic people, who are the largest population group in Australia (Paradies, Harris, & Anderson, 2008). Health professionals need to understand the impact of both historical and current events on the health outcomes of both Australia’s indigenous and non-indigenous populations. Such understanding will ensure the provision of culturally sensitive care; therefore, ensure the improvement of the overall health of the indigenous people. This paper provides a comparison of how historical events and policies have affected the provision of health care to Aboriginal Australians and Anglo-Celtic peoples concerning risk factors and health outcomes of the two groups.

Historical Events and their Effect on Health Care

Colonization

The British arrival in Australia in the late eighteenth century marked the onset of an oppression era for Australian indigenous population. The colonialist introduced Western knowledge in Australia but at the same time established a dispossession period that aimed at the elimination of the Aboriginals and Torres-Strait Islander people. Reading and Wien (2009) explained the colonial era as one that involved high levels of vilification and suffering for the Aboriginals and Torres Strait Islander due to the minimal provision of health services by the British colonialists. During the same colonial period, the Anglo-Celtic people, who were Irish and British natives received high levels of health care; therefore, the non-native population flourished as compared to the native populations.

The colonial era also saw the displacement of Australia’s native populations from their ancestral lands. This displacement to other lands led to Aboriginals losing connections to their families and land. According to Australian Indigenous HealthInfoNet (2015), displacement from their indigenous land resulted in a negative effect on the social health determinants of Australia’s native population. The loss of their history, connection to family and land also had an effect on the emotional welfare of the Australia’s indigenous population. The Australian Bureau of Statistics (2014) reported that native Australians experienced augmented levels of psychological distress in comparison to non-native populations including the Anglo-Celtic people.

Segregation Era

The segregation period was characterized by a forced seclusion of the Aboriginals and Torres Strait Islander people to reserves that were far from their ancestral land. Jacobs (2009) reported the segregation of native Australians to have resulted in very poor living environments that were characterized by minimal access to health care as well as the little provision of food. The reduced access to health care in the missions and reserves resulted in an amplified death rate among the native Australian population. During this segregation period, the Anglo-Celtic population lived in the cities and towns; therefore, had adequate access to health care services.

The Australian Indigenous HealthInfoNet (2015) explained the isolation during the segregation period to still have an impact on the health outcomes of present day Aboriginals and Torres Strait Islander people. Present day Australia is characterized by the native populations living in remote and rural areas. Although the government has introduced health care facilities in these areas, specialized services including cancer treatment are still limited. Despite having a lower prevalence rate of cancer as compared to the Anglo-Celtic population, the Aboriginals still experience higher death rates as a result of cancer as compared to the non-indigenous Australians (Shahid, Finn, Bessarab, & Thompson, 2009). The Anglo-Celtic population experience high instances of cancer occurrence, but access to specialized services in major cities and towns has resulted in reduced mortality rates among this population.

The protection period also saw the introduction of tobacco and opium as tools of controlling the native population. The introduction of both these drugs in the reserves resulted in an increased number of users as compared to the non-indigenous population. Johnston and Thomas (2008) explained tobacco introduction in the reserves to have affected current tobacco use in Australia, with Aboriginals and Torres Strait Islander populations accounting for the higher number of smokers. Although tobacco use rates have been reducing in Australia, a higher population of both male and female aboriginals still engage in cigarette smoking as compared to Anglo-Celtic populations. The high use of tobacco among the indigenous population has resulted in increased risks of coronary diseases among this population as compared to the non-indigenous population (Australian Indigenous HealthInfoNet, 2015).

The Stolen Generation Period

The 20th Century saw a change of approach in how the non-natives majority dealt with the indigenous Australian population. The period between 1910 to 1970 saw the Australian Federal government implement a law that gave the authorities full governance on the lives of Aboriginal and Torres Strait Islander people. The implementation of this law saw the forceful removal of Torres Islander and Aboriginal children from their homes. The children were taken white institutions where they were raised (Smith, 2016). The removal of children from their homes had a major effect on the psychological and mental health of a large majority of the Aboriginal and Torres Strait Islander people. Some of the psychological issues that may have resulted from Aboriginal children being taken away from their homes include grief due to loss of the community, erosion of culture and identity as a result of forceful assimilation. According to Australian Indigenous HealthInfoNet (2015), native Australians report more instances of mental health problems when compared with non-indigenous Australian. The various emotional issues resulting from the stolen generation events have resulted in Aboriginals and Torres Strait Islander people reporting more cases of depression, PTSD, and anxiety. The Anglo-Celtic community did not experience the forceful removal of their children, due to them being the majority; therefore, a reduced number of mental issues such as anxiety, and PTSD.

Current Events and their Effect on Health Risks

The Historical events and legislations have a major impact on the current lives of the Aboriginal and Torres Strait Islander people. The forceful eviction from their ancestral land to reserves resulted in reduced opportunities for the native populations; therefore, increased poverty levels. (Calma, 2007). Indigenous populations in Australia experience higher levels of unemployment as compared to individuals in the non-indigenous populations. These high poverty rates have resulted in Aboriginals and Torres Strait Islander people having reduced access to health care services including medication. Calma (2007) explained the high poverty rates to result in a poor diet for children and infants, which is associated with an increased risk of developing chronic diseases such as Cancer and Diabetes. The poverty rates among the Torres Strait Islander and Aboriginal populations have also contributed to overcrowding in settlements; therefore, increased risk of spread of communicable diseases (Australian Indigenous HealthInfoNet, 2015). High rates of poverty may result in instances of chronic stress; which has a major impact on an individual’s immunity, metabolic functions, and circulatory system. Current living conditions for a majority of the Aboriginal and Torres Strait Islander population have resulted in increased health risks in the population. Historically, the Anglo-Celtic people remained to be the most favored by the federal government; therefore, have increased opportunities, which have resulted in better living conditions. A high number of the Anglo-Celtic population lives near big towns and cities; therefore, access to major health services. This population also comprises the highest number of employed individuals; therefore, access to medicines and specialized care is not limited to financial issues.

The last decade of the 20th century saw the emergence of a movement that sought to reconcile the native population, with the non-indigenous population. This period saw the court cases ruling in favor of the natives in matters involving land. Politicians and activists also gave powerful speeches aimed at informing the public on past injustices. The reconciliation period also saw the establishment of a commission that sought to return children separated from their parents during the separation era (Calma, 2007). These various activities by the government have had some impact on the health of Aboriginals and Torres Strait Islander people. The reconciliation process has resulted in a cultural change in different organizations; therefore, fully embracing the Aboriginal and Torres Strait Islander people in different areas of the society. The cultural change has resulted in increased opportunities for the native populations; thus, improved living standards, which results in overall improve in health. The process of reconciliation has resulted in the establishment of culturally sensitive health care in Australia; therefore, allowing access to medical care to the native population. Culturally sensitive care has also resulted in more Aboriginals and Torres Strait Islander people visiting health facilities; therefore, ensuring reduction of health risks affecting the population. The reconciliation period has however had minimal impact on the health risks of the non-indigenous population including the Anglo-Celtic population.

Impact of Policies on Health Outcomes

The 21st Century has seen the introduction of health policies aimed at improving the overall health of all Australians. Some of the policies have targeted the whole Australian population, with other policies targeting the native population only. One policy that has affected the health outcomes of Aboriginals and Torres Strait Islander people is the empowerment of native populations by allowing them to have control of local services including the management of health services in Indigenous communities. Smith (2016) explained giving control of health facilities to indigenous populations resulted in health benefits for the population as well as increased impact on primary care. Giving control of health services to the Aboriginal and Torres Strait Islander populations has resulted in reduced psychiatric admissions in mental hospitals due to the reduction in stress and depression cases. Giving control of health services to Native communities in Aboriginal and Torres Strait Islander territory has also resulted in an increased rates of cervical cancer screening of Aboriginal women (Calma, 2007). The introduction of the health policy allowing management of health facilities by Aboriginals and Torres Strait Islander populations has also resulted in pregnant women seeking antenatal care; therefore, reducing the number of prenatal deaths.

The other government policy that has affected the health outcomes of Aboriginals and Torres Strait Islander people is the policy that gave the government control over different areas of the native people lives. The intervention involved banning all alcohol in native Australian territory with the aim of reducing alcohol intake within the population. The intervention resulted in an overall reduction of alcohol consumption within the Northern Aboriginal territory; therefore, overall improvement in health care. The Australian government has also increased funding to ensure equality in health care. The majority of the funds allocated for improvements in healthcare have targetted the indigenous communities (Australian Indigenous HealthInfoNet, 2015). These improvements have resulted in the native population visiting health facilities more; therefore, improved health outcomes. The other policy that affected the health outcomes of Indigenous people in Australia is the introduction of community education in Aboriginal and Torres Strait Islander people. Education on health issues has allowed Australia’s native population to develop healthier practices including improving their diet as well as the cessation of smoking. Education has also resulted in the Native Australian populations understanding the need for constantly visiting health facilities for regular check ups.

Conclusion

The British arrival in Australia resulted in an era of oppression for the indigenous Australian population. The non-indigenous population introduces policies that favored them but introduced suffering to the Aboriginals and Torres Strait Islander people. During the past two hundred years, the Australian indigenous population has faced inequalities in health related issues. The population has experienced systemic discrimination; therefore, resulting in increased health risks in the native population as compared to the non-native population. The Australian federal government has however been introducing policies aimed at ensuring equality in health care. Some of the policies include allowing indigenous communities control over health facilities; therefore, ensuring improved health care among the native population. Other than the introduction of the policy, the government has also promoted cultural sensitive care in health care, which has allowed the Aboriginal and Torres Strait Islander people creating trustful relationships with health care providers.

References

Australian Indigenous HealthInfoNet. (2015). Factors contributing to Indigenous health. Retrieved from Australian Indigenous HealthInfoNet: http://www.healthinfonet.ecu.edu.au/states-territories-home/wa/reviews/our-review/health-risk-factors

Australian Indigenous HealthInfoNet. (2015). Summary of Australian Indigenous Health. Retrieved from Australian Indigenous HealthInfoNet: http://www.healthinfonet.ecu.edu.au/health-facts/summary

Calma, T. (2007, April). Social determinants and the health of Indigenous peoples in Australia – A human rights based approach. international Symposium on the Social Determinants of Indigenous Health.

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, 67, 1708–1716. Retrieved from https://www.researchgate.net/profile/Vanessa_Johnston/publication/23400327_Smoking_behaviours_in_a_remote_Australian_Indigenous_community_The_influence_of_family_and_other_factors/links/09e41508c91bf10743000000.pdf

Mental Health Commision. (2010). Aboriginal mental health. Retrieved from Government of Western Australia, Mental Health Commission: http://www.mentalhealth.wa.gov.au/mental_illness_and_health/mh_aboriginal.aspx

Paradies, Y., Harris, R., & Anderson, I. (2008, march). The Impact of Racism on Indigenous Health in Australia and Aotearoa: Towards a Research Agenda. Discussion Paper Series: No. 4. Casuarina: Cooperative Research 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, 9-132.

Smith, J. D. (2016). Australia’s rural, remote and Indigenous health : a social determinant perspective. Chatswood, N.S.W: Elsevier Australia.