Indigenous Health Inequities Essay Example

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10INDIGENOUS HEALTH INEQUITIES

Indigenous Health Inequities

Indigenous Health Inequities

Closing the Gap, as mentioned by Australian Indigenous HealthInfoNet (2015) is a strategy that seeks to diminish disadvantage amongst the Indigenous people in terms of educational achievement, child mortality, life expectancy, employment outcomes early, and childhood education access. This strategy is Australian governments’ formal commitment to realise health equality amongst the Indigenous people in a span of 25 years. Early in 2008, Aboriginal and Torres Strait Islander people and Australian governments came to an agreement ‘to pool resources and join together in realising equality in health status as well as life expectancy between non-Indigenous Australians and Indigenous peoples by the year 2030. The Australian’s government’s core priority is achieving health equality since a good health is a key enabler in enabling the adults to work, the children to go to school, and building resilient as well as strong communities. To enhance access to integrated mental health and culturally sensitive services for the aboriginals the government invested $85 million over a span of three years, which started in 2016 (Department of Health, 2017).

Closing the Gap strategy has enabled the government to strengthen the links between family and child health services for indigenous families and access to primary health care services. Between 2015 and 2016, indigenous people received 8.7 million services related to Medicare (Department of Health, 2017). In 2015, an implementation Plan
that outlines the actions that the Australian Government and key stakeholders were planning to take was launched. As pointed out by Australian Government (2013), social determinants of health can explain between 33% and 50% of the gap in life expectancy since they affect the people’s health and could as well influence how people interact with health services. In addition, higher education levels are related to improved health literacy and healthier lifestyle choices. If socioeconomic barriers and disadvantage to health care access persist, the Aboriginal and Torres Strait Islander people will remain at risk of environmental factors like poor living and poverty. For over 25 years, the indigenous people have been denied a genuine say in their own lives as well as decisions which influence them. National Congress of Australia’s First Peoples (2017) argues that self-determination could help close the gap in health outcomes.

The varying approaches of both Territory as well as Federal State governments have created key hindrances in implementing the policy effectively to improve the health of Aboriginal and Torres Strait Islander peoples (Australian Human Right Commission, 2017). Every time a new government is elected, the relationships and approach are changed; thus, creating confusion, unnecessary complexity, uncertainty, and delays. According to the Productivity Commission, self-harm and mental health problems have increased alarmingly amongst the indigenous people and only 34 of 1000 indigenous programs, worth a staggering $5.9 billion, had been evaluated properly (The Australian, 2017). Still, there were some ­improvements in household income, educational outcomes, and child mortality rates. In the Prime Minister’s Report, it was observed that there were real successes at a local level across Australia by government, communities, individuals, and organisations. These improvements are not adequate to meet most of the outcomes that Council of Australian Governments (COAG) has set. The Prime Minister’s Report acknowledges that changes are happening and successes have been realised but the overall progress at the national level has been too slow. Still, the child mortality rate amongst the indigenous people has declined by 33 per cent and early childhood education enrolment has improved (Commonwealth of Australia, 2017). The other targets, according to the Prime Minister’s Report, are not on track.

According to AIHW (2017), 21% fewer indigenous people died as a result of avoidable causes in the duration between 2001 and 2010. The number of indigenous infants born of low birth weight is two times that of the non-Indigenous infants. Furthermore, only 1 per cent of health workforces are Indigenous. The Australian governments spent $4.6 billion in 2010–11 on ingenious people, but less than 21.5 per cent of aboriginals had used Medicare in 2013 to 2014 financial year (AIHW, 2017). As mentioned by Australian Human Rights Commission (2007), enhancing the Indigenous people’s health status in Australia is an enduring challenge for the governments. The health status gap between non-Indigenous and Indigenous Australians is still far too wide. Indigenous health inequality can be attributed to inequality in primary health care access and poor health infrastructure standard in Indigenous communities in contrast to non-indigenous Australians. Hitherto, the health status of the indigenous people is poor as compared to the non-indigenous population.
The Implementation Plan included seven domains that sought to improve health equality: the social and cultural determinants of health, adolescent as well as youth health, parenting and maternal health, effectiveness of health systems, healthy adults, childhood development and health and healthy ageing (Australian Government, 2013).

This demonstrates how enormous the inequality gap is in Australia. Besides that, Indigenous peoples have been denied an equal opportunity to improved healthcare. The socioeconomic disadvantage that Indigenous Australians experience put them at a greater risk of exposure to environmental as well as a behavioural health risk. This issues resulted in the introduction of the ‘Empowered Communities initiative’, which is considered as a new way for Indigenous communities and governments to team up in improving services, setting priorities, as well as applying for funding in an effective manner at the regional level. Essentially, the initiative seeks to improve Indigenous ownership and offer the Aboriginal and Torres Strait Islander people a greater say in decisions which affect them. Empowered Communities is associated with governments support for the Indigenous leaders who desire to bring forth positive changes in their regions as well as communities (DPMC, 2017). This initiative puts participation and culture of the Indigenous people to the centre and front of decisions made by the government. Up until now, the Australian Government has offered $5 million for supporting leaders of the Empowered Communities.

According to the Empowered Communities design report, the PM&C has started supporting an embedding adaptive learning approach that enables on-going progress tracking, allows for quick application of the lessons learnt across the regions, and supports innovation. This approach also enables the Government and Indigenous leaders to share responsibility while determining what is and what is not working with the goal of changing the actions accordingly. According to Empowered Communities (2017), this initiative is a long term initiative that would help create a balanced and genuine partnership between the government, Indigenous organisations as well as corporate Australia, where all and sundry collaborate towards a shared strategy. This initiative is important because it will reduce the socioeconomic disadvantage associated with indigenous people. Australian Human Rights Commission (2007) posits that there are associations between a person’s economic and social status as well as their health. Therefore, poverty is undoubtedly related to poor health. Amongst the indigenous people, poor literacy and education have resulted in poor health status, which consequently has affected how they utilise the health information. Besides that, poorer income amongst the indigenous people has reduced the accessibility of medicines and health care services.

As mentioned by Commonwealth of Australia (2014), the health behaviours origins are based on a multifaceted array of community, family, socioeconomic and environmental factors. Health inequalities are attributed to circumstances in which the indigenous people live and work as well as the systems set up to handle illness. The health gap between non‑Indigenous and Indigenous Australians is attributed to variances in socioeconomic status like income, employment and education. The gap in labour force participation between non‑Indigenous and Indigenous Australians can be reduced by adjusting levels of education, self-assessed health status and geographic dispersion. As pointed out by Forsyth and Gordon (2016), the Indigenous leaders under the Empowered Communities framework, develop a number planning elements such as development Agendas, first priorities agreements and deliver plans by consulting with their regional communities. In 2004, the Aboriginal and Torres Strait Islander commission (Atsic) was dismantled amid claims of improper nepotism, financial mismanagement and corruption. This re-centralised Indigenous Australia responsibility with Australian governments. Even though the Australian governments have spent billions of dollars on the Indigenous communities over last few decades, only minimal improvements have been achieved nationally.

Through Empowered Communities, the government is trying to give the Indigenous communities some autonomy in public services and funding. At the At the heart of the Empowered Communities initiative is that the government policies have for many years side-lined the local agendas. As a result, the local responsibility has been undermined, resulting in the poor outcomes and on-going dependence amongst the Indigenous people. The government has spent billions of dollars on the Indigenous people with the aim of improving their well-being and health outcomes, but little has been achieved. This initiative provides programs and policies that focus more on the tailored local solutions. When programs fail, the Empowered Communities will enable the Indigenous people to make the needed changes so as to facilitate effectiveness.

References

AIHW. (2017). http://www.aihw.gov.au/indigenous-australians/. Retrieved from Australian Institute of Health and Welfare: http://www.aihw.gov.au/indigenous-australians/

Australian Government. (2013). National Aboriginal and Torres Strait Islander Health Plan 2013-2023: The Social Determinants of Health. Department of Health, Canberra .

Australian Human Right Commission. (2017). Close the Gap – Progress & Priorities Report 2017. Retrieved from Australian Human Rights Commission: https://www.humanrights.gov.au/our-work/aboriginal-and-torres-strait-islander-social-justice/publications/close-gap-progress-0

Australian Human Rights Commission. (2007). Social determinants and the health of Indigenous peoples in Australia – a human rights based approach. International Symposium on the Social Determinants of Indigenous Health. Adelaide. Retrieved from https://www.humanrights.gov.au/news/speeches/social-determinants-and-health-indigenous-peoples-australia-human-rights-based

Australian Indigenous HealthInfoNet. (2015). What is Closing the Gap? Retrieved from Australian Indigenous HealthInfoNet: http://www.healthinfonet.ecu.edu.au/closing-the-gap/key-facts/what-is-closing-the-gap

Commonwealth of Australia. (2014). Aboriginal and Torres Strait Islander Health Performance Framework 2014 Report. Retrieved from Department of the Prime Minister and Cabinet: https://www.pmc.gov.au/sites/default/files/publications/indigenous/Health-Performance-Framework-2014/aboriginal-and-torres-strait-islander-health-performance-framework-2014-report/social-determinants.html

Commonwealth of Australia. (2017). Closing the Gap Prime Minister’s Report 2017. Retrieved from Department of the Prime Minister and Cabinet: http://closingthegap.pmc.gov.au/sites/default/files/ctg-report-2017.pdf or access via the web link: http://closingthegap.pmc.gov.au/

Department of Health. (2017, January 5). Close the Gap. Retrieved from Department of Health: http://www.health.gov.au/internet/main/publishing.nsf/Content/mc15-002185-close-the-gap

DPMC. (2017). Empowered Communities. Retrieved from Department of the Prime Minister and Cabinet: https://www.pmc.gov.au/indigenous-affairs/empowered-communities

Empowered Communities. (2017). Empowered Communities. Retrieved from Empowered Communities: http://empoweredcommunities.org.au/

Forsyth, L., & Gordon, S. (2016). Empowering Indigenous communities . Retrieved from KPMG: https://home.kpmg.com/au/en/home/insights/2016/10/indigenous-economy-empowering-communities.html

National Congress of Australia’s First Peoples. (2017). Redfern Statement A call for urgent Government action. Retrieved from National Congress of Australia’s First Peoples: http://nationalcongress.com.au/about-us/redfern-statement/

The Australian. (2017, April 21). $5.9bn fails to close the indigenous gaps. Retrieved from The Australian: http://www.theaustralian.com.au/national-affairs/indigenous/59bn-fails-to-close-the-indigenous-gaps/news-story/d3e687dcfa6d3f7ffc185457786a545d