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What are the causes and effects of substance abuse and drug addiction problems among Aboriginal Australians?

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12DRUG ADDICTION AMONG RACIAL MINORITY GROUPS

What are the causes and effects of substance abuse and drug addiction problems among Aboriginal Australians?

Introduction

Australia is renowned globally as a multicultural country. In 2009, nearly 25 percent of the country’s population consisted of immigrants and individuals born overseas from nearly 200 countries globally. A majority of the country’s immigrants originate from the United Kingdom, New Zealand, China, and India, while the minority are the immigrant populations from the Middle East, northern Africa, and sub-Saharan and northern Africa. The Aboriginal Australians also make up a minority group of the Australian population (Booth et al., 2010). The minority groups in Australia face varied health challenges, including the probable vulnerability to alcohol and other drug (AOD) use. This has significant bearing on the functioning and organisation of the Australian society, as it creates tension (Markwick et al., 2014). According to Brown and Renzaho (2010), the stigma fixed to drug abuse has traditionally been reinforced by ethnic and racial stereotypes although in some other circumstances, it is the stereotypes themselves that compel young people into substance abuse. Indeed, it is such a complex cycle of reinforcement by the negative stereotypes, as well as drug abuse and marginalisation of the minority groups that forms the backdrop of this paper. With particular focus on the Aboriginal Australians, this paper examines how substance abuse and drug addiction affects the Aboriginal Australians, the social determinants of the health problem among them, and the likely stakeholders that can be engaged to address the social determinants of health problems.

An underlying research question guiding this paper, therefore, includes, “What are the causes and effects of substance abuse and drug addiction problems among Aboriginal Australians?”

Description of problem

In Australia, among the minority groups that are adversely affected by substance abuse and drug addiction are the Indigenous Australians (Markwick et al., 2014). As AIHW (2016) also established in a recent 2013 study, the Indigenous Australians are at greater risk of nicotine and alcohol abuse. The study revealed that the Aboriginal Australians are 2.5 (32 percent) times more likely to smoke tobacco each day as compared to non-Indigenous Australians (12.4 percent). Additionally, the Indigenous Australians are almost two times (19 percent) more likely to use cannabis compared to non-Indigenous Australians (20 percent).

The AIHW (2016) further highlighted that the Indigenous Australians witness considerably greater level of ill health. Based on the above data, the AIHW (2016) concluded that socioeconomic deprivations that Indigenous Australians experienced in comparison to the non-Indigenous Australians positioned them at greater risks of exposure to health risk factors, including to alcohol and tobacco abuse. Related studies have showed that Indigenous Australians experience disproportionate levels of health risks from tobacco and alcohol abuse (Markwick et al., 2014). A majority of the literature that investigated adolescent drug abuse identified risk for some adolescents, although more explicitly, found the minority youth to be specifically at risk of AOD exclusively due to their minority status (United Nations Office on Drugs and Crime, 2002). According to AIHW (2016), in Australia, alcohol is currently the most widely abused psychoactive drug. A survey by the National Drug Strategy Household Survey (NDSHS) in 2007 indicated that some 82.9% of the people in Australians of ages 14 years and over had used alcohol in the preceding 12 months. Only some 10.1% of the population studied admitted to not having used alcohol.

Social determinants of health among Aboriginal Australians

Studies have established a complex relationship among the broad social determinants, individual risks, and protective factors. This implies that some categories of the population are likely to perform better on health measures, such as misuse of drugs, in spite of their material deprivation (Aggleton et al., 2013). These factors can generally be describes as social determinants. According to Dick (2007), social determinants refer to the societal and environmental factors that tend to affect the health outcomes of individuals in a population of interest. Studies have showed that the social and economic factors have significant influence on people’s health or increase their potential to greater risks of ill health or drug abuse. A past study conducted by the United Nations Office on Drugs and Crime (UNODC) (2002) established a relationship between dependency of drugs, such as nicotine and alcohol and socioeconomic deprivation.

According to Australian Institute of Health and Welfare (AIHW) (2016), there is significant disparity in the health, health risk factors, and health behaviours of diverse racial groups in Australia. Such health ‘health inequities’ are linked to factors like Aboriginality, ethnicity, different access to education, income inequity, and gender. Some groups within the Australian population are at high risks of adopting harmful drug use behaviours. The economic and social factors affect the health obliquely, as they shape people’s drug-use behaviours since they directly affect accessibility to economic resources, marginalization, social welfare system, and conformity to medication (AIHW, 2016). For instance, the minority groups witness an excessively high degree of social issues, including social exclusion, which adversely affect their health, in turn contributing to inequalities in health among the drug users.

According to Wilkes et al. (2008), the social determinants of health for Aboriginal Australians also include the long-drawn consequences of dispossession, invasion, as well as other factors, such as racism, which affect their day-by-day lives. As discussed by Wilkes et al. (2008), after the European invasion of Australia in 1788, they proclaimed the lands “terra nullius,” or unoccupied by any one, in spite of finding close to 750,000 Aboriginal Australians who had been the occupants of the lands for close to 60,000 years (AIHW, 2016). During the European settlement, the Aboriginal people became dispossessed of their lands, as many were driven into government settlements. Additionally, until the mid-20th century, they were subjected to discriminatory legislations, which pervaded many aspects of their lives, as result determining how they should live, eat, or even interact. In all, the cruel history has been significantly implicated in the drug and substance abuse among many Aboriginal Australians (United Nations Office on Drugs and Crime, 2002).

The separation of the Aboriginal Australians into concentration camps denied them education opportunities, prospects into gainful employment and access to capital resources. Indeed, as earlier explained by AIHW (2016), the social determinants of health among Aboriginal Australians include employment status, educational attainments, societal mechanism that necessitate exclusion, accessibility and capital (Wilson et al., 2010). These also comprised the historical forces that characterised the lifestyles of the Aboriginal people during the early years of the 20th century. Empirical pieces of research since the 1970s have stressed the correlation between these social determinants of health and poor health status among the Aboriginal Australians. Several other Australian scholarly reports have as well identified the link between drug abuse and the unemployment, poor education opportunities and low income among the Aboriginal Australians (Wilson et al., 2010).

Effects of drug abuse

Smoking is problematic to the Indigenous Australia. As a study by AIHW (2016,) shows, the Indigenous Australians are at a higher risk of suffering from smoking-related illnesses, including cancers compared to other Australians, as they are 2.5 times more likely to smoke as compared to other Australian. They are also likely to die from alcohol related illnesses (28 percent) than the non-Indigenous Australians (22 percent). As regards the use of illicit drugs, a survey by AIHW (2016) showed that more Indigenous Australians use illicit drugs, such as cannabis, ecstasy and cocaine as compared to non-indigenous Australians (See Figure 1). For instance, more Indigenous Australians (1.6 times) are more likely to use illicit drugs than non-Indigenous Australia (Wilkes et al., 2008).

What are the causes and effects of substance abuse and drug addiction problems among Aboriginal Australians?

Figure 1: Drug use among Indigenous Australians (Wilkes et al., 2008).

Drug abuse has been cited to be contributing to a variety of social problems among Indigenous Australians, such as social disorder, violence, child neglecting, loss of employment, loss of income, and higher levels of incarceration. Drug abuse also has considerably harmful effects on the health of Indigenous Australians (Brown & Renzaho, 2010). During the last three decades, studies have showed that Aboriginal Australians are more likely to suffer from conditions caused by drug abuse compared to the non-Indigenous Australia. For instance, it has been cited severally that tobacco smoking is among the most preventable causes of death among the Indigenous Australians (Markwick et al., 2014). In a past study by Wilkes et al. (2008), it was indicated that some 7 percent of the Indigenous Australians died from alcohol abuse, and tended to die at a younger age due to alcohol abuse compared to the non-Indigenous Australians.

Additionally, alcohol abuse also significantly contributed to the hospitalisation of Indigenous people. In a past study of the rate of hospitalization between 1994 and 2000 in Western Australia, it was established that a high rate of hospitalisation for conditions resulting from drug psychoses had rose by up to 8 times to reach 22.4 per 10,000 people among the Aboriginal males. This indicates the significant effects of alcohol on hospitalization of the Indigenous Australians (Wilkes et al., 2008).

Several emotional and social effects have been associated with drug abuse among the Indigenous Australians. For instance, Wilkes et al. (2008) estimates that among the Indigenous Australians who had alcohol-dependence disorder in 2003, about 20 percent had anxiety disorder while 24 percent had an affective disorder. In a related study by Wilkes et al. (2008), it is indicated that Aboriginal men and women are more than four and three times respectively to be hospitalised for ‘mental disorders” attributed to drug abuse (See Table 1).

Table 1: Hospitalization for mental health among Aboriginal Australians (Wilkes et al., 2008)

What are the causes and effects of substance abuse and drug addiction problems among Aboriginal Australians? 1

Drug abuse has also been linked to suicide among Aboriginal Australians. For instance, between 2001 and 2001, the suicide rate among the Indigenous Australians in Western Australia, South Australia, Queensland, and Northern Territory was nearly 3 times that of non-Indigenous Australians. As showed in Table 2 below, the link between drug abuse, specifically alcohol abuse, and suicidal tendencies was a common contributor to alcohol-related deaths among Indigenous Australian males.

Table 2: Alcohol attributable death among Aboriginal Australians (Wilkes et al., 2008)

What are the causes and effects of substance abuse and drug addiction problems among Aboriginal Australians? 2

Potential stakeholders needed to address social determinants of health problems

Addressing the social health determinants requires the involvement of a wide variety of players, who seek engagement across various sectors and disciplines. They include all parties who take part in creating and implementing strategies that can reduce unemployment opportunities, facilitate educational opportunities, and increase income prospects among the Aboriginal Australians.

Government

The Commonwealth government, state and territory governments have a huge role to play in providing greater educational opportunities for the Aboriginal Australians, such as sponsoring free educational programmes (Griffiths et al., 2007).

Research organisations

The research and data collection organisations like Australian Bureau of Statistics (ABS), Australian Research Council, data collection and Australian Institute of Health and Welfare (AIHW) have a vital role to play in improving the health outcomes of Aboriginal Australians by finding relevant data to help understand strategies for improving health care access of Aboriginal Australians, and health equity among the Australians.

Local government

The local governments in Australian would need to design and control local amenities. Through their representative body called the Australian Local Government Association, they can increase primary healthcare access and access to adult educational programmes targeted at Aboriginal Australians (Australian National Preventive Health Agency, 2016).

Health care providers

The health care providers may act as knowledge purveyors by promoting the risks of drug use. They can as well participate in primary health care through Aboriginal community-controlled health services and Medicare Locals to start and support actions that improve Aboriginal Australians’ access to healthcare.

Workplaces

Various workplaces or employers across Australia can be engaged to define strategies to provide more employment opportunities for Aboriginal Australians. They vary from small to medium-sized business, corporate organisations, as well as government agencies (Australian National Preventive Health Agency, 2016).

Conclusion

The minority groups in Australia face varied health challenges, including the probable vulnerability to alcohol and other drug (AOD) use. This has significant bearing on the functioning and organisation of the Australian society, as it creates tension. In Australia, among the minority groups that are adversely affected by substance abuse and drug addiction are the Aboriginal Australians. The social health determinants problems affecting the Aboriginal Australians include health inequities, poor access to education, income inequity, poor employment opportunities, poor accessibility to capital resources and societal mechanism that necessitate exclusion.

Substance abuse has contributed to susceptibility to drug-related illnesses like cancer, social disorder, violence, child neglecting, loss of employment, loss of income, and higher levels of incarceration among the Aboriginal Australians. Additionally, alcohol abuse also significantly contributed to the hospitalisation of Indigenous people. It is also been linked to suicide among Aboriginal Australians. The potential stakeholders needed to address social determinants of health problems include Commonwealth government, state and territory governments, research organisations, local government, health care providers, and employers.

References

Aggleton, P., Ball, A. & Mane, P. (2013). Sex, Drugs and Young People: International Perspectives. New York: Routledge

Australian Institute of Health and Welfare (AIHW). (2016). Specific population groups. Retrieved: <http://www.aihw.gov.au/alcohol-and-other-drugs/ndshs-2013/ch8/>

Australian National Preventive Health Agency. (2016). The roles of different stakeholders. Retrieved: <http://health.gov.au/internet/anpha/publishing.nsf/Content/national-preventive-health-research-strategy~roles>

Booth, A., Leigh, A. & Varganova, E. (2010). Does Racial and Ethnic Discrimination Vary Across Minority Groups? Evidence from a Field Experiment. IZA Discussion Paper No. 4947

Brown, J. & Renzaho, A. (2010). Prevention of alcohol and other drug problems in culturally and linguistically diverse communities. Prevention Research Quarterly. retrieved: <http://www.druginfo.adf.org.au/attachments/175_ADFPRQJune10_final.pdf>

Dick, D. (2007). Social determinants and the health of Indigenous peoples in Australia – a human rights based approach. Australian Human Rights Commission. Retrieved: <https://www.humanrights.gov.au/news/speeches/social-determinants-and-health-indigenous-peoples-australia-human-rights-based>

Griffiths, J. Maggs, H. & George, E. (2007). ‘Stakeholder Involvement’ Background paper prepared for the WHO/WEF Joint Event on Preventing Noncommunicable Diseases in the Workplace (Dalian/ China, September 2007) . World Health Organisation. Retrieved: <http://www.who.int/dietphysicalactivity/griffiths-stakeholder-involvement.pdf>

Markwick, A., Ansari, Z., Sullivan, M., Parsons, L. & McNeil, J. (2014). Inequalities in the social determinants of health of Aboriginal and Torres Strait Islander People: a cross-sectional population-based study in the Australian state of Victoria. International Journal for Equity in Health, 13(91), DOI: 10.1186/s12939-014-0091-5

United Nations Office on Drugs and Crime (2002). Drug abuse prevention among youth from ethnic and indigenous minorities. Retrieved: <https://www.unodc.org/pdf/youthnet/handbook_ethnic_english.pdf>

Wilkes, E., Gray, D., Sagge, S., Casey, W. & Stearne, A. (2008). Substance Misuse and Mental Health among Aboriginal Australians. Retrieved: <http://creahw.org.au/media/54886/chapter9.pdf>

Wilson, M., Stearne A., Gray, D., Sherry S. (2010). The harmful use of alcohol amongst Indigenous Australians. Australian Indigenous HealthInfoNet