Discuss about the Aboriginal and Torres Strait Islander Health.
The current assignment focuses upon the aspect of improvement of indigenous health by development of community based structures or models. In the current study, the Australia based aboriginal and Torres Strait islander people have been taken into consideration. In this respect, focus has been shifted upon the primary health care services. The assignment further emphasises upon the holistic approaches for emotional and social well being of the aboriginal and Torres Strait islander people. The indigenous health takes into consideration the physical, social, cultural and emotional well being of the aboriginal and Torres Strait islander people. The indigenous Australians compared to their non-indigenous counterparts have high mortality rates. Thus, a number of factors could be discussed over here which considerably affects the health patterns of the indigenous Australians. Some of these are social exclusion, poverty, unemployment, cultural sensitization. One of the major factors which have contributed to towards unequal health distribution in the indigenous Australians is paramount social exclusion. This could be further attributed to culture and language differences which prevents the population subsets consisting of the indigenous and the non-indigenous group from feely intermixing with each other. The gap is further represented in the form of unequal access to the basic living needs. Evolution of Aboriginal Community Controlled Health Organisations (ACCHO) and its application to Indigenous health management
The particular section discusses the evolution of the aboriginal community controlled health organizations (ACCHO). They have a history of being a sustainable, grass root organization that contributes significantly towards making a community self sufficient. The ACCHO continues to play a pivotal role in the empowerment of the aboriginal and Torres Strait islander people by development and implementation of local government responses (naccho.org.au, 2018). Some of these are provided in the form of effective collaboration between hospitals and local aboriginal medical services.
The aboriginal medical services (AMS) have been developed in order to provide improved and quality primary care services to the indigenous Australians. The primary healthcare services provision has been discussed further with regards to the Queensland region. Some of these have been discussed in the later sections. However, a number of other indigenous support care frameworks have been discussed over here such as close the gap. It is an indigenous health campaign aimed at improving responsiveness to health services for the aboriginal and Torres islander people (humanrights.gov.au, 2018). One of the main goals of the close the gap service was to speed up the referral processes between primary and acute healthcare services. It was aimed at improving the life expectancy of people. The close the gap services were aimed at increasing the control over life and physical environment of the aboriginal and Torres islander people. The close the gaps services also focuses upon the aspect of the inclusion of more and more indigenous health workers. This could help in dealing with the aspect of cultural sensitization within the aboriginal and Torres Strait islander people.
In the current context, the Queensland region of Australia has been taken into consideration. One of the mentionable services active in the Queensland could be mentioned over here which is the Northern Aboriginal Torres Strait Islander Health Alliance Limited (NATSIHAL). It is a medical service operational in Queensland with an annual turnover of $76,323 (Northern Aboriginal and Torres Strait Islander Health Alliance Limited, 2018). It is a registered charity and has been implemented within the Queensland region owing to large number of indigenous population residing in the area. It was found that one in three aboriginal and Torres Strait islander lives in Queensland. As reported Bainbridge et al. (2015), the Queensland population make up 3.7 % of the indigenous population. 50% of the indigenous population living in Queensland were less than 20 years of age (Smith et al., 2015). The indigenous group compared to their non-indigenous counterparts have been found to experience more ill health and disability. The health gaps cost the Queensland health system add an additional $245 million. The NATSIHAL aims to remove some of these health disparities by free funding the primary health care (PHC) in the area (Northern Aboriginal and Torres Strait Islander Health Alliance Limited, 2018). Some of the factors which influence the health gap in the indigenous community are- social and economic determinants, health system performance and health risk factors. It has been seen that the indigenous group of people have the highest rates of discharge against medical advice (DAMA). Most of the times, the indigenous community cannot afford the long stay at the hospital wards owing to the costly medical bills (Carey, 2013). Additionally, there is a gap in the support and care services from the government. The remote habitats of the indigenous community make it difficult for the healthcare workers to reach out to them (Bennett-Levy, Singer, DuBois & Hyde, 2017). Additionally, the high rates of addiction to smoking and drinking within the indigenous population group can make them more prone to development of ill health management.
The primary healthcare is applied within the Queensland aboriginal community with the help “Making tracks towards closing the gap in health outcomes for indigenous Queenslanders by 2033: policy and accountability frameworks” (humanrights.gov.au, 2018). It is an evidence based policy framework aimed at gaining sustainable health measures for the aboriginal and Torres islander people. As mentioned by Khoury (2015), the framework is aimed at making the healthcare services more accessible for the indigenous Queenslanders. It addresses two national indigenous health reforms – to close the gap expectancy in life by 2033 and halve the gap in child mortality by 2018 (Couzos & Thiele, 2016). It aims at providing culturally capable health services which would be readily acceptable across all culture and religions.
A vast difference lies in the conception of health and well being between the western and the indigenous aboriginal, Torres Strait islander group of people. As reported by Smith et al. (2015), indigenous people indulge in risky health behaviours more often than non-indigenous group of people. However as argued by Carey et al. (2017), there has been a lack of studies effectively highlighting the reason contributing towards the adoption or indulgence in health risk behaviour by the indigenous group of people. Some of these include the socio-economic and psychological factors. The others include a strong desire to retain cultural identity along with strong social connections intensified by cultural obligations. As mentioned by Waterworth, Pescud, Braham, Dimmock & Rosenberg (2015), the social marginalisation led to communication disruption between the two groups on matters of health. This further developed a situation of mistrust between the two communication groups leading to less exchange of information, which further affects their health behaviour or patterns.
The indigenous group of people are much more attached to their cultural roots and often lack a sense of trust in the healthcare system. 70% of the health gaps between the indigenous and non-indigenous group of people can be explained on the basis of non-communicable diseases. The highest rates have been noted for that of cardiovascular disease that of 23% followed by diabetes and mental health disorders which are 12% and 10% respectively within the indigenous population group (Hunt et al., 2015).
Additionally, lack of cultural competence of the healthcare system has also resulted in high rates of discharge against medical advice (DAMA) in the indigenous population group. The high amount of vigilance associated with the intensive care units of the hospitals have also been seen to disrupt the privacy concerns of the indigenous population group. The rate of contraction of the mental health disorders is 5% compared to 0.5% in the non-indigenous population group (naccho.org.au, 2018). The poverty and poor socio-economic conditions also affects the social and emotional well being (SEWB) of the indigenous group of people. 23.7% of the indigenous community have been seen to indulge in health risk behaviours compared to 11.1% in the non-indigenous population groups (humanrights.gov.au, 2018). The disparity could be attributed to the high amount of social neglect present within the population. Additionally, lack of sufficient amount of health education is another driving factor. As mentioned by Carey et al. (2017), the social neglect often mentally aggravates one to the point of indulging in health risking behaviours such as indulgence in drugs and alcohol.
In this respect, the implementation of cultural competency framework can help the nursing professional in understanding the mental dilemmas of the indigenous group of people. The women of the indigenous group often do not feel comfortable in receiving extended care at hospitals. As commented by McGough, Wynaden & Wright (2018), the privacy concerns prevent moist of the indigenous population group from availing of the healthcare services. The implementation of departmental cultural safety and policy also helps in the helps in the development of a culturally competent nursing care management.
Conclusion
The current study focuses upon the concept of delivery of effective care and support services to the indigenous population group. This has been further discussed with the help of ACCHO and AMS policies and programs. The services have been introduced in order to provide sufficient empowerment to the indigenous group of people. The study here also takes into consideration some of the effective policies and programs introduced by the government such as close the gap program. The policy aims at providing fast referral systems for the ones suffering from chronic illness.
However, a number of gaps were found in the implementation of the effective health and support care services for the indigenous population group. These could be attributed to the different cultural and social beliefs of the population. Additionally, the social gaps results in high level of mistrust between the different population groups. Hence, the indigenous group of population are sceptical regarding acceptance of the healthcare services, as the language barriers limits their ability to understand the delivery of certain medical procedures and services. Therefore, absorption of more and more indigenous community health workers can help in removing the biases.
References
Bainbridge, R., Tsey, K., McCalman, J., Kinchin, I., Saunders, V., Lui, F. W., … & Lawson, K. (2015). No one’s discussing the elephant in the room: contemplating questions of research impact and benefit in Aboriginal and Torres Strait Islander Australian health research. BMC Public Health, 15(1), 696. Retrieved from: https://doi.org/10.1186/s12889-015-2052-3
Bennett-Levy, J., Singer, J., DuBois, S., & Hyde, K. (2017). Translating e-mental health into practice: what are the barriers and enablers to e-mental health implementation by Aboriginal and Torres Strait Islander health professionals?. Journal of medical Internet research, 19(1). doi: 10.2196/jmir.6269
Carey, T. A. (2013). Defining Australian Indigenous wellbeing: do we really want the answer? Implications for policy and practice. Psychotherapy and Politics International, 11(3), 182-194. Retrieved from: https://doi.org/10.1002/ppi.1305
Carey, T. A., Dudgeon, P., Hammond, S. W., Hirvonen, T., Kyrios, M., Roufeil, L., & Smith, P. (2017). The Australian Psychological Society’s Apology to Aboriginal and Torres Strait Islander People. Australian Psychologist, 52(4), 261-267. Retrieved from: https://doi.org/10.1111/ap.12300
Couzos, S., & Thiele, D. D. (2016). Aboriginal peoples participation in their health care: A patient right and an obligation for health care providers. Aboriginal and Islander Health Worker Journal, 40, 6. Retrieved from: https://search.informit.com.au/documentSummary;dn=787446442102726;res=IELIND
humanrights.gov.au (2018). humanrights.gov.au . Retrieved 16 April, from: https://www.humanrights.gov.au/our-work/aboriginal-and-torres-strait-islander-social-justice/projects/close-gap-indigenous-health
Hunt, L., Ramjan, L., McDonald, G., Koch, J., Baird, D., & Salamonson, Y. (2015). Nursing students’ perspectives of the health and healthcare issues of Australian Indigenous people. Nurse education today, 35(3), 461-467. DOI: https://doi.org/10.1016/j.nedt.2014.11.019
Khoury, P. (2015). Beyond the biomedical paradigm: The formation and development of Indigenous community-controlled health organizations in Australia. International Journal of Health Services, 45(3), 471-494. Retrieved from: https://journals.sagepub.com/doi/abs/10.1177/0020731415584557
McGough, S., Wynaden, D., & Wright, M. (2018). Experience of providing cultural safety in mental health to Aboriginal patients: A grounded theory study. International journal of mental health nursing, 27(1), 204-213. Retrieved from: https://doi.org/10.1111/inm.12310
naccho.org.au (2018). naccho.org.au. Retrieved 15 April 2018, from: https://www.naccho.org.au/about/aboriginal-health/definitions/
Northern Aboriginal and Torres Strait Islander Health Alliance Limited (2018). Cemi.com.au. Retrieved 16 April 2018, from https://cemi.com.au/node/9211
Smith, J. D., Springer, S., Togno, J., Martin, M., Murphy, B., & Wolfe, C. (2015). Developing a cultural immersion approach to teaching Aboriginal and Torres Strait Islander health and culture. LIME Good Practice Case Studies Volume 3, 39. Retrieved from: https://search.informit.com.au/documentSummary;dn=050469477173926;res=IELIND
Waterworth, P., Pescud, M., Braham, R., Dimmock, J., & Rosenberg, M. (2015). Factors Influencing the Health Behaviour of Indigenous Australians: Perspectives from Support People. PLoS ONE, 10(11), 323. Retrieved from: https://doi.org/10.1371/journal.pone.0142323
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