Existing Healthcare Disparities Faced by Aboriginal/Torres Strait Islander Communities
As the country’s original occupants, Aboriginal and Torres Strait Islander (ATSI) peoples hold a special position in Australia, although they are yet to be fully acknowledged by the Australian system. Aboriginal and Torres Strait Islander peoples have unique rights outlined in international law.The paper comprises a reflection regarding the experiences of ATSI communities and the influence of cultural identity on health equity for Indigenous populations. Also, it explores the role of healthcare professionals and nurses in addressing healthcare gaps among Indigenous communities.
Reflection on Experiences of Aboriginal Torres Strait Islander Population
I have learned that, despite the recent advancements, Aboriginal and Torres Strait Islander people remain one of Australia’s most vulnerable populations. To better understand the Aboriginal Torres Strait Islander population, it is important to analyze important statistics regarding Aboriginal communities. Firstly, indigenous people comprise approximately 3.3% of the total Australian population. The number of Indigenous Australians in 2021 was projected by the Australian Bureau of Statistics (ABS) to be 881,600. Approximately 38% (337,400) of Indigenous Australians are expected to reside in major cities by 2021, while 18% (154,900) do so in remote and extremely remote regions (IWGIA, 2022). Indigenous people made up a larger share of the population overall as remoteness rose, from 1.8% in major towns to 32% in remote and very remote locations. This means that most ATSI people live in remote areas and therefore face significant challenges in accessing healthcare services and educational and employment opportunities due to increased distance barriers. It is also important to note that the median age of the non-indigenous population is 38, compared to 23 for the Aboriginal and Torres Strait Islander populations. According to projections, 32% of Australians who identify as Indigenous will be under the age of 15 in 2021, compared to 18% of non-Indigenous Australians, while just 5.4% of Indigenous Australians will be over 65, as opposed to 17% of non-Indigenous Australians (IWGIA, 2022). This means that the indigenous Australian population mostly comprises young people. Interventions to address the unique challenges affecting indigenous communities should therefore focus on improving the well-being of the youth population.
I have also learnt that Indigenous people were forced to abandon their traditional way of life, including diet, which contributes to poor health among the population. ATSI communities were denied access to their traditional territories, cultural knowledge, and food systems after the invasion and subsequent colonization of Australia through dispossession and forced assimilation. Traditional foods rich in protein, fibre, and micronutrients were replaced, first by rations regulated by the government and subsequently by a forced Western diet pattern heavy on sugar, grain, fatty meat, and salt, which has contributed to a high frequency of chronic diseases linked to diet(Christidis et al., 2021). Like many other First Nations Peoples across the world, Aboriginal and Torres Strait Islander Peoples today have a ten-year life expectancy difference from the rest of Australia.
The persistent disparity in socioeconomic and health outcomes between Indigenous and non-Indigenous Australians may be explained by racism, a major driver of Indigenous Australians’ health. According to research, adult Indigenous Victorians were four times more likely to have encountered racism than their non-Indigenous colleagues(Markwick et al., 2019). For instance, the Australian criminal justice system disproportionately over-represents Aboriginal and Torres Strait Islander peoples, with 2,481 convicts per 100,000 Indigenous peopleâ€”15 times more than the non-indigenous population (IWGIA, 2022).
However, the mere denial of racism’s existence is one of the most enduring features of the conversation about racism in Australia today. The social taboo against openly expressing racist beliefs has resulted in the development of strategies that present unfavourable views of minority groups as reasonable and justified while absolving the accusations of racism, according to a review of the linguistic and discursive patterns of contemporary speech settings in Australia (Markwick et al., 2019). This helps to limit political initiatives to alleviate racism, strengthening systemic racism.
Cultural Identity and Understanding Influence on Health Equity for Indigenous Communities
Importance of Cultural Health Determinants
Cultural identity is a term used to describe a person’s sense of group identification. Indigenous peoples could be unable to participate fully in their treatment due to physical and biological limitations. There is no denying that individuals are more likely to trust those from their tribal grouping, who follow the same religion, belong to the same socioeconomic class, are of the same ethnicity, and have comparable physical characteristics. With someone from a distinctively different ethnic group, it is more challenging to foster a warm and welcoming environment, a greater connection, and a more personal relationship (Li, 2017). Because of this, it makes sense why some indigenous people object to receiving medical care from a white doctor, alleging a lack of cultural safety.
The cultural determinants of health centre on an Indigenous understanding ofhealth, emphasising values that provide life and give people, families, and communities the ability to be resilient and empowered. Australian Aboriginal people view health as a holistic notion. Beyond a biological definition of health, well-being for the person and the community comprises physical, social, emotional, spiritual, and ecological aspects (Verbunt et al., 2021). A strong cultural identification may give someone a sense of self-worth, community, and purpose. A connection to a cultural group whose members shares and reinforce one another’s belief systems, values, duties, and practices might trigger this process. Research has shown that maintaining a strong cultural identity and/or engaging in cultural activities may have health advantages. For instance, research has also demonstrated that having a strong cultural identity fosters resilience, improves self-esteem, fosters pro-social coping mechanisms, and acts as a safeguard against mental health symptoms. Furthermore, cultural identification may alleviate the anguish brought on by discrimination(Shepherd et al., 2017).Awareness of and participating in Indigenous cultures has thus been associated with better life satisfaction, better educational and job results, and better self-rated health.
Cultural Health Disparities
The improper cultural assumptions healthcare workers hold towards Torres Strait Islanders and Aboriginal Australians are a rarer but still significant problem. Fewer than 40% of the community services in Australia that are financed by the government provide medical coverage to Aboriginal Australians and Torres Strait Islanders. Health clinics and centres are concentrated in urban areas with 400 nurses per 100,000 people, or twice as many as in rural locations where indigenous Australians and Torres Strait Islanders dwell. In addition, life expectancy was predicted to be 11.5 years shorter than that of the nonâ€“indigenous population for men and 9.7 years lower for females (Li, 2017). Indigenous people typically endure a much higher incidence of newborn and child mortality, perinatal mortality, low birth weight, and age-standardized death rates due to isolated, rural geographic settings, social-economic disparities and cultural differences(Oâ€™Donnell et al., 2019). Indigenous populations also have a higher infection rate with viral diseases, including HIV/AIDS, hepatitis, sexually transmitted infections, and chronic diseases like cardiovascular problems and diabetes mellitus (Jackson &Shiell, 2017). It is imperative to close the gap and guarantee that everyone, regardless of socioeconomic standing or circumstances, has fair, barrier-free access to healthcare to realize his or her full potential in terms of health.
Cultural barriers in the workplace include challenges that people may experience, such as different languages, customs and medical procedures, or gender and sexuality ideas. Cultural obstacles, which can result in major misunderstandings between people from different cultural backgrounds, are the fundamental reason healthcare results for Torres Strait Islanders and Aboriginal Australians are not up to pace (Topp et al., 2018). Indigenous Australians have uneven health as a result of these restrictions. According to the research, indigenous people are less likely to use conventional healthcare facilities because of their varied faith, beliefs, understandings, and interpretations of values, health, and identity (Gampa et al., 2017). Delays in receiving free health check-ups, cancer screenings, and follow-up hospital appointments are directly tied to their cultural ideas. Insteadof concentrating on individual health, indigenous tribes place more importance on maintaining daily routines and adhering to historical practices. As a result, cultural differences are a major influence in the dismal results of healthcare services for Torres Strait Islanders and Aboriginal Australians.
Role of Healthcare Professionals
A collection of harmonizing beliefs, ideas, attitudes, and practices that enable individuals to collaborate successfully across cultures has been widely characterized as cultural competence. Providing healthcare adapted to indigenous groups’ cultural and linguistic needs is strongly advised. Racial and ethnic inequalities in healthcare can be reduced by enhancing the cultural competency of healthcare practitioners and the healthcare system (McCalman et al., 2017). Healthcare professionals that have greater cultural understanding and competency might lessen healthcare inequities. According to the study, incorporating culture into service delivery, or attempting to comprehend a group’s values and fusing them with clinical procedures, abilities, and behaviours in the healthcare system, is one way to correctly respond to cultural obstacles.Organizations and healthcare providers must also collaborate to develop creative ideas to give solutions for establishing cultural competence (Bourke et al., 2022). Healthcare professionals can explain the healthcare system to indigenous and Torres Strait Islanders and win their trust by developing polite and nonjudgmental cultural communication skills.
Role of Nurses
By providing direct nursing care and upstream guidance, nurses, together with experts working in public health settings, significantly contribute to enhancing the health of indigenous peoples. Upstream techniques aim to identify the root cause of illness and preventable illnesses, address consequences through prevention as opposed to treatment, and start care early to ward off illness. By providing direct nursing care and upstream navigation, nurses significantly contribute to enhancing the health of indigenous peoples with professionals in public health workplaces (Marcellus et al., 2022). By addressing complications through prevention rather than treatment and starting care in advance to prevent individuals from being unwell, upstream techniques aim to identify the root cause of illness and preventable illness. Additionally, nurses are essential in reducing the effects of disorders, increasing health and well-being, and assisting individuals in leading fulfilling lives at home, at work, at leisure, and in their communities.
It is important to consider nurses’ expanded roles since they continually advocate for patients, show respect for all patients’ cultures, beliefs, and traditions, and advance moral and efficient cross-cultural healthcare for those from culturally varied backgrounds. According to research, education is crucial in shifting negative attitudes, dispelling myths and stereotypes, and enhancing nursing students’ familiarity with and respect for a culture that has faced serious hardships. Clinical nurses may organize a philanthropic club with volunteers in addition to providing culturally sensitive treatment for indigenous communities to help dispel myths and prejudices about indigenous Australians and Torres Strait Islanders (Martimianakis et al., 2019). Nurse managers are also essential in developing skilled nurses and providing clinical and operational leadership, management, and coordination of comprehensive healthcare services (Li, 2017). They are in a unique position to enhance the health outcomes for aboriginals since they strive to offer high-quality care and patient satisfaction.
ATSI communities experience a wide range of healthcare disparities compared to Non-indigenous Australians. Despite the Indigenous people being the first inhabitants of Australia, the communities have never been acknowledged by the Australian communities. A strong cultural identity fosters resilience, improves self-esteem, fosters pro-social coping mechanisms, and acts as a safeguard against mental health symptoms. Healthcare professionals, including nurses, can help address the healthcare inequalities faced by the Indigenous population through the development of cultural competency skills.
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