First peoples – A critical reflection of the negative impact on health of First Peoples 1

populations

Aboriginal and Torres Strait Islander peoples - A critical reflection of the negative impact on

health of First Peoples populations

Critical reflection
First peoples – A critical reflection on high incidence and prevalence of certain 2
diseases

It is known that in modern society Aboriginal and Torres Strait Islander peoples are

lacking resources and attention in order to reduce incidence of frequent diseases and rise

thresholds for overall survival and event free survival (ABS, 2014). While some may say that the

root of this problem lies within the discrimination of providing health care services, studies have

shown that not only the medical services are at fault, but also culture discrepancies, racism, lack

of proper education, and the quality of life. These aforementioned topics are the five main

themes of the debate at question.

Firstly, inequity in health care services, as provided by medical practitioners, have been

reported to be different for indigenous population than non-indigenous ones, one of the reasons

being the lack of medical education within Australia’s population. In addition, practitioners

usually omit to provide attention to emotional, cultural and social aspects, focusing only on

physical care (Aspin et al., 2012). An example of high prevalence stemming from this aspect

would be elevated levels of cardiovascular disease, due to indigenous populations having a lower

chance of receiving cardiac interventions than non-Indigenous Australians (Heeley et al., 2010).

Secondly, culture differences also play a big role, given that appropriate screening tools are not

utilized. Furthermore, medical staff does not use a holistic approach during evaluation and

treatment by not taking in consideration factors such as connection to land, history, spirituality,

and interactions between western and local medicine. Another reason culture discrepancies are

impacting negatively health care is because of the colonization by Western populations, which

generated an onset of modifications of indigenous lifestyle (Short, D. (2016). Reconciliation and

colonial power: Indigenous rights in Australia. Routledge). The most prominent result from this

is the high frequency of mental diseases among Aboriginal and Torres Strait Islander peoples

(Jorm et al., 2012). In addition, racism, as a belief of non-indigenous, especially within

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diseases

healthcare system, is very problematic, resulting from enforcement of oppressive practices and

being racially selective in one’s services (Ziersch et al., 2011). Results from these congeries of

prejudices and privileges, especially the white privilege (Durey et al., 2012), dramatically impact

the health of First Peoples, generating: psychological distress, which can evolve to severe

depression, anxiety, and may raise the tendency to suicide, but also to dyspepsia within

gastrointestinal system, tachycardia, headaches; and abuse of substances such as alcohol and

tobacco (Ziersch et al., 2011). Another theme tightly correlated to the topic is lack of medical

education. Being scant, in addition to ignoring most symptoms due to lacking of knowledge

about probable occurring diseases, aggravates epidemiological statistics of Aboriginal and Torres

Strait Islander peoples. Delivering efficient and affordable medical care, as well as implementing

an orthodox action in medical education, has been proved to reduce the health care gap between

populations of Australia, elevating the availability and services in rural areas, and Aboriginal

communities of Australia (Murray et al., 2012).

Last but not least among the themes, quality of life is greatly impacted by the income and

environment of an indigenous person. An analysis from 2011 has reported that 42% of the

Aboriginal and Torres Strait Islander peoples over the age of 15 have less than $300 income, and

compared to non-indigenous Australians they earn less in most domains. Access to potable water,

effective sewerage systems and climate changes also affect the quality of life and may determine

a higher prevalence and incidence of certain diseases. (AIHW, 2015)

Reflecting and making judgments of these themes revolving around higher prevalence

and incidence within Aboriginal and Torres Strait Islander peoples, the assumptions made can be

that due to inequities, as well as lack of opportunities, indigenous population tends to suffer more

than non-indigenous population, in addition to losing trust in the health care providers. The main
First peoples – A critical reflection on high incidence and prevalence of certain 4
diseases

concerns regarding this topic remain the disparity of social, environment, and cultural aspects of

Australian populations along with racism towards Aboriginal and Torres Strait Islander peoples,

and the lack of a proactive movement in the medical field. Solving these problems and

acknowledging these themes could amplify the movement which aims to reduce the gap and also

provide indigenous populations particular medical attention. In addition, intensive knowledge

about the differences between races should be considered, as well as equal treatments and

facilities, resulting in a steadily decreasing prevalence and incidence of such populations.

Furthermore, the reasons for these differences are well known and supposedly changeable

through evidence-based actions and mechanisms as seem in the study on education on

cardiovascular diseases among First Peoples, which specifically instructed a cohort of patients

with applicable igieno-dietetic notions about their diseases. The result of these actions was a

decrease in the onset of a large percentage of probable comorbidities (Aspin et al., 2012). These

processes require more straightforward attention and in depth explorations are further needed in

order to abolish the disparities which consequently lead to higher rates of epidemiological

statistics.

In addition to the initial reflection, an evaluation of current cultures should also be

considered. Western culture and medical professional culture have had a steady tendency

towards multiculturalism in the last couple of decades, as a result, impacting perceptions and

interactions with indigenous persons while under health care. The result would be providing

inefficient medical services which may prove to be inappropriate towards indigenous population

(Rigby et al., 2010). Therefore, in this case, multiculturalism may not be the solution, since

preservation of indigenous culture is vital to Australian culture, the national goal being striving

for diversity recognition. The only purpose is to achieve cultural safety by understanding
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diseases

differences between cultures, the legitimacy of such differences and how own experiences

impact on other populations, and ultimately recognition of safe services as defined by those

receiving such.

Given the aforementioned topics, the underlying issues of these themes may be more

subtle than what can be observed objectively, accounting for both external and internal factors.

Diseases’ rates in indigenous population have been reported to differ from non-indigenous

Australians. The incidence statistics, in descending order for Aboriginal and Torres Islanders

peoples out of all disease-affected First Peoples, being: 23% cardiovascular disease, 15%

infectious diseases and perinatal conditions, 15% injuries, 12% diabetes, 10% mental disorders,

10% other non-communicable diseases, 9% chronic respiratory disease, and 6% cancers .

Mortality statistics are also an important to mention, since they reveal that the most significant

percentage of indigenous population deaths are by external causes, in addition to endocrine,

metabolic and nutritional disorders, compared to non-indigenous who are more likely to die of

cardiovascular diseases and cancer. These indirectly reflect why mortality within indigenous

population is far lower than non-indigenous Australians.

One first important factor which may determine disease outcome is represented by

particular biological characteristics. First Peoples have been reported to have suppressed immune

functions, with variations to the endocrine and adrenergic systems. In addition, they are

genetically prone to develop hypertension, weight gain and insulin resistance (Vos et al. 2009).

Secondly, there have been found 11 main behavior-related risk factors, which may generate the

onset of a disease in Aboriginal and Torres Strait Islander Peoples have been assessed to be :

12% tobacco use, 11% high BMI, 8% sedentary lifestyle, 8% high levels of blood lipids

including cholesterol, 5% alcohol consumption, 5% arterial hypertension, 3% imbalanced diet by

First peoples – A critical reflection on high incidence and prevalence of certain 6
diseases

low intake of fruits and vegetables, 3% illegal drug usage, 3% domestic violence, 1% child

sexual abuse, 1% unsafe sex, and 37% a combination of such risk factors (Vos et al., 2009). As a

note: these percentages do not represent all healthy persons comprising the population of First

Peoples, but only the risk factors as seen in persons with associated pathologies within

Australia’s First Peoples. As observed, these all comprise health behavior factors which may

lead to increased incidence and prevalence in Australian population. Furthermore, psychosocial

issues are auxiliary problems which may lead to the onset of such diseases, by perturbing the

social and emotional wellbeing, having a lack of self-esteem and trust towards oneself and

society. Another issue is represented by the mental distress, involving coping mechanisms and

control loci, both external and internal being reduced, which could lead to isolation and hostility

towards members of the same community, relatives, and friends (Jorm et al., 2012). This would

generate a lack of communication, added to improper medical education creating a situation

where diseases go untreated and unobserved by medical system, due to personal negligence

stemming from psychological factors (AIHW, 2015).

One of the outcomes of such underlying issues is lower life expectancy which has been

reported in 2010-2012 to be 69.1 years for males and 73.7 years for females. While this has been

regarded to be low, it is to be noted that due to the endeavors made by multiple associations and

Australian Government in order to obtain equality and a free discrimination country, the overall

survival rate has elevated to 8-10 years from the period of 1996-2001 to 2010-2012. In addition

to lower life expectancy, other outcomes of aforementioned issues have been reported to be

developing a chronic disease and having a poorer health and wellbeing throughout life course.

Racism is still a problem, currently being abolished step by step. However, with that being the

case 7% of the Indigenous adult population still avoid health care due to the biased treatment
First peoples – A critical reflection on high incidence and prevalence of certain 7
diseases

from health care providers such as doctors, nurses, orderlies and others. Last but not least among

the underlying issues, environment also takes part in developing certain diseases. Examples

include overcrowding in households which are not corresponding to the lower threshold for a

healthy lifestyle. The average median percentage for overcrowded living space was 13% out of

all indigenous households. Adding to that aspect, a lower income compared to non-indigenous

Australians due to racism, education, behavior, lack of employment, and lack of access to clean

and safe water, efficient waste collection systems, the First Peoples have been reported to be

more susceptible to poverty-related diseases, such as respiratory system afflictions, injuries and

mental problems (Dudgeon et al., 2010).

We see that these problems that the First Peoples of Australia face should also interest

any citizen of Australia. In order to achieve prosperity and equity, we need to assimilate notions

and change perspectives. One main target is to earn trust by engaging more in activities that aim

to reduce the gap. Learning is an essential part of developing one’s knowledge in the health care,

but that does not restrict to medical practice only, but also to races and their particularities. The

lessons acquired and understood from this extensive search are that many of us, with emphasis

on First Peoples of Australia, have determinants which may influence the onset and outcome of

certain diseases. Culture, biological, psychosocial, environment are different for most of us and

that impacts our resilience and wellbeing. Understanding that protecting traditional values,

promoting a stronger collective identity, abolishing racism, we may evolve to a population that

presents elevated standards in the medical, social and environmental areas. While providing

cultural education nation wise to medical service providers, and medical education to indigenous

and non-indigenous population, we may obtain lower rates of prevalence and incidence in

diseases which should not have a high mortality rate.

First peoples – A critical reflection on high incidence and prevalence of certain 8
diseases

Emphasis should also be put on the relation between health care provider and individual from

any race but also the process of raising the standards for any of issue struck person. As far as

medical practice goes, we need to develop a holistic vision when providing services and have in

mind treatment for First Peoples should not include only a physical approach, but also provide

attention to emotional, cultural and social aspects. Not only is that important, but also developing

processes through which Aboriginal and Torres Islander peoples have access to knowledge,

medical education, and physical facilities which comprise the environment. Integrating systems

of different culture is also paramount. The reason is that having prior knowledge of multiple

aspects of one’s culture can improve the quality of medical service provided as well as the

relationship between the two parties. Abolishing racism, as well as providing empowerment and

emancipation in order to obtain equality is also a must, the efforts which we can make including

to offer equal attention and remove any bias when providing health care to any of Australia’s

inhabitants. Understanding and taking action against a disease, be it physical or psychological,

will also be much easier when assessing a patient, by taking in consideration his respective

traditional values and by having the means to establish a stronger cultural connection. With that

in mind, we should encourage programs comprising of screening, evaluating and educating of all

Australian population. The ultimate goal is to obtain equality and offer similar opportunities, so

that through these endeavors, the Aboriginal and Torres Islander Peoples of Australia would

reach in time lower rates of prevalence and incidence concerning different types of diseases.
First peoples – A critical reflection on high incidence and prevalence of certain 9
diseases

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