Indigenous Australians and Pacific Islanders

By Carley, Lyn, Nerida, Edie and Gabby

HISTORICAL FACTORS THAT HAVE IMPACTED UPON THE HEALTH OF

INDIGENOUS AUSTRALIANS

Indigenous people generally experienced better health.

They didn’t suffer from diseases such as influenza and tuberculosis.

BEFORE COLONISATION

Land, language, law and lore of the Indigenous were affected.

New diseases were introduced, i.e. small pox.

Resulted in depopulation.

DURING COLONISATION

Stolen generation.

Experience barriers when accessing health care, due to racism or feeling unwanted.

Segregation and integration.

Physical, social, emotional and spiritual wellbeing affected negatively.

AFTER COLONISATION

Indigenous life expectancy is approx. 17 years lower than non-Indigenous people within Australia.

Two times more infant deaths.

Five times more likely to be teenage mothers.

Two times more likely to smoke cigarettes.

In 2006, 45% of Aboriginals over the age of 15 were unemployed (Australian Human Rights Commission, 2008).

https://www.humanrights.gov.au/publications/statistical-overview-aboriginal-and-torres-strait-islander-peoples-australia-social (T.Dune, personal communication, March 5th, 2014)

STATISTICS

When the body has insufficient amounts of glucose.

Diabetes and high sugar were more common in remote areas (1 in 11) than in urban areas (1 in 20).

HEALTH NEEDS OF INDIGENOUS AUSTRALIANS

Diabetes

A group of diseases that affect the heart and circulatory system (heart attacks, stroke, heart failure, high blood pressure).

Such as coronary heart diseases, hypertensive diseases, strokes and rheumatic heart diseases.

Cardiovascular disease

Similar causes for both

Unhealthy diet, no exercise, obesity, smoking and alcohol consumption, poor housing environment and poor hygiene.

CLINICAL/PROFESSIONAL SKILLS REQUIRED TO MEET THESE NEEDS

DIABETES CARDIOVASCULAR DISEASE

Client empowerment

Effective health plans

Appoint expert diabetes mentors

Technology and research

Support

Provide medicine/medical needs

•Reduce alcohol use•Hygiene •Nutrition and dieting plans/guides: From 2004-05, NATSIHS found that most

Indigenous people ate fruit (86%) and vegetables

(95%) everyday, due to its availability and cost in

non-remote areas

Physical activity guides/routines

Reduce tobacco use: There has been a

reduction in the number of cigarettes smoked

daily by Indigenous people between 1994 and

2008; two out of three Indigenous current daily

smokers has tried to quit in the pervious years

EXPERIENCES OF INDIGENOUS AUSTRALIANS WHEN USING HEALTH SERVICES

Culture shock

Language barriers

Non-verbal barriers

WHAT ARE THE EXPERIENCES?

“Real life problem with real life consequences”

Being admitted to hospital, unaware of the type of medical treatment the patient was to receive.

Receiving medical treatment without consent.

Being mistaken for other hospital patients and receiving inappropriate treatment.

Being returned home with a serious condition.

Patients undergoing treatment at odds with their cultural beliefs.

WHAT ARE THE IMPLICATIONS OF THESE EXPERIENCES IN HEALTH

SERVICES?

Aboriginals described mainstream health services as not welcoming, sites of discrimination and can be isolating...

ABORIGINAL STORIES OF EXPERIENCE

HEALTH NEEDS OF PACIFIC ISLANDERS

Assessments from five Pacific Islander communities: Māori, Samoan, Papua New Guinean and Fijian (indigenous Fijian and Fiji Indian).

Main health needs include: psychological and mental health (stress, depression, suicide) and diabetes (physical activity, dietary behaviours, obesity).

Other health needs: coronary heart disease, cancer, cardiovascular disease

DIABETES STATS

The prevalence of diabetes or high

blood sugar in 1997 and 1998 was

5% for people born in the South

Pacific.

The rate of hospitalisations for

diabetes complications in 1995-96

to 1999-00 was statistically higher

at over five times the rate for

Australian-born people.

The incidence of insulin-treated

diabetes in 1999-2001 was higher

for females born in the South Pacific

and New Zealand, than for the

Australian-born females, but no

differences were observed for

males.

Diabetes-related mortality rates in

1997-2000 and hospitalisation rates

in 1999-00 for immigrants from the

South Pacific were higher than those

for the Australian-born population.

HEALTH NEEDS OF PACIFIC ISLANDERS

Assessments from five Pacific Islander communities: Māori, Samoan, Papua New Guinean and Fijian (indigenous Fijian and Fiji Indian).

Main health needs include: psychological and mental health (stress, depression, suicide) and diabetes (physical activity, dietary behaviours, obesity).

Other health needs: coronary heart disease, cancer, cardiovascular disease

SPECIFIC, RELEVANT AND DIVERSE EXPEREICNES OF PACIFIC ISLANDER PEOPLES

WHEN ACCESSING HEALTH SERVICES

Low health literacy - lack of knowledge of health issues and available health services

Lack of culturally tailored health promotion - Australian methods of health care “pushed” upon them. Lack of understanding or acceptance of traditional healing methods.

Communication barriers - difficulty in understanding medical terminology and jargon. Health service professionals unable to guarantee comprehension.

Economic barriers - general cost of healthcare. Lower average weekly income than Australian-born (Census, 2006).

SIMILARITIES AND DIFFERENCES BETWEEN THE HEALTH EXPERIENCES OF INDIGENOUS

AUSTRALIANS AND CALD AUSTRALIANS

SIMILARITIES DIFFERENCES

LanguageNon-verbal communication -

staring, where to look

Communication - low health literacy

Family in decision making process/distances needed to travel - need to be close to

family at all times

Economic

More media attention focused on health outcomes of A&TSI - Pacific Islanders seen as more

of a minority

Cultural tailored health promotion

Discrimination

OUR STRATEGY

As a group we are establishing a community centre within areas highly populated by Aboriginals.

Our purpose is to improve health through raising awareness and educating both the community and Aboriginal peoples.

Our four professions include sport and exercise science, podiatry, health promotion and theraputic recreation.

STRATEGY CONT.

Our holistic strategy identifies the interdependent determinants of health that can be improved to overcome Indigenous disadvantage, while also being applicable for use with our CALD group, Pacific Islanders.

- achieves this by focusing on each specific community involved.

The main feature of our strategy is the notion of interconnectedness and autonomy.

OUR AIM

Our strategy aims to work in association with the “Closing the Gap” campaign, with the intention of heping to reach the following CTG targets:

‣ Closing the life expectancy gap within the decade

‣ Halve the gap in mortality rates for Indigenous children under five within a decade

‣ Halve the gap for Indigenous students in year 12 attainment rates

‣ Halve the gap in employment outcomes between Indigenous and non-Indigenous Australians within a decade

REFERENCES

Australian Human Rights Commission. (2008). A statistical overview of Aboriginal and

Torres Strait Islander peoples in Australia: Social justice report 2008. Retrieved from

https://www.humanrights.gov.au/publications/statistical-overview-aboriginal-and-torres-strait-islander-peoples-australia-social

Australian Indigenous Health Info Net. (15th May 2012) Summary of australian indigenous

health. Australian Government Department of Health. Retrieved March 17, 2014, from

http://www.healthinfonet.ecu.edu.au/health-facts/summary#fnl-23

Cortis, N., Sawrikar, P. & Muir, K. (2008). Participation in sport and recreation by culturally

and linguistically diverse women. Retrieved March 25th, 2014, from

https://www.sprc.unsw.edu.au/media/SPRCFile/Report8_08_CALD_Women_in_sport.pdf

Dunbar, T. (2011. Aboriginal people’s experiences of health and family services in theNorthern Territory. International Journal of Critical Indigenous Studies, 4(2), 1-15. Retrieved from http://www.isrn.qut.edu.au/publications/internationaljournal/documents/Final_Dunbar_IJCIS.pdf

Henry, B., Houston, S. & Mooney, G. (2004). Institutional racism in Australian healthcare:

A plea for decency. Fairness and compassion are the basis for improving Aboriginal health, 180(10), 517-520. Retrieved from

https://www.mja.com.au/journal/2004/180/10/institutional-racism-australian-healthcare-plea-decency

Muecke, A., Lenthall, S. & Lindeman, M. (n.d.). Culture shock and healthcare workers in

remote Indigenous communities of Australia: What do we know and how can we measure it? Rural and Remote Health. Retrieved from

http://www.rrh.org.au

Queensland Health. (2010). Engaging culturally and linguistically diverse (CALD)

Queenslanders in physical activity: Findings of the CALD physical activity mapping project. Retrieved from

http://www.health.qld.gov.au/ph/documents/hpu/cald-pa-map-proj.pdf

REFERENCES CONT.

Queensland Health. (2011). The health of Queensland’s Fijian population 2009. Retrieved

from http://www.health.qld.gov.au/multicultural/health_workers/health-data-fijian.pdf

Queensland Health. (2011). The health of Queensland’s Maori population 2009. Retrieved

from http://www.health.qld.gov.au/multicultural/health_workers/health-data-maori.pdf

Queensland Health. (2011). The health of Queensland’s Papua New Guinean population

2009. Retrieved from http://www.health.qld.gov.au/multicultural/health_workers/health-data-png.pdf

Queensland Health. (2011). The health of Queensland’s Samoan population 2009.

Retrieved from http://www.health.qld.gov.au/multicultural/health_workers/health-data-samoan.pdf

Queensland Health. (2011). Queensland Health’s response to Pacific Islander and Maori

health needs assessment. Retrieved from http://www.health.qld.gov.au/multicultural/health_workers/qh-response-data.pdf

Rolls, M. & Johnson, M. (2010). Historical dictionary of Australian Aborigines. Retrieved

from http://lib.myilibrary.com/ProductDetail.aspx?id=297534

Throw, A.M. & Waters, A.M. (2005). Diabetes in culturally and linguistically diverse

Australians: Identification of communities at high risk. Retrieved March 25th, 2014, from

https://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=6442454961

Walton, S. (2001). Communication and cultural knowledge in Aboriginal health care.

Cooperative Research Centre for Aboriginal and Tropical Health, 1(1), 1-45. Retrieved from

http://www.lowitja.org.au/sites/default/files/docs/Communication_and_Cultural.pdf