HSC203-Analysis Of An Indigenous Health And Wellbeing Issue

Introduction

Health of a particular population usually depends on the economic, social and environmental factors. Furthermore, current and historical factors like discrimination, racism and dispossession also plays a significant role in the physical and mental health of the population. Recently, in Australia, racism is being cited very frequently to have a detrimental effect on the health of indigenous people. A person can experience racism in many forms. It can be encountered in systemic, internalised or interpersonal levels. The effect of racism in indigenous health can occur in two ways: direct and indirect. Physical assault provoked by racial belief is an example of direct impact whereas indirect effect leads to uneven access to economic, medical, and social resources necessary for good health or well-being (Shepherd et al., 2017). This not only affect the health of the indigenous people but also leads to withdrawal from health related activities or healthcare. In the last decade, many research article and media article is being published linking racism to the ill health of indigenous or aboriginal people of Australia. Evidence also suggests that racism is part of daily life of indigenous or aboriginal people (Herring et al., 2013). Racism affects both the physical and mental well-being of the affected people. According to Ferdinand, Kelaher and Paradies (2013), 84 percent indigenous people who took part in their survey have stated that they were racially abused. Recently, lots of researchers are being done to study the effect racism has on indigenous people. Not only that, mainstream media also focuses on the topic and lots of media coverage are being done. Therefore, this study will discuss and analyse four media article related to the impact of racism on the health of indigenous people. All four article will be summarised and the content of article will be linked to various model and recent debate related to the topic. Furthermore, each article will be incorporated with personal reflection. 

Media Item 1 – “Aboriginal people face ‘systemic’ racial discrimination: report”

Donelly, B. (2015). Aboriginal people face ‘systemic’ racial discrimination: report. Retrieved from https://www.theage.com.au/national/victoria/aborigines-face-systemic-racial-discrimination-report-20151104-gkqlii.html

Summary and key facts

This article by Beau Donelly presented a report on how aboriginal in Australia faces systematic racism in their day to day life. The author started the article mentioning that racial abuse against the aboriginals is still very much in play even after 40 years of legislation outlawing racism. In this article, it has been mentioned that Australian Human Rights Commission reported many Australians still facing social exclusion, vilification and racial discrimination. This report also summarised the findings of 130 government and community group which fights bigotry based on colour, ethnicity and race. The article also provides various example of different community facing racism including the racism faced by aboriginal Victorian of the year Jack Charles. Author also contacted with various related government authority and all of them acknowledged the presence and inevitability of racism faced aboriginal people. Deputy chief executive of legal service’s admitted that aborigines have been facing systematic racism which seems to be an omnipresent invisible barrier. In one example, the author presented that one university educated aborigine woman treated like an illiterate and were asked whether she could speak English. In a nutshell, the article is well structured with data, examples and bites of government authority to support his argument about the systematic racism faced by aboriginal Australians.

Current debate, models and approaches

Racism may occur in three theoretical levels and this article emphasises on a particular model of the racism present in Australian continent which is systematic or institutional racism. Systematic or institutional racism defines as where people faces unfair, avoidable, and inequalities based on their racial or ethnic group (Kelaher, 2014). Keyword search in Australian database shows that systematic discrimination or bias is very much common in Australian literature. The article also links this systemic bias to the school, government and workplace. However, use of the term institutional racism is much more frequent in Australian literature. Sometimes institutional or systematic racism is referred as an indirect racism in the literature (Ferdinand, Paradies & Kelaher, 2013). This article also provides example where people from all minority group experience indirectly in the institutional level.

Government approaches to tackle racism towards aboriginal Australians has also been discussed in the article. It has mentioned the milestone legislation which outlaws all discriminating behaviour towards a person based on the race, creed, colour or belief. Australian government has passed this legislation in more than 40 years ago and act is known as Racial Discrimination Act 1975 (Gelber & McNamara, 2013).

This article also cites an example where aboriginal actor and Victorian of the year were refused taxi service because of his skin colour. It also stated another example where a university educated woman were held up in the airport because she belonged to the aboriginal ethnicity. Thus, this article shows how aboriginal Australians and people from other minority facing racism as well as presented data and statistics regarding occurrence frequency.

Personal reflection

The article published by Beau Donelly is very precise, well-articulated and to the point. Author has presented the article well supported by data and statistics and examples. In my honest opinion, the examples are the soul of this article which helps paints a picture in reader’s minds about the real life situation faced by aborigines. The author has collected bytes from government official about the situation, but nobody mentioned about any preventive measure to stop racism. This is my only minor quibble about this article because it did not suggest or delve into preventive measures to be taken or have to take to stop racism. 

Media Item 2 – “Institutionalised racism’ reason for fewer Indigenous kidney transplants”

Davidson, H. (2015). ‘Institutionalised racism’ reason for fewer Indigenous kidney transplants. Retrieved from https://www.theguardian.com/australia-news/2015/aug/27/institutionalised-racism-reason-for-fewer-indigenous-kidney-transplants

Summary and key facts

In contrary to the previous article, this article focuses on a particular aspect of racism faced by the aboriginal Australians rather than the overall broad view. Here, author discussed on the institutional level racism faced by indigenous patients while applying for kidney transplant. The author stated in this article that there is a vast gap between aboriginal and non-aboriginal Australians receiving kidney transplant.  According to a kidney specialist and researcher, the aborigines are also less likely to put on a waiting list to receive treatment. The author stated that reason behind this discrimination is systematic bias in institutional level and misunderstanding of the challenges faced by indigenous patient. Indigenous people are fifty times more prone to kidney disease compared to no-indigenous people. Non-indigenous Australians assumed because of their bigotry that this happens because of alcohol abuse while the real reasons behind this are low birth weight, socioeconomic disadvantages, and poor nutrition during childhood. Lack of treatment centre also plays a significant role in this case and because of which a huge number of aboriginal people are forced to relocate to receive treatment. The Author, here, has also presented a statistics showing that while survival of indigenous dialysis patient have increased, the number of kidney transplant decreased compared to non-indigenous people. To sum it up, the author presented a well-rounded picture, supported by data and statistics, about the current situation facing by indigenous people in terms of receiving kidney transplant and dialysis.

Current debate, models and approaches

This article states that choric kidney disease is a major health issue in Australia especially in the remote area. According to Venuthurupalli (2018), resources, morbid conditions and geographical locations limit the access of the specialist which mentioned in the article as a significant factor for disparity between aboriginal and non-aboriginal Australians. Along with that, cultural differences, lack of support from family and perceived racism plays a hand in that matter. This leads to very low admittance in the renal clinics. Thus the researchers suggested alternative care models to tackle the problem one of which could be Telehealth (Caffery, 2017). The percentage of Chronic kidney disease in aboriginal people is more than double compared to the non-aboriginal Australians (22% versus 10%) (Hoy, 2014). Many researches and studies have been devoted to this disparity but none provide a clear solution except social bias and prejudiced opinion of non-compliance. Many studies have also found that the miscommunication or misunderstanding of cultural issue hindering the proper care of the aboriginal people.

This article also referred at the suggestion or approaches how to confront this particular predicament. Recently, the federal and northern territory government has risen their funding to support dialysis services and accommodation (Kildea et al., 2016). As per Dr. Paul Lawton, a renowned kidney specialist, set selection protocol related to kidney transplant and a multi-pronged although expensive approach required to stem this problem.

There is an ongoing debate amongst the specialist related to kidney transplant about why the rate of kidney transplant is low in the aboriginal people in urban and remote area. According to them, current system is in place for kidney allocation is not fair. Hence, they are advocating for the better and just allocation system which will be fair to all Australians.

Personal reflection

During reflection on this article, I realized that the article depicts a very morbid situation about the discrimination currently faced by aboriginal Australians regarding kidney transplant. The very interesting thing about this article is that it interviewed a renowned specialist of this field which helps to narrate an accurate and real picture of the problem. The author also provides few recommendations on how to tackle the situation along with the real scenario of the issue. As a whole, the article is very well articulated and very well structured from top to bottom.  In this context, I agree with all the author has discussed.

Media Item 3 – “Racism is a significant barrier to Aboriginal health improvement”

Racism is a significant barrier to Aboriginal health improvement | CAAC. (2015). Retrieved from https://www.caac.org.au/news-events/media-releases/2015/8/racism-is-a-significant-barrier-to-aboriginal-health-improvement

Summary and key facts

In accordance with the first article discussed, this article also discusses about racism as barrier to improvement of aboriginal health. This article uses the treatment of Adam Goodes as a foreword and develops the topic around it. According to the article, experience of Adam Goodes is just the tip of the iceberg al other aboriginals are facing in their day to day life. It has been argued in the article that Australian community can use the attention caused by the treatment of Adam Goodes to learn about the harm caused by racism to aboriginal Australians well-being and health. Almost 75 percent aboriginal Australians encounters racism in their daily life (Cunningham & Paradies, 2013). The article stated that nearly one-fourth of aboriginal children under 12 experiences racism which leads to consumption of alcohol and marijuana by these under 12 years old. In a survey conducted by National Aboriginal and Torres Strait Islander Social Survey showed that almost 40 percent people said that they could not trust the hospitals which leads to immature discharge risking their health (Cunningham & Paradies, 2013). Finally, the article comes to the conclusion that it will take a strong commitment and action as a whole country to overcome the adverse effect caused by racism to the indigenous Australians.

Current debate, models and approaches

This article lays emphasis on the effect racism has on health as a detrimental factor. In Australia, racial prejudice is a crucial problem faced by aborigines compared to other minority group. This detrimental effect in health can be seen in the statistics. The mortality and morbidity rate of aboriginal people continue to rise at an unacceptable rate compared to other Australians (Teng et al., 2014). Research has shown that the racism has harmful effect to physical and mental health. A report showed that life expectancy of aboriginal people is 17 years less compared to non-aboriginal Australians (Phillips et al., 2014). Many aboriginals did not avail the health service owing to the reason of distance, cost, transport, lack of available services and cultural barriers. The issue of aboriginal children getting addicted to the cannabis and alcohol at very young age highlighted in this article. Use of cannabis and alcohol at young age can have very adverse effect on the health of children. Research has shown that, this can particularly effect how brain develops in those children (DiGiacomo et al., 2013). This article also delves in how to tackle the racism facing by aboriginal people and its effect on the health of the concerned people. Researchers have established education as the first strategy to handle the issue (Freeman et al., 2014). Also a better understanding of aboriginal culture will help to understand the indigenous people and their behaviour. To eradicate the issue government, policy makers and the whole population has to commit in a multi-pronged approach to reduce racism. 

This article started its discussion by mentioning the treatment faced by Adam Goodes. Adam Goodes is a prominent indigenous AFL football player who was being booed by the Australian football fans all over the continent. Situation was so derogating that a 13 year old girl use racist word towards him. By using the example of Adam Goodes, this article has depicted a real picture of indigenous peoples are facing racism now a days.

Personal reflection

Just like the first article, this also delves into the racial barrier faced by indigenous Australians. Most interesting and important fact this article shows that the even famous indigenous person can be subject of vicious racism. It shows that racial abuse does not confined among the general aborigines. This suggests that the issue has far deeper root than just social and economic disparity between indigenous and non-indigenous Australians. This article also discusses about how racial abuse affecting under-12 children which in turn leads them to alcohol and cannabis addiction. In my opinion, this article could have done better to provide specific recommendation to thwart racism instead of generic ones.

Media Item 4 – “Depression, racism and the need to open up on ‘R U OK? Day”

Blanco, C. (2016). Depression, racism and the need to open up on ‘R U OK? Day’. Retrieved from https://www.sbs.com.au/nitv/article/2016/09/08/depression-racism-and-need-open-r-u-ok-day

Summary and key facts

This article by Claudianna Blanco has discussed about the racism experienced by indigenous Australians and its effect on the mental health. Alongside that, it also discusses about the campaign ‘R U OK? Day’ conceived to tackle the mental health conditions. According to the article, a clear link is present between the racism experienced and risk of mental illness like anxiety and depressions. This is concerning for the Aboriginal and Torres Strait Islander people who suffers maximum level of discrimination in Australia. It has been stated in the article that around 33 percent Aboriginal and Torres Strait Islander people have encountered some sort of racist remark in the last twelve months and almost 60 percent people have reported an experience of discrimination (Kelaher, 2014). With this regard, a campaign named ‘R U OK Day?’ has been promoted to counter the mental illness suffered by the indigenous people. Although, this campaign focusses all the Australians not just only indigenous people. This campaign encourages indigenous people to share their feelings too reduce mental health problems like suicidal thoughts, anxiety and depression. The article also mentioned three behaviour which are omnipresent in suicidal people. These are lack of belonging, lack of connection and burden to other’s life. The article also stated that 1 out of 10 indigenous young male stated extreme dissatisfaction towards life compared to 1 out of 100 non-indigenous young male.

Current debate, models and approaches

This articles gives particular stress on the effect racism has on mental health such as anxiety, depression and suicidal thoughts. Researches have shown that racism has an adverse and detrimental effect on mental health (Parker & Milroy, 2014). Racism can affect the mental health in more than one ways. A clear link is present between racial attack and mental illness. The more racial attack a person encounters, the more that person is prone to suffer mental illness such as depression or anxiety. However, this is not always true. Sometimes effect of a particular attack has done more damage than the number of frequency. Racism like property damage can scarred a person much more than verbal abuse. People suffered racism while searching new property has a great chance to have very high psychological distress (Ferdinand, Paradies & Kelaher, 2015). Reducing the occurrence of racism is a significant part to improve health of aboriginal people. 

Interventions from various institution and organisation are needed to diminish racism. This article also discusses such approaches by organisation to reduce mental health problem. Two promotion has been provided as an example and those are: ‘R U OK? Day’ and ‘Our Mob’. These are active all over Australia to provide support to the people suffering from the mental health issue. One of the foremost suggestion provided by them is to be mindful of one’s language as it has the potential to hurt a person’s emotion immensely. By publishing their activity, this article has helped them to reach many more suffering person.

Personal reflection

Unlike all three media article discussed above, this article delves into the effect racial abuse has on mental health. This article shows that even answering simple question like ‘how are you?’ truthfully is harder for the indigenous people. This article also offers detailed information about promotion and activity whose objectives are to lessen the burden of people suffering from mental health. From my own point of view, I personally think that this article has great job publishing about the activities which will now reach to much more people needing the help.

Conclusion

Therefore, from the above discussion, it can be safely concluded that racism is a significant barrier in the process of improving indigenous health. By analysing four different media articles, it can be inferred that aboriginal Australians have been facing racism from all direction. They are facing racism in their day to day life, office, school, government and in healthcare system. This has a detrimental effect on health of the aboriginal people. Racial abuse is neither confined to any particular settings nor to any particular community. It has reared its ugly head in all over the continent and in every form like shadows to the light. Similarly like shadows, it is always present but hard to eradicate. Only a commitment and understanding from all the people can eradicate such vicious transgression to humanity. 

References

Blanco, C. (2016). Depression, racism and the need to open up on ‘R U OK? Day’. Retrieved from https://www.sbs.com.au/nitv/article/2016/09/08/depression-racism-and-need-open-r-u-ok-day

Caffery, L. J., Bradford, N. K., Wickramasinghe, S. I., Hayman, N., & Smith, A. C. (2017). Outcomes of using telehealth for the provision of healthcare to Aboriginal and Torres Strait Islander people: a systematic review. Australian and New Zealand journal of public health, 41(1), 48-53.

Cunningham, J., & Paradies, Y. C. (2013). Patterns and correlates of self-reported racial discrimination among Australian Aboriginal and Torres Strait Islander adults, 2008–09: analysis of national survey data. International journal for equity in health, 12(1), 47.

Davidson, H. (2015). ‘Institutionalised racism’ reason for fewer Indigenous kidney transplants. Retrieved from https://www.theguardian.com/australia-news/2015/aug/27/institutionalised-racism-reason-for-fewer-indigenous-kidney-transplants

DiGiacomo, M., Davidson, P. M., Abbott, P., Delaney, P., Dharmendra, T., McGrath, S. J., … & Vincent, F. (2013). Childhood disability in Aboriginal and Torres Strait Islander peoples: a literature review. International journal for equity in health, 12(1), 7.

Donelly, B. (2015). Aboriginal people face ‘systemic’ racial discrimination: report. Retrieved from https://www.theage.com.au/national/victoria/aborigines-face-systemic-racial-discrimination-report-20151104-gkqlii.html

Ferdinand, A. S., Paradies, Y., & Kelaher, M. (2015). Mental health impacts of racial discrimination in Australian culturally and linguistically diverse communities: a cross-sectional survey. BMC public health, 15(1), 401.

Ferdinand, A., Kelaher, M., & Paradies, Y. (2013). Mental health impacts of racial discrimination in Victorian culturally and linguistically diverse communities: Full report of the Localities Embracing and Accepting Diversity (LEAD) Experiences of Racism Survey.

Ferdinand, A., Paradies, Y., & Kelaher, M. (2013). Mental health impacts of racial discrimination in Victorian Aboriginal communities. Lowitja Institute.

Freeman, T., Edwards, T., Baum, F., Lawless, A., Jolley, G., Javanparast, S., & Francis, T. (2014). Cultural respect strategies in Australian Aboriginal primary health care services: beyond education and training of practitioners. Australian and New Zealand Journal of Public Health, 38(4), 355-361.

Gelber, K., & McNamara, L. (2013). Freedom of speech and racial vilification in Australia:‘The Bolt case’in public discourse. Australian Journal of Political Science, 48(4), 470-484.

Herring, S., Spangaro, J., Lauw, M., & McNamara, L. (2013). The intersection of trauma, racism, and cultural competence in effective work with aboriginal people: Waiting for trust. Australian Social Work, 66(1), 104-117.

Hoy, W. E. (2014). Kidney disease in Aboriginal Australians: a perspective from the Northern Territory. Clinical kidney journal, 7(6), 524-530.

Kelaher, M. A. (2014). Experiencing racism in health care: the mental health impacts for Victorian Aboriginal communities. Education, 55(56), 8-3.

Kildea, S., Tracy, S., Sherwood, J., Magick-Dennis, F., & Barclay, L. M. (2016). Improving maternity services for Indigenous women in Australia: moving from policy to practice. Med J Aust, 205(8), 374-379.

Parker, R., & Milroy, H. (2014). Aboriginal and Torres Strait Islander mental health: an overview. Working together: Aboriginal and Torres Strait Islander mental health and wellbeing principles and practice. 2nd ed. Canberra: Department of The Prime Minister and Cabinet, 25-38.

Phillips, B., Morrell, S., Taylor, R., & Daniels, J. (2014). A review of life expectancy and infant mortality estimations for Australian Aboriginal people. BMC Public Health, 14(1), 1.

Racism is a significant barrier to Aboriginal health improvement | CAAC. (2015). Retrieved from https://www.caac.org.au/news-events/media-releases/2015/8/racism-is-a-significant-barrier-to-aboriginal-health-improvement

Shepherd, C. C., Li, J., Cooper, M. N., Hopkins, K. D., & Farrant, B. M. (2017). The impact of racial discrimination on the health of Australian Indigenous children aged 5–10 years: analysis of national longitudinal data. International journal for equity in health, 16(1), 116.

Teng, T. H. K., Katzenellenbogen, J. M., Thompson, S. C., Sanfilippo, F. M., Knuiman, M., Geelhoed, E., … & Hung, J. (2014). Incidence of first heart failure hospitalisation and mortality in Aboriginal and non-Aboriginal patients in Western Australia, 2000–2009. International journal of cardiology, 173(1), 110-117.

Venuthurupalli, S. K., Rolfe, A., Fanning, J., Cameron, A., & Hoy, W. E. (2018). Chronic Kidney Disease, Queensland (CKD. QLD) Registry: Management of CKD With Telenephrology. Kidney International Reports.