Aboriginal & Torres Strait Islander Peoples’ Wellbeing

This document discusses the concepts of personal racism, systemic/institutional racism, power dynamics associated with whiteness, and cultural competence and cultural safety. It explores the similarities and differences between personal and systemic racism, the implications of whiteness in nursing practice, and the importance of cultural competence and cultural safety in healthcare. The document also reflects on the social determinants of health and the impact of institutional racism on the healthcare access of Aboriginal and Torres Strait Islander peoples.

Running head: ABORIGINAL & TORRES STRAIT ISLANDER PEOPLES’ WELLBEING
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Aboriginal & Torres Strait Islander Peoples’ Wellbeing
Student’s Name
University

ABORIGINAL & TORRES STRAIT ISLANDER PEOPLES’ WELLBEING
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Aboriginal & Torres Strait Islander Peoples’ Wellbeing
Step 1 third person
a) Compare and contrast personal racism and systemic/ institutional racism
Individual racism entails a situation where the race characterizes individual attitudes and
preferences. On the hand, institutional racism is seen as a form of discrimination where color or
ethnic background are used as indicators for discrimination. Both the two types of racism are
similar since they tend to focus on discriminating the people based on skin color or ethnic
background which creates inequality between the races (Bowser, 2017; Salter, Adams, & Perez,
2018). However, the difference between the two is that in individual racism, people exhibit racist
elements to other people that they feel do not have the same skin color like them. This entails the
actions that the people use like refusing to talk or greet those who seem to an inferior race. On
the other hand, Feagin & Elias (2013) argue that institutional racism differs in such a way that
cultural rules are created and used to discriminate people of a certain race.
b) The power dynamics associated with the concept of whiteness and describe how it
relates to contemporary nursing practice in Australia.
The implications of white and non-white races are categories of domination and control
where skin color plays a significant part in distribution of benefits in the society. Structural and
institutional frameworks are created to define racism and create power differences that make
some people to access better privileges than the rest. Thus through racism and whiteness in
Australia, there are explicit advantages that are camouflaged in whiteness nursing. According to
Marmot (2011) systematic racism creates racial privileges which lead to advantages that are

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organized and stratified in social relations that perpetuate inequality and access to opportunities
in nursing. The outcome is a white nursing system which tends to progress based on the social
stratification of social relations and inequalities that the daily conduct of the nursing
professionals is thus guided by the fluid social routines
c) cultural competence and cultural safety
Henderson, Horne, Hills, & Kendall (2018) suggest cultural competence is the ability of
the individual to understand and communicate effectively with people from other cultures.
Cultural safety entails an environment that is socially, spiritually and emotionally safe where
people are free to be who they are and at the same tome have access to opportunities without
shared respect, meaning, knowledge and experience (SharonYeung, 2016). This means that the
two terms are related in such a way that they seek to create an environment that accommodates
and acknowledges the cultural differences of other people through allowing them to exercise
their cultural knowledge while at the same time ensuring that they accommodate the differences
in the cultures. On the other hand, the two concepts differ in such a way that cultural competence
is individual based where one learns how to relate well with other people through understanding
and accommodating their cultural needs (Woods, 2010). Further, cultural safety is based on
creating environmental conditions that allow the people to exercise their cultural rights while
relating to others.
Step 2: Reflection
Social determinants of health shape access to healthcare and determine how people
access healthcare needs in the society. This reading made me understand the importance of social
determinants of health and how the conditions that people are born in, grow in, work and age

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shape their access to healthcare. Paradies, et al. (2015) argue that the concept of social
determinants of health made me understand how people have been socially affected by these
social determinants of health and thus influencing the way people access healthcare. This means
that as a professional, I have to undergo professional training to improve my knowledge of the
social determinants of health and how they can be applied in life.
Step three: institutional racism
Institutional racism entails the way racist beliefs and values are built in the operations of
social institutions to discriminate, control and oppress minority groups (Bassett & Graves, 2018).
Bourke, Marrie, & Marrie (2018) states that institutional racism in Australia is a historical
element that has been there for some time based on the question of whether indigenous
populations should be counted as people or not. This means that the indigenous people have been
historically discriminated through opportunities of education where they have not sufficiently
gained education like the rest of the white population. This in turn denies them opportunities to
employment which also lead to the inability for them to access healthcare. Since education is one
of the factors for the high chances of employment, then it means that when the two social
determinants of health (education and employment) work together, then the ability of the
indigenous population to access better health services is limited. This is how white privileges are
developed because the indigenous people are not educated and this cannot hold high positions in
government that can influence decision making to address the healthcare needs of this
population. This is how cultural clash is developed since the policies that are developed and the
people who are in the healthcare facilities are predominantly white and thus the environment is
characteristically white thus creating the white privileges through institutional racism.

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Cox & Taua (2017) states that in Australia, cultural clash is one of the preceptors of
institutional racism where the healthcare system in the country has failed to acknowledge the
cultural stance of the population. Thus in Australia, the health services should be based on the
need of the Aboriginal-Torres Strait Islanders and the non-indigenous population to
accommodate the cultural needs of each population (Bourk, Marrie, & Marrie, 2018. Poor
funding restricts provision of healthcare and tailoring of the healthcare to meet the needs of the
population (Smith, 2017). On the other hand, Australian Health Ministers’ Advisory Counci
(2017) reported providing healthcare services that are tailored to indigenous needs will increase
the primary healthcare cost to 50% and thus the reason why the services have remained that way
despite the fact that they fail to meet the needs of the indigenous populations (Soutphommasane,
2017). Thus indigenous population will always be subjected to systemic racism in health until a
point when the government will be willing to invest more in meeting indigenous healthcare
requirements through the white privilege that is seen in education, employment and health.
Step 4: Cultural Safe Nursing
According to McGibbon & Etowa (2009) cultural safety is an effective nursing practice
through identifying and protecting the culture of groups to meet their needs. Since culture
defines a system of rules, beliefs, attitudes, behaviors and values that are shared by a group, then
it means that this approach can also influence medical seeking patterns of people like Aboriginal
and Torres Strait Islanders which determines their access to health. Vukic, Jesty, Mathews, &
Etowa (2012) suggest that cultural safety is an extension of cultural awareness and sensitivety
through the development of culturall apppropriate care that meets the needs of different
populations. It is designed on four principles of improving health status and well being of

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populations, enhancing the delivery of health services through culturally safe workforce,
recognition of inequalities, adressing their causes and accepting the legitimacy of the differences
and close focus on the impact of healthcare and the challenges that providers face.
Cox & Taua (2017) suggest that Aboriginal and Torres Strait Islanders present different
cultural needs that can be met through cultural safety. This means that cultural safety allows the
practitioner to understand the healthcare needs of the Aboriginal and Torres Strait Islanders and
develop a healthcare plan that meets their cultural needs (Shepherd, Li, Cooper, Hopkin, &
Farrant, 2017). For the indigenous people, the nature of care is important in ensuring that their
cultural needs are understood and taken care off. By focusing on the application of human rights
and social justice, this approach ensures that autonomy of the patient is achieved through
reflection on the cultural identity of the practitioner and those of the patient as a way of
developing a care plan that understands and meets the requirements of the people. Further, Phiri,
Dietsch, & Bonner (2010) add that ccultural safety leads to an understanding of the power
relationships that exist in the society that marginalizes the Aboriginal and Torres Strait Islanders
and preparing healthcare providers to understand the diversity in populations and how these
diversity can be accommodated into healthcare to improve outcomes.
Step five: Reflection
Cox (2017) presents 5r’s for practitioner students to use in reflection to assist them
understand their knowledge. From the unit learning and the previous research that I have done, I
learned that Aboriginal and Torres Strait Islanders have suffered and been discriminated health
wise due to cultural clashes that fail to recognize their needs and how their life can be shaped by
social determinants of health (Bourk, Marrie, & Marrie, 2018). This is based from the fact that

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racism breeds other social determinants of health which make it difficult to achieve cultural
safety and competence for meeting the needs of such groups of people. The challenge is that
institutional racism has been created to racial outcomes that fail to meet the need of these
communities. As a nurse, understanding of the needs of such people and aligning my
professional practice to accommodate them improves the health outcome of the communities.
The concept of racial marginalization creates conditions that make it difficult for the
indigenous people to overcome the inequalities in health and achieve the intended health
outcomes. In their article Bourke, Marrie, & Marrie (2018) suggest that these people approach
health from a communal point of view rather than an individual view. From my nursing
education knowledge, I feel that there are some gaps in education that can make it difficult to
achieve this issue. This means that although patient-centered approaches work well in meeting
the individual needs of the patient, these group of people presents communal needs that can be
challenging to me. Thus I need to understand and develop proper knowledge that will lead to the
best outcomes.
Despite that I have developed an understanding of the institutional racism framework
works through white people related policies that make it difficult to achieve the indigenous
people needs. This means that for the government and healthcare facilities to meet these
communal needs, then there is need for more funding to generate the resources for filling this
gap. This means that the government spending on health will have to be raised by 50% which
will make life more expensive.
Thus I have realized that the historical injustices that the indigenous have suffered in
healthcare is lack of inclusion and the need to tailor patient-centered care to meet the needs of

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these people. This means that although the previous health polices and decisions made were not
racist, they led to racial outcomes which have in turn affected the benefits of health to these
people (Bassett & Graves, 2018). I firmly think that the challenges that the indigenous people
have can be addressed through cultural safety in healthcare which will empower practitioners
with adequate skills for meeting the needs of the people. Thus practitioners have to tailor patient-
centered care with cultural competence and safety which will lead to better health outcomes for
the Aboriginal and Strait Islanders.
As a practitioner, I believe that having cultural safety knowledge is important in meeting
the needs of the Aboriginal and Strait Islanders. Thus what I need is to perfect my cultural safety
and competence knowledge that will lead to the ability to foster an understanding of the
inequalities that these people face and how addressing the inequalities can increase access to
healthcare. I have gathered that the cultural needs of these people are communal, rather than
individual, thus through cultural competence, I will be able to offer the best healthcare to these
population that focusses on their cultural and communal needs thus improving their healthcare
outcomes.

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