Health Inequalities in Australia: Causes, Effects and Solutions

This paper discusses the causes, effects and solutions of health inequalities in Australia, with a focus on the disparities between the aboriginal and non-indigenous populations. It highlights the role of social, political and economic factors, and the initiatives taken by the National Aboriginal Community Controlled Health Organisation (NACCHO) to address the issue.

Running head: HEALTH INEQUALITIES IN AUSTRALIA
HEALTH INEQUALITIES IN AUSTRALIA
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Introduction:
The health inequalities between aboriginal and population of metropolitan part of
Australia have emerged as one of the well documented public health issues which resulted in a
high prevalence of chronic disease and premature morbidity. Lawless et al. (2017), highlighted
the experience of colonization as well as the long-term impact of being colonized, which has
resulted in inequalities in Indigenous health status in terms of the physical, emotional, social and
mental health and wellbeing. Smith, Crawford and Signal (2016), suggested that Social
determinants are the fundamental contributing factors for 34% of the health discriminations,
whereas health behaviour such as smoking and obesity are estimated to be responsible for 19%
of the health inequalities in indigenous Australia. Hence, this paper aims to provide an overview
of the forces that contribute to these inequalities, further this paper will discuss the role of
aboriginal controlled community health services in addressing the health advantages experienced
by the Australians aboriginals.
Discussion
Part 1:
Social, political and economic factors behind health inequalities:
Refining the health status of the Indigenous population in Australia by reducing the
health inequalities between indigenous and non-indigenous Australian has emerged as a
longstanding challenge for governments in Australia (Www.aihw.gov.au, 2018). Many
researchers suggested that the gap of health status of these two diverse group remains
unacceptably wide where social, political and cultural factors play a crucial role.

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Social determinants theory recognized that health inequality of population are determined
by many interrelated social factors which resulted in the development of chronic disease and
high premature morbidity. The world health organizations highlighted that important social
determinants that resulted in Indigenous health inequality include unemployment, lack of
educational opportunities, lack of adequate resources, transportation, addiction, low financial
status, social exclusion, disability and race (Www.humanrights.gov.au., 2019). Northwood et al.
(2018), highlighted that the clustered living conditions, lack of healthy physical environment,
lack of access to health care, gender inequalities are also crucial factors that increased the high
gap of health status between two adverse populations. The unemployment rate in indigenous
Australia is three times higher compared to the non-indigenous population which resulted in
health (Javanparast et al., 2019). A significant number of indigenous individuals are involved in
substance abuse, tobacco smoking at early age due to cultural values which are considered as
health risk behaviors that in turn give rise to health inequalities (Lee, 2017). Consequently, the
rate of shorter life span, the prevalence of cardiovascular disease and diabetes, self-injury, lung
cancer, suicide rates, and mental health disorders are higher amongst the indigenous population
compared to the population from non-indigenous Australia, indicating high health inequalities.
Considering the political factors, British colonization in Australia under the paternalistic
ideology remains evident in federal, state, territory and local government of Australia. The
political decisions for the aboriginal and Torres Strait Islander populations usually designed by
National government had terrible effects on health and well-being of aboriginal population (Lee,
2017). Considering the history of the aboriginal population, a significant number of Australians
are the victim of the stolen generation and experienced violence, mistreat from the Australian
police because of diverse races and ethnicity (Lee, 2017). This tradition of discrimination in

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terms of health and resources is still evident in the unequal distribution of social policies. The
governments of Australia constantly failed to address the social determinants of health by taking
holistic views (Fisher et al., 2016). Due to persistent discrimination and racism, many policies
had developed by the national government for the aboriginal population which reflected
shameful inequity in terms of access to health care (Fenna, 2015). The majority of these policies
are taken on behalf of the aboriginal Australian population without considering the cultural
values or belies or without working with the policy (Fisher et al., 2016). Consequently, the
aboriginal Australian population has a shorter life span and high premature morbidity compared
to the non-indigenous population. Cultural factors are also responsible for the health disparities
since aboriginal populations tend to adhere to traditional health care practices which resulted in
health inequalities since health professionals are unaware of traditional health care practice.
The structured and economical inequities within the society are another cause of the
health inequalities which is also evident in the today’s Australia (Fenna, 2015). The inadequate
distribution of wealth, power income and status are also prime reasons behind health inequalities.
The ability to elevate class system is directly influenced by the socioeconomic position which
includes employment rate, education, and income. The employment rate and access to education
rates are extremely low in Torres Strait Island which resulted in an inability to access adequate
resources for adequate food, water, and housing. The inequalities of health are evident because
social class not only includes employment, education and income but also a discrepancy in
access to power (Boffa, Tilton & Ah Chee, 2018). Aboriginal individuals always experienced
discrimination and lack of access to culturally sensitive health care due to gender, race, ethnicity,
and religion which resulted in health inequalities.

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Part 2:
Features of NACCHO:
Approximately80% of indigenous individuals aged 35 to 74 years in experienced
premature mortality due to chronic diseases caused by health inequality. Hence, these factors are
required to address for reducing the health gap. For minimizing the health inequalities amongst
these two populations, The National Aboriginal Community Controlled Health Organisation had
taken initiatives with the partnership of the federal government to reduce the health and
wellbeing of the population. (NACCHO) is an organization Aboriginal communities for self-
determination (Panaretto et al., 2014). It is developed in 1997 when the Federal Government
funded NACCHO for establishing a helping hand that will provide access to health Aboriginal
Peoples involved in ACCHSs and participates in national health policy development
(Www.naccho.org.au., 2019). It is developed in the context of Australia due to the fact that it
operates 143 ACCHSs and provides services ranging from promoting and expanding the health
and wellbeing services through local ACCHSs, representing and advocating for the health care
services and fostering the partnership with government and non-government agencies
(Www.naccho.org.au. 2019).
Role of ACCHSs in reducing health inequalities:
The ACCHSs had taken the multifactorial approach to reduce the health inequalities
between these two populations. Closing the Gap framework is one of the most evident initiatives
which commits to reducing these disadvantages with initiatives of government. The organization
had developed models of comprehensive primary health care that focus on the prevention, early
intervention, and organization of care which in turn reduced unintentional racism and access to
health care. Patient-centred medical home (PCMH) model particularly based on maternal and

5HEALTH INEQUALITIES IN AUSTRALIA
child health which in turn improves health and wellbeing (Panaretto et al., 2014). The
organization reduced the racism and issues associated with unemployment by incorporating
aboriginal individuals in the medical workforce and arranged transportation for the population
who lived away from the health care services. To address the need, the population is provided
with the allied health team and health professionals along with health literacy where they feel
respected (Harfield et al., 2018). The sustaining program was also developed for reducing health
risk behaviours.
Barriers to provide services:
Freeman et al. (2016), suggested that common barriers for providing health care services
are the language barriers which in turn hinder the ability to receive quality care. The health
professionals from other cultural backgrounds are unable to provide health care services due to
language and cultural barriers. Even if the health professionals from the aboriginal community
were recruited to provide care, the population prefers to receive the traditional way of the
treatment which further hinders the support of the organizations. A significant number of
individuals are reluctant to attend health programs because of breaching autonomy and respect
by health professionals. The organization is able to provide limited support to the population
regarding health risk behaviour since health behaviour such as substance use and tobacco use is
part of traditional practice and hence reduction of these habits may impact the dignity and
respect of the population (Freeman et al., 2016). The limited support has been provided in terms
of nutrition, water, and sanitization which are also considered as one of the most common causes
of health inequality (Lee, 2017). The barriers regarding clustered housing could not be addressed
by the organization which is one of the prime reasons behind the health inequalities.

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Conclusion:
Thus on a concluding note, it can be said that the disparities in the health and welling
between non-indigenous and indigenous populations are highly evident in the prevalence of
chronic diseases. The socio-economic factors such as lack of education, unemployment, lack of
access to resources, income are the main cause of health inequality. The lack of access to health
care, poor health behaviour give rise to health inequalities. The role of racism, discrimination,
stolen generations and colonization is also evident in the health inequalities. The National
Aboriginal Community Controlled Health Organisation had taken initiatives with the partnership
of the federal government to reduce the health and well-being of the population by recruiting the
aboriginal population in medical force designing primary health care models and providing
access to transportation. However, common barriers in these cultural factors and social factors
require a comprehensive approach to address the issue.

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