Comparison of Indigenous Children's Access to Healthcare in Australia and Canada

This essay compares the access to healthcare services for Indigenous children in Australia and Canada, focusing on social-cultural and economic domains. It discusses the impact of poverty, education, gender, and economic considerations on healthcare access and highlights government policies and funding to address the disparities.

Running head: ASSIGNMENT 2
HLTC23 F, Issues in Child Health and Development
Assignment #2: Essay Fall 2018
Name of the Student
Name of the University
Author Note

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Introduction- In between 1910-1970, several indigenous children from Australia were
forcibly separated from their families, due to certain government policies. These generations
of the children who were removed from their families, under the influence of the government
came to be known as the Stolen Generations (Hamilton, 2017). On the other hand,
approximately 40% of the indigenous children residing in Canada have been found to live in
poverty (Symbol of the Government of Canada, 2018). It is often considered self-evident that
appropriate health care services play an important role in improving the health status among
children. When compared with the impacts of access to medical care on overall mortality
rates, the services prove their role as an essential determinant of children’s health status. In
the words of Levesque, Harris and Russell (2013) health care also is also determined by the
place, time, and contexts. In other words, access to health care services has been identified
important for maintaining and promoting health, preventing diseases, and effectively
managing them. Thus, if the indigenous children are provided with adequate access to these
services, the rates of unnecessary disability and premature death can be lowered. There is
mounting evidence for the discrepancies that exist in the socioeconomic status of the
indigenous and their non-indigenous counterparts in both Canada and Australia. This essay
will contain draw a comparison between Australia and Canada indigenous children’s access
to health care services, in relation to the social-cultural and economic domains.
Social-cultural lens- Reports from data published by the government indicates that the
Aboriginal and Torres Strait Islander individuals (including children) naturally die at much
earlier ages, in comparison to other Australians and manifest an increased likelihood to suffer
from disability and poor quality of life. The indigenous children were found less likely than
non-Indigenous counterparts for complete immunised in 2009 (Aihw.gov.au, 2011). Time
and again it has been proved that there exists an association between health and social and
cultural factors (Flottorp et al., 2013). Poverty can be theorised as an exposure persuading the

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health of persons at dissimilar levels of the society such as, within families and
neighbourhoods in which persons reside (Loignon et al., 2015). Furthermore, these diverse
stages of influence often co-exist and interrelate with each other to produce health. Some of
the major social and cultural variables comprise of socioeconomic status, gender and
acculturation and immigration status, poverty, social networks, deprivation, and social
support, in addition to collective characteristics of the environments such as, income
distribution of income, social capital, and collective efficacy. According to Akinyemiju et al.
(2013) low socioeconomic status are manifested by an increase in rates of unemployment,
less educational attainment, and poor household size. Absence of health insurance are linked
with health care access problems. It has been found that Indigenous Australians manifest
greater unemployment rates, when compared to non-Indigenous Australians. In 2006,
unemployment rate was 16% that increased to 20% in 2011, and dropped to 18% in 2016
(Abs.gov.au, 2018).
Unemployed indigenous people have lesser household incomes. It has been
established that unemployment is related to lack of adequate health insurance. Thus, it can be
stated that the indigenous Australians do not get all-inclusive health insurance coverage,
which in turn prevents them the children from accessing proper healthcare services. On the
other hand, prior to the 2008-20096 recession time, Aboriginals of Canada faced a difficult
time in seeking employment opportunities. The typical employment rate for Aboriginals was
57.0% in 2009, compared to 61.8% for non-Aboriginal people (Symbol of Statistics Canada,
2018). Furthermore, unemployment rates also saw a sharp increase for the Canada
Aboriginals from 10.4-13.9% in 2008. However, even the unemployed people in Canada
have an option of obtaining reasonable health insurance plans, with investments based the
household size and income. Hence, the income and household size determines the health
coverage and access the indigenous of Canada are entitled to. Marginalised sections of the

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society that comprises of the vulnerable indigenous population are most affected and
deprived of proper access to health services and money, which are considered imperative in
the prevention and management of diseases (Morris, Sikora, Tosteson & Davies, 2013).
Price of doctors’ fees, drugs and conveyance to reach healthcare centres are most
often devastating, both for the indigenous children and their relatives who require to care for
the kids and pay for their treatment. Under worst circumstances, families that are poor often
have to sell their property under the encumbrance of their child’s illness. Government reports
suggested that on an average, the indigenous Australians earn almost half the income of non-
indigenous Australians (Aifs.gov.au, 2018). In contrast, as per data from the Chair in
Indigenous Governance (2018) although the regular discrete income of the entire population
was an estimated $29,769, but merely $19,132 for a Canadian person of Aboriginal ancestry,
and an overwhelming $14,616 for a Canada Aboriginal existing on reserve. Time and again it
has been suggested that poverty is a major contributing factor to ill health and acts as a
barrier to children’s access to the health amenities. The poor indigenous people of both
Australia and Canada cannot pay for good health, together with adequate quantities of food
and health care facilities (Agarwal, Satyavada, Kaushik & Kumar, 2018).
Mossialos, Wenzl, Osborn and Sarnak (2016) affirms that health care system in
Canada is under the protection of the federal law and the services are informed by five
discrete principles namely, comprehensiveness, universality, portability, accessibility, and
public administration (Chambers & Burnett, 2017). Thus, it can be stated that for both
Canada and Australia, indigenous children living in poverty are less likely to procure
treatment services from family physicians and/or to acquire preventive and secondary care,
thus being more susceptible to report adverse familiarities of care. Traditional education amid
most indigenous children of Canada was achieved with the use of different techniques such
as, practice and socialisation, observation, community participation, and oral teachings (Kim

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& Dionne, 2014). Government statistical reports also reveal that the First Nations students
obtain 30% less education subsidy, when compared to the non-Indigenous Canadian children.
Furthermore, only 62% Canada Aboriginals have high school educational attainment, in
contrast to the 78% of the general population (People for Education, 2018). This is in clear
contrast with the increase in proportion of indigenous Australians who complete year 12, by
as much as 10% in 2016 (Abs.gov.au, 2017). Reports from 47% Aboriginals and Torres Strait
Islanders on the completion of 12 years in school or equivalent indicates that the Canadian
government is taking greater efforts in resolving the discrepancy that exists, in relation to
educational attainment amid the indigenous population.
According to Lam, Broaddus and Surkan (2013) educational status of parents
(especially mother) has long been identified as an important predictor of major health
consequences, and economic tendencies in the developed world. This in turn has intensified
the association between health and education. Poor educational attainment can be cited as a
major reason for reduced access to healthcare services among the indigenous population
owing to the fact that it is in schools that individuals learn about the ways to live a healthy
lifestyle and the different causative factors for preventable diseases. Years of education have
been found to be negatively correlated with mortality risk for educational attainment fewer
than high school graduation (Syed, Gerber & Sharp, 2013). Hence, less educational
attainment among the Aboriginals of Canada and Australia make both the population
disadvantaged as they cannot make their children adopt healthy lifestyle. Attaining positive
health consequences in the contemporary health care environment necessitates an assortment
of factors to arise together that may be exaggerated by scholastic attainment and an
amalgamation of soft and hard skills (Baidawi, Mendes & Saunders, 2017). In other words,
the indigenous children having educated parents most often benefit from their ability to

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comprehend their health requirements, track or read instructions, campaign for themselves
and their kin, and interconnect efficiently with health providers.
Evidences have also been established for pure gender prejudice in non-treatment
working against both poor and non-poor females, with little transformations between the
unfortunate and mediocre households (Khera, Jain, Lodha & Ramakrishnan,
2014). Furthermore, there is mounting evidence for the fact that women are found to seek
health care facilities for themselves and their children much later, when compared to males.
This in turn can also be associated clinically significant outcomes owing to the fact that
gender differences play a major role in affecting the health insurance consequences, based on
the hypothetical connection between care wanted later and the readiness of insurance
companies to provide coverage to females and children. Females have been found to account
for 50% of the indigenous Australian population in 2016 (Censusdata.abs.gov.au, 2016).
Though indigenous girls and women comprise of only 4% of the female Canadian population,
they were found to represent an estimated 16% of all woman homicides from 1980-2012
(Amnesty international, 2014). Thus, it can be stated that gender differences are more in amid
the Canada Aboriginals, when compared to Australia. This might account for the fact that the
women of Canada seek less health care access for their children in Canada.
Economic lens- According to The Guardian (2016), the aboriginal disadvantage in
Canada is identical that of the Indigenous population residing in Australia. The reason behind
this is both the population are the survivors of colonialism. From the Canadian perspective, it
can be said that the health of the Canadian population has both private and public part.
Canadian populations not only care about their own health, but are also equally conscious
about the health of their family. However, the collective state of population health in Canada
has significant implications on the overall health care system and the economic system of the
country. The economic considerations in turn have significant consequences on the health of

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the Canadian along with the fiscal sustainability of the healthcare system (The Conference
Board of Canada, 2018). As per the reports published by () there occurs a significant health
disparities between the Aboriginals and the non-Aboriginal Canadian children. This
economic disparity cast a prominent impact on the healthcare access of the indigenous
children residing in Canada. According to National Collaboration Centre of Aboriginal
Health (2011), census data collected during 2006 stated that there are fewer Aboriginal
people residing in Canada (age group: 25 to 34) who have attained high schools level of
degree in comparison to the non-indigenous group of population.
The lack of awareness of the basic diseases and anatomy of body create a gap in
knowledge about the importance of availing healthcare facilities. Their restricted level of
knowledge about healthcare is also forbids them in accessing the healthcare services. Thus
lack of initial treatment of the children increases the severity of the disease. When the
severity of the disease is surfaced, they visit the doctor but at this time the disease prognosis s
negatively hampered, increasing the overall healthcare cost. The economic perspective in the
in-equal access of the indigenous children health in Canada can also be defined from other
perspective. As majority of the children are paralysed or are affected with severe syndrome
during their childhood, they are unable to perform regularly in school. It is due to their poor
academic degree that they become unsuccessful in getting a job increasing the economic
crisis of the family further. However, in order to fight against this health access disparity
among the Indigenous children of Canada, the Government of Canada has come up with new
policies and funding. For example Indigenous and Northern Affairs Canada (INAC), the
federal body responsible for the satisfying the Government of Canada’s commitments and
obligations to First Nations, Metis and Inunit has released special funding in order to increase
the healthcare access of the Indigenous children so that their basic healthcare demands are
meet.

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Moreover, the Canadian government has also come up with special facility f the
residential schools under the funding of $8 billion given by INAC in order to meet their
healthcare and educational needs. Moreover, the indigenous communities residing in Canada
have special tax benefits known as Child Tax Benefit. The Child Tax Benefit mainly exempts
the expenses done against the childhood education and healthcare. However, the majority of
the Canadian Indigenous population are un-aware about this Tax Benefit (The Canadian
Encyclopedia, 2018).
In Australia also, the picture of the Indigenous children access to healthcare is same
like that of Canada. Improper access to the healthcare by the Indigenous children residing in
Australia has increased the chances of inequality. The inequality in the healthcare access and
lack of healthcare awareness has increased the level of smoking and smoking related illness
among the people who are aged 14 years and above. Moreover, 1.1 million of the indigenous
children suffer from different chronic diseases during the tenure of 2014 to 2015 (Australian
Institute of Health and Welfare, 2016). The increase in the burden of diseases has increased
the modifiable risk factors behind the use of tobacco. The increase in the tendency of
smoking has increased the chances of cancer among the indigenous children and the
condition is more pronounced in Australia in comparison to the Canadian sub-continent. This
increase in the prevalence of the cancer tendency among the indigenous children and
indigenous race of Australia has increased the overall economic burden of healthcare
(Australian Institute of Health and Welfare, 2016).
The increase in the consumption of the tobacco by the Aboriginal children might have
increased the sales figure of the tobacco industry in Australia but at the same time increased
the economic cost burden over the Aboriginal family. Australian Institute of Health and
Welfare (2016) stated that among the indigenous population residing in Australia, especially
to the one living in the remote areas, proper access of the healthy food is very limited.

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Moreover, children refuse to go to schools and indulge in different in-toxication. This lack of
availability of the proper diet and other healthy living conditions make them victims of
several non-communicable diseases like diabetes. The cost of care of these diseases is high
and thus creating the healthcare burden. At times the Indigenous family are called upon to
educate and to increase the healthcare awareness under the community health setup. But
under remote areas, setting up the community health setup for education and awareness
increases the overall cost burden over the government. Thus significant among of the funding
is wasted under community healthset-up. In order to promote the equality of health among
the Indigenous group of population in Australia, the government of Australia has come with
special policy known as Closing the Gap (Australian Human Rights Commission, 2018).
According to the Australian Human Rights Commission (2018), the aim of Closing the Gap
policy is to close the health and life-expectancy of the aboriginal and the Torres Strait
Islanders and the Aboriginal population residing in Australia. However, Zhao, Vemuri and
Arya (2016) are of the opinion that the long term goals of Closing the Gap is not effective is
reducing the economic burden of healthcare access among the indigenous population.
Effective government initiatives are required to be undertaken in order to reduce the
discrimination and at the same time developing local economies.
Conclusion- To conclude, it is imperative for all individuals to have adequate access
to wide-ranging, quality health care services. Thus, according to Hofstede's model, there is no
difference in the economic and social-cultural aspects of indigenous population between
Australia and Canada. Proper access to healthcare facilities will ensure that the entire
population is likely to receive best outcomes. However, an analysis of the findings presented
above suggests that although the governments of both Canada and Australia have identified
the existing health disparities between their indigenous and non-indigenous population, they
have not been able to avert the inequalities to a greater extent. Poor economic subsidies, low

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educational attainment, high rates of unemployment, poverty and lack of health access for the
females, who form a considerable part of the indigenous population of both the counties have
resulted in threatening situation for the children, by increasing their risk of suffering from
chronic conditions. Poor access to health care increases premature death among the children.
Owing to the fact that no significant differences were observed among both the nations, the
governments must take a collaborative approach to conduct a root-cause analysis and identify
the factors that reduce healthcare access among children.

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