1 INDIGENOUS HEALTH PERSPECTIVE MediaPortfolio-SocialDeterminantsandhealthconcernsofIndigenouspeoplesin Australia Introduction Enhancing the health conditions of Indigenous communities in Australia has been regarded as a enduring challenge for the government sector of Australia. The wide gap in the healthstatusexistingbetweengroupsofIndigenousandnon-IndigenousAustralianshas remained unacceptably wide. It has further been recognized as a concern related to human rights bytheUnitedNationscommitteeandhasfurtherbeenacknowledgedassuchatthe administrative level of Australia. Certain social determinants theory has identified that factors related to health and inequality are determined by several interrelated social aspects (Mitrou et al., 2014). However, similarly it is regarded as a fundamental ideology of human rights law that all privileges are associated with each other and further influencing on the level of gratification of one right that will further affect the enjoyment of others (Kingsley et al., 2014). It is further to recognizethatsignificantdeterminantsrelatedtotherateofhealthyinequalitiesofthe Indigenous people in Australia incorporate the shortage of equal accessibilities to the major health care as well as the decreased level of health infrastructure existing in the Indigenous communities in relation to the White Australians. Though elementary to enhance the health consequencesoftheIndigenouspeople,theseconcernshavenotbeengivensignificant consideration in several domains of observations. Recent data reveals that the health condition of Aboriginal and Torres Strait Islander communities of Australia is considered as underprivileged in comparison to the other section of the Australian population. An anticipated gap has been witnessed that states an approximate gap of over 15 years between Indigenous and Non- Indigenous life expectancy in the nation (Clifford et al., 2015). Furthermore, there have been
2 INDIGENOUS HEALTH PERSPECTIVE developments on certain measures related to the health conditions of the Aboriginal and Torres Islanders, these measures have further been incompetent to make it equivalent with the measures formulated for the Australian population as a whole. For instance, the level of death rates caused due to cardiovascular diseases among the general Australians have witnessed a decline of around 30% since past two decades while on the contrary the aboriginal communities have not witnessed any significant diminution in the rates of death due to cardiovascular disease over this period (Price & Dalgleish, 2013). It is further to note that the rate of inequity in the conditions of health experienced by the Aboriginal communities and Torres Strait Islanders is associated to systemic discrimination.PreviouslythecommunitiesofAboriginalshavenotreceivedsimilar opportunities and privileges to live a health status as the non-Indigenous people (Mitrou et al., 2014). However, this has been reportedly stated to have taken place through the inaccessibility of conventionalservicesalongwiththeloweraccesstowardshealthservicesthatinvolves fundamental health care and insufficient necessities and provisions of health infrastructure in certain communities of the non-Indigenous people (Kingsley et al., 2014). Further to it, the increased rates of mental disorder problems further indicate chronic stress in the Aboriginal population groups. It has been reported that the Indigenous people were up to twice more prevalent to be hospitalized because of mental as well as behavioural syndromes in relation to other Australians. Media Article 1 Report reveals stark protection rates for Indigenous kids, but fails to examine abuse in care (Staff Reporter, 2018)
3 INDIGENOUS HEALTH PERSPECTIVE https://www.sbs.com.au/nitv/nitv-news/article/2018/03/09/report-reveals-stark-protection- rates-indigenous-kids-fails-examine-abuse-care Key Issues This article explicitly focuses on the way in which the children belonging to the Indigenous communities receive the privileges on protection services since past few years and are further associated at a higher level with the authorities in comparison to the broader level of population. Report stated by the Australian Health of Welfare have been further reviewed that around 50,000 of Indigenous children have been receiving safeguard and protection at the rate of 165 out of 1000 children (NITV, 2018). However the author of this article stated that the degree of safeguard and welfare services provided for the Indigenous children has witnessed an increase from 125 to 165.3 per thousand children as estimated in the past five years further enhancing the increase among the aboriginal youths (Cuthbert & Quartly, 2013). However few indigenous leaders after the rape incident of a minor occurred in the Northern Territory along with the elevated rates of viruses affected were of the opinion that children suffering from sexually transmitted diseases must be kept in segregation from their families. Thus the proper recognition of child welfare programs must be given utmost significance in order to aid children and parents. In recent times, there has been an alarming growth nationwide of the children belonging to the Aboriginal communities segregated from their parents and has been situated in exclusion of their home-care. According to the reports revealed by the Productivity Commission, over 14,000 children of the Aboriginals and Torres Strait Islanders were held in reserve out of their home treatment in the mid 2015 (Bodkin-Andrews & Carlson, 2016). Furthermore, it has further been
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4 INDIGENOUS HEALTH PERSPECTIVE noted that the Indigenous children has been accounted for almost 35% of all children kept in concern despite creating over 5% of the nation’s total population (Paul, Ewen & Jones, 2014). Whilethearticlereviewsthewayexpertshaverecognizedthesecatastrophicsocial circumstances in the elevating level of interaction between child protection and wellbeing authorities along with the Indigenous families further including the intergenerational disturbance caused by the past segregation of Indigenous children from the supervision of their children, cultural environment and land. The article further observed how Cummings chief of Territory Stolen Generations Aboriginal Corporation, Cummings believed that the reason Indigenous children fail to grow up without acquiring proper knowledge of their parents is due to the lack of governmental legislatures thus certain levels of uncertainty remained among the administrative authorities in order to separate children because of the fear of criticism and backlash (NITV, 2018). Links to models and approaches The article has effectively shed light on the broad array of welfare rights and privileges which the children and youth of Indigenous communities are deprived of. At this juncture it is important to note that the average age of involvement of child welfare and safeguard provisions amongst young generation of both Aboriginals and White Australians (Monks, Cross & Pearce, 2016). However it has been witnessed that Indigenous children are more vulnerable to lack of home care whereby children of the Torrent Islander population further belonging to families of lower socio-economic regions are at a higher level exposed towards substantiated observation. Contribution to current debate
5 INDIGENOUS HEALTH PERSPECTIVE It can further be noted that this media article sheds light on some interesting aspects relatedtotheover-representationofchildprotectionservicesandfurtherbelievedthat unnecessary separation of the children from their families (NITV, 2018). However, the Australia Health of Welfare report has been facing severe criticisms for being incompetent to involve the levels of violation that the Indigenous children out of the domain of their known environment. However, there is a lack of consistent data based on the number of observations, queries and substantiations of child abuse and exploitation that occur when a child stays in out of home wellbeing. The article thus reinforces readers to reconsider the status of Aboriginal children in Australia. Personal Reflection Interestingly throughout the article the author has effectively reflected the way emotional exploitation and neglect have been regarded a common forms of substantiated violence and mistreatment of both Indigenous and non-Indigenous children. Regardless to the discourse on the protection and welfare services provided to the Indigenous children, the author has also intend to cast light on the authorities lack of inclination towards the concept of children and youths of Indigenous groups being raised within the environment of adoptive families. Media Article 2 Racism likely at play in low Indigenous kidney transplants, AMA says (Bridget Brennan and Isabella Higgins, 2017) http://www.abc.net.au/news/2017-12-14/racism-likely-at-play-low-indigenous-kidney- transplants-ama-says/9257516
6 INDIGENOUS HEALTH PERSPECTIVE Key Issues This article primarily focuses on the low rates of kidney transplant especially for the Indigenous communities of Australia that is further regarded as an appalling and objectionable and are further driven by racism (Brennan and Higgins, 2018). Though medical experts remain hesitant to discuss about factors incorporating racism within the health system, authors of this article consider such apathy or negligence as one of the primary reasons for such elevated disparity(BrennanandHiggins,2018).Furthermore,decisionstosanctionapprovalsof Indigenous patients must be formulated by the panel of medical experts. The article further reviewed the debatable subjects related to the causes behind the low rate of kidney transplant procedures for the Aboriginal patients in remote as well as urban areas. It has been also stated that Indigenous Australians who return to their native locations are exposed towards an increased level of kidney failure or any other kidney related disorders (Yiengprugsawan, Hogan & Strazdins, 2013). Links to models and approaches The article interestingly assesses the way factors related to racism has been playing a critical player in the health system that has further constraining the lives of the Indigenous patients on the diagnosis to stay healthy and alive. It focuses on the experience of Brenda Dall Acqua, one of the Aboriginal patients who still anticipate getting a kidney transplant but has been waiting for past few years to receive an active funding list in New South Wales. The persistent burden of related to the habitual dialysis procedures has led several patients like Acqua to travel and has further lost certain significant moments of her life (DiGiacomo et al., 2013). It has been further recognized by the Australia New Zealand Dialysis and Transplant Registry that
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7 INDIGENOUS HEALTH PERSPECTIVE 13% of patientswho have been undergoing dialysistreatmentbelong to the Indigenous population however only 240 out of over 10,000 patients are reported to be having a effectively functioning kidney transplant(Brennan and Higgins, 2018). Contribution to current debate The authors of this article have used this article as a means to direct media concentration surrounding the persistent issues related to the lack of services and provisions received by Indigenous people in order to undergo dialysis treatment (Brennan and Higgins, 2018). However, the article has not solely dealt with the way slow rated treatments of this population has created critical hindrances in their lives but has also aimed to evaluate how certain Indigenous transplant recipients and their high consideration towards the medical experts. Personal Reflection This article possesses a potentiality to be though provoking observation on the status of diagnosis and treatment Indigenous people have been receiving. It would have been interesting to gain knowledge on the way dialysis treatment has facilitated the lives of few. However, the authors of this article intend to enhance the awareness among the public and administrative levels about the current status of health services and investment offered to the Indigenous communities. Media Article 3 Indigenous doctors hide their racial identity to avoid racism; report finds (Robert Burton- Bradley, 2017)
8 INDIGENOUS HEALTH PERSPECTIVE https://www.sbs.com.au/nitv/nitv-news/article/2017/07/11/indigenous-doctors-hide-their- racial-identity-avoid-racism-report-finds?cid=inbody:racism-puts-indigenous-kids-at- abuse-risk-while-culture-protects-them-royal-commission-finds Key issues This article further highlights the fundamental issues related to racism that has been prevalent within the indigenous communities. The report has explicitly reviewed that a certain section of indigenous medical experts along with the medical students are concealing their identities in order to avoid factors related to racism (Burton-Bradley, 2018). However it further sheds light on another section which has been accused of utilising their racial recognition in order to 18 a sustainable progress in their careers or increases their economic status. According to the Australian indigenous doctors Association, there has been a wide range of factors related to racism discrimination playing a vital role within the medical industry thereby with a significant deficit of support for reporting search incidence related to such prejudice behaviour (Ewen & Hollinsworth, 2016). However, the author evaluated certain reports that explored certain situational contacts related to professionalenvironment, which encouraged racism and further supported activities related to bullying or harassing people belonging to the indigenous groups (Burton-Bradley, 2018). Further to note as per the statements of the head of AIDA, the Federal government along with the state must take into consideration factors related to racism and harassment prevailing in the medical industry and made declarations regarding the adherence to obligatory cultural protection regulation training for all health employees on a regular basis (Davidson et al., 2013). Article proves to be a well establishment one as it is provided a when observed data related to the rate of racism existing within the medical industry (Hollinsworth, 2013). It has been evaluated that over 60% of the indigenous medical professionals stated that
9 INDIGENOUS HEALTH PERSPECTIVE they have experience situations that had a strong relation with racism and have further faced incidents that triggered certain circumstances related to harassment (Burton-Bradley, 2018). Links to models and approaches This article acts as a reminder that indigenous Australians are not provided with equal privileges and opportunities in relation to the non-indigenous Australians when it comes to issues related to welfare (Burton-Bradley, 2018). There are several circumstances, which you feel the way racism prejudice and discrimination have been playing a dominant character in the lives of the aboriginal Australians. Several reports have reveal that the past few decades have witnessed 15% of the aboriginals have been ill-treated because of their identities (Grace et al., 2013). Furthermore, the article has evaluated certain self-reported experiences related to prejudice and racism among the aboriginal and Torres Strait islander that is ranging from over 15% to around 97% depending on the sets of racism that has been observed in these past years (Burton-Bradley, 2018). However, it is an undisputed fact that several medical professionals belonging to the app original communities have a significant role to play in the development of health consequences for indigenous jobs in Australia (Hoy et al., 2014). The article concentrates on the way the Indigenous Health experts have obtained unique competencies in order to align clinical as well as cultural understanding to serve traditionally suitable care. Contribution to current arguments Drawing facts related to one of the significant concerns of the indigenous wellbeing, the authors of this article have intended to concentrate on the degree of prejudice and racism the aboriginal communities have been with missing in both workplaces and social circumstances (Hoy, 2014). It is important to recognise over here that the way racial discrimination, vilification
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10 INDIGENOUS HEALTH PERSPECTIVE along with social exclusion have influenced the lives of the aboriginal communities. Reports for the reveal the level of persistent racial prejudice within the workforce that has been signifying the way the lives and choices of aboriginal people have been undergoing several transformations accordingly (Sköld, 2013). For instance the experiences shared by the indigenous roots related to institutional prejudice only season which has been frequently articulated for the reflecting the repeated indefinable nature of institutional racism (Freeman et al., 2014). The article serves as a way to understand how racism has been defined in the Australian shared imagination and has acquired a structural political traditional as well as economic characteristic. Personal reflection The article would have emerged as a well-established one if the authors effectively put their concentration on the level of racism and prejudice experienced by the Aboriginals at the larger context and not only focusing on the medical industry. Media Article 4 Racism 'a factor' in ACT's high rate of Indigenous child protection reports (Daniel Burdon, 2018) https://www.canberratimes.com.au/national/act/racism-a-factor-in-acts-high-rate-of-indigenous- child-protection-reports-20180124-h0nksl.html Key Issues The article has reviewed certain reports revealed that revealed ACT possess the second highest degree of Indigenous children kept under care and safeguard order in comparison to the non-Indigenous children. In the opinion of ACT’s Minister, Stephen Smith the cause of the
11 INDIGENOUS HEALTH PERSPECTIVE increase was because of the rise in public knowledge and awareness related to child exploitation and neglect that is further associated with high degree of racism and prejudice existing within the community (Burdon, 2018). It has further been observed by the article that there has been a predominant existence of cultural dilemma and concern around the exposure of Aboriginal children and youth safeguard services and has been stated that factors related to racism is playing a predominant characteristics within the Aboriginal communities. There has been an over- representation of the Aboriginal and Torres Islander children and adolescents in the youth integrity and justice system whereby it has witnessed a profound overlap with the regulation of child protection and welfare (Putt, 2013). However, the author of the article declared that the elevating community awareness related to the threats of child abuse and ill-treatment is gradually been acknowledged by certain welfare organizations by performing in amalgamation as a form of a community whereby the Aboriginal communities can enhance the protection of all children and youth belonging to the community. It further observed how these children has been more exposed towards the rate of abuse and exploitation, disregard and sexual assault thus resulting to the greater degree of hospitalization and mortality rates concerning abuse, harm and injury and thus has been over-represented in the juvenile justices system as well as among the dispossessed or destitute populace (Sprianovic et al., 2014). Links to models and approaches This article highlights the way factors related to racism and prejudice has been playing a critical role in the increasing degree of child safeguard revelations related to the Aboriginal children (Burdon, 2018). The article further evaluated the racist social behaviour and attitudes that has been encouraging dehumanized, degraded and sexualized people belonging to the Aboriginal and Torres Strait Islanders and further authorized executors by offering legal and
12 INDIGENOUS HEALTH PERSPECTIVE social authorization to increased rates of sexual and other aggression, sadism committed against Aboriginal and Torres Islanders communities. Contribution to current arguments This article has elevated interesting factors related to child welfare system and also assessed the rising awareness and knowledge associated with the levels of risks and threats of child exploitation (Burdon, 2018). However, the author shifted its focus to the queries posed to ACT’s Minister Stephen Smith who preferred to neglect subjects based on the possibilities of the government receiving high or low proportion of exposures related to the children belonging to Aboriginal communities that could be regarded vexatious or lack of effective information in comparison to the investigations based on non-Indigenous children. Personal Reflection The author of this article has not constructively identified the Aboriginal children experiencing low standard and vindictive situations as Indigenous. Though this paper dealt with Indigenous children it primarily focused on increased rate of Indigenous child concern and safeguardreportsdespiteofsheddinglightonracismwhichisregardedasoneofthe fundamentalfactorsofexploitationandabusetowardschildrencomingfromAboriginal communities. Conclusion This discussion concentrated on factors related to racism and prejudice and the way it has immensely influenced the lives of Aboriginals at various juncture. The articles have focused on several reports which investigated the way First Nation children experience greater degree of
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13 INDIGENOUS HEALTH PERSPECTIVE exposure towards child protection services but has been reluctant towards the increasing rate of abuse and exploitation which occurs after their segregation from families. This has been related to certain racial attitudes towards the Aboriginal and Torres Strait Islanders communities. Following to this, the articles further revealed reports regarding section of medical professionals and students concealing their identities to avoid racism and prejudice.
14 INDIGENOUS HEALTH PERSPECTIVE References Bodkin-Andrews, G., & Carlson, B. (2016). The legacy of racism and Indigenous Australian identitywithineducation.RaceEthnicityandEducation,19(4),784-807. https://doi.org/10.1080/13613324.2014.969224 Brennan, B. and Higgins, I. (2018).Racism likely at play in low Indigenous kidney transplants: AMA. [online] ABC News. Available at: http://www.abc.net.au/news/2017-12-14/racism- likely-at-play-low-indigenous-kidney-transplants-ama-says/9257516 [Accessed 11 May 2018]. Burdon, D. (2018).Racism 'a factor' in ACT's high rate of Indigenous child protection reports. [online]CanberraTimes.Availableat: https://www.canberratimes.com.au/national/act/racism-a-factor-in-acts-high-rate-of- indigenous-child-protection-reports-20180124-h0nksl.html [Accessed 11 May 2018]. Burton-Bradley, R. (2018). Indigenous doctors hide their racial identity to avoid racism, report finds.Retrievedfrom https://www.sbs.com.au/nitv/nitv-news/article/2017/07/11/indigenous-doctors-hide-their- racial-identity-avoid-racism-report-finds?cid=inbody:racism-puts-indigenous-kids-at- abuse-risk-while-culture-protects-them-royal-commission-finds Clifford, A., McCalman, J., Bainbridge, R., & Tsey, K. (2015). Interventions to improve cultural competency in health care for Indigenous peoples of Australia, New Zealand, Canada and the USA: a systematic review.International Journal for Quality in Health Care,27(2), 89-98.https://doi.org/10.1093/intqhc/mzv010
15 INDIGENOUS HEALTH PERSPECTIVE Cuthbert, D., & Quartly, M. (2013). Forced child removal and the politics of national apologies inAustralia.TheAmericanIndianQuarterly,37(1),178-202. http://dx.doi.org/10.5250/amerindidiquar.37.1-2.0178 Davidson, P. M., Jiwa, M., DiGiacomo, M. L., McGrath, S. J., Newton, P. J., Durey, A. J., ... & Thompson, S. C. (2013). The experience of lung cancer in Aboriginal and Torres Strait Islander peoples and what it means for policy, service planning and delivery.Australian Health Review,37(1), 70-78. DOI: 10.1071/AH10955 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: aliteraturereview.Internationaljournalforequityinhealth,12(1),7. https://doi.org/10.1186/1475-9276-12-7 Ewen, S. C., & Hollinsworth, D. (2016). “Unwell while Aboriginal”: iatrogenesis in Australian medical education and clinical case management.Advances in medical education and practice,7, 311. doi:10.2147/AMEP.S107334 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.https://doi.org/10.1111/1753-6405.12231 Grace, B. S., Clayton, P. A., Cass, A., & McDonald, S. P. (2013). Transplantation rates for living-butnotdeceased-donorkidneysvarywithsocioeconomicstatusin Australia.Kidney international,83(1), 138-145.https://doi.org/10.1038/ki.2012.304
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16 INDIGENOUS HEALTH PERSPECTIVE Hollinsworth,D.(2013).DecolonizingindigenousdisabilityinAustralia.Disability& Society,28(5), 601-615.http://dx.doi.org/10.1080/09687599.2012.717879 Hoy, W. E. (2014). Kidney disease in Aboriginal Australians: a perspective from the Northern Territory.Clinical kidney journal,7(6), 524-530.https://doi.org/10.1093/ckj/sfu109 Hoy, W. E., White, A. V., Tipiloura, B., Singh, G. R., Sharma, S., Bloomfield, H., ... & McCredie,D.A.(2014).Theinfluenceofbirthweight,pastpoststreptococcal glomerulonephritis and current body mass index on levels of albuminuria in young adults: the multideterminant model of renal disease in a remote Australian Aboriginal populationwith highratesof renaldisease andrenalfailure.Nephrology Dialysis Transplantation,31(6), 971-977.https://doi.org/10.1093/ndt/gfu241 Kingsley, J., Townsend, M., Henderson-Wilson, C., & Bolam, B. (2013). Developing an exploratory framework linking Australian Aboriginal peoples’ connection to country and conceptsofwellbeing.Internationaljournalofenvironmentalresearchandpublic health,10(2), 678-698.Doi:10.3390/ijerph10020678 Mitrou, F., Cooke, M., Lawrence, D., Povah, D., Mobilia, E., Guimond, E., & Zubrick, S. R. (2014). Gaps in Indigenous disadvantage not closing: a census cohort study of social determinants of health in Australia, Canada, and New Zealand from 1981–2006.BMC Public Health,14(1), 201.https://doi.org/10.1186/1471-2458-14-201 Monks, H. E., Cross, D., & Pearce, N. (2016). The Ripple Effect: Promoting a Supportive SecondarySchoolCulturebyMobilisingBystanderstoBullying.DOI 10.1177/1609406916628953
17 INDIGENOUS HEALTH PERSPECTIVE NITV (2018).Report reveals stark protection rates for Indigenous kids, but fails to examine abuseincare.[online]NITV.Availableat: https://www.sbs.com.au/nitv/nitv-news/article/2018/03/09/report-reveals-stark- protection-rates-indigenous-kids-fails-examine-abuse-care [Accessed 11 May 2018]. Paul, D., Ewen, S. C., & Jones, R. (2014). Cultural competence in medical education: aligning the formal, informal and hidden curricula.Advances in Health Sciences Education,19(5), 751-758. DOI 10.1007/s10459-014-9497-5 Price, M., & Dalgleish, J. (2013). Help-seeking among indigenous Australian adolescents: exploringattitudes,behavioursandbarriers.YouthStudiesAustralia,32(1),10. doi=10.1.1.731.6143 Putt,J.(2013).ConductingresearchwithIndigenouspeopleandcommunities.Sydney: IndigenousJusticeClearinghouse.Retrievedfrom: https://www.indigenousjustice.gov.au/wp-content/uploads/mp/files/publications/files/ brief015.pdf Sköld, J. (2013). Historical abuse—a contemporary issue: Compiling inquiries into abuse and neglect of children in out-of-home care worldwide.Journal of Scandinavian Studies in CriminologyandCrimePrevention,14(sup1),5-23. http://dx.doi.org/10.1080/14043858.2013.771907 Sprianovic, C., Clare, J., Bartels, L., Clare, M., & Clare, B. (2014). Aboriginal young people in the children's court of Western Australia: Findings from the national assessment of Australian children's courts.UW Austl. L. Rev.,38, 86. Retrieved fromhttp://research- repository.uwa.edu.au/files/9284676/SSRN_id2586825_Aboriginal_young_people.pdf
18 INDIGENOUS HEALTH PERSPECTIVE Yiengprugsawan, V., Hogan, A., & Strazdins, L. (2013). Longitudinal analysis of ear infection andhearingimpairment:findingsfrom6-yearprospectivecohortsofAustralian children.BMC pediatrics,13(1), 28.https://doi.org/10.1186/1471-2431-13-28