Indigenous Health Perspectives: Low Birth Weight Among Indigenous Children in Australia

This study analyzes media articles discussing low birth weight among Indigenous children in Australia and how it relates to social determinants of health. The articles highlight the health gap between Indigenous and non-Indigenous Australians and the need for improved access to healthcare and prenatal care.

Running head: INDIGENOUS HEALTH PRESPECTIVES
INDIGENOUS HEALTH PRESPECTIVES
Name of the Student
Name of the University
Author Note

1INDIGENOUS HEALTH PRESPECTIVES
Introduction:
Low Birth Weight is a situation in which babies are born weighing less than 2500
grams. Babies with low birth weight looks smaller than babies of normal birth weight, and
have higher risks of long term health conditions such as hypertension, diabetes, cardiac
problems, pulmonary complications and renal diseases. Higher risks of various types of
infections such as chickenpox, toxoplasmosis and rubella is associated with low birth weight
(Ghahfarokhi et al., 2018). Additionally, low birth weight can also cause developmental
disorders among the children and fetal growth restrictions due to which the infants are not
able to gain weight normally and they grow up to be underweight children and adolescents.
Studies show that the low birth rates can increase the risks of long term developmental
outcomes and neurodevelopment problems (such as Autism and ADHD) which can reduce
their overall health and wellbeing (Dudova et al., 2014; Franz et al., 2018).
In Australia, significant number of children born in Aboriginal and Torres Strait
Islander communities with a low birth weight, compared to non indigenous Australians.
According to statistics from the Australian Institute of Health and Welfare, 11.2% of live
born singleton babies born in the Indigenous Australian Communities were of low birth
weight (as of 2011) which was 2.5 times higher compared to child births from Non
indigenous communities (4.6%) (aihw.gov.au, 2014; Martinson & Reichman, 2016).
Additionally, according to Aboriginal And Torres Strait Islander Health Performance
Framework 2017 Report, the rates for low birth weights among Indigenous Mothers were at
the top of the list in the most remote areas (12.1%) and remote areas (11.7%) and the mean
birth weights of babies (3217 grams) born to Indigenous mothers were found to be lesser than
babies born to non indigenous mothers (3356 grams) (pmc.gov.au, 2017; Sayers et al., 2017).
This information clearly shows that the problem of low birth weight among Indigenous

2INDIGENOUS HEALTH PRESPECTIVES
Children is significantly higher compared to Non Indigenous children, making them more
prone to health conditions in later life (Kildea et al., 2017; Dossetor et al., 2017).
The aim of this study is to analyze four media articles which discusses the problem of
low birth weight among indigenous Australians and how the articles relate to the modules and
topics taught during the learning sessions.
Discussion:
Media Item 1:
Maguire, G., & Robson, B. (2016). Aboriginal – Māori: how Indigenous health suffers on
both sides of the ditch. The Conversation [Parkville]. Retrieved from
https://theconversation.com/aboriginal-maori-how-indigenous-health-suffers-on-both-
sides-of-the-ditch-48238
Summary To Key Issues:
In this article written by Maguire and Robson (2016), titled “Aboriginal – Maori: how
Indigenous health suffers on both sides of the ditch”, published on The Conversation on April
21, 2016, the authors points out that the health gap between the Indigenous and Non
Indigenous people in Australia and New Zealand still keeps on expanding and the Indigenous
people are seen to suffer more compared to Non indigenous people. The authors have studied
the life expectancies, infant mortality rates, birth weight, maternal mortality rates, nutritional
status and educational status of both Indigenous and Non Indigenous people, comparing the
statistics in both Australia and New Zealand to understand the drawback related to health
between the Non Indigenous and Indigenous communities in there two countries. From the
studies the authors concluded that across all the measures (mentioned above) the Indigenous
people fared less than the Non Indigenous people thereby showing a significant health

3INDIGENOUS HEALTH PRESPECTIVES
disparity between these people. One of the biggest disparity have been found to be in the
birth weight, with more Indigenous babies being born under the weight of 2500 grams,
making them underweight and increasing their risks to different health conditions compared
to non indigenous children. Moreover, the health discrepancies are further increased due to
lesser accessibility to proper education, and have higher risks of the babies born with low
birth weight towards mental health issues and exposure of high levels of alcohol consumption
and different communicable and chronic diseases (Saigal et al., 2016). According to their
studies, the life expectancies of Indigenous children (69.1 years for males and 73.7 years for
females) were significantly less compared to non indigenous children (79.7 years for males
and 83.1 for females). Similarly, risks of diabetes and suicide rates were also higher among
the indigenous people. According to Maguire and Robson, these higher risks of mortality and
health risks were significantly contributed by the low birth weight among the Indigenous
babies (Martinson & Reichman, 2016).
Links to Models, Approaches & Current Debates:
A complex interplay of various determinants of health can be related to the health
discrepancies between Non Indigenous and Indigenous people (Corpeleijn et al., 2016). This
complex interaction of different determinants creates a challenge to address the health
discrepancies, which have been discussed through the learning outcomes covered in the first
topic of Module 1. In the topic various factors or social determinants of health such as access
to proper education, poverty and unemployment were discussed and how its interplay can
affect the health and wellbeing of the Indigenous people. Through the studies were able to
learn how these factors can lead to Indigenous people living in below standard housing, lave
limited access to proper nutrition and healthcare and also reduce accessibility to proper
education among the youth, increase risks of addiction related problems, which moreover can
reduce employability rates and thus their socioeconomic standards (Kader & Perera, 2014;

4INDIGENOUS HEALTH PRESPECTIVES
Rahman et al., 2015; Demelash et al., 2015). The lack of access to healthcare also reduces
effective prenatal and antenatal care for the indigenous mothers, thereby increasing the risks
of low birth weight for their children.
These studies support debates which argue that the lack of prenatal and antenatal care
among the indigenous mothers would result in the continuance of the physical health
discrepancies between the non Indigenous and Indigenous children, and would result in the
prevalence of high mortality rates, lower life expectancies and higher risks of infections and
chronic health conditions, increasing the health related drawback between the Non
Indigenous and Indigenous Australians (Xaverius et al., 2016; Martinson & Reichman,
2016).
Personal Reflection:
Reflecting upon the above findings and opinions of the authors, it can be stated that in
order to reduce the health discrepancies between indigenous and non indigenous Australians,
it is vital to improve their accessibility to healthcare, especially towards prenatal and
antenatal care and steps must be taken to reduce the incidence or prevalence of indigenous
mothers giving birth to children with low birth weight. I believe that by improving access to
prenatal and antenatal care, the vicious cycle of low birth weight, poor health outcomes and
socioeconomic conditions can be broken and the wellbeing of the indigenous people
improved.
Media Item 2:
Aubusson, K. (2018). Aboriginal children healthier than ever but generations behind peers.
Retrieved from https://www.smh.com.au/national/nsw/aboriginal-children-healthier-
than-ever-but-generations-behind-peers-20180621-p4zmxm.html

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Summary To Key Issues:
In this news article titled “Aboriginal children healthier than ever but generations
behind peers” by Kate Aubusson in the newspaper The Sydney Morning Herald on June 21st,
2018, the author points out towards an improvement in the health of the Indigenous children
from the Aboriginal Australian communities over the last few decades. The author however
shows concern that the health of the Indigenous children still lags behind their Non
Indigenous peers, and thus there still exists a health discrepancy between the Indigenous and
Non Indigenous populations (Delany et al., 2018). According to the authors, even though the
rates of teenage pregnancies and rates of smoking among pregnant Indigenous women have
reduced over the years, these rates are still more than six times higher compared to Non
Indigenous people, showing that the improvement in the health and wellbeing of the
Indigenous people are not at par with the improvements seen among the non indigenous
population, and thus the health gap is not being overcome. The report also shows that the
disadvantage faced by the indigenous pregnant women were more than the non indigenous
pregnant women, due to which the rates of low birth weights for Indigenous children have not
reduced since 2012 and one in every three indigenous children have developmental
vulnerabilities (Ghahfarokhi et al., 2018; Mitrou et al., 2014).
Links to Models, Approaches & Current Debates:
During the topic one of module 3, it was discussed how the poorer health outcomes
for Indigenous neonates are caused due to several risk factors and social determinants of
health which compromises the cultural, social as well as emotional wellbeing of the
indigenous people, and low birth weight is one of these determinant which impacts the
overall health and wellbeing of these people (Lee et al., 2018). Due to this, it is vital that an
immediate intervention be implemented to address these social determinants and strategies to
address the problem of low birth weight among Indigenous neonates be identified as soon as

6INDIGENOUS HEALTH PRESPECTIVES
possible to prevent further widening of the health gap and health discrepancies between the
Indigenous and Non-Indigenous people (Mitrou et al., 2014). Discussion about the Steering
Committee for the Review of Government Service Provision report, it was clearly understood
that necessary precautions were not being implemented and proactive measures were not
taken to address the existing disparities in health between the Indigenous and Non Indigenous
people, especially in the context of higher rates of low birth weights among indigenous
neonates compared to non indigenous neonates, due to which the health discrepancies still
exist (directory.gov.au, 2017). This have also been supported by studies that show that a lack
in maternal and childcare programs for Aboriginal and Torrest Strait Islanders is one of the
biggest contributors in the incidence of premature births and babies born with low birth
weights (Delany et al., 2018; Grant & Greenop, 2018).
The article clearly supports the discussions made during the different modules on how
the social determinants of health such as access to healthcare as well as teenage pregnancies
and incidence of smoking among pregnant women can increase the risks of adverse health
effects for the children (Blakely et al., 2015). Additionally, although the report supported the
view that the wellbeing of the Indigenous people have improved over the last few decades,
the rate of improvement have not been at par with that of the non indigenous people, as a
result of which the health related drawback between the non- indigenous and indigenous
people still exist in Australia (Greenwood et al., 2015).
Personal Reflection:
I believe that no excuse can exist for the maintenance of such health gaps and health
discrepancies between the people living in the same country. This health discrepancy still
shows that the Indigenous people are still not over the historic inequalities faced by them
through the history of Australia.

7INDIGENOUS HEALTH PRESPECTIVES
Media Item 3:
Wahlquist, C., & Davidson, H. (2017). Drop in birth weights and school attendance could be
linked to NT welfare restrictions. Retrieved from
https://www.theguardian.com/australia-news/2017/dec/08/drop-in-birth-weights-and-
school-attendance-could-be-linked-to-nt-welfare-restrictions
Summary To Key Issues:
The article titled “Drop in birth weights and school attendance could be linked to NT
welfare restrictions” by Wahlquist and Davidson, posted on The Guardian on December 8th,
2017, discusses about how the Northern Territory welfare restrictions have resulted in a drop
in the birth weights as well as attendance is schools. The authors pointed out that between
September 2007 to October 2008, attendance in schools from approximately 73 Indigenous
communities in Australia have dropped by almost 4% along with a proportional increase in
the incidence of birth of children with low birth weights from these communities. The authors
have argued that these were interring related outcomes, since the low birth weight increases
the risks of health problems among the children, due to which their attendance in schools gets
lowered. It has also been pointed out that inappropriate welfare strategies is one of the most
significant causes of financial stress among the indigenous people living on state support
(Kallankari et al., 2015). The inadequate welfare, which only covers their ‘basic’ expenses
which are disbursed fortnightly have led to an increase in conflicts in households, while poor
implementation and income management strategies have effectively rendered the welfare
support systems ineffective to address the health discrepancies. According to the authors,
these financial stresses among the indigenous people have increased the incidence of smoking
and alcoholism especially among the Indigenous mothers, which also a significant risk factor
for the low birth weight (Serido et al., 2014). The financial problems and incidence of
domestic stressors have also resulted in the reduction in school attendance among the

8INDIGENOUS HEALTH PRESPECTIVES
indigenous children, which additionally affects their educational levels and also
employability rates, thereby causing the maintenance of the financial stressors. The authors
pointed out that the strategies to restrict the welfare of the people by allocating them
fortnightly instead of a large sum at one time can prevent the incidence of smoking in the
communities (Zhao et al., 2015).
Links to Models, Approaches & Current Debates:
In the news article, the author discussed the efficacy of welfare strategies such as
income management programs for the Indigenous people that can help them to overcome
dependencies on alcohol and tobacco through the allotment of welfare that can only cover the
basic expenses and prevent the welfare money to be spent of smoking or buying alcohol
(Martinson & Reichman, 2016). The strategy to promote the wellbeing through reduction in
smoking and alcohol dependency can be supported through studies that show a clear link
between these risk factors with several health conditions including low birth weight. Statistics
from Tobacco In Australia also shows a higher prevalence of low birth weight among for
children whose mothers smoked during their pregnancy, which affected size and growth of
the fetus in the womb, and also increased the risks of stillborn births as well as sudden infant
death syndrome (SIDS) (tobaccoinaustralia.org.au, 2015; Zhao et al., 2016).
Such aspects have also been discussed in the topics from second module in which the
risk factors such as smoking has been discussed which adversely affects the health and
wellbeing of the Indigenous people. Through the module, it was clearly understood that
addressing the problems of smoking was important to overcome several health conditions
such as lung diseases, hypertension, diabetes and low birth weight as well as congenital
defects (US Department of Health and Human Services, 2014). During the debates it has been
proposed that by reducing the rates of smoking among the indigenous people, the health
discrepancies between the indigenous and non indigenous people can be reduced. The article

9INDIGENOUS HEALTH PRESPECTIVES
by Wahlquist and Davidson (2017) clearly supports such a view, which points towards the
strategy by the Northern Territory to curb tobacco dependency among pregnant women from
the Indigenous communities.
Personal Reflection:
The article shows how it is vital to restrict the incidence of smoking among the
indigenous communities to prevent low birth weight for children. However, it was also clear
that an improper implementation of the strategy can have an opposite effect, increasing the
financial stress among the indigenous people and instead of reducing the rates of smoking
and alcohol dependency, can increase the risks and thus become ineffective in improving
their health conditions, especially the rates of low birth weight.
Media Item 4:
Barclay, L., & Nagel, T. (2013). Improving Aboriginal health and well-being: a view from
the north. Retrieved from https://theconversation.com/improving-aboriginal-health-
and-well-being-a-view-from-the-north-18522
Summary To Key Issues:
In the article titled “Improving Aboriginal health and well-being: a view from the
north”, the authors Lesley Barclay and Tricia Nagel in the news journal The Conversation on
September 25th, 2013 pointed out that indigenous Australians who are living in the remote
communities fare much worse than other Australians in terms of their life expectancies. The
authors also gave a stern render that the health discrepancies are unlikely to be reduced
without proper support from the government as well as the leaders from the Aboriginal and
Torres Strait Islander communities (Delany et al., 2018). According to the authors, the
differences and discrepancies between prenatal care for the indigenous women and non
indigenous women have resulted in the prevalence of low birth weight among the indigenous

10INDIGENOUS HEALTH PRESPECTIVES
children. Moreover, the author also pointed out that the prenatal care were not adequately
being utilized by the indigenous mothers mainly because of several social determinants such
as the socio economic status and a lack of trust on the healthcare system (Mitrou et al., 2014).
Thus the authors recommend that the government should take more careful and proactive
steps to ensure better utilization and accessibility of prenatal care among the indigenous
Australian communities. Also, according to the authors, improving the continuity of care
through antenatal care strategies and utilization of midwives to help the pregnant women to
prepare for childbirth can also help to address this health issue and help the government to
close the health gap between indigenous and non indigenous people.
Links to Models, Approaches & Current Debates:
During the Modules 1 and 2, it was discussed how the progression in the health and
wellbeing between the indigenous and non indigenous people were disproportional, due to
which the health gap between the people are never fully covered. In the topic 1 on module 1,
it was discussed how there exists a wrong perception among the healthcare workers that ‘poor
health’ is a common factor for the indigenous Australian population (Kader & Perera, 2014).
This creates a sense of complacency among the healthcare workers to promote the wellbeing
of the people. This have been supported by the news article. During the module 3, topic 2, it
was also emphasized that there has been an improvement in the health of indigenous people,
which can be seen through a reduction in the infant mortality rates and improvement in the
life expectancies among the indigenous people due to the expansion of the indigenous
maternal health services (Dossetor et al., 2017). However, still the non indigenous mothers
are more than twice likely to deliver healthy babies compared to the indigenous mothers,
showing that more needs to be done to bridge this health gap. Thus improvement in service
delivery is still required to address this gap (Lee et al., 2018).

11INDIGENOUS HEALTH PRESPECTIVES
Personal Reflection:
Reflecting upon this article, it can be clearly summarized that even though there is an
improvement in the overall wellbeing among the indigenous people, the health gap still exists
due to ineffective healthcare delivery system, which fails to address the health needs
especially in the remote indigenous communities and due to the poor reach of healthcare
delivery for indigenous mothers. I completely agree with the author’s conclusion that more
needs to be done to bridge the health gap.
Conclusion:
The incidence of low birth rates have reduced among the indigenous communities,
however the rates are still far greater compared to the non indigenous Australians. The low
birth rates have been influenced by several key health determinants such as socioeconomic
conditions, access to healthcare, financial strain, education levels and employment levels.
Moreover, smoking, alcoholism, teenage pregnancy have also led to the higher incidence of
low birth weight among the indigenous people. Through this essay, it was highlighted how it
is vital to prioritize the addressing of these risk factors in order to increase the health and
wellbeing of the Indigenous Australian people. The four media sources helped to understand
the continued health gap between the indigenous and non indigenous people exhibited though
the higher rates of low birth weight. It can be concluded that the government should approach
this problem by addressing these determinants, helping to increase use of healthcare
programs for prenatal and antenatal care for the indigenous mothers and helping to overcome
smoking and alcoholism to ensure better outcomes.

12INDIGENOUS HEALTH PRESPECTIVES
Reference:
aihw.gov.au. (2014). Birthweight of babies born to Indigenous mothers, Table of contents -
Australian Institute of Health and Welfare. Retrieved from
https://www.aihw.gov.au/reports/indigenous-australians/birthweight-of-babies-born-
to-indigenous-mothers/contents/table-of-contents
Aubusson, K. (2018). Aboriginal children healthier than ever but generations behind peers.
Retrieved from https://www.smh.com.au/national/nsw/aboriginal-children-healthier-
than-ever-but-generations-behind-peers-20180621-p4zmxm.html
Barclay, L., & Nagel, T. (2013). Improving Aboriginal health and well-being: a view from
the north. Retrieved from https://theconversation.com/improving-aboriginal-health-
and-well-being-a-view-from-the-north-18522
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255-270.

13INDIGENOUS HEALTH PRESPECTIVES
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low birth weight in Bale zone hospitals, South-East Ethiopia: a case–control study.
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sides-of-the-ditch-48238

15INDIGENOUS HEALTH PRESPECTIVES
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16INDIGENOUS HEALTH PRESPECTIVES
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school-attendance-could-be-linked-to-nt-welfare-restrictions
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17INDIGENOUS HEALTH PRESPECTIVES
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