First Peoples' Health HLTH 1047: Alcohol Consumption Impact Analysis

This assignment, a part of HLTH 1047, examines the significant impact of alcohol consumption on the health and well-being of Indigenous Australians, tracing the issue from its historical roots to its current prevalence. It explores the historical context of alcohol introduction, health risks, including liver disease, mental health issues, and increased mortality rates, and the social and family impacts, such as domestic violence and fetal alcohol spectrum disorder. The assignment delves into the epidemiology of alcohol abuse within the Indigenous community, comparing consumption levels and associated health problems. It also outlines strategies like the National Aboriginal and Torres Strait Islander People’s Drug Strategy, focusing on reducing demand, limiting supply, and raising awareness. The analysis underscores the need for culturally sensitive health promotion that considers the historical and social factors contributing to alcohol dependence and promotes holistic approaches to improve health outcomes for Indigenous Australians.

Part B (Poster)
Background
The National Aboriginal and Torres Strait Islander Health Plan 2012-13 reported that the
Indigenous Australians drank more than the NHMRC risk guideline. Increased alcohol
consumption has significant impacts on the community and has come up as a family stressor.
Moreover, it is associated with a bunch of health and social problems. In 2003, Burden of
Disease study, it was estimated that the alcohol accounts for 5.4% of the diseases and injuries
caused to the Aboriginals (Health, 2013).
The alcohol problem began with the invasion of Australia. Within weeks of the invasion, many
pubs and bars sprawled up for providing the European men with a place for merrymaking. Also,
what greatly impacted the Aboriginals was that they were often paid their wages for their
services in alcohol or tobacco, which was meant to be sold further or exchanged for a
necessary item (Aihw, 2011). It soon began the medium of payment for all sorts of illegal and
questionable activities like prostitution. Alcohol-induced prostitution on the other hand also
spoiled the rearing of children and as a result, many unwanted and unplanned infants roamed
the streets. These children often belonged to the mixed-race and were usually seen as an
abomination and rejected. The white settlers gave alcohol to the Aboriginals to watch and
encourage fights among them as a means of entertainment.
In 1964, the Legislative Council Committee members agreed to make alcohol available to the
Aboriginals. It clear from this fact that it was the Europeans who introduced alcohol to the
Aboriginals. However, they never intimated them about the ill effects of alcohol consumption
and the need to manage their consumption levels (Pmc, 2014).
After the advent of the modern era and advertising, alcohol was everywhere and often
considered as the glue that held the white community together. The omnipresence of alcohol
made it difficult for the Aboriginals to curb their addiction or know about its associated health
hazards. However, a non-indigenous Australian is also as likely to drink as an Indigenous. But
the Aboriginals are more prone to the health hazards as they are unable to access care and
health supplements that would have saved a non-indigenous Australian (Doty-Sweetnam and
Morrissette, 2018).
It soon turned out to be a common stereotype that Indigenous people were all alcohol addicted
and could not be trusted because of their addiction. As a result, it became even difficult for them
to find work and education that could improve their quality of life. Their dependence on alcohol
can also be because of their bleak lifestyle which causes them to soon fall prey to depression
and other drugs (Shakeshaft et al. 2018). Even if there are less number of indigenous people
who are dependent on alcohol than the Australian. They are likely to drink at harmful levels.
Contextual information about the risk factor
The issue of alcohol addiction needs to be viewed in the Australian context. Australians are
known to be heavy drinkers and alcohol is an integral part of their lifestyle and culture. As a
result, it is everywhere and a person trying to limit their consumption might have difficult to keep
themselves in control. In Australia, alcohol is the cause behind 44% of fire injuries,
40%domestic violence, 34% drawings, 30% road accidents and 70% of police time spent in
handling alcohol-related cases. In the year 2004-5, it was estimated that $55.2 billion was spent
on alcohol alone (Popova et al. 2017).
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The broader Australian context is strengthened by the historical context that had been briefly
hinted upon before. Alcohol began the cornerstone of colonial life for the Aboriginals as they
turned to it during the failing times. They lost their lands which were also their only sources of
earning and it turn had to turn towards menial jobs which also took away their freedom and
autonomy. Due to the forced removal of indigenous children from their homes to that of non-
indigenous Australians was a failing move of the colonialist to prevent the aboriginal population
from dying out. During 1838 to 1929, stringent laws were laid on the sale of alcohol to the
indigenous people (Martin, 2018). The laws were lifted when the Aboriginals were able to
demonstrate they were able to control themselves and mix with the wides and acceptable form
of society. However, the draconian laws caused the riskier Alcohol consumption patterns which
often included high levels of consumption at once. Also, alcohol became a prized possession
and they would rather drink to unhealthy levels than have it confiscated. This also promoted the
illegal sale and brewing of alcohol which increased the desire of the people towards it.
The above statistics paint the picture of a country rather than a community that is dependent on
alcohol. It is essential to understand that the alcohol consumption problem is social as well as
historical. The Aboriginals fell back and became dependent on alcohol as they lost their land,
their heritage, culture and head towards economic ruin.
Even though an Aboriginal is 1,3 times more likely to abstain from drinking than an Australian.
However, the ones that do drink, drink in harmful quantities, at 1.2-1.3 times more than what
Australian drinks (Harrison et al. 2016).
The health risks perpetuated among the Aboriginals include alcoholic liver disease, behavioural
disorders, assault, suicide and transport-related accidents. In states like NSW, WA and BT
during 2010-2914, Aboriginal and Torres Strait Islanders died 4.7 and 6.1 times more than a
non-indigenous Australian from Alcohol consumption and associated problems. The overall
suicide rate among the Aboriginals during 2015 was 2.1 times than a non-indigenous person.
40% of the male suicides and 30% of females suicides were accounted by alcohol consumption
and the accompanying behavioural changes (Munns et al. 2016). Also, the use of alcohol is
directly related to the use of other drugs and the prevalence of poor mental health among the
Aboriginals. Smoking is also commonly accompanied by alcohol consumption. However, the
prevalence of smoking has declined from 55% to 45% in 2014-15.
Epidemiology
In order to understand the epidemiology of alcohol, it is necessary to first standardise the limit or
context of alcohol that is likely to cause minimal or no effect in an average person. In Australia,
the standard limit of alcohol if 10 grams, irrespective of the type of alcohol or the contents of the
drink. In the United States, the accepted level is 14 grams. When discussing the effects and
consequences of alcohol in the body, it is necessary to first ensure the level of consumption.
The tradition means of diagnosing alcohol abuse or related complication mostly rely on
symptoms and consequences of drinking alcohol. However, the quantity and frequency of
alcohol consumption are also being considered as a key factor to assert a dependence on
alcohol (Fiel, 2018). In order to be diagnosed with an alcohol disorder, a person would need to
have a maladaptive pattern use and signs of impairment after alcohol use. These were set as
the minimum criteria to diagnose alcohol dependence. Is it essential to delineate the differences
between the abuse of alcohol and dependence on alcohol. Abuse of alcohol is associated with
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the adverse effects of alcohol consumption whereas a dependence will only include a
compulsive habit, loss of control and inebriation.
Other signs include the use of alcohol in dangerous situations such as while driving, hunting,
trekking or being at a place where the chances of harm and injury are increased. Consuming
alcohol is also likely to make them falter at their responsibilities, whether it be to a person or to
their job or education (Ridani et al. 2015). This is often followed by legal complications like
drunk driving and misbehaviour in public places. A person who is not dependent on it might be
able to understand the pattern ad stop drinking. However, the alcohol problem is easily
diagnosed in a person who has suffered much because of it and is still reluctant to give it up.
Death and disability are a common consequence of alcohol have increased among the
Aboriginals. The impact of alcohol is greatest on the liver, hepatologists have estimated that half
of the cirrhosis related deaths in Australia have been because of alcohol use. Women had a
higher risk of developing cirrhosis at the same level of alcohol consumption than males.
Impact on consumer/family experience
The family and kin are important cultural aspects of Aboriginal society. The consumption and
dependence on alcohol have led to a severe decline in the social and family life of an islander.
Reports from 2007 surveys indicate that 17.6% of the islanders suffer from mental disorders like
schizophrenia, mood and personality disorders. There is strong evidence that relates the use
and dependency on alcohol with the alarming mental health condition among the islanders. The
males of the family are most affected by alcohol consumption and as they are the sole in most
islander families, the whole family dynamic is left distraught. The rise of alcohol-related abuse
and violence both within and outside the family member has been on the rise. Islander men
were injured or hospitalised 217 times more than a non-indigenous person in per 100,00 people.
Aboriginal women were hospitalised 633 times per 100,00 person. The rate is 37 times higher
than that seen among non-indigenous people (Health, 2013). The reported ratio was much
higher in remote areas than in large cities where help was comparatively accessible. Suicide
and self-inflicted injuries re in prevalence given to the alcohol dependence and bleak scenario of
life elsewhere. The mortality rate is high and life expectancy very low, which causes an islander
to lose an important family member untimely. Sometimes they have violent and troubling deaths
because of inability to access healthcare quickly (Health, 2013). This leads to a deep-rooted
trauma that forces heavy alcohol use. Another severe impact of alcohol on the family
experience is through the fetal alcohol spectrum disorder. This is when a newborn has a severe
neurological and developmental impairment which can be traced back to the mother’s severe
alcohol consumption during and after pregnancy. It leads to a restricted and disabled life for the
child. Also, the mother, who has abused alcohol is unable to provide for further care and
nourishment to the child to ensure that they are able to make the most despite their crippling
disabilities. Such children often show delayed motor and cognitive skills which impacts their
ability to process any form of cues.
Strategies
The national Aboriginal and Torres Strait Islander People’s Drug Strategy has been made as a
sub strategy of the national drug strategy to especially focus on the demands of the Aboriginal
people. The goal of the strategy is reducing the health concerns of the Alcohol and related
drugs on Aboriginal people. It would work in three phases to bring out the desired effect. The
first phase would be to decrease the demand or dependency on these products by increasing
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the preoccupation of the youth and by giving them work (Health, 2013). In the next phase the
supply and exposure to alcohol and related drugs will be reduced. The last stage will deal with
raising an awareness among the indigenous about the health concerns of consuming alcohol in
high quantities. The strategy values the health of the indigenous people through a holistic
approach that also considers their social conditions. This approach identifies that there is a
need to first reinforce the cultural systems of care and control services so that the strategy can
be implemented rigorously (Health, 2019). Yet, the care providers have to be aware and
acknowledge the cultural rights of the people and treat them with respect and decadence.
Part C
Summary of the scenario
The poster depicts a brief but impactful scenario of the issue of alcohol consumption among the
aboriginals. The problem has been traced from its historical conception after the invasion of the
Europeans and how they made use alcohol as a means to control and plunder the aboriginals.
Also, the ongoing alcohol culture and its prevalence in the society make it difficult for Aboriginals
to ignore the addictive agent. From this brief review, it becomes clear that the issue cannot be
just viewed as a social and health problem but one that historical and national context. The
standard limit of alcohol consumption if 10grams irrespective of the type and quantity of alcohol.
However, even though the Aboriginals are less likely to drink than the non-Aboriginals. But, their
quantity of consumption is very high because they lack the knowledge of impacts and healthy
limit of consumption (Pmc, 2014). Also, the prevalence of high consumption in among the
people who otherwise lack other resources and lead a purposeless life.
Health promotion strategies
The main problem with alcohol is that the Aboriginals drink in high quantities and are often
aware of the social and health consequences it has. They were never intimated about the past
about the damage alcohol does as it was used as a tool to subjugate them. The National
Aboriginal and Torres Islander Drug Strategy 2014-2019 aims to build a workforce that is able to
intervene the barriers set up by the Aboriginals and provide them with services that build their
resistance against alcohol or other drugs (Health, 2019). The campaigns and prevention
programs are culturally and socially active which enables them to strengthen the relationships
between the communities and the healthcare professionals.
Knowledge gained
This project allowed to understand how the cultural and social barriers have been raised and
how the condition of the Aboriginal communities have degraded over the years through the
repetitive subjugation, discrimination and lack of focus on their needs. As a result, these
indigenous communities have become resistant to any outside help and are reluctant to accept
it (Munns et al. 2016). In order to be able to engage them in promotion and development
campaigns, it is needed that the service providers are culturally aware, acknowledging the
differences and also respectful of their capabilities.
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References
Aihw, (2011), Australia’s health 2016, Available at https://www.aihw.gov.au/getmedia/77682069-
48f3-4b46-b145-07f8f8fca53f/ah16-4-8-health-behaviours-biomedical-risks-indigenous-
australians.pdf.aspx
Doty-Sweetnam, K. and Morrissette, P., 2018. Alcohol abuse recovery through the lens of
Manitoban First Nations and Aboriginal women: A qualitative study. Journal of ethnicity in
substance abuse, 17(3), pp.237-254.
Field, C., 2018. Hazardous alcohol consumption in non-aboriginal male inmates in New South
Wales. International journal of prisoner health, 14(1), pp.46-55.
Harrison, C., Charles, J., Miller, G.C. and Britt, H., 2016. Chronic alcohol abuse. Australian
family physician, 45(12), p.858.
Health, (2013), NATIONAL ABORIGINAL AND TORRES STRAIT ISLANDER HEALTH PLAN
2013–2023, Available at
https://www1.health.gov.au/internet/main/publishing.nsf/content/B92E980680486C3BCA257BF
0001BAF01/$File/health-plan.pdf
Health, (2019), National Aboriginal and Torres Strait Islander Peoples’ Drug Strategy 2014 –
2019, Available at https://www.health.gov.au/sites/default/files/national-aboriginal-and-torres-
strait-islander-peoples-drug-strategy-2014-2019_0.pdf
Martin, D.F., 2018. The supply of alcohol in remote Aboriginal communities: potential policy
directions from Cape York. Canberra, ACT: Centre for Aboriginal Economic Policy Research
(CAEPR), The Australian National University.
Munns, A., Toye, C., Hegney, D., Kickett, M., Marriott, R. and Walker, R., 2016. The emerging
role of the urban-based aboriginal peer support worker: A Western Australian study. Collegian,
23(4), pp.355-361.
Pmc, (2014), Risky alcohol consumption, Available at
https://aodknowledgecentre.ecu.edu.au/healthinfonet/getContent.php?
linkid=590984&title=Review+of+the+harmful+use+of+alcohol+among+Aboriginal+and+Torres+
Strait+Islander+people
Popova, S., Lange, S., Probst, C., Parunashvili, N. and Rehm, J., 2017. Prevalence of alcohol
consumption during pregnancy and Fetal Alcohol Spectrum Disorders among the general and
Aboriginal populations in Canada and the United States. European journal of medical genetics,
60(1), pp.32-48.
Ramamoorthi, R., Jayaraj, R., Notaras, L. and Thomas, M., 2015. Epidemiology, etiology, and
motivation of alcohol misuse among Australian aboriginal and torres strait islanders of the
northern territory: a descriptive review. Journal of ethnicity in substance abuse, 14(1), pp.1-11.
Ridani, R., Shand, F.L., Christensen, H., McKay, K., Tighe, J., Burns, J. and Hunter, E., 2015.
Suicide prevention in Australian Aboriginal communities: a review of past and present programs.
Suicide and Life‐Threatening Behavior, 45(1), pp.111-140.
Shakeshaft, A., Clifford, A., James, D., Doran, C., Munro, A., Patrao, T., Bennett, A., Binge, C.,
Bloxsome, T., Coyte, J. and Edwards, D., 2018. Understanding clients, treatment models and
evaluation options for the NSW Aboriginal Residential Healing Drug and Alcohol Network
(NARHDAN): a community-based participatory research approach.
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