Aboriginal Hearing and Special Senses: HEALT 2114 Assignment

This essay provides a comprehensive overview of hearing and special senses among Aboriginal Australians, focusing on the high incidence of ear disorders and associated hearing complications. It begins by describing the health issue, primarily otitis media (OM), detailing its causes, prevalence, and impact on Aboriginal children. The essay then explores the historical context, highlighting the detrimental effects of colonization on Indigenous health, including the introduction of pathogens and the segregation that led to unequal access to healthcare. The social determinants of health, such as socioeconomic factors, environmental conditions, and cultural beliefs, are also discussed as significant contributors to hearing problems. The essay concludes by emphasizing the cultural implications and obstacles in addressing these health issues, underscoring the need for culturally appropriate healthcare and improved access to services to reduce hearing loss and improve the overall well-being of Aboriginal communities. The essay uses current statistics and references to support its arguments.

Hearing and special senses among Aboriginals
Introduction
The high incidence of ear disorders and associated hearing complications among the Aboriginal
and Torres Islander peoples of Australia has been in existence since the 1970s, after colonization.
In the 80s it was categorized as a public health issue for the Indigenous Australians (Closing the
Gap Clearinghouse (AIHW & AIFS, 2014). Hearing loss is likely to be caused by genetic
problems, birth complications, some communicable illnesses, acute ear infections, the
consumption of some drugs, accidents and injuries, ageing and exposure to very loud noise.
According to the World Health Organization (WHO, 2017) hearing loss among children is
caused by preventable causes (WHO 2017). The most common hearing problem among the
Aboriginal people is otitis media. The Aboriginal children are the most affected with otitis media
globally and are 5 times more likely to have the disease than other Australians. Otitis media have
critical long-term impacts such as delay in speech and vocal development leading to challenges
in learning, behavioural issues and general challenges in education progression. The high
prevalence of otitis media among Aboriginal and Torres Islander people has been attributed to
the social determinants of health, poor nutrition and hygiene and overcrowded housing among
others. However, the high rates of hearing loss can be reduced through effective management of
childhood infections through a thorough hearing screening and the existence of preventing
approaches. This paper aims at assessing Hearing and special senses among Aboriginals by
conducting a critical review of relevant literature. A description of the health concern is
provided, its prevalence, history concerning colonization, social determinants of health and
cultural implications in addressing the disease

Description of the health-issue
Otitis media (OM) is a range of diseases that consists of inflammation or infection in the middle
ear. This variety of illnesses includes a range from acute to chronic disorders that are clinically
diagnosed by the presence of fluid in the middle ear (Coticchia, Chen, Sachdeva, & Mutchnick,
2013). It is not clear why OM develops, but its prevalence has been attributed to multiple factors
such as bacterial infection, viruses, environmental smoke and daycare attendance among others.
Studies have found bacterial and viral microorganisms in those diagnosed with OM.
Alloiococcus otitis and S. pneumonia were detected in a study conducted by Coleman et al.
(2018) in younger children aged two years from which middle ear samples were obtained for
assessment. In another study, middle ear samples were examined and viral RNA was found using
reverse transcriptase in nineteen children and Respiratory syncytial virus RNA was the most
prevalent in 8 out of 11 cases (Hoberman et al., 2011). The major viral pathogens of OM include
respiratory syncytial virus (RSV), coronaviruses, influenza viruses, and picornaviruses.
Environmental smoke accounts for a higher incidence of OM. Studies examining middle ear
found an odds ratio for parental smoking. There was consistency in OR (1.7) for OM in mothers
who smoked over ten cigarettes each day.
Statistics of the health issue
According to the Australian Bureau of Statistics (ABS, 2016) survey the Aboriginal children
aged 0-14 years were three times (8.4%) more likely to be diagnosed with long-term hearing
problems than the non-Indigenous children (2.9%). Over 30% of the Aboriginal children
diagnosed with hearing difficulties had otitis media. Indigenous children aged 4-14 years

(10.5%) were highly affected by OM than those aged 0-3 years (3.2%). Hearing problems were
more common among Aboriginal boys (9.5%) than girls (7.4%) (ABS, 2016). Community-based
epidemiological studies carried out in central Australia indicate that OM was more common
(90%) among children aged 0-5 years (Marchisio et al., 2010). Approximately 72% of the 1,541
children participated in the Stronger Futures in the Northern Territory (SFNT) program and
underwent audiology services and the findings indicated that the children had at least one ear
disease. 51% of the children were diagnosed with different forms of hearing loss (AIHW, 2014).
Timms, Grauaug, and Williams (2012) assessed screening data gathered from 119 Indigenous
people enrolled in three primary schools in Western Australia and reported that 42% of them
were diagnosed with OM. 19% had moderate hearing loss. The prevalence indicates that the
Indigenous population is significantly affected by multiple forms of hearing problems with otitis
media being the most common and affects majorly children (Timms et al., 2012).
History of colonization and the health issue
Aboriginal Australian historical studies indicate that disorders associated with hearing were not
common among the Indigenous community until colonization (Kortiff, 2019). Aboriginal justice
issues have also been linked to the high prevalence of hearing loss among the Indigenous
community than non-Indigenous counterparts. Persistent middle ear infections or OM among the
Indigenous community are caused by bacteria and viral microorganisms. The study by Kortiff
(2019) on the prevention of hearing loss among Indigenous Australians proposed that these
pathogens were transferred from overpopulated European states into the formerly remote
Indigenous communities, and the Indigenous people were not immune to the pathogens. The
current segregation between Indigenous and non-Indigenous communities in terms of healthcare
access is believed to be a consequence of colonization. As a result, Aboriginal people are not

able to access basic quality healthcare and any ear infection grows to an advanced level making
medication difficult. Such persistent infections lead to continuous ear discharge and punched
eardrums in almost 40 per cent of the Indigenous Australians living outside cities. Inequality in
the accessibility of quality healthcare has led to total ear loss among Indigenous children and
adults. Moreover, the rate of ear loss in urban centres is 4 times much higher than that of the
non-Indigenous population (Coleman et al., 2018).
Colonization is responsible for urbanization and the movement of the Aboriginal peoples to the
cities. As a result, they are exposed to loud noise, long car trips and loud music. Such
environmental exposures of loud music are risk factors for healthy hearing and affect hearing.
Colonization also led to the segregation of the Indigenous community and thus they were not
able to gain access to education like the non-Indigenous community. Knowledge is important
because it helps in critical decision making on health issues, thus a lack of it implies that the
Indigenous community could engage in activities that endanger their hearing health (Kortiff,
2019). The Aboriginals could discharge firearms near the ear of another one while hunting,
causing ear drum bust.
Social determinants of health and the health issue
The major social determinants of health affecting hearing health of the Aboriginal peoples are
socioeconomic and environmental factors. Environmental factors are the major determinant of
hearing issues. Factors such as poor hygiene, overcrowding, inaccessibility to clean running
water, and poor sewage disposal are risk factors that are significantly related to remote areas
which are characteristic of Indigenous community (Burns & Thomson 2013). The risk of OM is
also increased when individuals are exposed to second-hand tobacco smoke and wood smoke.
According to the ABS (2016), 57% of the Aboriginal children lived in a house with at least one

adult smoker who smoked daily. 17 per cent of the Aboriginal children who lived outside the
cities belonged to a household with smokers as opposed to 13% in cities ABS (2016). These
factors increase the risk of developing hearing problems.
Multiple social and economic factors affect the prevalence of hearing problems among the
Aboriginal peoples. Living in remote areas is associated with low socioeconomic position and
hearing problems among Indigenous people. Such a factor limits accessibility to healthcare
services (Simpson, Enticott, & Douglas, 2017). The loss of hearing is common among the low
socioeconomic community.
Cultural implications and obstacles to address the health issue
The cultural beliefs of the Aboriginal Australians regarding western medication is a significant
barrier to addressing the hearing problem among the Indigenous community. The community
believes that every illness is caused by some other factor and not pathogens etc. This conflict
with the western medication system which they have to rely on to obtain treatment. Additionally,
there is limited access to quality healthcare services, delay in diagnosis and treatment. This result
in long waiting lines leading to loss of hearing (AIHW, 2018). Lack of culturally appropriate
services and infrastructure in remote areas are some of the barriers to address hearing problems
Conclusion
The high incidence of ear disorders and associated hearing complications among the Aboriginal
and Torres Islander peoples of Australia has been in existence since the 1970s, after colonization.
The Indigenous community is the most affected by hearing problems with otitis media being the
most common and is caused by viral and bacterial infections, smoke etc. The high prevalence of
OM among the Aboriginal community can be attributed to the effects of colonization. However,

the social determinants of health that are critical to the health issues include socioeconomic and
environmental factors. The successful elimination of OM is hindered by barriers such as cultural
beliefs on medication and inequality in healthcare access

References
ABS (Australian Bureau of Statistics) 2016. National Aboriginal and Torres Strait Islander
Social Survey, 2014–15. ABS cat. no. 4714.0. Canberra: ABS.
AIHW. (2014). Stronger Futures in the Northern Territory: hearing health services 2012–2013.
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https://www.aihw.gov.au/reports/indigenous-australians/stronger-futures-nt-hearing-
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Coleman, A., Wood, A., Bialasiewicz, S., Ware, R. S., Marsh, R. L., & Cervin, A. (2018). The
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WHO (World Health Organization) (2017). Deafness and hearing loss fact sheet. Geneva:
WHO. Retrieved from https://www.who.int/en/news-room/fact-sheets/detail/deafness-
and-hearing-loss