University Name - ATSI Health Vulnerability Report - Semester 2, 2019

This report examines the health vulnerabilities of Aborigines and Torres Strait Islanders (ATSI) in Australia, focusing on social determinants of health, health inequalities, and health inequities. It highlights disparities in health outcomes, including lower life expectancy and higher rates of chronic diseases, mental health issues, and elder abuse. The report explores relevant evidence, the impact on health, and the need for interventions such as the National Plan for Elder Abuse. It emphasizes the role of colonization, racism, and socioeconomic factors in contributing to these disparities. The report also discusses the importance of addressing the social determinants of health and promoting culturally sensitive healthcare to improve the well-being of the ATSI community. The report concludes by emphasizing the need for government action and policy changes to address these critical health issues.

Running Head: ABORIGINES AND TORRES STRAIT ISLANDERS
HEALTH VULNERABILITY OF ABORIGINES AND TORRES STRAIT ISLANDERS
Name of the Student
Name of the University
Author’s Note

1ABORIGINES AND TORRES STRAIT ISLANDERS
Table of Contents
Introduction......................................................................................................................................2
Social Determinants of Health.....................................................................................................2
Health Inequalities.......................................................................................................................3
Health Inequities..........................................................................................................................4
Health Outcomes.........................................................................................................................5
Health Disparity...............................................................................................................................6
Relevant Evidences......................................................................................................................6
Impact on Health..........................................................................................................................8
National Plan for Elder Abuse in Aborigines..................................................................................9
Recommendation.............................................................................................................................9
Conclusion.....................................................................................................................................10
References......................................................................................................................................12

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Introduction
Aborigines and Torres Strait Islanders (ATSI) are the indigenous community of
Australia, who are the natives of the country since time immemorial. As they have a tribal
history, this community has always been behind in every aspect be it literacy, economy, health,
privileges, equities and other such factors which signifies the prosperity of any community.
Social Determinants of Health
The social determinants of health are visible in every community who are backward and
do not get any benefits from the society or the government. In the same way, the Aborigines and
Torres Strait Islanders of Australia have quite a number of social determinants of health such as
employment conditions, education, income, housing issues, social relationships, poverty and the
distribution of power and resources. This type of issues can make them indulge into smoking,
alcohol consumption, mental health issues, illiteracy, social anxiety, negative diet alterations,
lack of health awareness, physical health deterioration, prone to infectious diseases. In addition,
ATSI are the indigenous community so they also suffer from extreme racism that can lead them
into stress, which can cause mental illnesses, substance abuse and other such anti-social activities
and this can reduce the access to healthcare. Especially the Aborigines living in the crowded
areas of the city can face more health issues such as ear and eye infection and other ill health as it
has higher chances of spreading infection. A high incarceration rate can also reduce the health
standards of this community (Zannettino, 2015). The processes of Colonisationis the cause of
disempowerment for this community and underpinning the inequities, seen in access to social
determinants of health, and contribute to on-going stress. Improving the health status of the
indigenous community is the prime agenda for the Australian government, but even after that, a

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wide gap is seen between the health status of ATSI and non-indigenous population of Australia.
In addition, United Nations Committee has taken a note on this issue as a Human Rights Concern
and the Australian Government has acknowledged this (Humanrights.gov.au, 2019). The social
determinants theory proves that the issue of health and inequality is the cause of many
interconnected social factors, and this needs to be taken into consideration when looking after the
effects of health social determinants.
Health Inequalities
Health Inequalities is prevalent in Aborigines and Torres Strait Islanders, as they do not
get many benefits from the government regarding healthcare. Therefore, they are backward in
the health sector and suffer from many health issues due to the socio-economic condition.
Disparities in health conditions between ATSI people and their non-ATSI counterparts are seen
by the World Health Organization (WHO) to be an extreme. In 2010-2012, the life expectancy
for the ATSI population group is estimated to be 10.6 years less than that of the non-ATSI
population in males and 9.5 years lesser in females. The Non-communicable diseases is the cause
of health gap that is 70%, leading with (12%) of mental disorders, diabetes (12%), (23%) of
cardiovascular disease and (9%) of chronic respiratory diseases. It is necessary to close the gap
between the health disparities between indigenous and non-indigenous population, as the history
of Aborigines and Torres Strait islanders is a factor for the inequality. The history of Aborigines
had a plethora of massacres that led to communicable diseases. During 1850, only 10% of the
ATSI population were found alive. ATSI people were disposed of from their lands and were sent
into reserves or missionaries. Government intervention policies ignored the wholesome
destruction of communities and families through the massacre of their children, and that is
known as `stolen generations´ (Markwick, Ansari, Sullivan, Parsons & McNeil, 2014). The

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definition of health equality should be broadened by including mental health, physical health and
the spiritual wellbeing and not just the symptomatic health of an individual. The emotional,
cultural and social wellbeing of ATSI is a concept that is mostly ignored by the mainstream
government health services. It is therefore not surprising that the health services face extreme
challenges in trying to gain the trust of ATSI people.
Health Inequities
The health inequities are the reason of social and economic issues, which makes it
difficult in accessing healthcare, unaffordability due to economic issues and backwardness in
taking actions regarding health. Aborigines and Torres Strait Islanders are mostly poor and
illiterate as they are the indigenous population so they are not able to access best medical
facilities and care, as it requires financial aids. The government is not able to suffice the needs of
this indigenous population as they have a history of prevailing health disparities in the country. It
is to be seen that they get access to best medical health facilities and medical experts so that they
have a low mortality and morbidity rate. Chronic diseases such as cardiovascular disease,
diabetes, obesity has a high prevalence in Aborigines and Torres Strait Islanders community so
they need efficient health care facilities and low rate treatment so that they can get diagnosis and
the medications related to their health conditions. This community also needs to be made aware
about the procedures needed to be followed when any such health complication arises so that
they can easily reach the medical centers and this can only happen if the hospitals are nearby to
their location. This community living in suburbs and rural areas are also one of the reasons why
they such health inequity issues, so the government should make options for them in those
secluded areas so that they get access.

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Health Outcomes
The ATSI community suffers from a variety of communicable and non-communicable
diseases due to the excessive health disparity, health inequality and health inequities in this
community. They suffer from respiratory diseases such as asthma and lung issues, cardiovascular
disease, diabetes, mental health issues, emotional disturbances during old age, sexually
transmitted diseases and kidney diseases. It is said that Aborigines have chronic diseases from a
younger age than the non-indigenous people do, and they have higher chances of dying from a
chronic disease than a non-ATSI person (Australian Indigenous, 2019). In the year of 2012–13,
(24%) Indigenous Australians 15 years of age assessed their health as fair or weak. Mental
health-related complications counted for 11% of all the other issues handled by medical experts
for ATSI patients in the 5-year period from 2008 to 2013. Medical Experts managed mental
health problems for Indigenous Australians at 1.3 times more than the rate for the other non-
indigenous population. Mental health-related diseases calculated to 4.4% for ATSI in 2012-2013.
The ATSI people were hospitalized more for such conditions at double the rate of non-ATSI
Australians (Rosen, 2014). 31% of aborigines were reported for respiratory diseases in the year
2012-2013, and ATSI people reported this 1.2 times more than the non-ATSI people did.
Aborigines reported cardiovascular disease 1.2 times more than non-ATSI people.
Cardiovascular disease accounted for 3 % for the reason of hospitalizations of Indigenous people
in 2012–13, and 8.1% of all issues handled by medical experts for ATSI patients in 2008-2013
(Australian Institute of Health and Welfare, 2019).

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Health Disparity
Until now, it has been evident that health disparity is prominent in this community or the
indigenous people of Australia, one of the on-going issues is the Elder Abuse which is suffered
by people above the age of 50.
Relevant Evidences
According to WHO, the act of despair, single or repeated trauma and no form of action in
a relationship, which affects an older person, is an Elder Abuse. Common forms of abuse in
mental, physical, social, financial, sexual and neglect can be considered tormenting for older
people. This abuse can be of one type but can happen concurrently. The Australian Law Reform
Commission informed governments to look after the different traumas and requirement of older
people, which included ATSI (Australian Institute of Health and Welfare, 2019). The older
people of the local community are more vulnerable to health issues is due to the health inequities
and other factors which affects the life of these helpless individuals. Geriatric syndrome is
prevalent amongst indigenous group is because of the long time inequalities and endogenous
insults faced by the community, this increases in the earlier stages of the life. It is seen that older
people above the age of 50 suffer from dementia, disability and frailty is due to the fact that that
they do not get the basic needs, which the non-indigenous population receive. The problem of
socio-economic backwardness, illiteracy, housing and sanitation barriers, low employment, in
addition with political changes that breaks families and causes indigenous population to have
trust issues with the government is the overall picture of the health disparity in this community.
To understand the issue of dementia and frailty in the context of Torres Strait Islanders and
Aborigines it is necessary to look after the sociopolitical culture that influences the high rates of
chronic conditions such as kidney disease, diabetes, high blood pressure and Dementia.

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Dementia is one of the alarming issues in the older people as it is caused due to several
reasons, they consider it as a sick spirit looking for help. Other causes of dementia are the issues
of physical, emotional and social trauma, dispossession, stolen generation, alcohol and drug
abuse, poor diet and child abuse (LoGiudice, 2016).
Source: (Australian Institute of Health and Welfare, 2019)
Impact on Health
The old age group of people above the age of 50 is the target of many social
determinants, which affects their health in the long term. As it is the indigenous population such
as Aborigines and Torres Strait Islanders suffers from extreme discrimination, which makes it
evident that the older people who do not have much strength to fight for their issues are suffering
more. This causes extreme health issues in them causing geriatric syndrome. The social aspect

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such as poverty, sanitation and housing issues, illiteracy and also the disposition of the
population has been some of the reasons for the negative impact on the health of older people
(Kaspiew, Carson, & Rhoades, 2015).
Dementia is a crucial effect on the old people of the indigenous groups, the Australian
Government. Attorney-General’s Department considered Australian Institute of Health and
Welfare (AIHW) to do surveys on the reasons behind the increasing health issues amongst the
people of age 50 and above. Even international approaches are being taken into consideration
such as the involvement of the US National Research Council Panel to review the risk in the
Prevalence of Elder Abuse and Neglect, they also instructed to collect the data and analyze the
vulnerability of the elder people. The 2018 National Ageing Research Institute structures a
framework to find out the reasons behind the impact of negative health, which includes three
level factors (Australian Institute of Health and Welfare, 2019).
1. Individual level factors—aims on the individuality of the ‘older’ person in a
personal level or the people they trust. In addition, reasons such as risk taking
behaviors, demographics, living situation, personal relationships and health and
well being.
2. Community level factors— this includes the broad level factors such as people
living in old age homes and the service provided by the government there.
3. Society level factors—encompasses cultural norms and beliefs at a society level
such as ageing, family violence and discrimination.

9ABORIGINES AND TORRES STRAIT ISLANDERS
National Plan for Elder Abuse in Aborigines
The government of Australia is the body who can do something for this indigenous group
in a larger scale as they have the major power in regards to the welfare of the country (Blundell
& Warren, 2019). Aborigines and Torres Strait Islanders are the under privileged class who are
detained of many facilities that the non-indigenous people get from the government. All the
government bodies of the country should come up together to give better medical facilities to this
population especially the elders who are disposed of many rights. The local health departments
should collaborate with the government bodies so that the plan could be more efficient and
hassle free. The national plan is to team up together and create plans to execute. It includes
policies such as promoting positives views about ageing, ensuring support and guidance to the
elderly if they are into trouble. In addition, developing a nationally consistent approach if an
older person is going through neglect or abuse and spreading awareness about the negative
consequences of elder abuse (Council of Attorney General, 2019).
Recommendation
According to nurses, the scenario is very much under the control of the health
departments if they implement it accordingly and act upon the plans initiated. The role of nurses
should be the focus on the root cause of all the issues the elder people are facing in indigenous
communities. Implementation of health programs, which will aware the older people to look
after themselves and ask for medical facilities they need. Irrespective of racism and
discrimination, this group of people should get all the rights they deserve as a human. Nurses
here can help the health departments by organizing workshops, demonstration programs,
screening tests to teach and diagnose the older people about any diseases they are suffering from
(Taylor, 2014). Dementia is on a high rise so they can keep mental health programs to make

10ABORIGINES AND TORRES STRAIT ISLANDERS
them aware about the symptoms and the medication needed. Australian Primary Health Care
Nurses Association can also council the elders and their family members to keep a positive
environment in their homes and free them of any neglect and abuse (Radford et al., 2015).
Conclusion
To conclude this report, the recommendation given above can be linked to the standard
practices of nurses. The standard practice implemented here will be number 5, which is Develops
a Plan for Nursing Practice. Under this practice there is a sub category of plan 5.2, which is
collaboratively constructs nursing practice plans until contingencies, options priorities, goals,
actions, outcomes and timeframes are agreed with the relevant persons
(Nursingmidwiferyboard.gov.au, 2019). The recommendation given above seems relevant to this
nurse’s standard, as there is collaboration with the health care industries and the government and
a planning of the nursing practices in regards to the older people above the age of 50. The plan is
made keeping in mind the options and priorities the target group has, with the amount of
resources they can bring in to help the cause. Then the main part comes in to action and that is
the setting of goal, in this case it is the welfare of the health of the elder people and how to keep
them away from abuse and neglect. Then taking actions regarding the health issues of the elder
people by organizing programs and workshops for them who are not educated enough. In the
end, it comes down to the outcome of the whole plan and how it has benefit the relevant people.
This will help in understanding how much time will be needed to implement such goals. The
nurses could be a game changer when it comes to starting new venture into the healthcare
industry, as they are the one who personally interact with the sick. The elder abuse can be
prevented if some changes are made in the government and the healthcare departments.

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References
Australian Indigenous HealthInfoNet. (2019). Chronic diseases - Western Australia - Australian
Indigenous HealthInfoNet. Retrieved 20 October 2019, from
https://healthinfonet.ecu.edu.au/learn/locations/wa/chronic-diseases/
Australian Institute of Health and Welfare. (2019). Australia's welfare 2017: in brief, Ageing and
aged care - Australian Institute of Health and Welfare. Retrieved 20 October 2019, from
https://www.aihw.gov.au/reports/australias-welfare/australias-welfare-2017-in-brief/
contents/ageing-and-aged-care
Australian Institute of Health and Welfare. (2019). Insights into vulnerabilities of Aboriginal and
Torres Strait Islander people aged 50 and over—in brief, Introduction - Australian
Institute of Health and Welfare. Retrieved 20 October 2019, from
https://www.aihw.gov.au/reports/indigenous-australians/vulnerabilities-aboriginal-torres-
strait-50-over/contents/introduction
Australian Institute of Health and Welfare. (2019). The health and welfare of Australia’s
Aboriginal and Torres Strait Islander peoples: 2015, Health and disability key points -
Australian Institute of Health and Welfare. Retrieved 20 October 2019, from
https://www.aihw.gov.au/reports/ihw/147/indigenous-health-welfare-2015/contents/
health-disability-key-points
Blundell, B., & Warren, A. (2019). Reviewing the extent of rural and remote considerations in
elder abuse policy: A scoping review. Australian journal of rural health, 27(4), 351-357.
doi: 10.1111/ajr.12549

12ABORIGINES AND TORRES STRAIT ISLANDERS
Council of Attorney General. (2019). National Plan to Respond to the Abuse of Older
Australians (Elder Abuse) 2019–2023 [Ebook] (1st ed.). Australia: Council of Attorney
General. Retrieved from https://www.ag.gov.au/RightsAndProtections/protecting-the-
rights-of-older-australians/Documents/National-plan-to-respond-to-the-abuse-of-older-
australians-elder.pdf
Humanrights.gov.au. (2019). Social determinants and the health of Indigenous peoples in
Australia – a human rights based approach | Australian Human Rights Commission.
Retrieved 20 October 2019, from
https://www.humanrights.gov.au/about/news/speeches/social-determinants-and-health-
indigenous-peoples-australia-human-rights-based
Kaspiew, R., Carson, R., & Rhoades, H. (2016). Elder abuse in Australia. Family Matters, (98),
64.
LoGiudice, D. (2016). The health of older Aboriginal and Torres Strait Islander
peoples. Australasian Journal On Ageing, 35(2), 82-85. doi: 10.1111/ajag.12332
Markwick, A., Ansari, Z., Sullivan, M., Parsons, L., & McNeil, J. (2014). Inequalities in the
social determinants of health of Aboriginal and Torres Strait Islander People: a cross-
sectional population-based study in the Australian state of Victoria. International Journal
For Equity In Health, 13(1). doi: 10.1186/s12939-014-0091-5
Nursingmidwiferyboard.gov.au. (2019). Nursing and Midwifery Board of
Australia - Registered nurse standards for practice. Retrieved 20
October 2019, from https://www.nursingmidwiferyboard.gov.au/codes-guidelines-
statements/professional-standards/registered-nurse-standards-for-practice.aspx

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Radford, K., Mack, H. A., Draper, B., Chalkley, S., Daylight, G., Cumming, R., ... & Broe, G. A.
(2015). Prevalence of dementia in urban and regional Aboriginal Australians. Alzheimer's
& Dementia, 11(3), 271-279. doi: 10.1016/j.jalz.2014.03.007
Rosen, A. (2014). Where mental health and elder abuse intersect. Generations, 38(3), 75-79.
Taylor, R. M., Institute of Medicine (US), & National Academies Press (US). (2014). Elder
abuse and its prevention: Workshop summary. Washington, DC: National Academies
Press.
Zannettino, L., Bagshaw, D., Wendt, S., & Adams, V. (2015). The role of emotional
vulnerability and abuse in the financial exploitation of older people from culturally and
linguistically diverse communities in Australia. Journal of elder abuse & neglect, 27(1),
74-89. doi: 10.1080/08946566.2014.976895