Aboriginal Nursing Assignment: Closing the Gap and Health Issues

This essay examines the Australian government's 'Closing the Gap' policy, launched in 2008 to address health and life expectancy disparities between Aboriginal and Torres Strait Islander people and the non-indigenous population. It explores the policy's origins, triggered by the Social Justice Report 2005, and analyzes its impact on improving health outcomes, focusing on improvements in areas like life expectancy, child mortality, and access to education and employment. The essay also highlights the policy's role in addressing the specific health issue of cancer among indigenous Australians, including the launch of Cancer Australia. It reviews progress, identifies barriers such as language and cultural differences, and emphasizes the need for increased cultural competence in healthcare to achieve the policy's goals by 2030. The essay concludes by recommending strategies to improve healthcare access and outcomes for Aboriginal and Torres Strait Islander communities.

Running head: ABORIGINAL NURSING ASSIGNMENT
Aboriginal nursing assignment
Name of the student:
Name of the University:
Author’s note

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The Aboriginal and Torres Strait Islander people are regarded as the original inhabitants
or the first people of Australia who have a strong connection with their culture, language and
traditional lands. However, they are the most vulnerable group in Australia due to inequality or
gap between health and life expectation outcomes of indigenous and non-indigenous population.
‘Closing the Gap’ policy launched in 2008 was the Australian Government commitment to
reduce disadvantage of Aboriginal and Torres Strait Islander people and improve the indigenous
statistics related to life expectancy, child mortality, health outcomes, education and employment
outcomes (Australian Together 2017). The main purpose of this essay is to briefly discuss the
events that lead to the creation of the ‘Closing the Gap’ policy and analyze the significance of
the policy in influencing health outcome of the Aboriginal and Torres Strait Islander people. It
also gives an insight into one specific health issue that has been addressed by the policy and
challenges or barriers that affected the change process.
Closing the Gap is an Australian Government strategy that targets improving the health,
education and employment of the Aboriginal and Torres Strait Islander people. This policy aims
to achieve health equality for Aboriginal and Torres Strait Islander people in the areas of life
expectancy, child mortality and access to education and employment outcomes within 25 years
period (Closing the Gap 2017). The Social Justice report 2005 was the main trigger for the
government to establish and launch the Closing the Gap policy. The report gave the idea that
about the level of improvements needed in the health status of indigenous people. The report
mentioned that the old approach failed to address the life circumstances of Aboriginal and
Torres Strait Islander people and called upon the Australian Government to develop a long-term
government focused activity to provide equality in health status and life expectancy to them
(Social Justice Report 2005 : | Australian Human Rights Commission 2017). Hence, in response

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to this report, Closing the Gap policy was launched by the Government in 2008 and the goal was
to achieved the health equality and life expectancy target by 2030.
The Council of Australian Government (COAG) put forward many measurable targets to
be achieved by 2030. It included many targets like reducing the gap in life expectancy, reducing
mortality rate by half in children below five years within 2018 and providing full access to early
child education in remote communities. Other aim was to halve the gap in reading, writing and
numeracy skill by 2018 and halve the gap in employment outcomes between indigenous and
non-indigenous groups by the end of 2018 (Brown et al., 2015). Since the launch of policy, it is
approaching the one decade goals and there are many improvements and further areas of actions
that are still remaining.
According to the Australian Bureau of Statistics data, 2.8% of the Australian population
consists of Aboriginal and Torres Strait Islander people as counted in the 2016 census. This
includes a total of 744, 956 aboriginal people (Census: Aboriginal and Torres Strait Islander
population 2017). Closing the Gap framework has resulted in improvements in many of the
important indigenous outcomes. The focus on long-term priorities of education, employment,
health and well-being of children and adults led to the growth of many antenatal and post natal
services for them. They also focused on investment to provide better access to right service in all
areas such as health, childcare and early year schools for indigenous population. Many
employment programs were also implemented to build the skills of indigenous Australians and
improve employment outcomes (Scott 2015). Improvements in all this aspects have ultimately
translated to positive health outcomes too. For example, the life expectancy outcome of
Aboriginal and Torres Strait Islanders improved. Indigenous males born between 2010 and 2012

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had life expectancy of 69.1 year. However, this was still much lesser than non-indigenous life
expectancy outcomes by about 10.6 years (Anderson, 2017).
Closing the Gap policy focused on providing health equity to aboriginal and Torres Strait
Islander people by improving child and maternal health, increasing access to indigenous specific
primary health care services and improving the capacity of aboriginal health force workers
(Closing the Gap 2017). However, this evaluates the role of policy in addressing the specific
health issue of cancer in indigenous Australians. The gap in the cancer mortality rate between
the indigenous and non-indigenous Australians is rising. This is evident from the statistics that in
the period between 1998 and 2015, the cancer mortality for indigenous and non-indegnous
Australians has increased to 21% and 13% respectively. The high prevalence of cancer is in turn
the leading cause of gap in life expectancy between the two group of Australians too (Chronic
disease (AIHW) 2017). According to the Australian Bureau of Statistics data, about 5,946 new
cases of cancer has been diagnosed in indigenous Australian in between 2008 and 2012. The
number of deaths from cancer has been found to be 2, 558 in indigenous Australian (Aboriginal
and Torres Strait Islander cancer statistics | Cancer Australia, 2017). Hence, to address this, the
Australian Government worked with state and territory governance decided to lauch Cancer
Australia, a national program that provided seven evidence based goals to improve cancer
outcome in Aborginal and Torres Strait Islander people. It was part of the National Aboriginal
and Torres Strait Islander Cancer Framework 2015 (National Aboriginal and Torres Strait
Islander Cancer Framework | Cancer Australia, 2017).
The launch of the Cancer Australia program in association with the Close the Gap policy
mainly focused on addressing disparities in the group and improving cancer related outcome. For
example, to prevent new cased of cancer in the target group, appropriate resource were

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developed to support patients with lung cancer. Secondly, many community level workshop were
implemented to enhance people’s knowledge and awareness regarding lung cancer. A lot of
health care transformation was also done to detect the disease early and reduce the suffering of
indigenous group. The government’s effort and commitment resulted in improvement in health
care access and reducing the smoking rates as it is also a risk factor for cancer ( Panaretto et al.
2013). Progress in reducing the cancer related outcome has been seen but at a very low pace. To
achieve the target of achieveing the life expectancy target of the Close the Gap policy, a lot more
needs to be done in reducing the cancer related mortality rates. (Closing the Gap 2017).
The improvement in mortality rate for chronic disease was possible also because of early
detection and focus on risk factors too. For instance, smoking has been found as a risk factor for
cancer and the Australian Government Action’s towards reducing the smoking rates resulted in
9% reduction in smoking rate in 2015 compared to 2002 (Closing the Gap 2017). Increasing
access to primary care in remote and rural areas and raising awareness about risk factor also
played a role in prevention and management of cancer. To improve the public health agency’s
role in early detection and raising awareness about cancer, evidenced based cancer information
and training resources were circulated to health workers working with the Aboriginal and Torres
Strait Islander community (For Aboriginal and Torres Strait Islander people | Cancer Australia
2017). Despite such wide level action, the review of national report on cancer survival among
Aboriginal and Torres Strait Islanders has revealed that survival rate of indigenous Australians is
still lower than non-indigenous Australians. Hence, a lot of development in cancer care is still
needed and support services needs to be designed in such a way that target group can readily
access and accept the service (Condon et al. 2014).

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Closing the Gap policy has played an influential role in gradually reducing the gap in
health outcomes of Aboriginal and Torres Strait Islander people. However, a lot needs to be done
still because improvements are seen but complete equality in health status between indigenous
and non-indigenous Australians has not been achieved yet. Achieving the full goals by 2030 is a
challenging task because of many factors (Ware 2013). . Firstly, improving health care
accessibility in rural and remote areas has been challenged by the difference in language gap and
cultural preference of indigenous group. It has been predicted that communicating with this
group might be hampered due to gap in language and culture. Aboriginal and Torres Strait
Islander people have different understanding about health and illness and they mainly relate it to
spiritual dysfunction. Even if health services are available to them, then also they feel reluctant
to approach health services because of past injustices or negative experience likes systemic
racism, discrimination, shame and shyness (Mellor et al. 2016).
The cultural background and negative experience of colonization has had a devastating
effect on mental health and well-being of Aboriginal and Torres Strait Islanders. They are
regarded as stolen generation because of experience of racism as a cultural group and this
negative experience has challenges the health care workforce in achieving the healing goals for
indigenous people. The research by Kelaher, Ferdinand, & Paradies 2014) gave the evidence that
experiencing interpersonal racism in health care settings acted as a major challenges in
addressing health accessibility issue according to the Close the Gap policy. Cross cultural
miscommunication between indigenous people and non-indigenous patients were also regarded
as a barrier in improving health outcomes of indigenous people (Herring et al. 2013). Hence, due
to such limitations in achieving the goals of policy, there was an increased focus on developing
cultural competence in the delivery of health service for indigenous population. Systemic

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cultural competency can be introduce in Australian health care by eliminating the systemic and
institutional barrier to accessing care in this group such as language barrier, lack of trust, poor
understanding about treatment and dissastifaction with care. Secondly, cultural aspect
compentency in health care work force can be enhanced by improving their cultural knowledge
and skill/behavior needed to work with indigenous group (Cedric et al. 2014).
The essay summarized the purpose and history of Close the Gap policy and highlighted
the role and commitment of Australian Government in improving the life expectancy, child
health, education and employment outcome of Aboriginal and Torres Strait Islanders. The
evaluation of the policy explained how it has helped to address the specific health issues of
chronic disease in this group. However, the evaluation also revealed slow progress in minimizing
the gap in health status between indigenous and non-indigenous group. This was seen due to
different in culture, language and past experiences of the indigenous group and its impact on
accessing the services. Based on the barriers identified, it is recommended to increase the levels
of cultural competence in health care staffs to efficiently work in cross-cultural situations.

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