HEALT 2114 Task 2a: Diabetes Incidence in Indigenous Population

This essay examines the concerningly high incidence of diabetes within the Australian Indigenous population, specifically the Aboriginal and Torres Strait Islander communities. It highlights the disproportionate burden of type 2 diabetes, gestational diabetes, and related mortality rates compared to the non-Indigenous population, emphasizing the critical need for effective chronic care. The essay delves into the historical context of colonization, tracing the impact of lifestyle changes, socioeconomic disruptions, and policy implementations on the health of the Indigenous population. It identifies and discusses the influence of social determinants of health, such as socioeconomic disparities, unequal access to healthcare, and population increases, on the development and progression of diabetes. The analysis incorporates current statistics to underscore the health inequalities and explores the intersection of culture, policy, and poverty in managing diabetes rates. Ultimately, the essay underscores the urgent need for improved healthcare access, culturally competent care, and comprehensive strategies to address the diabetes epidemic within the Australian Indigenous communities.

Running head: DIABETES INCIDENCE 1
Diabetes Incidence among the Australian Indigenous Population
Student’s Name
Institutional Affiliation

DIABETES INCIDENCE 2
Diabetes Incidence among the Australian Indigenous Population
Diabetes ranks highly among the fastest growing chronic illnesses worldwide.
Particularly, type 2 diabetes has outstretched to alarming levels in Australia and all over the
world, thereby posing threats for public health set ups nearly everywhere. The Torres Strait
Islanders and the Aboriginal populations are mainly impacted by the alarming incidences of
diabetes and are faced with challenges when it comes to access to effective chronic care. To
many of the Torres Strait Islander and the Aboriginal, the fairly high diabetes levels highlight a
wide range of social, historical, and culturally-related determinants of health among other sets of
risk related factors.
Sadly, the most pronounced burden of disease incidence tends to fall on the disadvantage
parties and groups in the society. The Torres Strait Islander and the Aboriginal people are
victims of alarming rates of diabetes incidence. In close comparison to the non-indigenous
Australian population, their likelihood to have diabetes is three times more. According to
Kirkham et al., (2017) and Burns et al., (2016), singling out the female population, the odds are
two times high that the women from the Torres Strait Islander and the Aboriginal populations
will fall victims to gestational form of diabetes when they are closely compared to the women
from the non-indigenous Australian population. There is much evidence to suggest that the
Torres Strait Islander and the Aboriginal children are an unlucky bunch. They are about eight
times far likely to be diabetic in contrast to the children from the non-indigenous population
(Mayer-Davis et al., 2017). With the high rates of diabetes incidence, the mortality rates are
fairly high given that figures highlight that the odds of the Aboriginal and the Torres Strait
Islanders succumbing to diabetes are significantly high in contrast to the non-indigenous
Australian populations. Precisely, the odds stand at six.

DIABETES INCIDENCE 3
In line with health care, the Australian indigenous population has been in distress from as
early as colonization. Many persons fail to recognize how Australia’s colonization tale
continually impacts the wellbeing of the indigenous Australians. The history of the Aboriginals
and the Islanders dates back to as early as 1606 (Smylie & Firestone, 2015). The Aboriginals and
the Torres Strait Islander were hunters and gatherers who roamed around the land fully utilizing
the readily available resources. Their diet was largely made up of plant foods, land animals, fish,
and birds but the arrival of the European population in 1788 began to initiate lifestyle changes
(Smylie & Firestone, 2015).
The Aboriginals and the Torres Strait Islander’s traditional activities which included the
likes maintenance of familial and culturally tied practices, finding food and other resources and
spirituality changed with time. The second half of the 20th century saw adjustments to nutrition
and physical activities which partly played a part in the diabetes development on the Torres
Strait Islander and the Aboriginal populations (Burrow & Ride, 2016). After colonization, the
Australian indigenous population was subjected to disruptions in their socioeconomic element of
life thus resulted in a steady decline in its health status. The changes forced the Aboriginals and
the Torres Strait Islander into switching to the European ways of life. According to Johnson et
al., (2015), the groups abandoned their traditional way of life and reluctantly switched to those of
the colonialists. As time passed by, the indigenous Australians saw the introduction of refined
foods and sugar into their meals which make up for a couple of the risk factors tied to diabetes.
Additionally, the colonization set in motion a couple of policies, events, institutions, and
established systems that continue to affect the indigenous population today. Of course, this is in
spite of the two populations’ (the Islanders and the Aboriginals) desire to overcome the
adversity. The economic and social impact of the colonization has been evident across

DIABETES INCIDENCE 4
generations. The invasion and control led to the increase in poverty, fear, and other
disadvantages from one generation to the next (Zhang, Valenti, & Britt, 2014). Today’s situation
is a mirror of the long-standing effects of inadequate opportunities in previous generations of the
Aboriginal people and the Torres Strait Islanders. Some of them inadequate education, poor
nutrition, and health care.
In present-day society, social conditions, physical infrastructure, and economic
opportunity largely influence the health of communities and individuals. The set mentioned
above of factors are evident in employment, access to various services, education, population
pressure, connection with land, and discrimination among others. Out of the mentioned factors,
in close contrast to the non-indigenous Australians, the Aboriginal and Torres Strait Islanders
populations are at a sizable disadvantage (King, Willis, Munt, & Semmens, 2015). The
indigenous population does not have an equal chance to lead a healthy life as the non-indigenous.
The relatively high socioeconomic difference between the indigenous and the non-indigenous
Australian populations places the Aboriginal and Torres Strait Islander at a higher risk of being
exposed to environmental and behavioral related health risk factors linked to diabetes (Smylie &
Firestone, 2015). Moreover, the indigenous persons are subjects of unequal access to primary
health care and health resources including sound sewerage systems, safe drinking water, healthy
housing, and garbage collection.
The large inequality gap in existent between the indigenous Australians and the non-
indigenous population is to blame for the poor health status of the Aboriginal community and the
Torres Strait Islanders. This is backed up by various statistics. For instance, in line with life
expectancy, there exist a gap of roughly 17 years difference between the indigenous Australians
and the non-indigenous population. For nearly all age groups 65 years and below, the death rates

DIABETES INCIDENCE 5
tied to specific ages for the Torres Strait and the Aboriginal are approximately twice those the
non-indigenous Australians experience (Nguyen, Chitturi, & Maple-Brown, 2016).
The health care inequality that the indigenous Australian population faces is closely tied
to systemic discrimination. From as early as the 18th century, the Torres Strait Islander and the
Aboriginals have not had similar opportunities as the non-indigenous Australian population
when it comes to health. This is apparent in the inaccessibility to mainstream services and
significantly low access to health care such as inadequacy of health infrastructure in the
indigenous populations’ settings, and primary health care. The Australian Health System stresses
that the existing health inequalities are systematic and therefore, avoidable (Johnson et al., 2015).
Population increase also makes the list of the social determinants linked to health for the
indigenous Australian population. Going by the statistical projections, the scope of the diabetes
issue that the Aboriginal and the Torres Strait Islander currently face is likely to increase due to a
rise in population. It is estimated that the youth population of the indigenous Australian
population will increase in terms of size. The sizable increment in population would also require
a step up in health care provision programs and services to keep up with the looming demand for
health care services (Paul et al., 2017).
A review of progress towards addressing health concerns including incidence of diabetes
and its related complications highlights obstacles. For the indigenous Australian population, it is
fair to say that there has been some notable progress for mortality and morbidity of the chronic
disease. The figures for diabetes and diabetes-related deaths are still high among the indigenous
Australian population. Coined at the end of 2015, the Australian national diabetes strategy for the
years 2016-2020. The strategy outlines a nation-wide response to diabetes incidence with the
specific goal of countering the impact of the disease among the indigenous Australian

DIABETES INCIDENCE 6
populations (Zhang et al., 2014). The plan recognizes that a lot of efforts needs to be placed as
far as developing policy options is concerned.
Despite several obstacles, the coined strategies were bent on putting an end to the
practice of setting somewhat lower goals for the indigenous populations. The initiatives to deal
with the alarming rates of diabetes have been undermined by culture in several ways. A section
of the Aboriginals firmly believes in the indigenous medicine. This make it hard to fully
undertake disease prevention and mitigation incentives such as early diagnosis and
hospitalization. In that regard, the discussion of cultural related health care dynamics cannot be
fruitful without paying attention to the ways with which culture intersects with issues such as
access and care utilization, equity, cultural incompetent health programs and providers, and
institutional discrimination (Li, 2017). For instance, the income of the indigenous Australian
population lags behind that of the non-indigenous. The low-income factor, directly and
indirectly, influences financial when it comes to access to health care. Apart from the
Aboriginals who believe in traditional medicine, the remaining population of indigenous
Australians fail to afford out-pocket purchases and health care payments. Combined with cultural
limitations, the income position of the Torres Strait Islander and the Aboriginals creates
limitations on a patient’s ability to effectively manage diabetes.
Another notable example of the indigenous population interactions of culture, policy, and
poverty has resulted in the difficulties in managing the rates of diabetes. The Aboriginals and the
Torres Strait Islanders had their land grabbed leading to most of them being resettled on
reservations. Initially the rates of diabetes were low. The factors mentioned above coupled with
others such as the changes in traditional culture and work patterns and access to fast foods has

DIABETES INCIDENCE 7
increased among the indigenous Australian population (Reeve, Church, Haas, Bradford, &
Viney, 2014).
In finality, the government and non-government bodies recognize the impact of diabetes
and the burden it has left for the Torres Strait Islanders and the Aboriginals, yet challenges still
exist. Provision of effective measure when it comes to diabetes prevention and management calls
for improvements in access to both top notches primary health care and tertiary services.
Additionally, much needs to be learned from the way the indigenous populations conduct their
day to day activities to provide culturally competent care.

DIABETES INCIDENCE 8
References
Burns, J., Burrow, S., Drew, N., Elwell, M., Gray, C., Harford-Mills, M., … Rutherford, L.
(2016). Overview of Aboriginal and Torres Strait Islander health status 2015. Australian
Indigenous HealthInfoNet.
Burrow, S., & Ride, K. (2016). Review of diabetes among Aboriginal and Torres Strait Islander
people. Australian Indigenous HealthInfoNet. https://doi.org/10.1007/s11695-015-1733-4
Johnson, D. R., McDermott, R. A., Clifton, P. M., D’Onise, K., Taylor, S. M., Preece, C. L., &
Schmidt, B. A. (2015). Characteristics of Indigenous adults with poorly controlled diabetes
in north Queensland: Implications for services. BMC Public Health.
https://doi.org/10.1186/s12889-015-1660-2
King, M., King, L., Willis, E., Munt, R., & Semmens, F. (2015). Issues that impact on
Aboriginal Health Workers’ and Registered Nurses’ provision of diabetes health care in
rural and remote health settings. Australian Journal of Rural Health.
https://doi.org/10.1111/ajr.12062
Kirkham, R., Whitbread, C., Connors, C., Moore, E., Boyle, J. A., Richa, R., … Maple-Brown,
L. (2017). Implementation of a diabetes in pregnancy clinical register in a complex setting:
Findings from a process evaluation. PLoS ONE.
https://doi.org/10.1371/journal.pone.0179487
Li, J.-L. (2017). Cultural barriers lead to inequitable healthcare access for aboriginal Australians
and Torres Strait Islanders. Chinese Nursing Research.

DIABETES INCIDENCE 9
https://doi.org/10.1016/j.cnre.2017.10.009
Mayer-Davis, E. J., Lawrence, J. M., Dabelea, D., Divers, J., Isom, S., Dolan, L., …
Wagenknecht, L. (2017). Incidence trends of type 1 and type 2 diabetes among youths,
2002-2012. New England Journal of Medicine. https://doi.org/10.1056/NEJMoa1610187
Nguyen, H. D., Chitturi, S., & Maple-Brown, L. J. (2016). Management of diabetes in
Indigenous communities: lessons from the Australian Aboriginal population. Internal
Medicine Journal. https://doi.org/10.1111/imj.13123
Paul, C. L., Ishiguchi, P., D’Este, C. A., Shaw, J. E., Sanson-Fisher, R. W., Forshaw, K., …
Eades, S. J. (2017). Testing for type 2 diabetes in indigenous Australians: Guideline
recommendations and current practice. Medical Journal of Australia.
https://doi.org/10.5694/mja16.00769
Reeve, R., Church, J., Haas, M., Bradford, W., & Viney, R. (2014). Factors that drive the gap in
diabetes rates between Aboriginal and non-Aboriginal people in non-remote NSW.
Australian and New Zealand Journal of Public Health. https://doi.org/10.1111/1753-
6405.12211
Smylie, J., & Firestone, M. (2015). Back to the basics: Identifying and addressing underlying
challenges in achieving high quality and relevant health statistics for indigenous populations
in Canada. Statistical Journal of the IAOS. https://doi.org/10.3233/SJI-150864
Zhang, C., Valenti, L., & Britt, H. (2014). General practice encounters with aboriginal and
Torres Strait Islander people. Australian Family Physician.

DIABETES INCIDENCE 10