HEALT 2114: Indigenous Australians' Health Disparities Essay.

This essay examines health disparities affecting Aboriginal and Torres Strait Islander Australians, specifically focusing on hearing, sight, and other senses. It begins by describing the health issues, supported by comparative health statistics between indigenous and non-indigenous populations. The essay then delves into the historical impact of colonisation on these health issues, followed by an analysis of two social determinants of health—remote living and poor lifestyle conditions—that exacerbate these problems. Cultural implications and obstacles, such as a lack of indigenous healthcare professionals and poorly performing electronic support systems, are also discussed. The essay concludes by highlighting the Australian government's efforts, such as the Closing the Gap policy, to address these health inequalities, while acknowledging the ongoing challenges and barriers to effective healthcare implementation.

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Introduction
The Aboriginals and the Torres Strait Islander population are regarded as the indigenous
population in the Australia. There is a significant level of health disparity that exists within the
indigenous and the non-indigenous population of Australia (Australian Institute of Health and
Welfare [AAIHW], (2018). The following assignment will focus on the health disparity existing
in the domain of hearing, sight and other senses. The assignment will initiate with the
description of the health issue followed by the representation of the comparative health statistics
among the indigenous and non-indigenous population. The later part of the assignment will focus
on how the colonisation has impacted the development of the chosen health issues, two social
determinants of health affecting the development of the health issues and the cultural
implications and obstacles associated with the health issue.
Description of the health-issue
Ear diseases and the associated hearing loss are common among the Aboriginals and
Torres Strait Islanders children. Otitis media is characterized by hearing loss. It is common
among the indigenous children (AAIHW, 2018). Otitis media leads to inflammation in the
middle ear caused by microbial infection and is a common childhood illness. The incidence rate
of otitis media is higher among the children who are between the age group of 6 to 24 years and
4 to 5 years (Liese et al., 2014).
In the domain of eye health, it can be stated that the Aboriginal and Torres Strait Islander
people mainly start their life with normal vision in comparison to the rest of the Australian
population. The existing information suggest that Aboriginal and Torres Strait Islander children

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mainly have decreased prevalence of the vision loss, refractive error and blindness in comparison
to the non-indigenous population however, the data reverses during the adulthood. Three major
causes of loss of vision among the non-indigenous population include formation of cataract,
uncorrected refractive error and increased vulnerability of developing diabetic retinopathy.
However, there is a positive trend in the domain of avoidable vision loss among the indigenous
population in the area of trachoma (Australian Indigenous Health Bulletin, 2018).
Statistics of the health issue
The clinical presentation of the hearing loss resulting from the otitis media infections
differs among the indigenous and non-indigenous children. Among the indigenous population,
otitis media is characterised by an outbreak of severe infection during the first episode of the
early childhood. The repeated ear infections remain undiagnosed and untreated leading to
subsequent hearing loss among the indigenous children (Jervis-Bardy et al, 2017). During the
age of 2 to 20 years, the indigenous group of children is likely to experience loss of auditory
capacity due to middle ear infection for at least 32 months in comparison to the 3 months of
infection among the non-indigenous children. The disease burden due to hearing loss is 8.6 times
higher among the indigenous children in comparison to the non-indigenous children(Jervis-
Bardy et al, 2017).

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(Source: AIHW, 2018)
Figure: Comparison between the disease burden among the indigenous and non-indigenous
population

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(Source: AIHW, 2018)
The comparison between the data of the hearing loss between the indigenous and non-
indigenous population highlighted that the disease burden has dropped from 2001 (11%) to 2014
(8.4%)(AIHW, 2018).In the domain of the vision loss, with the progress of the adulthood, the
tendency of developing ophthalmological problems among the indigenous population increases
by three fold in comparison to the non-indigenous population (National Eye Health Survey,
2016). The prevalence of blindness does not have reduced among the indigenous population
during the tenure of 2008 to 2016 (2.8%). This increases by gap with the non-indigenous
population by 6.2 fold high (Australian Indigenous Health Bulletin, 2018). The rate of disease
burden arising out of from the loss of senses among the indigenous population (0 to 14 years) is
12 times higher in comparison to the non-indigenous children (AIHW, 2018).
(Source: National Eye Health Survey Report, 2016)

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History of colonisation and the health issue
Aboriginal and Torres Strait Islander population have maintained a life-style by
maintaining hunter-gather lifestyle up to late 18th century. However, upon invasion of the
Europeans during 1788 there occurred a significant change in the lifestyle of the indigenous
population of Australia. Traditional activities that are associated with the search of the renewable
resources or food by maintaining the familial and cultural lifestyle practices and thus sustaining
spiritual connection over the entire country experienced a significant change during the course of
time. The adverse change in the overall physical activity sessions and nutrition also played a
significant role in the development of the eye and the ear problems and other vision problems
along with the increase in the vulnerability of developing type 2 diabetes mellitus among the
indigenous population of Australia(Australian Indigenous Health Bulletin, 2018). Another reason
behind the high prevalence of the hearing, vision and other senses problem among the
indigenous population of Australia is they specifically colonised in the corners of Australia that
are now labelled as outer region or very remote areas. This increased the odd ration of the
healthcare access. Poor healthcare access increased the health inequality in hearing, vision and
loss of senses among the indigenous population(Australian Indigenous Health Bulletin, 2018).
Social determinants of health and the health issue
According to the World Health Organization (WHO) (2018), social determinants of
health (SDH) play a crucial role in defining the disease prevalence and disease burden among a
particular population. The main SDH that plays a determining role in determining the health
inequalities among the indigenous population include employment, education, finance,
surroundings (environment), hygiene and health awareness

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The two main socio-economic determinants of health that are associated with the increase
in the vulnerability of the hearing, vision and other senses loss among the indigenous population
of Australia include the residing in the remote areas (poor environmental surroundings) and poor
lifestyle conditions. The majority of the Australian population suffering from the high disease
burden of the hearing, vision and loss of other senses resides in the remote areas. In the remote to
very remote areas, there is a lack of healthcare access along with the lack of health awareness.
This gap in proper availability of the healthcare service is increasing the disease burden among
the indigenous Australia population(Lloyd et al., 2015). Jervis-Bardy, Sanchez and Carney
(2014) are of the opinion that Otitis media is treatable and can be prevented under effective
healthcare surveillance. Thus lack of health access in the remote area is increasing the disease
burden.
Unhealthy lifestyle habits or staying under unhygienic condition is another important
social determinant of health that is increasing the chances of developing vision and hearing loss
along with the loss of the other senses(Lloyd et al., 2015). For example, smoking during
pregnancy, lack of proper nutrition among the new born child creating immunodeficiency are
increasing the chances of developing hearing loss among the indigenous children. On the other
hand, unhealthy lifestyle habits like smoking, alcohol consumption, sedentary lifestyle habits is
increasing the chances of developing vision loss due to type 2 diabetes development or formation
of the cataracts. Increase in the healthcare access along with awareness about the lifestyle habits
will help to bring all the senses together and thus helping to reduce the disease inequality arising
out of the vision and hearing problems(Lloyd et al., 2015). Australian Government is however,
working effectively in order to reduce the disease burden among the indigenous population by
the introduction of the Closing the Gap policy. Closing the Gap policy mainly stresses over the

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importance of the community healthcare services in order to reduce the prevailing health
inequalities among the indigenous population(Durey et al., 2016).
Cultural implications and obstacles to address the health issue
Li et al. (2017) are of the opinion that the health inequity exists among the Aboriginals
and Torres Strait Islanders increases with the cultural barriers and it is regarded as the vital
factors in addressing the aboriginal health inequality. The health professionals can be an
effective solution for reducing the ethnic and racial disparities in healthcare. The main cultural
implications in reducing the health inequalities include improvement in the health overall socio-
economic status of the Australian population. The reduction in the health inequalities will further
help to reduce the cultural barriers among the Aboriginal population.
The main obstacles to address these health issues among the Aboriginals and the Torres
Strait Islander population include lack of dedicated Aboriginals healthcare professional work-
force under the community healthcare settings working in the remote and the very remote areas.
The indigenous population in Australia are more comfortable in sharing their healthcare concerns
solely with the indigenous workforce(Gibson et al., 2015). The death in the indigenous
workforce under the rural community based healthcare setting is creating a barrier in the
addressing these health issues in a comprehensive manner. Poorly performing electronic support
systems like the telemedicine, electronic health records are creating a barrier in getting an
approximate estimation of the affected group of the indigenous population who are suffering
from the hearing and vision loss along with the loss of the other senses and thus creating a gap in
a gap behind the effective implementation of the healthcare services on time (Gibson et al.,
2015).

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Conclusion
Thus from the above discussion it can be concluded that vision and hearing along with
the loss of the other senses are comparatively higher among the indigenous population in
comparison to the non-indigenous population. Colonization in the remote areas, poor SDHs and
cultural gaps are creating barriers in addressing these health issues. Lack of adequate aboriginal
healthcare workforce and technical advancement in the aboriginal health care are other noted
barriers. However, the Australian government is working for reducing this health inequalities by
implementation of the Closing the Gap Policy.

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References
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Jervis-Bardy, J., Carney, A. S., Duguid, R., & Leach, A. J. (2017).Microbiology of otitis media
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