PUBH6000 Essay: Health Inequities in Indigenous Australian Population

This essay critically examines the health inequalities between Indigenous and non-Indigenous Australians, highlighting the significant disparities in life expectancy, infant mortality rates, and chronic disease prevalence. It delves into the social, economic, and political forces contributing to these inequalities, including communication barriers within healthcare systems, economic disadvantages, and unequal distribution of resources. The essay also explores the role of Aboriginal Community Controlled Health Services (ACCHSs) in addressing these public health challenges, detailing their structure, services, and impact on reducing health disparities. It acknowledges the barriers faced by ACCHSs, such as communication issues and unequal resource distribution, concluding that while ACCHSs play a vital role, broader societal changes are needed to achieve health equity.

Running Head: Assessment 2: Essay: Health Inequities Between Indigenous and
Non‐Indigenous Australians
ASSESSMENT 2: ESSAY: HEALTH INEQUITIES BETWEEN
INDIGENOUS AND
NON‐INDIGENOUS AUSTRALIANS

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Assessment 2: Essay: Health Inequities Between Indigenous and
Non‐Indigenous Australians
Table of Contents
Introduction................................................................................................................................3
Part 1: Contribution of economic, political and social forces to the health disadvantages
experienced by aboriginal people of Australia...........................................................................3
Part 2: The role of ACCHS in decreasing the levels of health inequalities in Australia...........5
Role of ACCHSs in reducing inequalities in health...................................................................6
The barrier for ACCHSs in reducing health inequalities...........................................................7
Conclusion..................................................................................................................................7
Reference list..............................................................................................................................9

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Assessment 2: Essay: Health Inequities Between Indigenous and
Non‐Indigenous Australians
Introduction
The main purpose of the assignment is to analyze health inequalities between non-
indigenous and indigenous Australians, which are a major public health problem. Indigenous
Australians have shorter life expectancy, a high rate of infant mortality and poorer health as
compared to non-indigenous Australians. According to reports of 2016, indigenous children
experience 1.7 times higher levels of malnutrition than others. Moreover, it was found that
hospitalization rates due to chronic diseases are higher in indigenous Australians. This essay
has provided an overview of forces, which contribute to these inequalities. In addition, this
essay will discuss the role of Aboriginal Controlled Community Health Services (ACCHSs)
in addressing this public health problem.
Part 1: Contribution of economic, political and social forces to the health disadvantages
experienced by aboriginal people of Australia
There are several social forces that are influencing the health disadvantages of
indigenous Australians. According to Waterworth, Pescud, Braham, Dimmock & Rosenberg
(2015), communication between representatives of healthcare organizations and indigenous
patients impacts on health behavior. Many indigenous people have claimed that non-
indigenous staff members of healthcare organizations do not listen to them carefully and
judge them on the basis of their ethnicity. It makes them feel that they are not getting equal
healthcare services like other non-indigenous Australians. Miscommunication takes place due
to the differences between different cultural backgrounds of aboriginal and other groups of
Australian people. Non-indigenous healthcare professionals do not understand the values and
the culture of the aboriginal people. Lack of knowledge about indigenous culture is
preventing them from providing equal care to all people. According to the theory of the In-

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Assessment 2: Essay: Health Inequities Between Indigenous and
Non‐Indigenous Australians
group/out-group, people prefer to develop a good relationship with people of the same group
and they easily develop prejudices for opposite group members. Due to this reason, social
discriminations are taking place within Australian society and this is causing health
inequalities. On the other hand, Taylor & Guerin (2019) have contradicted that interaction
between indigenous patient and healthcare staff has a positive impact on healthy behaviors. In
this kind of situation, aboriginal people are getting appropriate healthcare services as
required.
The economic status of indigenous communities is effectively contributing to the
health inequalities in Australia. Reportedly, in the National Census of 2001, it has been found
that the weekly income of indigenous people is approximately 62% less than that of non-
indigenous people (Humanrights.gov.au, 2017). The rate of unemployment was 20% for
aboriginals at that moment, which was approximately 3 times higher than in other Australian
communities. It is indicating that indigenous people do not have financial support to get
access to all available healthcare facilities. On the other hand, the income of non-indigenous
people is high and they are able to have all the healthcare facilities required for ensuring
mental and physical wellbeing. It is important to take initiatives to ensure equal annual
income of all Australian communities to reduce the health inequalities in this country.
Political determinants are present in Australia and these are causing the inequalities
in terms of healthcare facilities. As mentioned by Thompson, Talley & Kong (2017), unequal
distribution of resources and power among non-indigenous and indigenous communities are
affecting their abilities to access healthcare services equally. The government of Australia has
taken many initiatives to remove this issue from society, but it fails to control the social
determinants of health (Aihw.gov.au, 2019). Due to this reason, the indigenous community is
facing social isolation and different kinds of discrimination in every stage of their lives.

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Assessment 2: Essay: Health Inequities Between Indigenous and
Non‐Indigenous Australians
Health inequalities are among the barriers to the lives of this Australian group. In 2007, the
National Territory National Emergency Response was implemented and this initiation of the
federal government has contradicted the previous report regarding the needs of working with
aboriginal people. Hence, it can be stated that this political initiative has denied the equal
rights of aboriginals within society.
Part 2: The role of ACCHS in decreasing the levels of health inequalities in Australia
Description and features of ACCHS
ACCHS is an incorporated aboriginal firm that is initiated by and based in a local
indigenous community. The main function of this organization is to provide holistic and
culturally specific health care services to the indigenous community (Spurling, Felton-Busch
& Larkins, 2018). There are more than 150 ACCHS located in Australia (Mja.com.au, 2014).
Primary health care services that are offered by this organization include maternal and
children health, general health, health checkups, initiation and conducting preventative
programs, which focus on removing bad practices like smoking and drinking. Key features
of this model include providing services to gain long term benefits and providing
commitment and continuity to reduce the inequality gap (Naccho.org.au, 2019). The role of
their services has become more critical with the increasing complexity of health services.
Moreover, the population of indigenous communities is also increasing rapidly with time.
This model helps to provide service more than capacity. ACCHSs provide 3 million episodes
of care every year to about 350000 people. Moreover, it provides healthcare to different
remote areas of the country. This model is proven clinically effective, which is another
essential feature. ACCHSs play an effective role to train the medical workforce, those who
are employed for aboriginal people. Moreover, Javanparast, Windle, Freeman & Baum
(2018) stated that ACCHSs diminished the challenge of delivering the best-practice care to

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Assessment 2: Essay: Health Inequities Between Indigenous and
Non‐Indigenous Australians
affected people. Another feature is that the majority of ACCHS staff are from indigenous
communities, which helps them to provide service properly.
NACCHO was formed in 1992 and is formed as an umbrella organization for
ACCHSs. In 2003-04, there were about 140 government fed aboriginal health services out of
which 127 has been operated by ACCH (Naccho.org.au, 2019). This model is necessary for
indigenous people in Australia to mitigate gaps in health care services. Different primary
health care needs can be offered to these communities through the help of this organization
and model.
Role of ACCHSs in reducing inequalities in health
ACCHSs have provided many benefits to the indigenous population of this country.
This has helped to reduce inequalities in the healthcare sector. ACCHSs are cost-effective. As
opined by Harfield et al. (2018), activities of this model aim in providing greater benefits in
comparison with per dollar spent. Lifetime health impact of the interventions delivered is
50% higher than interventions provided by mainstream health services. Collected revenues
are reinvested to improve health care services. ACCHSs have a greater level of community
oversight and accountability. The service board is formed with the help of indigenous
representatives, which help them to serve the community properly. Thus, the gaps in
healthcare provision get reduced properly. The inclusion of representatives from local
communities has increased the responsiveness of this program to meet the needs of
indigenous people (Naccho.org.au, 2019). These innovative, flexible and culturally suitable
services of ACCHSs have helped to reduce the healthcare gap and inequalities and improved
the lives of indigenous people in Australia.
ACCHSs provide comprehensive primary care services as per clients' needs. The
services include home and other site visits, conducting health promotion services, nursing

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Assessment 2: Essay: Health Inequities Between Indigenous and
Non‐Indigenous Australians
services, and child care. The service is funded by Australian and state governments. They
also collaborate with mainstream services for extending the reach of service and improving
cultural safety. Moreover, the ACCHSs are generally funded by the state government but
they have the power to accept funds from the commonwealth government. This flexibility is
allowing them to work properly with all the parties and achieve the best outcomes in reducing
inequalities (Azzopardi et al. 2018). In addition, the network of ACCHSs has helped to
provide services to vulnerable aboriginal people, which government models struggle to
deliver.
The barrier for ACCHSs in reducing health inequalities
Lack of communication skills of healthcare staff members is creating a gap between
indigenous and non-indigenous people. It can be considered as a barrier to ACCHs in
achieving their aim of reducing health inequalities in Australia. On the other hand, Freeman
et al. (2016) have mentioned that the lower-income of people of this community is
challenging for ACCHSs as they are being forced to set a very lower amount for healthcare
facilities for aboriginals. Political forces including unequal distribution of power and
resources are influencing the actions of ACCHSs. However, they are putting their best effort
to arrange required sufficient resources for the aboriginal Australian (MacPhail & McKay,
2018). This unequal distribution of power is causing non-cooperation from different levels of
society and this fact is limiting the action areas of ACCHSs.
Conclusion
After reviewing the entire discussion of this study, it can be concluded that indigenous
people are not getting equal healthcare services like non-indigenous people. Social
determinants and economic status of this group are contributing to health inequalities in
Australia. On the other hand, the unequal distribution of resources and power is preventing

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Assessment 2: Essay: Health Inequities Between Indigenous and
Non‐Indigenous Australians
this group from having equal health benefits. ACCHS is playing a vital role in reducing the
level of health inequalities in this country by ensuring the required healthcare facilities of
aboriginal people. However, this authority is facing limitations due to the present social,
economic and political determinants of health including lack of communication between
people from different cultures, unequal income systems, unequal power distribution, and
others.

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Assessment 2: Essay: Health Inequities Between Indigenous and
Non‐Indigenous Australians
Reference list
Aihw.gov.au (2019), Understanding indigenous welfare and wellbeing, Retrieved on 4th
February 2020
from:https://www.aihw.gov.au/reports/australias-welfare/understanding-indigenous-
welfare-and-wellbeing
Azzopardi, P. S., Sawyer, S. M., Carlin, J. B., Degenhardt, L., Brown, N., Brown, A. D., &
Patton, G. C. (2018). Health and wellbeing of Indigenous adolescents in Australia: a
systematic synthesis of population data. The Lancet, 391(10122), 766-782. Retrieved
from:https://www.burnet.edu.au/system/asset/file/2801/Health_and_wellbeing_of_Ind
igenous_Adolescents_in_Australia.pdf
Freeman, T., Baum, F., Lawless, A., Javanparast, S., Jolley, G., Labonté, R., ... & Sanders, D.
(2016). Revisiting the ability of Australian primary healthcare services to respond to
health inequity. Australian Journal of Primary Health, 22(4), 332-338. Retrieved
from:https://dspace2.flinders.edu.au/xmlui/bitstream/handle/2328/35539/
Freeman_Revisiting_AM2015.pdf?sequence=1
Harfield, S. G., Davy, C., McArthur, A., Munn, Z., Brown, A., & Brown, N. (2018).
Characteristics of Indigenous primary health care service delivery models: a
systematic scoping review. Globalization and health, 14(1), 12. Retrieved
from:https://link.springer.com/article/10.1186/s12992-018-0332-2
Humanrights.gov.au. (2017). Social determinants and the health of Indigenous peoples in
Australia – a human rights based approach. Retrieved on 3rd February 2020,

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Assessment 2: Essay: Health Inequities Between Indigenous and
Non‐Indigenous Australians
from:https://www.humanrights.gov.au/about/news/speeches/social-determinants-and-
health-indigenous-peoples-australia-human-rights-based
Javanparast, S., Windle, A., Freeman, T., & Baum, F. (2018). Community health worker
programs to improve healthcare access and equity: are they only relevant to low-and
middle-income countries?. International Journal of Health Policy and Management,
7(10), 943. Retrieved from:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6186464/
MacPhail, C., & McKay, K. (2018). Social determinants in the sexual health of adolescent
Aboriginal Australians: a systematic review. Health & social care in the community,
26(2), 131-146. Retrieved
from:https://onlinelibrary.wiley.com/doi/abs/10.1111/hsc.12355
Mja.com.au. (2014). Aboriginal community controlled health services: leading the way in
primary care. Retrieved on 3rd February 2020,
from:https://www.mja.com.au/journal/2014/200/11/aboriginal-community-controlled-
health-services-leading-way-primary-care
Naccho.org.au (2019), Key features of ACCHS, Retrieved on 4th February 2020
from:http://www.naccho.org.au/wp-content/uploads/Key-facts-1-why-ACCHS-are-
needed-FINAL.pdf
Spurling, G., Felton-Busch, C., & Larkins, S. (2018). Aboriginal and Torres Strait Islander
health. Australian journal of primary health, 24(5), i-ii. Retrieved
from:https://pdfs.semanticscholar.org/412e/afa3b4e466d2c6da438c8660cb5f2befebc6
.pdf.

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Assessment 2: Essay: Health Inequities Between Indigenous and
Non‐Indigenous Australians
Taylor, K., & Guerin, P. (2019). Health care and Indigenous Australians: cultural safety in
practice. Macmillan International Higher Education.
Thompson, G., Talley, N. J., & Kong, K. M. (2017). The health of Indigenous Australians.
The Medical Journal of Australia, 207(1), 19-20. Retrieved
from:https://staging.mja.com.au/system/files/issues/207_01/10.5694mja17.00381.pdf
Waterworth, P., Pescud, M., Braham, R., Dimmock, J., & Rosenberg, M. (2015). Factors
influencing the health behaviour of indigenous Australians: Perspectives from support
people. PloS one, 10(11), e0142323. Retrieved
from:https://journals.plos.org/plosone/article%3Fid%3D10.1371/journal.pone.014232
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