Health and Society Assessment 3: Smoking and Indigenous Australians

This assignment, focusing on the health issue of smoking and its impact on Indigenous Australians, addresses three key questions. The first question explores two reasons for health inequity between Indigenous and non-Indigenous Australians, highlighting the gap in life expectancy and the influence of social norms and lack of education. The second question examines a primary health care intervention, specifically tobacco intervention for pregnant women, and its impact on reducing inequity, including tailored advice and nicotine replacement therapy. The final question discusses how cultural knowledge and sensitivity in healthcare affect access to primary health care services, emphasizing the importance of effective communication and culturally appropriate care, providing examples of how cultural insensitivity can hinder access to services and the importance of one-to-one counseling options. The assignment emphasizes the need for government planning, improved healthcare facilities, and culturally sensitive approaches to address smoking-related health disparities within the Indigenous Australian community.

Health and Society
Assessment 3
Extended ResponseTemplate
Choose one health issue from the list below:
 Smoking
 Coronary heart disease
Answer all of the three questions below based on this one health issue.
Each extended response should be approximately 500 words in length each.
The reference list for all three extended response should be provided under the references heading
of this template.

Question 1
Discuss two different reasons for inequity between Indigenous Australians and non-Indigenous
Australians in relation to this health issue.
The health status of the Aboriginal residents of Australia is poor compared to that of the rest
of Australian population. A vast inequity gap is detected in healthcare service provided by the
Australian Government. For instance, the estimated gap in life expectancy between
indigenous and non-indigenous residents of Australia is Approximately 17 years
(McBainRigg & Veitch 2011). The closing the gap campaign is trying to minimize the
inequity between indigenous and non-indigenous Australians since several years now. While
positive results have been evidenced in child mortality, early childhood education and year 12
or equivalent attainment, the gap has still not closed when it comes to unemployment, life
expectancy, literacy, school attendance and finally numeracy of the indigenous people
(McBainRigg & Veitch 2011).
When it comes to smoking-associated health issues, two of the chief reason behind the still
prevailing inequity between indigenous and non-indigenous Australian is as follows:
The healthcare policy goals of the government are not matching the policy action.
Unlike the non-indigenous Australians, smoking is still considered to be a social norm in the
aboriginal culture. Government employees who are appointed to prevent smoking activities
among children are found to be reluctant or unable to interfere as smoking activities are

considered to be a social norm within the aboriginal community (Di Cesare et al. 2013). As a
result of this, a majority of the aboriginal children gets exposed to smoking activity in their
early phase of life. It is to be remembered that, the social norms of smoking is not a
traditional part of the Aboriginal culture but is introduced in the mentioned society in the
later period of time. Consumption of tobacco from a very early age results in several diseases
that include Lung cancer, Chronic Obstructive Pulmonary Disease (COPD), heart diseases
and others. Along with that, lack of education in the Aboriginal community enhances the
tendency of smoking to a great extent. According to a survey, it has been found that
Aboriginal and Torres Islander people who completed year 12 are not daily smokers
compared to those whose highest years in school was 10 years or bellow (Lawrence et al.
2013).
Lack of employment facilities provided to the indigenous people can be considered as
another reason behind the excessive amount of smoking-related issues in Australian
Aboriginal community. The survey states that aboriginal people who are employed are more
likely to stop chain smoking compared to aboriginal individuals who are unemployed.
Unemployment results in poverty and physiological stress. Where 76 percent of the non-
indigenous people of Australia are employed, only 34.6 percent of aboriginal Australians
have jobs. As a result of this, the stress associated with employment is found to be higher
among the aboriginal people of Australia compared to that of the non-indigenous Australian
(Campbell et al. 2013). Moreover, lack of availability of healthcare facilities often results in a
mental illness which encourages smoking and drug abuse.
From the above discussion, it can be concluded that lack of planning and facilities provided
by the government are the two major reasons behind the smoking-related healthcare issues of
the Australian Aboriginal individuals.

Question 2
Provide one example of a Primary Health Care intervention that is addressing this health
issue for Indigenous Australians. Explain the impact this intervention is having on reducing
inequity.

Considering the fact that that the use of tobacco is one of the chief reasons behind premature
morbidity and mortality among indigenous people, several primary health care interventions
have been conducted by health care professionals, researchers as well as community
members. One of the mention worthy primary health care intervention for reducing
healthcare issue associated with tobacco use is tobacco intervention for pregnant women.
Smoking during pregnancy is considered to one of the most modifiable risk factors for long-
term health condition as well as adverse pregnancy outcomes (Passey et al. 2012). Australian
indigenous women are most likely to smoking due to social norms, socio-economical
disadvantage and poor access to culturally appropriate social support.
The aim of the mentioned primary health care intervention is to provide assistance to
pregnant aboriginal women to successfully reduce tobacco use and increase the birth weight
of the baby. According to the survey, more than 72 percent of pregnant indigenous women of
Australia smoke. When compared to non-indigenous infants, indigenous infants are found to
be more likely to born underweight (Hoekzema et al. 2014). Under the intervention, several
health-promoting resources have been developed to address the effect of smoking in
indigenous women. The first step of the tobacco intervention for indigenous pregnant women
includes tailored advice as well as support provided by the general practitioners as well as the
healthcare workers (Simons & Hughes 2012). This is generally done during the first antenatal
visit. The counseling is done with the help of evidenced-based communication skills. Along
with that, the partner of the tobacco-addicted healthcare user, along with other adults are
engaged in the intervention to provide support to her during her attempts to quit smoking.
Another major part of the counseling process involves providing effective education about
the negative effect of smoking on the respiratory system of human beings and how it is fatal
for the baby to be born (Eades et al. 2012). Healthcare users who are recruited to deal with
the mentioned intervention are provided effective training by the government so can they

develop the capability to understand the psychology of the healthcare service users and
provide necessary support and medication to help them out. However, in 26.3 percent of
cases, it has been found that mere counselling and education about negative aspects of
tobacco use during pregnancy are not able to make the health care users quit or minimize
smoking habit (Toohill et al. 2014). In that case, Nicotine Replacement Therapy (NRT) is
offered to the healthcare service users after two failed attempt to quit smoking.
The result of the mentioned intervention is positive since the smoking rate in pregnant
women in Australia has got reduced by 6.2 percent in the year 2017 (Clifford et al. 2017).
However, this decrement is much lower than what is required. In order to decrease smoking
among pregnant Indigenous women and guide this process, there is an urgent requirement for
rigorous studies.

Question 3
Discuss how cultural knowledge and sensitivity in health care may affect access Primary Health Care
services. Provide one example based on your chosen health issue.
Lack of cultural knowledge and low cultural sensitivity in the Australian healthcare industry
impose highly negative impact on the access to Primary Health Care services oof the
Aboriginal and Torres Islanders. Due to the mentioned gap, the life expectancy of Indigenous
males are found be 9.7 percent lower than that of the non-indigenous Australian and the life
expectancy of the female is found be lower by 11.5 percent (Demaio, Drysdale & de Courten
2012). According to researchers, lack of proper knowledge of the healthcare service providers
along with low cultural competency is closely relate to their delay in healthcare checks,
following up hospital appointments and cancer screening (Simons & Hughes 2012).
Considering the fact that language is considered to be the most crucial component of a
culture, ineffective communication between the healthcare professionals and the aboriginal
healthcare users is considered to be a major reason behind dramatic failure in the healthcare
outcomes. For instance, approximately 97.5 percent of the overall population of the Northern
Territory of Australia is consists of Aboriginal Australians. However, only 2.1 percent of
them are able to speak English (Clifford et al. 2017). In spite of the fact that the Australian

healthcare system is considered to be one of the most sophisticated healthcare systems across
the world, it provides little benefit if the healthcare users and healthcare providers fail to
communicate. Ineffective communication results in high amount of misunderstanding as well
as confusion. As a result of these, loopholes in the treatment process arrises which in several
cases have resulted in fatal outcomes (Simons & Hughes 2012). Lack of cultural sensitivity
along with proper training of the healthcare service provider to show respect for the culture of
the healthcare service user prevents the latter to willingly access healthcare service.
Aboriginal and Torres Islanders are highly sensitive when it comes to their cultural beliefs.
The traditional health-related beliefs of the aboriginal people emphasize that social, as well as
spiritual dysfunction, is the chief reason behind diseases an illness caused to an individual. A
majority of the aboriginal people residing in remote areas beliefs in supernatural
interventions. Supernatural interventions, as well as sorcery, are a part of the perceived reality
of Aboriginal Culture (Rowan et al. 2014). As a result of this, a good number of Aboriginal
people often tend to avoid Hospitals and healthcare services since they believe they are less
effective or against their culture.
One of the examples of the absence of cultural sensitivity is the absence of Aboriginal
community engagement. It has been noticed that due to lack of cultural sensitivity among
healthcare providers, Aboriginal and Torres Strait Islander people often find it difficult
disclosing information about their smoking issues in group settings. According to researchers,
conducting one-to-one counselling options will be highly effective for solving the mentioned
issue (Rowan et al. 2014). Similarly, face to face aftercare should be provided to the
healthcare service users instead of providing suggestion over phone. As being discussed
earlier, smoking is considered to be a social norm and hence is a part of the culture in the
Aboriginal society. Sharing of tobacco is considered to be highly crucial in maintaining and
reinforcing relationship as well as social cohesion. Refusal to smoke is considered to be a