NUR332 Report: Assimilation Policy's Impact on Indigenous Health

This report examines the historical and contemporary health status of Indigenous young people in Australia, focusing on the profound impact of the assimilation policy of 1961. It begins by outlining the pre-invasion health challenges, including respiratory and cardiovascular diseases, and contrasts them with current health issues such as depression, diabetes, and substance abuse. The report delves into the assimilation policy, its objectives, and its detrimental consequences, including increased racism, loss of identity, and disruption of family structures. It explores the policy's effects on access to essential services like housing, healthcare, and education, as well as its influence on smoking during pregnancy, traditional birthing practices, and higher education attainment. Furthermore, the report emphasizes the importance of culturally safe nursing practices, advocating for a deeper understanding of Indigenous culture, building collaborative relationships, and promoting self-evaluation to address biases and improve healthcare outcomes for Indigenous communities. The report concludes by emphasizing the need for healthcare professionals to understand the historical context and current inequalities to provide effective and culturally sensitive care.

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Indigenous Young People’s Health and Cultural Safety
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Indigenous Young People’s Health and Cultural Safety
Pre-invasion Health Status
Young Indigenous people in Australia face significant obstacles that originated from
historical events. Inter-generation trauma, socioeconomic challenges, racism, and prejudice are
part of the problems that are rooted in the pre-invasion period (AIHW, 2016). During the pre-
invasion period, the most common health challenges among young Indigenous people in
Australia were respiratory and cardiovascular diseases (Australian Institute of Health and
Welfare, 2018). Cases of critical social determinant emanated from a lack of proper health
awareness campaign and access to healthcare. However, reported cases on other health
complications such as cancer and depression were limited (Azzopardi, Sawyer, Carlin,
Degenhardt, Brown, Brown, and Patton, 2017). Such a scenario could be because of limited data
regarding the healthcare status of Indigenous people the country during the pre-invasion period.
Current Health Status
There is a significant degree of health status among Indigenous people in the country
based on several systematic changes focusing on Indigenous communities. It is now possible to
assess different dimensions of healthcare because of available data. Currently, Indigenous people
young people in Australia are associated with high diagnostic representation in several
conditions (Azzopardi et al., 2017). In addition to respiratory and cardiovascular illnesses, a
notable number of youths are diagnosed with depression, diabetes, anxiety, cancer, mental health
problems, and other infectious diseases (Haynes, Kalic, Cooper, Hewitt, and Davis, 2016). Social
disadvantages such as racism and prejudice have impacted the wellbeing of a greater percentage
of young Indigenous people (Bielefeld and Altman, 2015; Bovill, Bar-Zeev, Gruppetta, O’Mara,
Cowling, and Gould, 2016). Moreover, cases of suicide, alcohol use, and smoking are commonly

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reported among individuals between the age of 12 and 24 (Australian Institute of Health and
Welfare, 2018).
Assimilation Policy
Assimilation policy is a key historical occurrence that impacted young Indigenous people
and as well as children and adults. In 1960, the Australian government enacted the policy whose
objective was to ensure that Indigenous people are assisted to adopt a modern lifestyle and be
part of the Australian mainstream community (Commonwealth Government, 1961). The policy
highlighted how and why it as necessary to teach and influence Indigenous people to accept
Whites’ way of life so that they could also enjoy similar rights and opportunities as non-
Indigenous people. Indigenous people were therefore required to abandon their traditional
practices and start observing modern customs, hopes, and beliefs (Commonwealth Government,
1961). It was believed that this transition could improve and advance the political, social, health,
and economic lifestyle of Indigenous people. Nevertheless, the impact of the policy exacerbated
the social and health status of young Indigenous people.
Assimilation Policy
Racism and Identity
As noted earlier the purpose of the assimilation policy was to provide a framework for
Indigenous people to be absorbed into the mainstream community as they abandon their culture
and Indigenous practices. However, the implementation of the policy provided a platform for
increased racism and loss of identity. First, ‘full-blood’ Indigenous people were expected to ‘die
out’ so the policy targeted non-‘full-blood’ young people and children of Aboriginal and Torres
Strait Islanders origin. Children were separated from families and young people disintegrated
from respective communities. Indigenous people were considered a threat to the society and

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designated reserves became home. With time some of these reserves were converted into mining
grounds, which became the onset of homelessness among Indigenous people. Being seen as
uncivilized and threat to non-Indigenous people created social restrictions since Indigenous
people were not allowed to access some locations or services in some areas.
The assimilation policy wanted Indigenous people to abandon traditional culture, which
is a hallmark of identity. Young people were taken to school and children were taken from
families even when it was not ascertained that they were in need of foster care. Young people
living away from their families faced critical integration problems as they attempted to adjust to
the mainstream community. The rest of Indigenous people who did not succumb to the
requirements of the policy remained isolated and discriminated (Australian Institute of Health
and Welfare, 2018). Access to essential services such as housing, healthcare, and education
while embracing traditional identity became a challenge for Australian young Indigenous people.
Aboriginal culture is intergenerational and is shared from elders to parents and eventually to
children. By disintegrating the cohesion between members of the family and the
interconnectedness of the community, the government destroyed children values and family ties
among Indigenous people by implementing the assimilation policy. At the same time, through
the policy, it was a forceful responsibility of Indigenous young people to change their way of
life. It was not presented as a choice but as the only option to enjoying the available rights and
privileges the same way as non-Indigenous people.
Smoking During Pregnancy and Traditional Birthing Practices
The effect of assimilation on Indigenous communities in the country created a
disconnection on how families interacted and the process of instilling values among young
people. Behavioral shifts such as tobacco consumption during pregnancy impacted the health of

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young mothers and children born under such conditions. Currently, about 31% of Indigenous
young people in Australia are regular smokers (Australian Institute of Health and Welfare,
2018). Although smoking frequency is common among men, young women have also been
reported. Smoking during pregnancy is a health risk factor common to Indigenous young people
when compared to a non-Indigenous population of the same age bracket (Carson, Brinn,
Labiszewski, Peters, Veale, Esterman, and Smith, 2012). Young mothers are at risk of death and
birth-related complications, which emanate from smoking during pregnancy. Other implications
are the high infant mortality rate and low birth weight that affect children born to mothers who
smoked during pregnancy. It is important to note that these negative effects of smoking during
pregnancy exist amid the socioeconomic disadvantages among Indigenous young people
(Australian Institute of Health and Welfare, 2018; Kikkawa, 2014). At the same time, such
behaviors exacerbate health status already marred by pre-invasion occurrences and assimilation
implications.
On the other hand, traditional birth practices have equally affected Indigenous young
people. Aboriginal culture considers birth as a special occasion in the community (Aseron,
Greymorning, Miller, and Wilde, 2013). Traditional midwives are responsible for this role,
which is carried out in secluded locations. The adherence to these traditional practices is a risk
factor for infant mortality. Traditional medication for infants does not have any scientific
backing and could be the reason behind the witnessed health complications among young
mothers and children in Indigenous communities. Although modern practices are encouraged, a
significant number of Indigenous young mothers prefer traditional birth practices based on the
inherited culture in the community. Different clinical reports affirm that inclining towards

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traditional birth practices and methods escalate health risk factors for both the mother and the
infant especially in cases involving first time deliveries.
Higher Education Attainment and Professional Employment Opportunities
The assimilation policy was enacted to provide opportunities for Indigenous young
people to compete and become part of the mainstream community in Australia. Although the
intentions of the policy were good, the approach to implementation caused increased harm that
later exacerbated the representation of Indigenous young people in higher education and
professional employment opportunities (Aseron, Wilde, Miller, and Kelly, 2013; Bandias, Fuller,
and Larkin, 2014). Currently, there is an increase in Indigenous young people enrolling to higher
education programs (Australian Institute of Health and Welfare, 2018). Those who join
healthcare professionals have been inspired by the desire to improve the living condition of
Indigenous people. The government has embarked on education programs meant to foster a
positive life experience among Aboriginals. One key trend that dominates education acquisition
among Indigenous young people is the decrease in attendance with an increase in age (Behrendt,
Larkin, Griew, and Kelly, 2012). It is estimated that about 11% of young people aged between
20 and 24 attend higher education, which is lower when compared with the number of non-
Aboriginal people in Australia (Australian Institute of Health and Welfare, 2018). Currently,
about 3,400 and 5,001 Indigenous young people are attending technical and university education
respectively. Increased access to education among Indigenous young people has improved and
encouraged positive health practices as depicted by the declining overrepresentation.
On the other hand, based on the disparity in access to education, which is part of the
disadvantages faced by Indigenous young people, the same pattern is depicted in professional
employment. Indigenous people live in remote areas with limited employment opportunities.

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Around 30% of young people have attained professional qualifications beyond primary and
secondary schooling levels (Australian Institute of Health and Welfare, 2018). Most Indigenous
young people are not included in government support programs that are established to improve
professional development for marginalized people or groups. Currently, a greater percentage of
Indigenous young people, about 51%, are in labor force while only 20,000 are in employment.
However, this statistic was extremely low several decades ago (AIHW, 2017; Australian Institute
of Health and Welfare, 2018). When compared to non-Indigenous people, Indigenous young
Australians are not equally represented in professional employment. Nevertheless, those in
medical field have played a major role in offering individualized healthcare services to
Aboriginal communities, which has significantly improved the health status of children and
young people.
Improving Culturally Safe Nursing
Indigenous people of Australia have gone through intergenerational racism and prejudice.
The assimilation policy and pre-invasion experiences affected the health of a significant
percentage of young and old people. One of the major contributors to poor health among young
Indigenous people is the lack of a comprehensive framework that supports culturally safe
healthcare practice. In this case, I will ensure that I learn how to improve the healthcare
experience of Indigenous people by first understanding the Indigenous culture. The knowledge
of history and culture of Indigenous people provides a clear understanding of experiences and
existing inequalities in terms of healthcare factors (Aseron, Greymorning, Miller, and Wilde,
2013). Such a move will ensure that when working with Indigenous people, I will be aware of
the culture and values upheld and those that directly impact care delivery.

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The other approach to improve culturally safe nursing practice to curb healthcare
inequality depicted among Indigenous young people is the adoption of a collaborative
environment. I will consider the advantages of establishing a therapeutic relationship with each
Indigenous patient I encounter to ensure that there is a professional relationship that could be
used to improve the quality of treatment outcomes. Trust plays a key role when building a
therapeutic relationship with a healthcare consumer. Indigenous people have a unique culture
and beliefs, which implies that successful relationship with patients should equally pay attention
and recognize cultural diversity (Aseron, Greymorning, Miller, and Wilde, 2013).
Moreover, self-evaluation is necessary. I will evaluate my attitude and perception about
Indigenous people by comparing my understanding of the existing cultural diversity with non-
Indigenous people. From my evaluation, I will list down the factors that could increase my
possibility of developing prejudice or racial perspectives against Indigenous people. My goal
will be to address these personal elements and consider ways of eliminating such beliefs and
attitude. I will also support my fellow nurses to develop a positive attitude towards Indigenous
culture and practices and strive to offer culturally safe healthcare.

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