Working Effectively with Aboriginal and Torres Strait Islander People
Why are Indigenous people in Australia still disadvantaged with regard to health care and services?
For the last 200 years Indigenous people have been victims of discrimination, prejudice and disadvantage. Poor education, poor living conditions and general poverty are still overwhelming issues for a large percentage of our people and we remain ‘as a group, the most poverty stricken sector of the working class’ in Australia (Cuthoys 1983).
As a people, our rate of chronic disease is still 2.5 times higher than that of other Australians, and Indigenous people in this country die 15 to 20 years younger than those in mainstream Australia. More than half of these figures are caused by chronic diseases such heart disease, stroke, diabetes, chronic respiratory disease and kidney disease. The majority of these chronic diseases are preventable and while research is continuing to find ways to reduce the risk factors, issues such as smoking, alcohol and substance abuse, diabetes, chronic kidney disease, and promoting healthy eating and active lifestyles are still major challenges in Indigenous communities throughout Australia.
Healthy living choices are not easy for people living in remote communities which results in a high incidence of preventable chronic disease. Good nutrition is fundamental to the maintenance of general wellbeing and the prevention of sickness and disease. It plays an imperative role in pregnancy and early childhood, prevents obesity and type 2 Diabetes and can lower the risk of recurrent heart disease by up to 70%. However, remote communities face many barriers to healthy eating, including isolation, the high cost of food, the variable supply of fresh food, lack of community town infrastructure and inadequate health promotion support, are just a few of these barriers that prevent community people from being able to make healthy living choices.
Community programs in the Northern Territory aimed at building healthy communities are based on nutrition-related Menzies research and work to support community capacity to create a supportive environment for healthy eating and physical activity. These projects operate within the communities and are aimed at influencing food-related policy, promote healthy eating and physical activity, and encourage community engagement in activities for better health.
Not as many health services are as user-friendly or culturally appropriate for Indigenous people as they are for non-Indigenous people, adding to higher levels of disadvantage and a greater reluctance to utilise these services. Sometimes this is because more Indigenous people live in remote locations and not all health services are offered outside of major centres.
Specific issues such as reducing the incidence of chronic disease requires a significantly greater effort in coordinating collective strengths, creating and delivering preventative programs and primary health care for Indigenous communities and while great work is being done, more efforts are required to reduce the high incidence of chronic disease on Indigenous people and communities. When designing and developing services to meet the needs of our Indigenous people, close collaboration and consultation with the people for whom the service will be provided is vital.
There is also much evidence suggesting that Indigenous women are over-represented in our hospitals and health clinics as victims of domestic and family violence. There is no clear measure of the extent to which Indigenous family violence is under-reported, but it is expected to be higher than for the general population (Cripps 2008; Cunneen 2009). In a report to the Australian Government about Indigenous violence, it was suggested that ‘priority should be placed on implementing anti-violence programs, rather than on further quantitative research’.
The key risk factors for Indigenous family violence...
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