Health Inequalities Among Indigenous And Non-Indigenous Australians

Question

Task:
Part 1
What are the social, economic and political forces contributing to health disadvantages experienced by Indigenous Australians?
Part 2
What are the key features of Aboriginal Community Controlled Health Services (ACCHSs) as a model of PHC delivery?
What role can ACCHSs play in reducing health inequities between Indigenous and non? Indigenous Australians?
What are the barriers that might prevent ACCHSs in reducing health inequities between Indigenous and non?Indigenous Australians?

Answer

Introduction
The present report sheds light on the health inequalities among Indigenous and non-Indigenous Australians in a detailed manner. According to Deravin, Francis & Anderson (2018, p:480), aboriginal Australians are regarded amongst the oldest form of population who are known to live on the continent for more than 50,000 years. There are two types of aboriginals such as Aboriginal individuals as well as Torres Strait Islander individuals. The Aboriginal individuals are those who have populated Australia during the year 1788 when colonization started by Britishers. On the other hand, Torres Strait Islander individuals are those who have descended from inhabitants of the Torres Strait Islands. Bond & Singh (2020, p:198) opined that the inequality in health between Aboriginal as well as Torres Strait Islander individuals in Australia besides their non-Indigenous aristocracies is essential business for the Aboriginal community measured health service (ACCHS) sector. The report will provide an overview on the aspects that has been leading to health disadvantages among indigenous Australians and provides a brief comparison between Indigenous and non-Indigenous Australians. It will also reflect on the way ACCHS has been playing an imperative role in diminishing health inequalities that exists between Indigenous and non-Indigenous Australians.

Part 1
Health disadvantages experienced by Indigenous Australians
The improvement of health status among Indigenous Australians has always remained a major challenge for the government. In other words, there has always been a wide health gap that exists between Indigenous and non-Indigenous Australians. The health disadvantages that are experienced by Indigenous Australians are contributed by social, economic as well as political aspects that are as follows:

Physical Health
There has always been a strong relation between life expectancy for Indigenous Australians as well as deprived health. In the year 2016, it has been observed that there has been 1.7 times more malnutrition among Indigenouschildren as compared to non-Indigenous children (Twizeyemariya, Guy, Furber & Segal, 2017, p:340). While talking about Indigenous and non-Indigenous Australians, the hospitalization for enduring diseases in the year 2014-15 has been greater amongIndigenous rather than non-Indigenous Australians.

Mental Health
According to Birch & Marshall (2018, p:20), racism has been acting as the major aspect affecting physical as well as mental health among Indigenous children. It has been observed that 21.5 percent Indigenous children experienced racism that indulged them into smoking, alcohol consumption as well as using marijuana. In the year 2015, the suicide rate among Indigenous individuals has been double that in increased from 5 percent in 1991 to 50 percent in 2010.

Education
In comparison to 86 percent non-Indigenous Australians only 62 percent Indigenous students have completed their school studies in 2014-15. Due to poor education they remained deprived from using suitable health information (Brown, 2019, p:60).

Employment
The employment to population proportion for Indigenous 15–64-yearelderlies was approximately 48 percentduring 2014-15 in comparison to 75 percent for non-Indigenous Australians. While comparing Indigenous and non-Indigenous Australians, it has also been observed that only 39 percent Indigenous females were employed as compared to 55 percentnon-Indigenous females. This in turn increased the rate of assault among Indigenous females thus raising the overall hospitalization rates (Howard-Wagner, 2018, p:1340).

Colonization
This has been regarded as one of the major political aspect that contributes towards health disadvantages. The health as well as well-being amongIndigenous and non-Indigenous Australiansindividuals has been affected due to policy decisions that are incorporated by State as well as Territory governments (Genger, 2018, p:4). In other words, the government has not been able to implement a holistic approach in order to address social determinants of health among Indigenous individuals. A welfare data published by the government in the year 2017 reflects that Indigenous children have been getting removed from their families at a higher rate as compared to non-Indigenous children that impacted their health.

Part 2
Key Features
While researching on Indigenous and non-Indigenous Australians, it has been established that Indigenous individuals deals with deprived health results as compared to their non-Indigenous complements. The introduction of primary health care (PHC) model took place due to the inability of mainstream health services to sufficientlydeal with the requirements of Indigenous communities. The first PHC service for aboriginals was established in the year 1971 and at present there are over 150 Aboriginal Community Controlled Health Services (ACCHSs). The major characteristics are as follows:

Available health services: The major characteristics of ACCHS as a part of PHC are to provide reasonable health services. It also makes sure that a wide range of services are available to the indigenous individuals (Campbell, Hunt, Scrimgeour,Davey & Jones, 2018, p:220). It makes sure about awareness among communities regarding existence of services by providing mobile services.

Incessant Quality Improvement: The feature is to meet the requirements of each community through program evaluation besides gathering data. Undertaking study to reinforce health systems so as toencounter the requirements of the society with an importance on decoding research results into practice (Visser et al., 2019, p:24). Skilled employees: The aim is to deal with range of skilled employees who are well-equipped to meet the health requirements of local individuals. Providing training as well as development opportunities to all employees that include cultural awareness.

Holistic healthcare: The aim is to provide all-inclusive primary health care that is holistic. It also provides diverse types of services to patients that include health promotion thus preventing chronic diseases.

Role of ACCHSs in Reducing Health Inequities
The health inequity between the Indigenous and Non?Indigenous Australians is evident from the lower life expectancy of the indigenous people of Australia, when compared to the non-indigenous Australians. The aim of the ACCHS is to reduce the health inequity so that the indigenous Australians have a healthier and longer life (Caffery et al., 2018, p:680). The primary healthcare facilities set up by the ACCHS are established as well as managed by the Aboriginals. These primary healthcare facilities strive to provide comprehensive healthcare services that are culturally suitable for the community running the facilities.

The primary healthcare facilities controlled by the ACCHS work towards enhancing the quality of health of the indigenous Australians. The indigenous people face health issues like hearing problem experienced among children, high death rate among children before they reach the age of five, long-term disabilities, psychological problems, etc. (Coombs, 2019). Smoking and consumption of alcohol is a very common practice among the indigenous Australians. These lead to severe health problems like lung cancer and heart related diseases. The primary healthcare facilities for the indigenous Australians are trying to provide better healthcare services addressing the health issues like heart problems, lung diseases, childcare, mental healthcare, diabetes, etc.

The ACCHS has identified the major reasons behind the health inequities between the non-indigenous and indigenous Australians. The two major reasons include the lack of timely reporting of health problems by the Aboriginals and lack of affordable healthcare services for the community. These people also lack a proper diet as well as exercise. This increases the chances of high blood pressure (McFarlane et al., 2017, p:245). The ACCHS has to address these problems while providing primary healthcare services. The social factors like lower education, lower income and employment opportunities, poor housing and nutrition, etc. need to be taken into account while providing healthcare to the Aboriginals.

The ACCHS trains and employs Aboriginals in the PHC facilities as non-clinical staff. This provides financial freedom to the community and is likely to attract more Aboriginals to take up healthcare as their profession. The ACCHS also visits the homes of Aboriginals, gives them nursing and transportation help, etc. As opined by Bradley et al. (2020), the Australian government along with the ACCHS aims at bridging the health gap between the non-indigenous and indigenous Australians through upliftment of social condition, creating healthcare awareness, prevention of diseases and generating better healthcare outcome.

Barriers Preventing ACCHSs in Reducing Health Inequities
Insufficient Funds
The ACCHS faces problem in providing better healthcare services to the indigenous Australians as they lack sufficient funds. The government of Australia has not extended the required help and funding for the ACCHSs. The fund that has been allocated by the Australian government is more inclined towards the hospitals (Manifold et al., 2019, p:505). The government fails to understand the healthcare requirements of the Aboriginals. The ACCHS needs more budget allocation for the community-specific healthcare needs. The indigenous people are totally dependent on the primary healthcare facilities for healthcare. ACCHS not only faces scarcity of funds, but also has difficultly in coping up with the inadequate human and physical resources. When it comes to budget allocation, the government neglects the downstream healthcare services and prioritizes the mainstream healthcare services. The primary healthcare facilities of the ACCHS do not get their required fund for catering to the health needs of the indigenous population. A fairer fund distribution by the Australian government is required to reduce the health inequity between the Indigenous and non-Indigenous Australians.

Staff Turnover
The ACCHS has set up its primary healthcare facilities in rural, metropolitan and remote areas. These facilities are managed entirely by the indigenous people. Therefore, there is a need for increasing participation of the community is enhancing the health condition of indigenous Australians. The non-clinical staffs working at the primary healthcare facilities of ACCHS comprise mostly the indigenous people. These Aboriginals are trained and employed at the healthcare facilities. Through community engagement, ACCHS aims at encouraging the indigenous people for taking up the medical and healthcare profession (Thompson, Talley & Kong, 2017, p:19). It is observed in most of the primary healthcare facilities of ACCHS that there is a high staff turnover. The higher rate of staff turnover is prevalent in the PHC units that are located in the remote regions. The people who are being trained to work at these care facilities, need to be made aware of the area-specific requirements of the community. As the PHC facilities are associated with preventive healthcare, the staff needs to work effectively towards enhancing the health outcome of the community. There are situations when the staff in-charge of the wellbeing and healthcare of the Indigenous and non-Indigenous Australiansget extremely stressed out due to the difficult working conditions in the remote PHC facilities. The Indigenous and non-Indigenous Australians staff also experiences burnouts due to long working hours (Lee, 2016, p:3). These often result in staff turnover. Therefore, cultural safety, workplace security, managerial and peer support, etc. are needed to reduce staff turnover. This will enhance the need-based healthcare for the indigenous people.

Conclusion
The current healthcare sector in Australia provides healthcare based on standardised requirements of the population. The needs of the marginalised indigenous people who come from a different background and culture remain unaddressed. ACCHS is trying to reduce the health disparity between the Indigenous and non-Indigenous Australians. However, while taking about Indigenous and non-Indigenous Australians, the health policies as well as the funds allocated by the government for healthcare of the indigenous are not sufficient. The ACCHS is working towards improving the health condition of the Aboriginals through their primary healthcare facilities. The employment opportunity provided to the Aboriginals at the PHC units also elevates their financial condition. The community engagement has not only enhanced the quality of health but has also improved their social condition to some extent. For ensuring wellbeing and better health for the indigenous people, the Australian government needs to design more effective health policies.

References
Birch, E., & Marshall, D. (2018). Revisiting the earned income gap for Indigenous and non-Indigenous Australian workers:

Evidence from a selection bias corrected model. Indigenous and non-Indigenous AustraliansJournal of Industrial Relations, 60(1), 3-29.

Bond, C. J., & Singh, D. (2020). More than a refresh required for closing the gap of Indigenous health inequality. The Medical Journal of Australia, 212(5), 198-199.

Bradley, C., Hengel, B., Crawford, K., Elliott, S., Donovan, B., Mak, D. B., ... & Wand, H. <(2020). Establishment of a sentinel surveillance network for sexually transmissible infections and blood borne viruses in Aboriginal primary care services across Australia: the ATLAS project.

Brown, L. (2019). Indigenous young people, disadvantage and the violence of settler colonial education policy and curriculum. Journal of sociology, 55(1), 54-71.

Caffery, L. J., Bradford, N. K., Smith, A. C., & Langbecker, D. (2018). How telehealth facilitates the provision of culturally appropriate healthcare for Indigenous Australians. Journal of telemedicine and telecare, 24(10), 676-682.

Campbell, M. A., Hunt, J., Scrimgeour, D. J., Davey, M., & Jones, V. (2018). Contribution of Aboriginal Community-Controlled Health Services to improving Aboriginal health: an evidence review. Australian Health Review, 42(2), 218-226.

Coombs, D. (2019). Fighting for health equity: Aboriginal Community Controlled Health Services in a challenging policy context.

Deravin, L., Francis, K., & Anderson, J. (2018). Closing the gap in Indigenous health inequity–Is it making a difference?. International Nursing Review, 65(4), 477-483.

Genger, P. (2018). The British Colonization of Australia: An Exposé of the Models, Impacts and Pertinent Questions. Indigenous and non-Indigenous AustraliansPeace and Conflict Studies, 25(1), 4.

Howard-Wagner, D. (2018). Governance of indigenous policy in the neo-liberal age: indigenous disadvantage and the intersecting of paternalism and neo-liberalism as a racial project. Ethnic and Racial Studies, 41(7), 1332-1351.

Lee, A. (2016). Closing the nutrition gap in Indigenous health disadvantage. Nutridate, 27(3), 3.

Manifold, A., Atkinson, D., Marley, J. V., Scott, L., Cleland, G., Edgill, P., & Singleton, S. (2019). Complex diabetes screening guidelines for high-risk adolescent Aboriginal Australians: a barrier to implementation in primary health care. Australian Journal of Primary Health, 25(5), 501-508.

McFarlane, K., Devine, S., Judd, J., Nichols, N., & Watt, K. (2017). Workforce insights on how health promotion is practised in an Aboriginal Community Controlled Health Service. Australian journal of primary health, 23(3), 243-248.

Thompson, G., Talley, N. J., & Kong, K. M. (2017). The health of Indigenous Australians. The Medical Journal of Australia, 207(1), 19-20.

Twizeyemariya, A., Guy, S., Furber, G., & Segal, L. (2017). Risks for mental illness in Indigenous Australian children: a descriptive study demonstrating high levels of vulnerability. The Milbank Quarterly, 95(2), 319-357.

Visser, H., Passey, M., Walke, E., & Devlin, S. (2019). Screening for latent tuberculosis infection by an Aboriginal Community Controlled Health Service, New South Wales, Australia, 2015. Indigenous and non-Indigenous AustraliansWestern Pacific Surveillance and Response Journal: WPSAR, 10(4), 24.