Context of Indigenous health Essay

Historical context and complaisant determinants of endemic wellness on that point is a clear relationship between the social disadvantages experienced by native mint and their current wellness status 1. These social disadvantages, instanter related to dispossession and characterised by poverty and powerlessness, argon reflected in measures of education, employment, and income. sooner presenting the key indicators of endemic wellness status, it is important, therefore, to provide a brief epitome of the context within which these indicators should be considered.The historical context of original health autochthonal great deals gener wholey enjoyed better health in 1788 than around good deal living in Europe 23456. They did not suffer from variola major virus, measles, influenza, terabit, scarlet fever, venereal syphilis and gonorrhoea, distempers that were common in 18th century Europe. Indigenous flock probably suffered from hepatitis B, al just closely bact erial infections (including a non-venereal form of syphilis and yaws) and or so intestinal parasites.Trauma is likely to have been a major reasonableness of remainder, and anaemia, arthritis, periodontal disease, and tooth attrition be kn accept to have occurred. The impact of these diseases at a universe level was relatively sm every(prenominal) compared with the effect of the diseases that modify 18th century Europe. All of this changed after 1788 with the arrival of sneak ind illness, initially smallpox and sexually transmissible infections (gonorrhoea and venereal syphilis), and later tuberculosis, influenza, measles, scarlet fever, and whooping cough 3478.These diseases, particularly smallpox, caused considerable loss of life among Indigenous tribes, solely the impacts were not cut back to the immediate victims. The epidemic similarly affected the fabric of Indigenous societies done de nation and social disruption. The impact of introduced diseases was almost cert ainly the major cause of death for Indigenous nation, but direct conflict and problem of Indigenous homelands in like manner contributed substantially to Indigenous mortality 7910.The initial responses of Indigenous heap to the arrival of the commencement exercise Fleet were apparently quite peaceful. It didnt take long, however, before conflict started to occur initially over access to fish stocks and thusly over access to another(prenominal) resources as non-Indigenous commonwealth started to plant crops and introduce livestock. This pattern of conflict was almost certainly widespread as non-Indigenous people spread across the country. Conflict escalated in numerous places, in some instances resulting in overt massacres of Indigenous people.The 1838 massacre at Myall Creek (near Inverell, NSW) is the most infamous 11, but less well-known massacres occurred across Australia 10. As Bruce sr. notes, as painful and shameful as they are, the massacres should be as much a par t of Australian history as the First Fleet, the explorers, the gold rushes and the bushrangers (10, p. vi). Prior to 1788, Indigenous people were able to define their own sense of being through control over all aspects of their lives, including ceremonies, spectral practices, medicine, social relationships, management of land, law, and economic activities 121314.In addition to the impacts of introduced diseases and conflict, the spread of non-Indigenous peoples undermined the great power of Indigenous people to lead healthy lives by devaluing their culture, destroying their handed-down food base, separating families, and dispossessing whole communities 347. This loss of autonomy undermined social vitality, which, in turn, affected the efficiency to meet challenges, including health challenges a cycle of dispossession, demoralisation, and poor health was established.These impacts on Indigenous tribes eventually forced colonial authorities to try to harbor remaining Indigenous peoples. This pressure led to the establishment of native protective covering boards, the first established in Vic by the primordial Protection mould of 1869 15. A similar Act established the NSW Aborigines Protection Board in 1883, with the other colonies also enacting legislation to protect Indigenous populations within their boundaries. The breastplate provided under the provisions of the various Acts imposed enormous restrictions on the lives of many Indigenous people.These restrictions meant that, as late as 1961, in eastern Australia nearly one-third of all Australians recorded as being of Aboriginal logical argument lived in settlements (16, p. 4). The provisions of the Acts were also used to justify the forced detachment of Indigenous children from their families by compulsion, duress or undue influence (15, p. 2). The case Inquiry into the separation of the children concluded that between one-in-three and one-in-ten Indigenous children were forcibly unconnected from their families and communities in the period from virtually 1910 until 1970 (15, p. 31).It was the 1960s, at the earliest, when the various protection Acts were every repealed or became inoperative. The importance of contemporary social determinants and cultural concepts of Indigenous health The health disadvantages experienced by Indigenous people can be considered historical in origin 14, but perpetuation of the disadvantages owes much to contemporary structural and social factors, embodied in what have been termed the social determinants of health 11718.In broad terms, economic opportunity, physical infrastructure, and social conditions influence the health of individuals, communities, and societies as a whole. These factors are specifically manifest in measures such as education, employment, income, accommodate, access to services, social ne 2rks, connection with land, racism, and incarceration. On all these measures, Indigenous people suffer substantial disadvantage. For ma ny Indigenous people, the ongoing effects of protection and the forced separation of children from their families compound other social disadvantages.It is also important in considering Indigenous health to understand how Indigenous people themselves conceptualise health. There was no separate term in Indigenous languages for health as it is understood in western society 19. The traditional Indigenous perspective of health is holistic. It encompasses everything important in a mortals life, including land, environment, physical body, club, relationships, and law. Health is the social, emotional, and cultural wellbeing of the whole community and the concept is therefore linked to the sense of being Indigenous.This conceptualisation of health has much in common with the social determinants model and has crucial implications for the bare(a) application of biomedically-derived concepts as a means of improving Indigenous health. The reductionist, biomedical approach is undoubtedly usef ul in identifying and reducing disease in individuals, but its limitations in addressing population-wide health disadvantages, such as those experienced by Indigenous people, must be recognised. Indicators of Indigenous social disadvantage.The key measures in these areas for Indigenous people studyly include Education According to 2011 Australian enumerate 20 92% of 5 twelvemonth-old Indigenous children were attending an educational brass 1. 6% of the Indigenous population had not attended school compared with 0. 9% of the non-Indigenous population 29% of Indigenous people reported course 10 as their highest year of school completion 25% had completed year 12, compared with 52% of non-Indigenous people 26% of Indigenous people reported having a post-school qualification, compared with 49% of non-Indigenous people 4.6% of Indigenous people had attained a bachelor degree or higher, compared with 20% of non-Indigenous people. An ABS school report 21 revealed, in 2011 the apparent retention rate for Indigenous students from year 7/8 to year 10 was 99%, from year 7/8 to year 12 it was 49% for non-Indigenous students, the apparent retention rate from year 7/8 to year 10 was 101% and from year 7/8 to year 12 it was 81%.The 2011 topic report on discipline in Australia 22 showed 76% of Indigenous students in year 3 and 66% in year 5 were at or above the interior(a) lower limit measurement for reading, compared with 95% and 93% independently of all Australian students 80% of year 3 Indigenous students and 69% of year 5 Indigenous students were at or above the content minimum standard for persuasive writing, compared with 96% of all year 3 students and 94% of all year 5 students 72% of year 3 Indigenous students and 69% of year 5.Indigenous students were at or above the national minimum standard for spelling, compared with 94% of all year 3 students and 93% of all year 5 students 71% of year 3 Indigenous students and 65% of year 5 Indigenous students were at or above the national minimum standard for grammar and punctuation, compared with 94% of all year 3 students and 94% of all year 5 students 84% of Indigenous students in year 3 and 75% in year 5 were at or above the national minimum standard for numeracy, compared with 96% and 96% respectively of all Australian students.Employment According to the 2011 Australian Census 20 42% of Indigenous people vulcanized 15 years or one-time(a) were employed and 17% were unemployed. In comparison, 61% of non-Indigenous people aged 15 years or older were employed and 5% were unemployed the most common occupation classification of employed Indigenous people was mariner (18%) followed by community and personal service workers (17%). The most common occupation classification of employed non-Indigenous people was professional (22%).Income According to the 2011 Australian Census 20 the mean equivalised gross household income for Indigenous persons was around $475 per week approximately 59% of that f or non-Indigenous persons (around $800). Indigenous population Based on information self-collected as a part of the 2011 Census of world and Housing, the ABS has estimated the Aboriginal and Torres narrow islander population at 669,736 people at 30 June 2011 23. The estimated population for NSW was the highest (208,364 Indigenous people), followed by Qld (188,892), WA (88,277), and the NT (68,901) (Table 1). The NT has the highest proportion of Indigenous people among its population (29. 8%) and Vic the lowest (0. 9%).Table 1 Estimated Indigenous population, by jurisdiction, Australia, 30 June 2011 JurisdictionIndigenous population (number)Proportion of Australian Indigenous population (%)Proportion of jurisdiction population (%) source ABS, 2012 23 Notes Preliminary estimates are subject to revision population projections are expected to be finalised by 2014 Australian population includes Jervis Bay Territory, the genus Cocos (Keeling).Islands, and Christmas Island Proportions of jurisdiction population have used total population figures estimated from demographic information for June 2011 NSW208,36431. 12. 9 Vic47,3277. 10. 9 Qld188,89228. 24. 2 WA88,27713. 23. 8 SA37,3925. 62. 3 Tas24,1553. 64. 7 execute6,1670. 91. 7 NT68,90110. 329. 8.Australia669,736100. 03. 0 There was a 21% increase in the number of Indigenous people counted in the 2011 Census compared with the 2006 Census2 24. The largest increases were in the ACT (34%), Vic (26%), NSW (25%) and Qld (22%). For all jurisdictions, the 55 years and over age-group showed the largest relative increase. There are two structural reasons contributing to the growth of the Indigenous population the about higher fertility rates of Indigenous women compared with the rates of other Australian women (see Births and pregnancy outcome) and the significant numbers of Indigenous babies born to Indigenous fathers and non-Indigenous mothers.Two other factors are considered likely to have contributed to the increase in people identifying as Indigenous changes in enumeration processes (i. e. more than(prenominal) Indigenous people are being captured during the enumerate process) and changes in identification (i. e. people who did not previously identify as Indigenous in the census have changed their response). Based on the 2011 Census, around 33% of Indigenous people lived in a capital city 25. Detailed information about the geographic distribution of the Indigenous population for 2011 is not yet available, but figures from the 2006 Census indicated that the majority of Indigenous people lived in cities and towns 26.Slightly more than one-half of the Indigenous population lived in areas classified as major cities or inner regional areas, compared with almost nine-tenths of the non-Indigenous population. (As well as these two classifications of remoteness in terms of access to goods and services and opportunities for social interaction, the Australian Standard Geographical Classification (ASG C) has four other categories outer regional, remote, very remote, and migratory 27. ) Almost one-quarter of Indigenous people lived in areas classified as remote or very remote in relation to having very little access to goods, services and opportunities for social interaction (28, p. 3). Less than 2% of non-Indigenous people lived in remote or very remote areas 26.In terms of specific geographical areas, more than one-half (53%) of all Indigenous people counted in the 2011 Census lived in nine of the 57 Indigenous regions (based largely on the former Aboriginal and Torres fling Islander Commission (ATSIC) regions) 25. The three largest regions were in eastern Australia (Brisbane, NSW rudimentary and the nitrogen Coast, and Sydney-Wollongong), which accounted for 29% of the total Indigenous population.According to the 2011 Census, around 90% of Indigenous people are Aboriginal, 6% are Torres walk Islanders, and 4% people identified as being of both Aboriginal and Torres strait Islander descent 25. Around 63% of Torres Strait Islander people3 lived in Qld NSW was the only other state with a large number of Torres Strait Islander people. The Indigenous population is much younger overall than the non-Indigenous population (Figure 1) 23.According to estimates from the 2011 Census, at June 2011 about 36% Indigenous people were aged less than 15 years, compared with 18% of non-Indigenous people. About 3. 4% of Indigenous people were aged 65 years or over, compared with 14% of non-Indigenous people.Figure 1. Population pyramid of Indigenous and non-Indigenous populations, 30 June 2011 Population pyramid of indigenous and non-indigenous populations, 2011 Source ABS, 2012 23 References Carson B, Dunbar T, Chenhall RD, Bailie R, eds. (2007) Social determinants of Indigenous health. Crows Nest, NSW Allen and Unwin Jackson LR, Ward JE (1999) Aboriginal health wherefore is reconciliation necessary?. Medical Journal of Australia 170(9) 437-440 Butlin NG (1993) frugal s and the dreamtime a hypothetical history.Melbourne Cambridge University shake Campbell J (2002) Invisible invaders smallpox and other diseases in Aboriginal Australia 1780-1880. Melbourne Melbourne University Press Webb S (2009) Palaeopathology of Aboriginal Australians health and disease across a hunter-gatherer continent. Cambridge Cambridge University Press Anderson W (2007).The colonial medicine of settler states comparing histories of Indigenous health. Health and History 9(2) 144-154 Butlin NG (1983) Our original belligerence Aboriginal populations of southeastern Australia, 1788-1850. Sydney Allen & Unwin Thomson N (1991) Tuberculosis among Aborigines. In Proust AJ, ed. History of tuberculosis in Australia, New Zealand and Papua New Guinea.Canberra, ACT Brolga Press 61-67 Reynolds H (1982) The other side of the frontier Aboriginal resistance to the European invasion of Australia. Ringwood, capital of Seychelles Penguin Books Elder B (2003) Blood on the wattle massacres and maltreatment of Aboriginal Australians since 1788. 3rd ed. Frenchs Forest, N. S. W New Holland Harrison B (1978)The Myall Creek massacre. In McBryde I, ed. Records of time past ethnohistorical essays on the culture and ecology of the New England tribes. Canberra Australian Institute of Aboriginal Studies 17-51 Howitt R (2001) Rethinking resource management justice, sustainability and Indigenous peoples. capital of the United Kingdom Routledge Hunter E (1993) Aboriginal health and history power and evil in remote Australia.Cambridge Cambridge University Press Saggers S, Gray D (1991) Aboriginal health and society the traditional and contemporary Aboriginal struggle for better health. North Sydney Allen and Unwin bailiwick Inquiry into the Separation of Aboriginal and Torres Strait Islander Children from their Families (1997) carry them home report of the internal Inquiry into the Separation of Aboriginal and Torres Strait Islander Children from their Families. Retrieved 17 November 2011 from http//www. humanrights. gov. au/pdf/social_justice/bringing_them_home_report. pdf Long JPM (1970) Aboriginal settlements a batch of institutional communities in eastern Australia.Canberra Australian National University Press Marmot M (2004) The status syndrome how social standing affects our health and longevity. New York Holt Paperbacks Wilkinson R, Marmot M (2003) Social determinants of health the solid facts. Denmark World Health Organization National Aboriginal Health Strategy Working Party (1989) A national Aboriginal health strategy. Canberra Department of Aboriginal Affairs Australian Bureau of Statistics (2012) Census of population and housing characteristics of Aboriginal and Torres Strait Islander Australians, 2011. Canberra Australian Bureau of Statistics Australian Bureau of Statistics (2011) Schools, Australia, 2010.Canberra Australian Bureau of Statistics Australian Curriculum Assessment and Reporting Authority (2011) National Assessment Program L iteracy and Numeracy achievement in reading, persuasive writing, language conventions and numeracy national report for 2011. Sydney Australian Curriculum Assessment and Reporting Authority Australian Bureau of Statistics (2012)Australian demographic statistics, March quarter 2012. Canberra Australian Bureau of Statistics Yap M, Biddle N (2012) Indigenous fertility and family formation CAEPR Indigenous population project 2011 census papers. Canberra Centre for Aboriginal Economic Policy Research Australian Bureau of Statistics (2012) Census of population and housing counts of Aboriginal and Torres Strait Islander Australians, 2011. Canberra Australian Bureau of Statistics Australian Bureau of Statistics (2010) Population characteristics.