The health of Aboriginal or the Torres Strait Islander has been of grave concern for long, due to various reasons. The fact that they are living in the same condition as they were, decades earlier, or in even poorer conditions due to non-availability of land or no great faith in the health care system gives enough proof about their health conditions. Although a few aboriginals still live as ‘Bush Tucker’, many have originated in cities and farmlands for employment. This essay is an effort to discuss the four determinants of health in aboriginals and Torrer Strait Islanders living in cities, farmlands or along the coast. The determinants that are to be discussed include:
There are several determinants which govern the health of an aboriginal in Australia, and the primary among them are as follows:
The study conducted by Lowell and his colleagues concluded that western education, or a formal education is as much essential as the traditional one that aboriginals gain from their elders, to focus on health (Lowell, 2003). Education, therefore, becomes a mandatory requirement for recognizing the health factors, and the problems related to unhealthy living.
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Although Aboriginals have shifted towards urban areas and have moved to cities for employment, the lack of education has seen as a serious factor that affects their health. Every year, children of aboriginal are admitted to lung diseases, which usually turns out to be a serious case of bronchiectasis, and malnutrition due to lack of sufficient funds, and knowledge about the seriousness of the illness. Although there have been sufficient steps taken to educate Aboriginal and Torres Strait Islander children, the fact that there has been a innumerable drop-out every year, does not show favorable towards the issue. Every year, the percentage of dropouts among indigenous children far exceed the average of non-indigenous dropouts. Hence, education posses a major threat towards maintenance of health and nutrition among the indigenous community.
The lack of education and sufficient knowledge about the ‘food to eat’ or treatments to be provided for a particular illness makes health care a serious issue. The experts believe that ‘education leads to empowerment, and also a medium to enlighten the indigenous children’ about the important facts of life, such as hygiene and nutrition. Since children are future citizens, tapping this potential can lead to a major improvement in health of indigenous people.
However, the lack of funds or enough people to feed make indigenous people take out the children from western education, and put them to work as laborers at an early age. The circle continues, since without sufficient education, all the work that the indigenous children (or youngsters) are able to find is those in farmlands or those jobs which pay less.
Thus, education is a main instigator, which can bring in changes in the lives of indigenous people, both living in urban and rural areas. Education not only can make the aboriginals view health care system positively, and bring their children for treatment with greater faith, but it can also provide them with an opportunity to earn well. A well-educated person can look into better jobs, and thereby provide good living conditions for his/her family. As living conditions are one of the significant issues which leads to Health conditions, unless the indigenous people are brought to the western education system, which can help them in finding good employment, it is difficult to focus on health concerns that are rising at an alarming rate among Aboriginals due to lack of fund and knowledge.
As per an estimation done in 2011, about half of the indigenous population, above the age of 15 earned $362 per week, as compared to $582 earned by the non-indigenous crowd. Although the estimate is done six years before, the difference today is still considerable.
Employment, and income, therefore, remains a vital issue among the Aboriginals and Torres Strait Islanders, and thereby affects their health.
It is often noted that despite a considerable increase in the minimum education status of the Aboriginals and Torres Strait Islanders, there remains a steep gap between their income and those of non-indigenous population. This is, attributed to either:
A formal education or higher education, above 12th grade, is essential to land up in a better job. However, due to non-belief in the system, and also due to lack of funds in parents, children drop-out at the age of 15 or less, to take up farm work or other less paying jobs for their survival. This process continues, thereby making them survive on less wages.
Now, with lower income and sometimes lack of employment, or no proper instigation (sheer laziness sometimes) to find good work, the health suffers. Substance abuse, malnutrition and other problems such as lung diseases are common among the indigenous crowd, because with low income, they do not have the means to approach the health care system. Even though there are many free clinics and hospitals to encourage the indigenous crowd to take care of their health, they are hesitant to approach in case they are charged for something. Hence, instead of getting sufficient and primary care for health issues, they deal with the problem in their own way, by practicing their healing methods.
The only way to tackle this issue of lack of employment or lower income is to empower them with the knowledge that education leads to good jobs, and that can then give a better lifestyle. Many steps have been taken to mentor and teach them the values of education, and also to inculcate habits that can then help them to change their lives for good. Several health care providers approach the indigenous people living in rural and Urban areas, to inculcate better habits, such as eating a proper diet and maintaining hygiene. These health care providers also teach them the necessity of approaching health care for any serious issues, at an early stage, to avoid major problems at a later stage.
A better employment can bring in more income, and thereby can increase the standard of living among the aboriginals. As PER an analysis, an indigenous male or female, with a graduate degree has more than 80% chance of finding better employment than their parents, while it reduces considerably when the children are dropouts.
Living conditions are as essential as income, to maintain healthy conditions in Aboriginals and Torres Strait Islanders. As we know, hygiene is related to the water we use for everyday purposes, the air we breathe, and the food we eat or even store.
When you live on a farm land, the housing provided by the employer is not always (or most of the time) up to the mark. There are issues such as no sufficient toilets and bathing areas for children and adults, the food is stored in areas where they might not be safe hygienically, or even the toilets not as per standards. This, then, affects the health of children as well as the farmland workers.
The laborers are forced to stay in cramped up conditions, where maintaining hygiene is a challenge. Hence, basically, it trickles down to again the problems of unemployment or lower income, which leads to no proper housing conditions to live in.
The experts believe that ‘Housing is a key factor which determines the health of an individual’. A proper housing can help in overcoming issues related to hygiene and health. Since both health and housing are interrelated, unless a proper housing condition is offered, maintaining the standards of living, or health, is difficult. However, this works both ways.
A serious illness due to lack of hygiene conditions (or poor housing) can cause one to lose employment, and reduce the income further, again leading to poor living conditions. Hence, experts call housing and health as bi-directional. Lack of one leads to lack of another. Although the effect of housing on the health of indigenous crowd vary according to their geographic location, the impact is more or less the same. (The magnitude may vary).
Hence, the only way to address this issue is to provide proper guidance and promotions as to ‘what works better, where hygiene can be improved, design guidelines for proper housing infrastructure’ and so on. The indigenous health workers, can provide this guidance by instructing on proper housing maintenance and also provide tips to improve living conditions of indigenous people. Issues such as availability of toilets, taps, sinks and so on, can be raised, and addressed to, thereby ensuring essential hygiene is maintained.
The issues such as temperature regulations, prevention of dampness (and thereby putting an end to health issues due to it), and cleaning up areas which are infested with molds and fungus can be addressed to maintain proper living conditions.
To do that, apart from the indigenous health care workers providing sufficient instigation and tips, the people involved need to actively participate in the plans provided. Knowledge here, (education) becomes an essential and mandatory criteria, to understand what is required and to act upon it. The necessity of the indigenous crowd to understand the tips and suggestion provided, and receive it with positive mind is critical to improve housing conditions, and thereby, their health. Hence, all trickles down to education and gaining sufficient knowledge to accept the changes brought forth by welfare workers.
The issue of racism and racial discrimination rears its ugly head now and then. With the senior indigenous crowd more apprehensive about accepting change, since they have been at the receiving end of racial discrimination for long, it becomes extremely difficult for the younger crowd to accept changes. They have been, since early, told stories of racism and discriminations they have faced earlier in their lives, to cloud the judgements of the youngsters.
The experts and researchers believe that the ‘self-reported perceptions’ about racial discrimination leads to ‘mentally not accepting’ changes and thereby suffering ill health. A person, who believes that he or she will not be treated well by the non-indigenous crowd, fail to approach health care in advance for any illness. This, then, leads to mental and physical strain on those dealing with the illness at home.
There are several ways, therefore, from racism to ill-health. Not sending children to school, and thereby, lack of knowledge, which then leads to lack of proper employment, poor housing, and so on and so forth. Hence, a person believing in racism where none exists, can bring ill-health upon themselves and their family, for no reason.
The reason for such beliefs, although not completely ill-founded (since some discrimination occurs both in public places and employment), several times are exaggerated, making the indigenous crowd vary of approaching the system for any help. Hence, instead of sending children for higher education, they stop their formal education at an early stage, in the belief that they will be anyways discriminated in employment.
This, then, make the children as small as 15 seek lower employments such as farm laborers, leading again to poor housing, low income and ill-health due to lack of hygiene.
While ‘Racial discrimination and racism’ cannot be completely ruled out as ‘non-existent’, steps need to be taken to build enough confidence among the aborigines and Torres Strait Islanders to come forward and report issues of discrimination.
Building confidence, and thereby ensuring they come up in the system for education, and employment can help them in maintaining their health sufficiently.
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Since a person facing racism in health care, will start avoiding it completely in the future, and will ensure his family and friends are told about it, it is also the responsibility of those concerned to act upon any complaint that arises due to discrimination. The point here is that the authorities in health care need to identify the issues relating to racial discrimination of indigenous people in health care, and act upon it immediately when a complaint is raised.
Issues such as education, employment, housing and racism, all leads to health related problems among the Aboriginals and Torres Strait Islanders. Since all these are interrelated, and health care suffers due to any of the discussed factors, it is important to address the above issues to solve the problem of health care in indigenous crowd. Education can lead to better employment and income, and that can then ensure good housing conditions among the indigenous crowd. When the housing conditions (and income) are sufficient, it is easier to maintain hygiene and approach health care for any illness. The health care of indigenous people, can only succeed, if they can come forward to put racism of the past behind, and look forward to educate themselves to empower their youngsters.
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