INDIGENOUS HEALTH
Abstract
Indigenous health wellbeing of the Indigenous Australians and their communities. This essay explores the impact of colonization on health in Victorian Indigenous populations. Colonization resulted in health disparities for the Indigenous populations causing chronic diseases such as diabetes to become of existence. This was caused by the introduction of western diets for the Indigenous populations who were used to traditional diets and foods. Diabetes in the indigenous population became the second cause of death because, upon colonization, these populations were discriminated against and could not access healthcare which had become very expensive. Due to the low economic status, these populations became disadvantaged in such a way that they were jobless, lacked income and human rights. Their emotional well-being deteriorated upon colonization because of the sexual exploitation by the colonizers, their children were taken away from them and diseases killed their families. This caused a huge impact on their social behavior hence creating barriers. Closing the health care gap between the Indigenous and the non-indigenous has become a challenge for the government and the diabetes cases continue to rise. There have been health promotions interventions that have been developed to educate the Indigenous people about diabetes and ways in which it can be managed. Empowerment, education, self-management, and web-based interventions can help Indigenous people acquire more knowledge about the disease. The Victorian Indigenous population has been targeted because of its historical, political, and cultural impact and outcome of Indigenous health. The health promotion interventions will work towards educating the Indigenous populations on how to live healthier.
Introduction
How does colonization in Australia continue to affect Indigenous health in regards to diabetes? Indigenous health is the holistic wellbeing of indigenous Australians which comprises of their physical, emotional, and social wellbeing. It is also the well-being of the whole community whereby each person can attain their full perspective as a human being. Upon colonization, the indigenous people have experienced inequalities in health, diabetes being one of the diseases that has been introduced. This has been a result of the Victorian Indigenous populations having a low social economic status, living a westernized lifestyle which includes unhealthy diets and lack of easy access to healthcare. Education, self-management, and web-based interventions for diabetes in the indigenous populations can help to improve knowledge about the disease and improve the general well-being of the people.
Health status incorporates factors such as social and emotional well-being and functioning. Social and emotional well-being is indicated by the extent people face stressors in their lives. Upon colonization, the Indigenous population was prone to stressors that included loss of their land, loss of their children who were taken away from them, sexual exploitation and family members who died as a result of diseases that were brought by the people who came to their land (Waterworth et al. 2015.). The indigenous populations experience stressors that include the death of family members or friends, joblessness, illnesses such as diabetes, and mental illness. These stressors had a negative impact on the Indigenous populations because they also experienced discrimination from the colonizers. The negative impact included the populations becoming exposed to poor health care and diseases such as diabetes.
Diabetes and the complications it causes results in early deaths worldwide and in Australia, it is no different and majorly high in the indigenous populations. Aboriginal and Torres Strait Islander population are known to have the longest continuing culture in the world and have lived for many years. The process of colonization has made the Aboriginal people experience health disparities compared to the rest of the Australians (Adams et al. 2017). This led to the government agreeing to close the gaps and improve health outcomes for the Aboriginals but unfortunately not much has been achieved so far. Diabetes which is the second cause of death in the Aboriginal population came into existence to the population after colonization. This is because colonization disrupted the traditional lifestyles and introduced western diets which have resulted in increased rates of chronic diseases. Research shows that in every ten Aboriginal people, one of them has diabetes and this applies even to the younger generation. This is causing very many deaths and complications because diabetes increases the possibilities of development of other problems for example heart diseases and others later in life.
Since colonization, healthcare services for the Victorian Indigenous populations have become expensive. There has been increased expenditure on health services for the Indigenous populations and this has not helped in closing the health outcome gap rather has made it more difficult for them to access healthcare. There has been a lack of recognition for these populations and therefore their health has not been considered as important as the other Australians. The prevalence of poor health for the Aboriginal Victorians is determined by psychological distress, food insecurity, financial stress, and lifestyle risk factors. Most of this was as a result of colonization whereby the Indigenous population’s lands were dispossessed, the government policies that allowed their children to be taken from them leading to the destruction of families and communities (Markwick et al. 2014). Indigenous people cannot afford a healthy meal due to a lack of employment or financial income. They relied on the produce they got in their lands before they were taken away from them. The population lacks access to community help and services and are not valued by society. The lifestyle risks that are faced by the Indigenous populations include excessive intake of alcohol, smoking, not enough fruit and vegetable consumption, and lack of physical exercise which results in diseases such as hypertension and diabetes among other complications.
For the social-economic status, the Aboriginal Victorians experience low income, are unemployed, or are unable to work leading to the incapability for them to live a healthy life. Low income makes it difficult for the Indigenous Victorians to afford a healthy meal, and access healthcare. Unemployment which is a result of low educational levels is connected to low levels of health knowledge. Help from families and friends concerning stressful moments and healthcare is also a problem for the Aboriginal Victorians because they were more affected by the removal of their children from their families after colonization (Markwick et al. 2014). This is also a threat to their social life since they find it hard to trust other people and this causes an impact in the behaviors that would enhance their collective wellbeing. Trust is vital in the healthcare system and helps to increase the health and wellbeing of an individual and when it does not exists, the affected person does not gain. The trust issues resulted from the colonizers taking their land, children, discrimination, and denying them their rights. Lack of trust leads to the non-attendance of health services which leads to medical complications and risk-taking behaviors and this is because the healthcare system fails to address their cultural security. Evidence shows that even the Aboriginal Victorians who use health services do not get the same quality of care compared to non-Aboriginals.
There is a strong connection between diabetes and its prevalence with the socioeconomic disadvantages of the indigenous populations. Despite the government’s initiative of closing the gap, data has shown that very little has changed in terms of health and wellbeing in Aboriginal Victoria (Hill et al. 2017). The Indigenous population has the worst health and healthcare, the lowest life expectancy, and the highest mortality rates compared to the rest of the Australians. They also have the most death cases resulting from diabetes and mainly because they are an ethnic minority and also because of their low social-economic status hence associated with poor outcomes in diabetes. Social-economic determinants that make health worse in the Indigenous population include overcrowding, poor housing, low labor force, and low income. Health care access is significant in socially determining the health outcomes of diabetes but because of the low levels of health literacy that exist in the Indigenous population, it is difficult for them to figure this out.
Health promotion is a process that ensures people are in charge of what determines their health and therefore improves their health. Through its empowerment, health promotion can contribute largely to health equity and social justice. Empowerment is the central factor that will help to close the gap in the health and well-being of the Indigenous populations and the other Australians (Percival et al. 2018). Health promotion will help the Indigenous populations to increase the capability as individuals, families, and communities to take control of their lives. For people living with diabetes, this will help them gain insight into the need for healthcare. It will also empower them to engage in physical activity and have healthy diets. The will to close the gap has led the government and the non-governmental institutions to develop health promotion tools or interventions. These are structured guidelines, instruments, programs, and resources that are designed to improve development, implementation, and assessment of Indigenous health promotion programs or enhance the ones that are already in existence. The tools include one that determines the quality improvement in health promotion, the family well-being empowerment program, and one that monitors the ecological methodology of the programs. The health promotion tools help to engage and relate, develop and use evidence, modify programs for diverse groups, and strengthen the capability.
The process of engaging and relating comprises of developing and sustaining relationships with people, organizations, and the community at large. This involves developing trust with the Indigenous population. Trust is an issue with the Indigenous populations because of what they went through after colonization and therefore important for them to undergo this process. The strengthening capability is a process that focuses on the level of the worker and the organization. This process helps to improve the accessibility of resources, knowledge, and skills by a practitioner in health promotion (Percival et al. 2018). It also entails strengthening and changing the environment to support Indigenous health promotion. This includes offering training, mentorship, and any other requirement that the Indigenous researcher or worker may need. This will help to ensure that the Indigenous population gets the health services they deserve and help reduce the deaths caused by diabetes. Modification of diversity programs and settings is a process that supports the adaptation and modification required to fit the implementation setting. This allows the programs to fit the preferred group that is intended for. Developing and using evidence is a process that entails having a recognition of the different sources of evidence and using the correct ways according to culture to gather and combine the different sources. This will help to improve Indigenous health promotion.
A health program that is geared towards preventing diabetes in Victoria was developed to support individuals that were considered to be at a higher risk of diabetes. It was intended to help them take a healthier life approach and make changes in their lifestyles for example take healthier foods and drinks, and be physically active. This would help to reduce the risk of developing diabetes and other complications such as cardiovascular diseases (Kagie et al. 2019). The program included the impact of different kinds of food on one’s health and the kind of food that is healthy and affordable. It also included how an individual should spend their money on food and how a person can maintain and healthy weight. The program also enlightens individuals on what to look for on a food label and how to choose healthy foods. The free program also gave insights into the different ways of becoming active and preventing diabetes.
Education and self-management are very important when it comes to diabetes care. Evidence shows that suitable cultural self-management programs can influence and improve an individual’s management practices, physical activity, and quality of life. Web-based programs for diabetes have also shown an improvement in different individuals (Adams et al. 2017). A diabetes strategy developed to reduce diabetes among the Aboriginal people includes peer support programs that are either done by phone, physically, or through the web. Health promotion focused on the Aboriginal population has increased its focus on web-based and digital environments. Web-based health interventions for diabetes improve knowledge, helps to track and monitor the disease, and have more impact on the change of behavior. With most of the Aboriginal people having access to the internet, the web-based interventions have created a platform where people can advance their knowledge about diabetes and how to control and manage it.
Victorian Indigenous populations have been targeted because of the cultural, political, and historical outcomes of their health and well-being (Burrow and Ride 2016). The Indigenous populations were among the first populations to occupy Australia before the colonizers came to possess the land they owned. Chronic diseases such as diabetes resulted from the introduction of unhealthy diets brought by the colonizers. Colonization resulted in the lack of access to healthcare for the Indigenous populations and this caused an increase in the risk of diabetes. Diabetes has been rated the second cause of death in these Indigenous populations making it a serious problem and a point of focus. Health inequality due to racism, poor housing, low income, and unemployment has existed since colonization for these populations. The Indigenous populations experience a gap in the health status compared to the other Australian populations and closing the gap has been a challenge for the government.
Conclusion
Indigenous health is the physical, emotional, and social wellbeing of the Indigenous populations in Australia. Colonization had a great impact on the health of these populations because they experienced discrimination, sexual exploitation, land dispossession, and lack of human rights. This destroyed their health and social well-being and also gave rise to chronic diseases such as diabetes which has caused a lot of deaths including young people. This is because they interfered with the traditional lifestyles that the Indigenous people were used to and introduced western diets. Because of their low social- economic status, the Aboriginal Victorians, they are unable to live a healthy life or even have access to healthcare. Being social-economically disadvantaged has also led to the prevalence of diabetes in the Indigenous populations. Health promotion interventions have been established to try and close the health care gap between the indigenous and non-indigenous populations. Health programs and tools have been developed to educate individuals, offer the relevant resources to practitioners, and contribute to the health and well-being of the Indigenous populations. Web-based interventions have also been introduced to create a platform where people can interact and find more information concerning diabetes. Victorian Indigenous populations have been targeted because of the association of the historical, cultural, and political health and well-being outcomes. Future research on Indigenous health should focus on having members of the Indigenous population being representatives in the policy-making decisions to help establish policies that will be geared towards improving their health and well-being.
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