Health Issues in the Aborigines Culture Over the course of history, the state of Aboriginal health has deteriorated in a relation much similar to the culture’s struggle to survive in the ever-changing society. As a result, this state has changed from an ideal balance with nature during the days of their hunter-gatherer lifestyle, to the more disoriented form of endurance in order to cope with obligatory integration and open antagonism by other ‘modern’ communities (Grbich, 2004).
This has led to an augmentation of the encumbrance of illness and death as well as diverse forms of morbidity that Aboriginal communities experience throughout their lives. It is indeed ironical that while under the context of an organized and industrialized nation such as Australia, indigenous communities continue to face increased health problems even despite countrywide efforts at eradicating health risks thereby reducing mortality rates for children and adults alike as well as communicable and non-communicable morbidity indicators.
Indigenous health problems are also noted to be a combination of third world-associated quandaries such as high rates of maternal and infant mortality as well as low life expectancy, malnutrition and other communicable diseases; as well as more ‘Western lifestyle’ health problems such as cardiovascular diseases, diabetes, drug and alcohol abuse, mental illness, and many others (Lewis, 2003). This paper therefore looks at the epidemiology of the state of health for the Aboriginal community, delving into the possible sociological reasons behind this increasingly deplorable condition.
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At the same time, a clearer perspective will be offered into the widening gap that is noted between the state of health for Aboriginal communities and that of other Australians further putting this into a social context. The effect of a modern society on health care provision to indigenous communities is also discussed, as well as the health issues facing these people such as high blood pressure, stress, drugs, alcohol and poor children’s health. According to the Australian Bureau of Statistics (2008), the Aboriginal community faces higher rates of ill health than any other group in Australia.
From the estimate of an average of 450,000 Aborigines in Australia, it is observed that when compared to other communities, this community faces enhanced problems of chronic illness and problems from cigarette smoking in addition to other health issues. Among the various problems faced by the Aboriginal people include children’s health issues. These include low birth weight accompanied by an infant mortality rate that is almost three times that of the national average; such a figure results to 15. 2 deaths of Aborigine infants as compared to 5 from other communities per 1,000 births (Thomas, 2003).
Other factors connected to low birth weight include that of an enhanced risk for consequent diseases during puberty and adulthood that may lead to neonatal death. Low birth weight of the infant is associated with a slow growth rate and short pregnancy length, with Aboriginal women noted to have a 12. 4% chance to have a low birth weight baby as compared to 6. 2% for a non-Aboriginal woman (Australian Bureau of Statistics, 2008). Other issues noted in Aboriginal children include the prevalence of poverty among the members of this group thereby leading to ill-health and poor benefits especially for the young.
In addition to a higher rate of low birth weight in Aboriginal women, their children also face a greater risk of malnutrition. The advantage of breastfeeding is noted during the early months, with this offering an additional defense against common infant diseases. However, after weaning, the lack of nutritious foods increases the likelihood of children to contract infectious diseases further enhancing the children’s malnutrition. Other health problems faced by children include the prevalence of middle ear infection, consequently affecting the learning abilities of the child that may have speech and hearing problems.
At the same time, the high rate of smoking among the Aboriginal community leads to a high exposure of the children to tobacco smoke during pregnancy and even after birth. This then leads to the noted increase in the prevalence of respiratory disorders including asthma and other related ailments. Other diseases faced by pre-pubescent Aborigines include chest and throat infections as well as injuries from accidents. Adult male Aborigines also face higher risks of accidental injuries as compared to non-aboriginal adult males.
This increases their chances for hospitalization which is also enhanced by heart and chest diseases as well as digestive tract ailments. Aboriginal women similarly have higher rates of urinary and reproductive complications as compared to non-aboriginal women with the latter complications leading to strained pregnancy and births. On an overall basis, members of the Aboriginal communities are twice as likely to be hospitalized as compared their non-aboriginal counterparts (Australian Bureau of Statistics, 2008). These results from an enhanced susceptibility to injuries sustained during accidents as well as the aforementioned causes.
It is also noted that Aboriginal people usually have a higher vulnerability to infectious diseases such as sexually transmitted infections including HIV/AIDS, Gonorrhea, Syphilis, as well as other potentially fatal conditions such as Tuberculosis and Haemophilus influenza type b (Lutschini, 2005). Diet and nutrition plays a major role in the state of health of the Aboriginal people. Before the influence of settlers who arrived in Australia, Aboriginal people were used to their hunter-gatherer lifestyles that incorporated the consumption of wild meats and fallow plants.
These customary foods were rich in nutrients, protein and carbohydrates, while also having limited supplies of sugars and fat. As a result, the Aboriginal people were healthy and did not face diet-related ailments. With the introduction of Westernized foods, which contain higher levels of sugars and fat, while being low on essential nutrients, the Aboriginal people have become more vulnerable to diet disorders such as diabetes, obesity and cardiovascular disease. This increased rate is also noted to be higher in Aborigines than in non-aborigines who are considered to be used to these ‘modern’ foods.
Aboriginal people have also been noted to have a shorter life expectancy than that of non-indigenous communities with Aboriginal males expected to live for around 57 years as compared to 62 years for their female counterparts; this translates to a shortfall of around 18 to 20 years when compared to non-aborigines (Australian Bureau of Statistics, 2008). There are diverse causes of this early death amongst the aborigines that include twice the rate of cardiovascular disorders that include strokes and heart failures as compared to non-aborigines.
At the same time, aborigines are three times as likely to succumb to injuries sustained from accidents as well as other causes such as homicide and even suicide. When seeking an explanation as to these health profiles, it is important to take into consideration the historical context of the changing environment that the Aborigines have had to contend with. Prior to European colonization, these individuals were used to a supportive environment as well as a multifaceted social support network. They also had an advanced comprehension of their ecology which was advantageous in providing all their nutritional and health requirements.
This was also enhanced by an active lifestyle whose foundation was a community that promoted a family culture that exhibited psychosocial veracity (White, 2002). The advent of colonization brought with it a change in lifestyle making the Aborigines more inactive and dependent on the European settlers. This resulted in their acquisition of undesirable products and infectious diseases that their health systems were not equipped to handle. At the same time, a societal shift was noted that clashed with the culture, heritage as well as the concept of family that the Aborigines were used to.
In recent years, there has been an effort at social integration coupled with dealing with public health issues at all facets of the community (Carson, Dunbar & Chenhall, 2007). However, even with an overall reduction in the mortality and death rates of all Australians, it is noted that the Aboriginal community still records significantly higher rates of the same. Due to the overall effect that historical events have had on the Aboriginal community including lack of education, poor employment opportunities, elevated drug and alcohol abuse, the improvement of health amongst this community continues to be an uphill battle.
Other problems are as a result of the lack of access to health services by some Aboriginal communities. This is credited to both the physical distance to such amenities as well as various aspects of cultural insensitivity. Due to the occupation of rural areas by the Aboriginal people, they accessibility to healthcare is hampered by the lack of transport usually resulting in less frequent visits to health professionals. The cultural perception about health and quality of health services also plays a major role in healthcare service provision (Germov, 2004).
Indeed, it is noted that the Aborigines are more likely to be influenced by spiritual beliefs such as curses and punishment from alleged transgression than biomedical views on health. As a result, Aboriginal people are more likely to accept the views of traditional healers as opposed to opinions offered by Western health professionals. Other conflicts between traditional Aboriginal views and those provided under the constructs of biomedical provisions include the notion of informed consent especially when an approval is sought to proceed with a medical procedure.
For instance traditional applications of the role of kinship as well as community relationships will take precedence, in the minds of the Aborigines, over that of the sole consent of a patient (McGrath & Phillips, 2008). These cultural differences also expand into the concepts of immediacy and time, the comprehension of health and illness, as well as information on the potential benefits, and harms of treatment especially when a language barrier is present thereby hindering the patient-doctor interaction.
In precis of the epidemiological aspects of Aboriginal health, it is noted that the advent of European colonization brought with it the change in the community’s health structure. This was either due to an alteration of the epidemiological dynamics of diseases that were already present including an induction of novel and contagious diseases, or by a change in lifestyle increasing the vulnerability of the indigenous people to such ailments.
Irrespective of the sources of the problem, it is noted that the prevalence of health problems is higher in Aborigines than in non-aborigines with inequities arising due to inadequate healthcare for the former, as well as cultural disparities that exist between the two societies and that promote the further segregation of health services among them. When making considerations into the various views held by social theorists to the situations faced by Aborigines, a further analysis can be drawn into the health situation and the disparities faced by this community in relation to that of non-aborigines.
Marx’s view of class, work and alienation, is such a theory. This theory has been utilized by many ideologists who have affirmed the presence of an oppressive structure in any society that is maintained by the dominant culture, language or social position (Western & Najman, 2000). The lesser group therefore undergoes manipulation and control at the will of the more ascendant group. This phenomenon is also noted to traverse generations, cultures and time therefore being present in all societies.
To further its causes, the dominant culture promotes its ideologies through education as well as other services provisions which favor the ruling class and keep the lesser group unaware of their rights. Thus the ownership of power of capital maintain structures that provide for the maintenance and concentration of this power among the elite thereby ensuring that it is not lost or watered down with the effects of time. Such structures, according to various social theorists, extend past the constructs of schools and education and even go as far as health provisions such as the case under study (McGrath & Phillips, 2008).
In the societal and cultural context of the state of Aboriginal health in Australia, it can be argued that its structure over time has been altered to serve the best interests of the more dominant non-aboriginal communities. As a result, the Aboriginal people have received constant interference, oppression and misinterpretation as to the rights that are provided to them in healthcare as well as other community services that they are entitled to. There are also similarities noted between this form domination and the colonialist tyranny by Europeans over other societies in Africa, South American and parts of East Asia.
The main effect of such oppression was the changing of the mindset or perceptions of the indigenous communities as to their rights and the changes they had to make to their traditions (Grbich, 2004). Proponents of this view argue of its accurate assertion on the negative Western attitudes towards cultural aspects and the wellbeing of Aboriginal people and how these have been propagated in all aspects of the society, including healthcare provision.
This can therefore be construed as the actions of a dominant culture that reserves its gains in science to not only promote the agenda of this ‘stronger’ community but to also portray the Aborigines as being crushed and submissive. This further alienates the two societies further alienating the Aboriginal people and resulting in cultural insensitivity. Indeed, this has been noted as one of the reasons behind why the Aborigines do not advocate for the use of biomedical options of treatment but opt to stick to traditional forms of healing based more on their spiritual beliefs.
The sociological change in relation to this theory can be observed with the Aboriginal approach at self-empowerment in which they aim at gaining the necessary skills to seek their rights thereby gaining security from current and future forms of oppression. This is evident with the acceptance by the Aboriginal communities to not only seek biomedical approaches to treatment but to also comprehend the underlying aspects of science and language that the non-aboriginal communities had used to oppress them in the past.
By taking a proactive approach at undertaking research into the health issues affecting them as well as the possible application of their findings into their communities, the Aboriginal people are gaining assurance and assertion from the knowledge of medicine and other forms of science through. As a result, the possibility of improving their health and wellbeing becomes an ever-closer reality (White, 2002). Another perspective that can be adopted scrutinize issues based on Aboriginal health are those proposed by Erving Goffman.
This theorist discussed various notions such as stigma, passing, deviance and social control and how these affected social structures and the manner in which individual members of a community interacted with each other. For instance, Goffman affirmed that the prevalence of stigma resulted from the lack of comprehension of an unknown, with this perspective leading to a change of attitude or behavior towards the object under scrutiny. This theorist further described three forms of stigma including physical abominations, imperfections of character, and tribal stigma (Lewis, 2003).
Aspects of the latter form can therefore be observed in the provision of healthcare to Aboriginal communities being neglected by the mainstream communities that are predominantly non-aboriginal. This is due to a lack of understanding of the Aboriginal customs and beliefs especially regarding health and illness and the associated forms of treatment. Similarly proponents of the theorist’s views assert the clear observations of aspects of social control against Aboriginal communities in all aspects of the society, and including the healthcare system.
In the past, some form of segregation has been observed amongst healthcare providers when offering their services to Aborigines and non-aborigines (Carson et al. , 2007). The poor delivery of health services the former leads to the deplorable health state of this particular community and can be further attributed to the widening gap between the states of health on a community level. Providing primary health care to meet specific Aboriginal needs has not been put under consideration with this being a major indicator of the flaws of the system.
Various other social theorists have added their diverse views about the state of health of the Aboriginal community in Australia. According to McGrath & Phillips (2008), research into the effects of public health system and especially on the response by various institutions to indigenous public health needs is lacking. At the same time, healthcare provision for aboriginal communities is not directed by the needs of the indigenous people, as it should be, thereby demonstrating a flaw in the power structure between non-aboriginal health experts and Aboriginal health workers.
As a result, provision of indigenous health care takes a back seat thereby promoting the already deplorable state of affairs. Such a notion is further promoted by the sociological view that the flaws in the public healthcare systems that are not in the favor of the Aboriginal community, stem from the unbalanced nature of the political economy. According to this perspective, the political and economic relations that exist promote the negative effects noted in the public healthcare system.
The asymmetrical access that the Aboriginal people have to the political and economic resources in Australia is therefore translated into various structural and situational disadvantages such as the lack of access to health services by Aboriginal communities. At the same time, the public health system is flawed for dealing with population-based aspects of healthcare in which the population is considered to be asocial.
The resultant notion therefore asserts that the public health system assumes that the needs of various communities are similar and that no underlying societal disparities exist (Western & Najman, 2000). The resultant situation is that of a system that deals with the needs of the predominant culture or community which in this case is that of the non-aborigines and neglects the needs of the lesser communities. This leads to the lack of appropriate health care for the needs of the Aboriginal people further adding to the poor state of health affairs faced by the indigenous societies.
In retrospect, the sociological explanations behind the state of Aboriginal health are noted to be based on flaws in the political and economic structures that provide the basis of public health. As a result, a relation can be further made between the social and political influences and the provision of public healthcare to Indigenous communities. Such flawed structures can therefore be blamed for the poor state of affairs in a situation that can be controlled by an emphasis for health services that cater for the needs of the Aboriginal community.
Such systems should also not offer any room to any form of segregation whether as a result of stigma or as a result of forms of oppression by a dominant culture over another that it deems as inferior. Aboriginal health is indeed an important aspect of health, illness and well-being in Australia that needs consideration. The increasing disparities that are noted between the states of health of Aborigines and non-aborigines provide a sufficient need to worry especially with the differences being added by sociological boundaries that exist in the healthcare system.
The changes in social, political and economic attitudes should provide a foundation to improve health services and awareness of the Aboriginal community in order to increase life expectancy, decrease mortality rates at all stages of life, reduce the impact of diseases and enhance the social and emotional well being of members of this and all communities, thereby leading to a unified healthy nation. Works Cited
Australian Bureau of Statistics 2008, The Health and Welfare of Australia's Aboriginal and Torres Strait Islander Peoples, 2008, Viewed June 3, 2009, Carson, B, Dunbar, T ; Chenhall, RD 2007, Social Determinants of Indigenous Health, Allen ; Unwin, Sydney Eckersley, R, Dixon, J, Douglas, RM ; Douglas B 2001, The social origins of health and well-being, Cambridge University Press Grbich, C 2004, Health in Australia: Sociological Concepts and Issues, Pearson Longman, Sydney Germov, J 2004, Second opinion: an introduction to Health Sociology, Oxford, Melbourne Lewis, MJ 2003, The People's Health: Public health in Australia, Greenwood Publishing Group, Sydney Lutschini, M 2005, ‘Engaging with holism in Australian Aboriginal health policy – a review’, Australia / New Zealand Health Policy, vol. 2, no. 5, Department of Public Health, University of Melbourne McGrath, P & Phillips, E 2008 ‘Western Notions of Informed Consent and Indigenous Cultures: Australian Findings at the Interface’, Journal of Bioethical Inquiry, vol. 5, no. 11, pp. 21-31 Thomas, RK 2003, Society and health: sociology for health professionals, Springer Publishers, New York Western, JS & Najman, JM 2000, A sociology of Australian society, Macmillan Education, Sydney White, K 2002, An Introduction to the Sociology of Health and Illness, Sage Publications: London Willis, E 2004, The Sociological Quest: an introduction to the study of social life (4th Ed), Allen & Unwin, Sydney
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