Ch12

Question 1

Describe the social, colonial, economic and cultural determinants of the health of ATSI people in Aust.

Answer 1

#Culture- whole of life- whole of community- and life/death/life. #social- Intercultural distrust has made it difficult to produce ethical and rigorous research- unintended encroachment on values and principles.
#economic- health improvement depends fundamentally on the effective and timely implementation of strategies to achieve targets as they must address the complex and substantial systemic inequities
# Close the Gap- human rights based campaign by Dr Calma and Oxfam- "Closing the gap" are the initiatives introduced by governments. Closing the gap is very different and doesn't necessarily reflect the human rights approach and is not endorsed by the Close the gap steering committee. 
# must find common ground to begin the rship understanding that 'Time + Respect= Trust'
# constitutional recognition needs to go beyond the race clause- focus on equitable settlement on all levels of govt
- do no harm- respecting dignity of all ppl and their life decisions.
- we all need space and respect for boundaries
- where the rship is mutual, there is solidarity and action for change.

Question 2

Understand the theoretical and practical links btwn community controlled health orgs and health status of ATSI

Answer 2

-self- determination: the right to choose own ideas of development, as well as help to reconstruct current institutions to improve indigenous peoples situations and that of humanity as a whole.
- community controlled- enables local communities to identify priorities, policies, management structure, staff and service profile.
- ACCHOs emerged in the early 1970s to provide access to culturally appropriate primary health care, which many First Peoples were not receiving in mainstream orgs due primarily to systemic racism.
- viability and sustainability are vital- ACCHOs make up a significant portion of the provision of health care to Indigenous people. - by creating dependency on people from outside communities, this acts principles of community control. Resources provided to the sector are inequitable because they are not commensurate with the health needs of Austs First Peoples populations.
It is difficult when govt policies and funding are based on neoliberal values. neoliberal mgmt principles conflict with principles of community control, leading to conflicting goals among multiple parties and subsequent implementation problems. These problems are exacerbated by an intercultural environment of distrust and disagreements about the rights for collective participation and control over healthcare by Aboriginal communities.

Question 3

Understand how racism influences health outcomes

Answer 3

-3 specific determinants- history, racism and country. Importance noted in the ATSI commissioners Social Justice report- which highlighted the significant contribution to health and I’ll health of land and culture and particularly stressed that racism was detrimental to health
- emotional and psychological reactions
- gaining cup port from social networks
- confronting the situation
- ignoring it
- avoiding situations
- minimising the significance or questioning whether incidents were racist
- consuming alcohol and drugs and tobacco.
So not only is racism detrimental to health- as are some coping responses.

Question 4

Dealing with racism- wirkara way- meaning alongside

Answer 4

1. Acknowledge the inconvenient truth of being a colonised nation.
2. Avoid the excuse, “I don’t know how’.
3. Let go of the fear of being racist and of getting things wrong. Engage respectfully and you’ll learn as you go.
4. Avoid the excuse ‘ it’s all too hard’ while occupying positions of power- change your attitude and then take action to change the narrative
5. Understand that cultural safety require health care providers to to ‘see’ their won culture- racism doesn’t have to be intended- it’s often inbuilt.
6. Don’t be afraid to take a leap of trust in the rship
7. Don’t be a ‘know it all’
8. ATSI have a right to talk within themselves- it’s not reverse racism
9. Question your own defensive reactions
10. All ATSI ppl carry knowledge, experiences and close the gap strategies. Lighten the load by respecting and valuing this knowledge.