Indigenous health

Question 1

3 criteria to be considered “Indigenous”

Answer 1

1. Be of ATSI descent
2. Identify as an ATSI
3. Be accepted as an ATSI by the ATSI community they live in

Question 2

Statistics about health inequities

• demographic
• rural
• stolen generation

Answer 2

• Life expectancy 8.1 years lower for ATSI women
• Life expectancy 8.8 years lower for ATSI men
• End-stage kidney disease RISK: 7x
• End-stage kidney disease MORTALITY: 4x
• RHD:
  – 26/37x (NT)

Conditions with higher prevalence:
- Trachoma
- Ear disease
- Asthma
- RHD
- TB, Hep B & C, pneumococcal, meningococcal, HIV

• 2.5% of population is ATSI
• 24% of ATSI live in rural areas
• 10-30% of ATSI children were in the Stolen Generation

Question 3

Barriers decreasing the efficacy of Closing The Gap

Answer 3

• Cultural barriers: racism, mistrust of Western culture, language barrier
• Lack of accountability
• Treating symptoms only
• Majority-WHITE government
• Limits change every year
• Assumes ATSI health = Western health

Question 4

Outcomes of Closing The Gap

Answer 4

• Progress in 4/15 measurable targets
• On track to meet 4 (3, 8, 11, 15A)
• Getting worse in 4 (4, 10, 12, 14)

Question 5

4 stages that led to an accumulation of inequities (DSFS)

Answer 5

1. DISPLACEMENT (1770s)
   - Diseases brought by settlers (TB, smallpox)
   - Sexual violence/trafficking (STD, mental health, infertility)
   - Disruption to connection with land
   - Addiction (tobacco/alcohol)
   - Massacres
2. SEGREGATION (1837-1937)
   - Lost freedom over movement, properties, names, language, religious conversion
3. FORCED ASSIMILATION (1937-1969)
   - 1937-1960s: diluting blood systematically
   - 1910-1970s: stolen generation
4. STRUCTURAL DISCRIMINATION (1960/70s - now)
   - Cultural blindness
   - Lack of cultural safety

Question 6

Ways of creating cultural safety

Answer 6

• Indigenous health training to all workforce
• Indigenous healthcare workers, liaison officers
• Engage with family and community leaders
• Recognise that ATSI wellbeing specifically also includes environmental and cultural wellbeing
• Recognising ATSI values, principles and norms

Question 7

Indigenous Australians living in remote + very remote locations

Answer 7

24%