EH2 Lecture 4 - Closing the gap

Aboriginal and Torres Strait Islander people die sooner than non-indigenous Australians. 66% die before age 65 (retirement age)

What are some of the important points to note regarding differences in lifespan between Aboriginals and non-indigenous Australians

1. ischaemic heart disease

2. Diabetus mellitus

3. Lung cancer

4. Chronic lower respiratory disease

5. intentional self-harm

What are the top 5 reasons for indigenous death?

social determinants of health

Aside from addressing biomedical problems, what else should be addressed in order to close the gap in health outcomes?

3% (700,000)

What percentage of Australia is Aboriginal or Torres Strait Islander?

10.6 years, 9.5 years (approximately 10 years average)

How much is the gap in life expectancy for men and women respectively?

It is 2.5 times higher in ATSI people

What is the gap in disease burden?

- SES

- Low incomes

- High unemployment

- poor educational attainment

What are 4 big social determinants of health affecting ATSI

21.6% in ATSI - more than 4 times that of non-indigenous

How do unemployment rates between non-indigenous and ATSI peoples compare?

Mental, cultural and spiritual well-being

Aside from the absence of sickness and disease, what else is important in the Aboriginal concept of health?

strong sense of kinship extending to 1st and 2nd cousins, shared child rearing, contributing to shared resources, obligations to attend ceremonies

What are some cultural obligations for Aboriginal people?

-Believe in being 'sung': cursed by member of community, which is beyond medical help

-Have traditional Lore and healing and potentially prefering traditional medicine over western medicine

-Distrust toward doctors and non-indigenous people

-Age differential determines acceptance of advice

-Very influenced by social surrounds eg: smoking cessation will be very difficult if contemporaries aren't involved

How does Aboriginal culture affect health beliefs?

Aboriginals may have been refused treatment,

Aboriginals had 'native wings' which were tin sheds

Aboriginals' treatment was often paid for by stolen wages

Explain some of the segregation that occured in health care toward Aboriginals in the mid-60s

1971

When was the first ACCHS established?

- Aboriginal people didn't trust existing health services

- Poor access to health services

- Lack of financial ability to pay for health services

- Lack of appropriate Aboriginal services

- Practical expression of 67 referendum

Name 5 reasons why ACCHS were treatment

- Disconnection of families, culture and land

- Hardships in health

- Inadequate housing

- Education and employment

- Economic disadvantage (eg minimal government representation)

What are some of the social and health repercussions still felt by Aboriginal people due to European settlement?

Reducing gap in:

- child mortality

- life expectancy

- reading, writing, and numeracy

- year 12 attainment rates

- emloyment outcomes

What are some "closing the gap" targets?

4.6 billion

How much money has gone into closing the gap over 4 years?

- Improving indigenous access to mainstream care programs

- Indigenous employment program (IEP)

- Learn Earn Legend

- Children and family centres - inidgenous early childhood development

- Health an well-being program

- Tackling indigenous smoking measure

What are some CTG programs?

Only requirement is ticking a box "Are you of Aboriginal or Torres Strait Islander origin?"

What is the requirement for association with ATSI background in health?

2 pieces of proof of ATSI background:

- evidence such as birth records

- evidence of self-affirmation: an official document stating the individuals identification

- evidence of community recognition: document signed by chairperson of an ATSI incorporated organisation in a community where the applicant lives or has lived

What is the requirement for association with ATSI background in ACCHS?