ABH Exam

Define terra nullius (2)

• A legal doctrine used by the British to justify claiming Australia as “land belonging to no one”

• Ignored the sovereignty and land ownership of Aboriginal and Torres Strait Islander peoples and allowed land to be taken without treaty or compensation

How does labelling the land ‘terra nullius’ affect health (5)

• Dispossesion of land

• Disrupted

  • Food systems

  • Governance

  • Culture

  • Economic structures that support health

Define colonisation (1)

• The process through which European powers invaded, settled and controlled Indigenous lands and peoples

What did colonisation in Australia involve (4)

• Land dispossesion

• Frontier conflict and violence

• Introduction of disease

• Government control policies

How does colonisation affect health (1)

Disruptions influence modern social determinants of health

Define frontier expansion/frontier violence (1)

The period of expansaion of European settlement across Australia during the 18th and 19th centuries

What did frontier expansion/frontier violence in Australia involve (4)

1. Armed conflict

2. Massacres

3. Displacement

4. Loss of land and resources

How does frontier expansion/frontier violence (1)

• Disruption of social structures and leadership systems

Define protectonism

Government policies (late 1800s - mid 1900s) that controlled many aspects of Aboriginal peoples lives

What are examples of protectionism (4)

• Movement restrictions

• Control of wages

• Regulation of marriage

• Confinment to reserves or missions

How does protectonism influence health (1)

Bureacratic control replaced overt violence

Define assimilation

Government policy aiming to absorb Aboriginal peoples into white Australian society

What were the goals of assimilation (3)

• Abandonment of culture + language

• Adoption of European lifestyles

• Removal of children from families

How did assimilation influence health

• Assimilation policies contribute to the stolen generations = intergenerational trauma

Define colonisation as a determinant of health (1)

Colonisation shaped the social, political and economic conditions influencing health outcomes

Define social determinants of health

The conditions in which peopole are born, grow, live, work and age

What are examples of social determinants of health (5)

1. Income

2. Housing

3. Education

4. Access to healthcare

5. Social support

How are social determinants of health affected by colonisation

• Colonisation shaped these conditions for Aboriginal peoples

Define structural determinants of health

Broader political, historical and economic systems that shape social conditions

What are examples of structural determinants of health (4)

1. Government policy

2. Racism

3. Colonisation

4. Economic inequality

Define cultural safety

A healthcare approach where patients feel respected and safe

What does cultural safety require (4)

1. Awareness of power

2. Reflexivity

3. Understanding historical context

4. Respect for patients perspectives

Define historical determinants

Understanding how historical events and policies shape present health outcomes and healthcare interactions

Define self-determination

Define cultural humility

Define cultural safety

What are the 5 R’s of cultural humility (5)

1. Reflection

2. Respect

3. Regard

4. Relevance

5. Resiliency

What is the health impact of historical narratives (5)

1. Racisms

2. Blame

3. Lower expectations

4. Power imbalances

5. Poor trust in healthcare

What has colonisation shaped in modern day times (determinants 5)

1. Poverty

2. Housing

3. Education

4. Trauma

5. Service mistrust

What are the contemporary health outcomes affected by colonisation (disease - 5)

1. Rheumatic heart disease

2. CKD

3. Diabetes

4. Suicide

5. Reduced life expenctancy

How can nurses show advocacy within systems (5)

1. Strengths based language

2. Avoid deficit framing

3. Negotiate care plans

4. Involve family

5. Clarify barriers

What is involved in culural safety (4)

1. Recognising power

2. Understanding historical context

3. Avoid structural harm

4. Practising relational care

What were the immediate impacts of the stolen generation (6)

1. Mistrust

2. Lost culture

3. Lost family

4. Lost language

5. Psychological harm

6. Physical injury

Define intergenerational trauma

What might patients experience in hospitals as a result of the Stolen Generation (5)

1. Mistrust of government and health institutions

2. Fear of authority figures

3. Distress when seperate from family

4. Anxiety in institutional environments

5. Trauma triggers in clinical settings

Define racism

System of power that produces unequal outcomes based on race

Describe the four different types of racism (4)

1. Institutional - policies and practises

2. Structural - institutions upholding policies

3. Interpersonal - racist acts and micro-aggressions

4. Internalized - reinforce negative beliefs + self hared in individuals

What are some examples of interpersonal racism (3)

1. Assumptions

2. Stereotyping

3. Dismissive communication

What are some examples of institutional racism (3)

1. Policies not designed for Aboriginal people

2. Lack of culturally safe services

3. Underfudning ACCHOs

What are three examples of internalised racism

1. Shape

2. Reduced help-seeking

3. Distrust of services

What are some of the health impacts of racism (4)

1. Delayed care

2. Reduced access

3. Chronic stress

4. Poor outcomes

When does racism become fatal (3)

1. Pain dismissed

2. Assumptions made

3. Care delayed

What can nurses do to help fight racism (6)

1. Reflect

2. Listen

3. Advocate

4. Challenge assumptions

5. Use respectful communication

6. Support culturally safe care

How can the system be decolonising (3)

1. Power

• Governance

• Funding to the ACCHOs

2. Knowledge

• Indigenous knowledges

• Cultural healing

3. Workforce

• Aboriginal workforce

• Cultural safety educaiton

Describe the Aboriginal Community Controlled organisation model of care

Why do ACCHOs work (4)

1. Trust

2. Cultural safety

3. Holistic care

4. Community ownership