Abstract
BackgroundAboriginal and Torres Strait Islanders persistently experience a significantly lower standard of health in comparison to non-Indigenous Australians. The factors contributing to this disparity are complex and entrenched in a history of social inequality, disempowerment, poverty, dispossession and discrimination. Aboriginal medical services (AMS) provide a culturally appropriate alternative to mainstream medical services as a means to address this health disparity and also advocate for Indigenous rights and empowerment. This study provides a vignette of lay perspectives of Aboriginal and Torres Strait Islanders accessing community and government controlled AMS in Brisbane, Queensland with the intention of identifying self-perceived health determinants to inform the post-2015 international development goals.MethodsFocus group discussions and semi-structured interviews were held with clients of a government-controlled AMS and an Aboriginal community controlled health service (ACCHS) in order to identify their self-identified essential health needs. Conversations were audio recorded, transcribed verbatim and de-identified for analysis. Common themes were identified to highlight important issues around community health needs, how they can be addressed and what lessons can be extended to inform the post-2015 development goals.Findings and discussionParticipants acknowledge the complexity of health determinants faced by their peoples. Thematic analysis highlighted the pervasive influence of racism through many perceived health determinants; resulting in reduced healthcare seeking behaviour, unhealthy lifestyles and mental health issues. Participants emphasised the marked health improvements seen due to the establishment of Aboriginal medical services in their communities and the importance of the AMS’ role in addressing the negative effects of discrimination on Indigenous health.ConclusionIt is concluded from this study that AMS are crucial in addressing the negative impacts of continued discrimination on Indigenous health by providing comprehensive, culturally appropriate, community empowering health services. Such services improve Indigenous healthcare seeking rates, provide invaluable health education services and address mental health concerns in communities and must be supported in order to address health inequalities in Australia. Community driven and culturally informed health services should be encouraged globally to address health disparities.
Highlights
Damning statistics expose Australia’s failure to improve third world health experienced by Aboriginal and Torres Strait Islanders in an advanced economy [1]a
It is concluded from this study that Aboriginal medical services (AMS) are crucial in addressing the negative impacts of continued discrimination on Indigenous health by providing comprehensive, culturally appropriate, community empowering health services
Findings and discussion The determinants of Aboriginal health, and all health, are diverse and complex; and research participants cited a variety of needs as essential to addressing the disparity between Indigenous and non-Indigenous health experienced in Australia
Summary
Damning statistics expose Australia’s failure to improve third world health experienced by Aboriginal and Torres Strait Islanders in an advanced economy [1]a. In 2009, the Australian Government recognised that Indigenous health, education and employment outcomes have not improved significantly in over a decade [2,3]. In comparison to their non-Indigenous counterparts, Aboriginal and Torres Strait Islanders can expect to die almost 10 years earlier and experience a much higher burden of disease [4]; the Aboriginal infant mortality rate is almost twice that of non-Indigenous Australians and the child mortality rate is more than double [5]. Aboriginal and Torres Strait Islanders persistently experience a significantly lower standard of health in comparison to non-Indigenous Australians. This relocation served the purpose of segregating Aboriginal people from colonial society [23] and ‘controlling reproduction’; full-blooded Aboriginal people were corralled into missions and expected to die out
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