Abstract
The poor health of Indigenous Australians is highlighted by the fact that their life expectancy is 17 years less than that of non-Indigenous Australians. The cause of this health disparity is multifactorial, and includes the under use of health services and medications. Distance, cost, and embarrassment, or fear of seeking help from culturally inappropriate services have all contributed to the reduced health status of Indigenous Australians. The introduction of Aboriginal medical services (AMS), Aboriginal health workers, and Section 100 (S100) of the Australian Pharmaceutical Benefits Scheme (PBS) have been important steps towards improving Aboriginal access to health services and medications. Despite this, spending on pharmaceuticals under the PBS per capita among the Indigenous population remains significantly lower than that of the non-Indigenous population. Because Aboriginal people from all areas experience similar barriers in their access to medicines, it has been suggested that the S100 scheme be made available to all AMS. Ensuring quality use of medicines needs to be addressed because patient counselling is carried out by the clinic staff, rather than the pharmacist and, therefore, in this case the pharmacist's role converts to one of training and providing information to the AMS. This expansion of S100 services may lead Indigenous health down a path of separation from mainstream services, which in turn would require nearly no adjustment by pharmacies and pharmacists to meet the needs of Indigenous people. Unfortunately, for no known reasons, previous suggestions to improve Aboriginal people's utilisation of mainstream health services and pharmacies have not been actioned.
Highlights
The poor health of Indigenous Australians is highlighted by the fact that their life expectancy is 17 years less than that of nonIndigenous Australians
The estimated life expectancy of Indigenous Australians is comparable to certain developing countries such as Pakistan and Indonesia, notable in Aboriginal mortality is that the majority of deaths occur in middleage, which is unlike any other country in the world[4]
The lack of improvement in mortality has been attributed to the absence of a treaty between the Indigenous and nonIndigenous population, the official Australian policy of assimilation[3,5], and a lack of a single identity in many Indigenous communities, due to grouping individuals from different tribal groups in one location[6]
Summary
It is commonly known that the health of Indigenous Australians is poor. In 1999-2001 the life expectancy of Indigenous Australians was 17 years less than that of nonIndigenous Australians[1]. While the mortality rates for non-Indigenous Australians are improving[3], Indigenous Australians are continuing to experience poorer health compared with the Indigenous populations of New Zealand, Canada and the USA, who experienced similar disempowerment and mistreatment. Risk-taking behaviour, such as smoking and excess use of alcohol, and misuse and under-use of medications contribute to the poor health status of the Indigenous population[9]. This is evident from 2002 figures that revealed 49% of the Indigenous population aged 15 years or older smoked and 51% had not participated in any physical recreational activities in the past 12 months[2]. While many initiatives have been undertaken in remote areas of Australia, this article explored how these same initiatives might be implemented in urban, regional and rural areas, and the possible consequences of this
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