Health Of Aboriginal People Research Articles

Cultural safety in health for Aboriginal people: will it work in Australia?

Medical Journal of AustraliaVolume 193, Issue 3 p. 136-137 Ross Ingram Memorial Essay Competition Cultural safety in health for Aboriginal people: will it work in Australia? Rosemary Van den Berg PhD, Corresponding Author Rosemary Van den Berg PhD Associate Professor* murri_murri@bigpond.com * Since submitting this essay, Rosemary van den Berg has resigned from her position at Curtin University because of ill health.Correspondence: murri_murri@bigpond.comSearch for more papers by this author Rosemary Van den Berg PhD, Corresponding Author Rosemary Van den Berg PhD Associate Professor* murri_murri@bigpond.com * Since submitting this essay, Rosemary van den Berg has resigned from her position at Curtin University because of ill health.Correspondence: murri_murri@bigpond.comSearch for more papers by this author First published: 02 August 2010 https://doi.org/10.5694/j.1326-5377.2010.tb03830.xCitations: 4Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume193, Issue3August 2010Pages 136-137 RelatedInformation

Smoking Kills

This paper brings to the reader‟s attention a history of tobacco smoking that arguably had a negative effect on the health of Aboriginal communities in the Hunter region of central eastern New South Wales during the early colonial contact period from 1800 to 1850. Furthermore, it will also be shown that tobacco was used by colonists to engage the services of Aboriginal people, not only in Aboriginal communities in the Hunter region, but further afield across many other frontiers of colonial expansion in Australia in the 19th century. It will be demonstrated through primary archival and secondary sources that colonists utilised tobacco as a coercive agent to appease, befriend, pacify, coerce and remunerate Aboriginal People, resulting in widespread addiction. It is argued that tobacco smoking not only undermined the health of traditional communities, but also this unhealthy habit has been largely overlooked in measurements of the impact of colonization on the health of Indigenous people. While historians widely acknowledge that exotic diseases such as smallpox had a negative effect on the health of Aboriginal People, it is rarely considered in contemporary historical accounts that tobacco had an even more insidious effect on the well being of Aboriginal societies during the early colonial contact period. Furthermore, while diseases such as smallpox have hopefully disappeared forever, health destroyers like tobacco have endured and continue to impact on Aboriginal health. Finally, this paper recognises the enormity of challenges faced by health authorities, and indeed Indigenous Australians, in contemporary society in combating a chronic problem that has been embedded in Aboriginal post-colonial culture during the long course of European occupation.

Indispensible guide to Aboriginal people's health

Healing Traditions: The Mental Health of Aboriginal Peoples in Canada Laurence J. Kirmayer and Gail Guthrie Valaskakis, editors UBC Press; 2008. 528 pp $39.95 paper This essay collection, intended as a resource for health practitioners, students, policymakers, educators and others, questions the

Planning Without Facts: Ontario's Aboriginal Health Information Challenge

ABSTRACT The majority of First Nations, Métis, and Inuit people living in the Canadian province of Ontario have less access to quality health care than the population as a whole. Yet improving the situation is hampered by the lack of an information system that documents fundamental facts about Aboriginal people's health status and services utilization. Without a means to collect such data, these knowledge deficits will persist, making the planning and provision of culturally appropriate services impossible. The Ontario Health Quality Council commissioned a study to (1) review data collection systems in other Canadian jurisdictions and (2) determine what Ontario needs in order to have a comprehensive Aboriginal health information system. The study involved a review of 177 policy and technical documents and interviews with 20 key informants in Ontario, as well as Canada's other provinces and territories. Results showed that the capacity to document Aboriginal peoples' health and service utilization varies significantly, depending on existing provincial/territorial health data sets and the ability to cross-link health data using unique identifiers. Some jurisdictions can locate Aboriginal data using health cards, health benefits payment information, or vital statistics identifiers; others rely on linkages using federal or provincial Aboriginal registry and membership lists. All have the capability to conduct geographical analyses to identify health and service utilization for communities or regions that have significant Aboriginal populations. To improve health information in Ontario, Aboriginal people's collective entitlements to information about their communities must be recognized. The authors outline implications of a set of principles that Canada's First Nations have adopted, commonly referred to as OCAP (Ownership, Control, Access, and Possession), on the collection, storage, use, and interpretation of health data. Only through negotiation with Aboriginal peoples can health information systems be established that meet their needs, as well as those of decision-makers and care providers.

Closing the gap depends on ACCHSs

[Extract] The Hon. Kevin Rudd, Prime Minister of Australia, addressed federal Parliament on 26 February 2009 regarding the Closing the gap on Indigenous disadvantage: the challenge for Australia report.1 In his speech, he asserted that government strategy to close the gap will focus on the treatment of Indigenous Australians' illnesses largely through the mainstream health system, because that is where 70% of Indigenous people are treated. Unfortunately, the 70% figure is an urban myth based on one poorly worded question in the Australian Bureau of Statistics (ABS) National Aboriginal and Torres Strait Islander Health Survey 2004–05.3 At the National Aboriginal Community Controlled Health Organisation (NACCHO), we are concerned about the use of distorted evidence regarding the health of Aboriginal peoples, in particular the use of questionable data to formulate policies that undermine investment in Aboriginal community controlled health services (ACCHSs).

Protecting our gifts and securing our future: Eliminating poverty among First Nations children

Editor’s Note: The provision of health services to address the poor health status of Aboriginal people, especially children, has been rooted in a complex environment of legislation. The British North America Act in 1867 placed Aboriginal health ‘under federal authority’ but subsequent acts, accords, white papers and royal commissions have failed to solve the broad social determinants of health, or the provision of equitable, culturally sensitive services for Aboriginal children. Concerned readers are referred to an excellent previous article for further discussion (Moffatt MEK, Cook C. How can the health community foster and promote the health of Aboriginal children and youth? Paediatr Child Health 2005;10:549–552), available at . National Chief Phil Fontaine illustrates that all areas of life must be changed to make any lasting difference in the health of Aboriginal children and youth. Increased dollars alone will not improve the overall health of Aboriginal people. A comprehensive approach that addresses housing, language, education and overall cultural well-being must go hand-in-hand with increased health care spending.

James B Waldram, D Ann Herring, and T Kue Young, Aboriginal health in Canada: historical, cultural, and epidemiological perspectives, second edition, University of Toronto Press, 2006, pp. xii, 367, £45.00, $70.00 (hardback 978-0-8020-8792-8); £20.00, $29.95 (paperback 978-0-8020-8579-8).

James B Waldram, D Ann Herring, and T Kue Young, Aboriginal health in Canada: historical, cultural, and epidemiological perspectives, second edition, University of Toronto Press, 2006, pp. xii, 367, £45.00, 29.95 (paperback 978-0-8020-8579-8). - Volume 51 Issue 4

Review of Aboriginal Health in Canada: Historical, Cultural and Epidemiological Perspectives by Waldram J, Herring A and Young TK

This revised and updated second edition, published more than a decade after the first edition, presents the reader with a clear and readable picture of the health of aboriginal people in Canada, how the health status got to be what it is and how history, politics and culture have conspired to create the deplorable situation in which many aboriginal people find themselves today. The book begins with a chapter on who the aboriginal people of Canada are, from whence they came and the probable timing of the arrival of different waves. It describes the immense cultural and linguistic diversity that existed prior to contact and a brief history of what happened postcontact in terms of legislation and cultural and economic changes. This chapter alone is a nice summary for the uninitiated. International Journal of Circumpolar Health 66:1 2007

Interactive drama: teaching aboriginal health medical education

Context and setting Approximately 100 students attended this attitudinal learning activity designed for a Year 1 undergraduate medical education course on cultural diversity. The learning activity took place in an urban community with approximately 30 000 aboriginal people. Why the idea was necessary While lip-service is often given to the proverbial 3-legged stool in medical education (attitudes, knowledge and skills), most medical teaching institutions are perched precariously on a wobbly 2 legs at best. Attitude-oriented courses are typically perceived as being ‘soft’ and unimportant compared to more science-oriented courses. Most curricula squeeze in a mere hour or so for introspection and self-reflection, leaving students unaware of the importance that their attitudes have on their clinical interaction. Learning about aboriginal people's health tends to be limited to a knowledge-focused approach. Learning must illustrate the complex interaction of cultures (aboriginal, learner's natal and medical) and then offer tools to help negotiate and bridge the complexities. This learning activity was designed to provide an opportunity for students to explore cultural perspectives, reflect on attitudes toward aboriginal people, and learn ideational frameworks through which local aboriginal people experience health care. What was done An interactive genre called Forum Theatre encouraged students to move from being passive observers to active participants within a play consisting of a series of scenarios between an aboriginal elder, her granddaughter, her doctor and a medical student. The play wove together themes of relationship, culture and conflict within a health care setting. Students observed the play once. Following this, the play was run through a second time; however, this time students were instructed to shout out ‘Stop!’ when they felt that the medical student could engage with her preceptor or aboriginal patient differently. The audience member who shouted ‘Stop!’ would then take the place of the actor in the play and attempt to mitigate the conflict scenario. Thus, the students could practise and learn from alternative interventions. The activity created space for discussion around intervention effectiveness and diversity of cultural perspectives and preferences. Key issues that arose were: accepting gifts and conflict of interest, negotiating student−preceptor disagreements, intergenerational conflict, the role of the chart, medical professionalism, racism, gaining trust, and eliciting the patient's worldview without imposing assumptions based on ethnicity. Evaluation of results and impact Following this activity, students were asked to complete a mixed qualitative and quantitative evaluation. Student feedback included: ‘It made me realise how many issues I wouldn’t have answers for.' Students expressed their particular enjoyment in being involved and participating in ‘real life examples’: ‘It was fantastic to be able to “test out” alternate approaches or tactics and see how they work.’ The play fostered exploration of vital covert and overt issues, rarely dealt with in a traditional teaching setting. It was apparent that this activity enabled students to connect mentally, physically, spiritually and emotionally with the content and begin to develop an appropriate approach towards interacting with aboriginal patients.

Merging Traditional Aboriginal and Western Health Practices in a Canadian Urban Aboriginal Community

The health of Aboriginal peoples in Canada has been compared to that of people in third world countries. Shkagamik-Kwe Health Centre, an Aboriginal-based primary health centre, was recently established to address the unique needs of the Aboriginal population in one area of an urban community in Canada. The purpose of this paper is to describe the Shkagamik-Kwe Health Centre in terms of the history of its development within the Aboriginal Healing and Wellness Strategy and its current programs, with particular emphasis placed on how traditional Aboriginal healing and health practices are being utilised within a multi-disciplinary team approach.

The Austin Doyle Lecture, High Blood Pressure Research Council of Australia. Renal disease as a metaphor: towards a more integrated view of aboriginal health.

1. The health of Aboriginal people in the Northern Territory of Australia is among the worst in the world, with mortality rates increased in every 'disease-specific' category and averaging overall approximately five-fold those of non-Aboriginal Australians. Health services, which in most regions are rudimentary, fragmented and under-resourced, have been slow to recognize and meet this challenge. However, the cost implications of an epidemic of renal failure have stimulated concern that broader mortality statistics could not. 2. In one high-risk Aboriginal community, we found that renal disease can be detected and its course chartered by a simple and reliable screening test. Renal disease arises out of a broad menu of risk factors that reflect poverty, disadvantage and accelerated lifestyle changes and its expression is progressively amplified with the simultaneous operation of more than one risk factor. It is intimately related to other 'diseases' through shared risk factors and pathophysiology. We also found that people with established renal disease participated enthusiastically in a pharmacological treatment programme, with excellent clinical responses that predict a marked reduction in renal failure and cardiovascular morbidity and mortality over the intermediate term. 3. It is likely that most other causes of excess mortality in Aboriginal people are, like renal disease, multideterminant, with a substantial base of shared risk factors. They are probably equally susceptible to modification. We must move away from 'single-cause' disease models, eliminate counterproductive specialty barriers and rectify the unbalanced focus and resource commitment to hospital-based, high technology treatments of people with advanced and irreversible disease. We must advocate for coherent, sustained, integrated public health and primary care programmes to improve the whole health profile and for screening and treatment programmes to modify the course of disease in people already afflicted.