Indigenous Health Essay
The poor health position of Indigenous Australians is a contemporary reflection of their historical treatment as Australia’s traditional owners. This treatment has led to Indigenous Australians experiencing social disadvantages, significantly low socio-economic status, dispossession, poverty and powerlessness as a direct result of the institutionalised racism inherent in contemporary Australian society.
Indigenous populations have been the carers and custodians of Australia and the Torres Strait for a period in excess of 60,000 years before being invaded/colonialised by the British on January 26, 1788 (Hampton & Toombs, Racism, colonisation/colonialism and impacts on indigenous people, 2013). Before this time, it is suggested that Indigenous Australians lived relatively affluent lives and enjoyed generally better health than most people living in Europe (Hampton & Toombs, Indigenous Australian concepts of health and well-being, 2013).
The arrival of introduced diseases, especially smallpox, caused considerable loss of life among Indigenous Australians. The impact of this is loss extended far beyond the immediate victims of disease, affecting the very fabric of Indigenous societies through depopulation and social disruption (MacRae, et al. , 2012). Whilst introduced diseases were the most substantial part of the Indigenous Australians mortality, death caused by direct conflict also contributed significantly (Elder, 2003).
Traditionally, Indigenous Australians had complete autonomy over all parts of their lives such as, ceremonies, spiritual practices, medicine, social relationships, management of land and law and economic undertakings (Saggers & Gray, 1991). In addition to the impacts of introduced diseases and conflict, Indigenous Australians also experienced ill effects related to disconnection from Country due to the spread of colonists and their subsequent political policies.
For an Indigenous Australian, Country is not just physical territory but the central aspect of their identity (Hampton & Toombs, Racism, colonisation/colonialism and impacts on indigenous people, 2013). Occupation and colonialism impacted far beyond the physical, as Indigenous Australians had their culture devalued, traditional food sources destroyed, and were separated from their families and in some cases entire communities were dispossessed.
This led to disruption or loss of languages, beliefs and social structures which form the underlying basis of Indigenous cultures. These impacts, prompted British colonists to develop several different political policies of institutionalised racism to address the real and perceived issues regarding Indigenous Australians. The first of these policies was Protectionism (1788 – 1890’s). Prior to Protectionism British colonies practiced exclusion as they assumed ‘Terra Nullius’ and seized control of the land, evicting Indigenous Australians from their traditional Country.
The negative impacts this had on Indigenous Australians eventually forced colonial authorities to establish “Aboriginal ‘protection’ boards” (Hampton & Toombs, Racism, colonisation/colonialism and impacts on indigenous people, 2013). The first was established in Victoria by the Aboriginal Protection Act of 1869, with the other colonies following with similar legislation, to ‘protect’ Indigenous populations within their boundaries (Parliament of Victoria, 1869). The ‘protection’ provided under the various Acts imposed enormous restrictions on the lives of many Indigenous Australians.
These restrictions included dictating where Indigenous Australians could live and not live, and set out limitations on movement, marriage, employment, earnings and ownership of property. The child welfare provisions of the Acts underpinned the removal of Aboriginal children from their families and communities ‘by compulsion, duress or undue influence’ (State Library of Victoria, 2014). The National Inquiry into the separation of the children concluded that ‘between one-in-three and one-in-ten Indigenous children were forcibly removed from their families and communities in the period from approximately 1910 until 1970’ (Wilkie, 1997).
It was the 1960s, at the earliest, when the various ‘protection’ Acts were either abolished or discontinued. In the early 1890’s, protectionism gave way to state and commonwealth government regimes of segregation. In the development of the constitution, politicians included sections specifically excluding Indigenous Australians, such as the white Australia policy, ensuring that racism became entrenched in the new nation’s future.
Reserves and missions were set up far from white settlements, to exclude and control Indigenous Australians, especially those of mixed descent (Hampton & Toombs, Racism, colonisation/colonialism and impacts on indigenous people, 2013). By the 1950’s all state governments invoked a new policy called assimilation (1950’s – 1960’s), which aimed to eliminate Indigenous cultures, religion and languages. Assimilation was based on the belief that if living conditions were improved, Indigenous Australians were to be absorbed into White Australian society (Hampton & Toombs, Racism, colonisation/colonialism and impacts on indigenous people, 2013).
After the failure of the assimilation policy, governments aimed their sights towards Integration (1960’s – 1980’s). Integration was a step towards multiculturalism by allowing Indigenous Australians and non-Anglo European immigrants to keep certain aspects of their culture whilst conforming to mainstream white Australian society. During 1970’s Indigenous Australians were beginning to become acknowledged as Australian citizens, this led to the development of the self-determination and self-management (1970’s-1990’s) programs (Hampton & Toombs, Racism, colonisation/colonialism and impacts on indigenous people, 2013).
These policies were based on the slow acceptance of multiculturalism and the beginnings of Indigenous Australians involvement in Australian politics, although the actual amount of self-determination available to them was limited. When these polices were found to be ineffective the Council for Aboriginal Reconciliation (CAR) was established in 1992 to overcome differences and inequities between Indigenous Australians and the wider Australian community (Hampton & Toombs, Racism, colonisation/colonialism and impacts on indigenous people, 2013).
The Reconciliation movement (1990’s-present) seeks to advocate for Indigenous Australians rights, their place in our shared history and to establish economic independence among Indigenous Australians in order to promote equality for all Australians (Hampton & Toombs, Racism, colonisation/colonialism and impacts on indigenous people, 2013). Whilst government policy appears to be moving in the right direction, we are still a long way away from Indigenous autonomy and self-determination.
All of these policies had a very detrimental effect on the health of Indigenous Australians both in terms of physical and mental health issues, many of which have continued through to contemporary times. Perhaps the most poignant of these impacts are those that have resulted from the Stolen Generations. There is much dispute surrounding when colonial authorities began removing Indigenous children from their families and communities, although many experts believe that it was very soon after the establishment of the British colony in Australia (Duffy, 2000).
Children with Indigenous mothers were seen to be legally ‘neglected’ at birth, and removed from their families, communities and in most cases their culture, to be ‘raised right’ up until the latter part of the 20th Century (Hampton & Toombs, Racism, colonisation/colonialism and impacts on indigenous people, 2013). Because of these practises, many Indigenous Australians have deep psychological and mental health issues that continue to plague them today.
Modern literature tells of many instances of suicide and ongoing identity issues, emerging from the torment of being disconnected from family, culture and country. The status of Indigenous Health has been impacted severely by the Stolen Generations and other past Government practises. For many Indigenous Australians, the ongoing effects of ‘protection’ and the forced separation of children from their families compound other social, emotional and physical disadvantages (Wilkinson & Marmot, 2003).
These disadvantages are embodied by the Social determinants of health, including; economic opportunity, physical infrastructure, and social conditions that influence the health of individuals, communities, and societies as a whole. Inequalities in these are especially evident in education, employment, income, housing, access to services, social networks, connection with land, racism, and incarceration rates (McDonald, 2010).
In all of these factors, Indigenous Australians experience substantially lower rates than non-Indigenous Australians, with the most worrying being that Indigenous Australians have a significantly lower life expectancy rate and overall health status, than their non-Indigenous counter-parts. These inequalities, combined with the social attitudes towards Indigenous Australians and their health in contemporary Australian society, contribute to the difficulties Indigenous Australians have accessing adequate healthcare.
It is also difficult to provide adequate healthcare for Indigenous Australians as many service providers do not understand how Indigenous Australians conceptualise health. Until recently, there was no separate term in Indigenous languages for health as it is understood in western society (Eckermann, 2010). The traditional Indigenous perspective of health is holistic. It encompasses everything important in a person’s life, including land, environment, physical body, community, relationships, and law.
Health is the social, emotional, and cultural wellbeing of the whole community and the concept is therefore linked to the sense of being an Indigenous Australian. This conceptualisation of health has much in common with the social determinants model and has crucial implications for the simple application of a medical model as a means of improving Indigenous health. Whilst the purely medical approach is undoubtedly useful in identifying and reducing disease in individuals, but its limitations in addressing population-wide health disadvantages, such as those experienced by Indigenous people, must be recognised.
It is important to remember that policies and practises of the past have had major adverse impacts on the health of contemporary Indigenous Australians, and these impacts have contributed significantly to the inequalities present in Indigenous and non-Indigenous health status. However, whilst health disadvantages experienced by Indigenous Australians are considered to be historical in origin, the perpetuation of the disadvantages relies heavily on contemporary structural and social factors.
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