Groups experiencing inequities Aboriginal and Torres Strait Islander Peoples (ATSI)

Lesson Aim Students learn to: Research and analyse Aboriginal and Torres Strait Islander peoples by investigating: The nature and extent of health inequities The sociocultural, socioeconomic and environmental determinants The roles of individuals, communities and governments in addressing the health inequities.

The nature and extent of the health inequities Aboriginal and Torres Strait Islander peoples (ATSI) experience significant differences in their levels of health compared to other population groups ATSI peoples have a life expectancy of at least 17 years less than other Australians. ATSI peoples experience high mortality rates from CVD, cancer, injuries and respiratory disease. Infant mortality rates are more than three times higher for ATSI peoples than for all Australian males and females. ATSI peoples have 8-10 times higher rates of death from diabetes than that of other Australians. ATSI peoples continue smoking at twice the level of other Australians. Approx. 50% of the population over 18 smoke. ATSI peoples experience higher obesity levels by one and a half more times compared to other Australians. Higher rates of depression. Assault and self-harm are the second leading cause of death.

Sociocultural, socioeconomic and environmental determinants Determinants of Health Sociocultural Peers Family Media Culture Religion Socioeconomic Education Employment Income Environmental Geographic location Access to health services Technology

Inquiry For each of the inequities listed in ‘Nature and extent of the inequities’ identify which determinants from each of the following areas contribute to the trend: Sociocultural Socioeconomic Environmental Once you have identified the most significant determinant in each area, write a sentence establishing a cause and effect relationship between the determinant and the inequity. determinants

Sociocultural, socioeconomic and environmental determinants Low community self esteem Loss of dignity with community Feeling little control over their environment Restriction to connect with their traditional culture Racism – stress affecting mental health History of discrimination Domestic Violence in communities Unemployment 3 times higher Lower average income ($364 compared to $585) Being poorer leads to lower health care Lower health care leads to more risk of disease Indigenous students half as likely to finish yr 12 education. Poor literacy – leads to reduced capacity to use health information Poorer living conditions Overcrowded and run down housing Lower safe drinking water in remote communities Large distance from health services Living in remote areas often has higher mental issues, less recreational opportunities

Roles of Individuals, communities and governments in addressing health inequities This slide applies to each group experiencing health inequities Government: Administers funding  Brings greater focus to the delivery of mainstream health services to groups experiencing health inequities   Communities: Provide support services Modifying laws for alcohol consumption in certain areas Providing healthy, supportive environment Empower members of communities to access health services Individuals: Responsible for; Educating themselves Accessing available health care services

Roles of Individuals, communities and governments in addressing health inequities Find an example of an existing health initiative in Australia to determine the role of individuals, communities and governments in addressing the health inequities experienced by ATSI peoples. Government: Communities: Individuals:

Roles of Individuals, communities and governments in addressing health inequities There are two peak agencies which coordinate Indigenous health services at the federal government level, while a third peak body in New South Wales oversees Indigenous health at a state level. The Office of Aboriginal and Torres Strait Islander Health (OATSIH ) Delivery of mainstream health services Administering and funding ATSI community controlled health services The National Aboriginal Community Controlled Health Organisation (NACCHO) Body that advocates for improvements to ATSI health The Aboriginal Health and Medical Research Council of NSW (AH&MRC) Body for Aboriginal health in New South Wales

Their strategies working in partnership with the community Roles of Individuals, communities and governments in addressing health inequities Community Indigenous Australians do not access primary healthcare services. Mainly due to: lack of availability of services, transport and distance to services, cost and language or cultural barriers OATSIH, NACCHO and the AH&MRC all aim to improve the access. Their strategies working in partnership with the community Aboriginal Community Controlled Health Services (ACCHSs) Aims to deliver holistic, comprehensive and culturally appropriate healthcare to the community that controls it. Services include clinical care, health education, promotion, screening, immunisation and counselling, as well as specific programs such as men’s and women’s health, aged care, transport to medical appointments, hearing health, sexual health, substance use and mental health.

Roles of Individuals, communities and governments in addressing health inequities An individual’s capacity to reduce their risky health behaviours and to increase their protective health behaviours or promote good health in others is influenced by a variety of factors including: Age Family History Community support Education Role modelling Access to health services SES Education and access appear to have the greatest impact. Health services focus on improving the knowledge and skills of community members. Women and mothers are often targeted as custodians of health knowledge and practice.

Roles of Individuals, communities and governments in addressing health inequities Department of Health – Indigenous and Rural Health Division: The Indigenous Australians' Health Programme funds activities, previously funded under the Aboriginal and Torres Strait Islander Chronic Disease Fund, to improve the access and quality of health services for people with chronic disease, deliver the most effective outcomes, and better support efforts to achieve health equality between Aboriginal and Torres Strait Islander and non-Indigenous Australians. Communities OXFAM Close the Gap - The Close the Gap Coalition is a grouping of Indigenous and non-Indigenous health and community organisations. Advocates for governments to take real, measurable action to achieve Indigenous health equality by 2030. Individuals Healthy for Life – an Australian government program that aims to educate ATSI’s about health issues in order to empower individuals to make positive health decisions in regards to child and maternal health care and chronic disease.

Groups experiencing inequities Socioeconomically disadvantaged people People in rural and remote areas Overseas-born people The elderly People with disabilities Choose one of these for your assessment task