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Dragon, N 2007, ‘A call to action: health equality for indigenous Australians’, Australian Nursing Journal, vol.14, no. 7, pp. 21-24.
The author, Australian Nursing Journal (ANJ) journalist, describes at a campaign to improve health and social conditions for Indigenous people and successful initiatives in this area. The author states problems that persist are also outlined such as issues of access to primary health care and nutrition as well as socioeconomic issues. The article suggests the importance of incorporating awareness and understanding of Indigenous culture into the nursing curriculum is emphasised. It is resolved that nurses play the important roles as the key persons to provide community health education and educating indigenous people to realize they have power of their health.
The considerable health disparity between Australia’s non indigenous and indigenous people can be significantly improved by educating more indigenous nurses.
Although on average Australians have good health, life expectancy at birth of Indigenous Australians were 67.2 of age years for men and 72.9 of age years for women, while the average life expectancy of non-Indigenous Australians were 78.7 of age years for men and 82.6 age of years for women based on 2005–2007 data (Australian Bureau of Statistics (ABS) 2009). In addition, the life expectancy difference is 17 years in Australia compared to 8 years in New Zealand, 5-7 years in Canada and 4-5 years in USA (Ring et al 2003 cited in Dragon 2007, p.21). It is proven that there is a gap in health between indigenous and non indigenous people. This problem touches my heart and my mind to understand about whom and what are indigenous people. It is my first time ever in life reading the articles about it. Furthermore, I found that the meaning of indigenous is defined as people from Aboriginal and Torres Strait Islander background (Turale & Miller 2006, p.171). Indigenous Australians are consisting of 2. 4% of a total population which nearly 20 million and located in remote situations (ABS & AIHW 2003 cited in Turale & Miller 2006, p.171). However, it is surprised me that Australia is one of the wealthier countries in the OECD (Organization for Economic Co-Operation and Development) but why do Indigenous Australians have health outcomes worse those of other Australians?. I believe that it is a complex issue, caused by the interrelationship of many contributing factors. Two of these are lower accessibility of primary care and lower education history, both of which have increased at an incredible rate over recent years. In my opinion, it is such as the signal for Australians to figure out the solutions immediately. To quote from Dragon (2007, p. 21), “‘It is not acceptable for governments to continually state the situation is tragic and ought to be treated with urgency and then fail to put in place targets, funding and time frames to address the issue”.
In this essay, I will describe the health disparity between Australia’s non indigenous and indigenous by firstly, describing the probable causes and negative impact of these situations. It is followed by a discussion of how to improve primary care access and to educate more indigenous nurses. It is argued that the improvement of education support may help to facilitate educating more indigenous nurses.
Firstly, Indigenous people have much less access to primary health care because of cost and lack of provision of health services in the areas where most Indigenous people live (ABS & AIHW cited in Turale & Miller 2006, p.173). Furthermore, the lack of access to primary care due to location issue, poor health linkages, social factors, lack of public health focus, workforce issue and financial barriers (National Strategic Framework for Aboriginal and Torres Strait Islander Health 2003, p.10 cited in The Fred Hollows Foundation 2004). In my observation, these factors could reflect not only poorer indigenous health, but also negative image for Australian government. Most agrees that indigenous and non indigenous Australians may be facing the similar health problems but the effects could be worst for indigenous people. For example, circulatory disease, injury, respiratory illness and diabetes are described for almost 70% of health problem that causes death of indigenous people (Ring 2003, pp.3-12 cited in Armstrong 2004, p.16).
Another probable cause is lower education background. In my opinion, there is a powerful relationship between education and health. People with no educational qualifications have fewer life opportunities, poorer health, lower incomes and are more likely to be unemployed (Booth & Caroll 2005, p.2). Moreover, in my opinion, it can accelerate many problems. For example, indigenous people may experience higher rate of mental problem such as poor self-esteem (Turale & Miller 2006, p.173). In addition they are more likely to engage in activities which is giving negative impact to their health such as smoking, and consuming of alcohol (Booth & Caroll 2005, p.2). Furthermore, the newest data indicating 0.5% of registered nurses in Australia are indigenous which is under the 2.4% indigenous people in Australian population (Dragon 2007, p. 23).
There are solutions to reducing the health disparity between Australia’s non indigenous and indigenous people, two of which are training indigenous nurses and improving access to primary health care. Firstly, I agree that Armstrong (2004, p.160) says the fundamental changes in education system can lead more indigenous people to access university study easily. The INEWG (The Indigenous Nursing Education Working Group) suggests that the provision of support can help Indigenous people to enable their greater involvement in nursing academia such as introducing potential students to university life, providing scholarships, travelling allowances for those attending clinical places in rural and remote, and facilitating clinical practice in local hospitals (Turale &n Miller 2006, pp.174-175). Turale & Miller also note that specifically, the nursing university system is to be streamlined for indigenous enrolment and particular places for indigenous students. Moreover, CATSIN (Congress of Aboriginal and Torres Strait Islander Nurses) is encouraging Australia universities for compulsory study units in Indigenous culture, health and history in nursing courses (Dragon 2007, p.3). These curricula will be beneficial for nursing students to have better understanding in providing appropriate care for indigenous people in the future application (Armstrong 2004, p.16). Another example is encouraging indigenous students to be the role model for other indigenous. Copley (cited in Dragon 2007, p.24) says “I am 54 you are 24 tell me why you cannot do this?’. When this article published, he was in the third year of Bachelor of Nursing program at Flinders University (Dragon 2007, p.24). Dragon also informs that he was one of 12 indigenous students out of 500-600 students and the purpose of his statement try to motivate other indigenous to continue their studying.
Secondly, the improvement of primary care access is another part of the solution to reduce health disparity problems. It is proven that community-controlled service is delivered by indigenous nurses’ community provide appropriate care to increase Indigenous health as general because they have a feel it belongs to them (Dragon 2007, p.22). In addition, the recruitment and retention of indigenous nurses are one of the important strategies to provide most suitable care for indigenous (Dragon 2007, p.23).
In conclusion, the improvements of indigenous nurses’ education support contribute positive approaches to overcoming the health gap between Australians and non-Indigenous Australians. It is clear that the provision of support can invite more indigenous people to continue their higher education especially in nursing. In addition, Copley’s messages that never says too late and nothing is impossible, be one of the positive examples for other indigenous people. Chinese General, military strategist, Sun Tzu (c. 6th century BC), says that “know your enemy, know your battle, you will be the winner”. Most agrees that the enemy is the health problems; our battle is creating an opportunity for all Australians to unite and take effective action to reduce the health gap. If we work together to build healthier live, we save the life of future Australian generations.
