ABH

• cultural safety: developed through openness to peoples interpretation of their cultural identity and how their expressions of culture shape their behaviour
• cultural conflict: people are not committed to similar goals or philosophies, and societal decision-making is based on dissimilar principles and philosophies
• culture: beliefs, values and knowledge that are inherited from one generation to another and that determine social behaviours
• cultural sensitivity: understanding one's own culture and how it relates to other cultures with a view to promoting cultural protection
• cultural capital: the power and resources that help people maintain social capital in a way that values cultural understanding
• culturally safe practice: any health care relationship is unique, power-laden and culturally dyadic. recognising that there is always the potential for the health provider to hold power over another person (eg pt)
• cultural literacy: being responsive to the way an individual or groups cultural mores and lifestyle habits shape health and health behaviours
• cultural awareness: knowledge of and ability to discuss the history underlying a culture, particularly one's own and those of others
• racism definition: a body unfounded opinions or attitudes relating to an individual or group that represents them in an unfavourable light
• racism definition: a system that maintains advantages and disadvantages based on social group membership and operates unintentionally on individual, institutional and cultural levels
• racism definition:

  • one group determining theirs to be better than another
  • one group unfairly treats another based solely on differences
• throughout history, humankind has treated others with contempt and committed atrocities upon them just because of the colour of their skin or the culture from which they come
• racism a driver of aboriginal ill health

  • on an individual level, exposure to racism is associated with psychological distress, depression, poor quality of life, and substance abuse, all of which contribute significantly to the overall ill-health experienced by aboriginal and torres strait islander people. prolonged experience of stress can also have physical health effects, such as on the immune, endocrine, and cardiovascular systems
• racism impacts your health:

  • inequitable and reduced access to the resources required for health (employment, education, housing, medical care etc)
  • inequitable exposure to risk factors associated with ill-health (junk food, toxic substances, dangerous goods)
  • stress and negative emotional/cognitive reactions which have negative impacts on mental as well as affecting the immune, endocrine, cardiovascular and other physiological systems
• racism impacts your health:

  • engagement in unhealthy activities (smoking, alcohol and drug use)
  • disengagement from healthy activities (sleep, exercise, taking medications)
  • physical injury via racially motivated assault
• Cultural safety: Understanding one’s own culture and how it relates to other cultures with a view to promoting cultural protection
• Cultural awareness: Any health care relationship is unique, power-laden and culturally related. Recognising that there is always the potential for the health provider to hold power over another person e.g. patient.
• Cultural sensitivity: Being responsive to the way an individual or group’s cultural norms/rules and lifestyle habits shape health and health behaviours
• Systematic bias: Systematic bias can occur when the health of Indigenous people is analysed according to norms established in the non-Indigenous population. It can occur when the blame for social and health problems is attributed to cultural characteristics instead of inequalities in the health system. Systematic bias can stereotype Indigenous people, resulting in their exclusion from making decisions about health care.
• 4 additional social determinants of health

  • history
  • land
  • culture
  • racism
• why are the additional determinants of health important: There is an interrelated nature of wellbeing and the environment. History, land, culture and racism affect Aboriginal peoples’ wellbeing, such as connectedness, sense of control, and history, and visually shows how these factors interrelate
• 5 closing the gap targets in relation to health and wellbeing:

  1. close the gap in life expectancy within a generation by 2031
  2. increase the proportion of babies with a healthy birthweight to 91% by 2031
  3. increase the proportion of children assessed as developmentally on track in all 5 domains of the australian early development census to 55% by 2031
  4. reduce the rate of over-representation of aboriginal and torres strait islander children in out-of-home by 45% by 2031
  5. significant and sustained reduction in suicide of aboriginal and torres strait islander people towards zero
• what causes health inequities?

  the social determinants of health are mostly responsible for health inequities - the unfair and avoidable differences in health status seen within and between countries. the structural roots of health inequities lie within education, taxation, labor and housing markets, urban planning, government regulation, health care systems, all of which are powerful determinants of health and ones over which individuals have little or no direct personal control but can only be altered through social and economical policies and political processes
• social determinants of health:

  social-physical-economic-services determinants

  • income and income inequality
  • education
  • race/ethnicity/gender & related discrimination
  • built environment
  • stress
  • social support
  • early child experiences
  • employment
  • housing
  • transportation
  • food environment
  • social standing
• social determinants of health

  • healthy child development
  • social support networks
  • education, literacy
  • employment and working conditions
  • social environments
  • physical environments
  • health practices and coping skills
  • health services and resources
  • gender culture
  • biology, genetic characteristics
• protective factors for indigenous social and emotional wellbeing:

  • connection to land, culture, spirituality and ancestry
  • kinship
  • self determination, community governance, and cultural continuity
• complex and sophisticated kinship system in Aboriginal and Torres Strait Islander peoples

  -> Aboriginal nations bordered off by natural landmarks like rivers, forests etc

       -> within nations are clan groups 

       -> within clan groups are family groups (kinship)

            -> children are attached to and cared for by many adults, including grandparents, aunties, uncles 
• kinship and family life is important for social and emotional well being to Aboriginal and Torres Strait Islander peoples

       -> hence why disruption to family life is detrimental to their wellbeing
• -> central part of social and cultural life

  -> strong families = good health and wellbeing

  -> families are responsible for teaching the social norms for interacting with others, along specific cultural values

  -> also find out who they can and cannot marry 

  -> patrilineal vs matrilineal

  Patrilineal- individual’s clan or lineage is determined by men or male relatives

  Matrilineal- clan or lineage is determined by women or female relatives
• Aboriginal families have a connection to the land 

  Aboriginal and Torres Strait Islander cultures thrive through knowledge of family and kin, connection to country and community.
• ‘Ngangkari’ means healer

       -> The Healing Touch - a traditional healing practice involving Ngangkaris that can see through the body and heal with their hands

  -> Anangu Ngangkari Tjutaku Aboriginal Corporation (ANTAC)

       -> a cooperation of 20 Ngangkari from the Apy lands of remote South Australia

       -> ANTAC aims to have traditional Aboriginal healing next to the Western doctors to provide the option of traditional healing to patients
• 1770 - James Cook claimed possession of east coast of Australia for Britain after claiming it as Terra Nullius (nobody’s land) 
• 1787 - Australia chosen as site of penal colony for Britain, First Fleet arrived in Botany Bay
• Missions were created by churches or religious individuals to house Aboriginal children and train them in Christian ideals

  • typically offered greater physical protection from extremes of violence
  • approx. ten missions established between 1824 - 1923
• Reserves were parcels of land set aside for Aboriginal people to live on and were not managed by the government.
• Between the 1910s and the 1970s, Aboriginal children were forcibly  removed from their families under government policy

  • Rationalised by various governments claiming ‘it is to protect these children’
  • Also rationalised by governments to help ‘breed out’ the Aboriginal blood
  • Some families had up to three generations stolen
• White Australia Policy (1901 - 1973)

  • AKA Immigrations Restrictions Act
  • To prevent  non-Europeans from entering Australia
  • Prevented Aboriginal soldiers from returning from Boer War in South Africa
  • Took 72 years to abolish
• Assimilation Policy (1951)

  • Part of the Stolen Generations
  • Removal of Aboriginal children from their families as a deliberate effort to assimilate them into White Australia
  • Disallowed transgenerational passing of traditions, culture etc
  • Loss of language, culture, 
• Integration Policy (1965-1972)

  • Recognises the reality that assimilation doesn’t actually work
  • A policy to reduce acts of segregation in an attempt to bring all Australians together
• 1967 Referendum

  • Counted Aboriginal and Torres Strait Islander people in the population
  • Meant they could vote