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Task Aim: To enable you to critically analyse the impact of history and colonisation on contemporary First Peoples’ health outcomes and how this influences trustful and respectful relationships with Australia’s First Peoples.
Part A: Critically analyse the impact of history and colonisation on contemporary First Peoples’ health outcomes and how this has influenced Australia’s First Peoples ability to build trustful and respectful relationships within the healthcare system
Part B: Identify and discuss strengths based approaches that a health practitioner might use to build trustful and respectful relationships with First Peoples, on an individual and/or community basis
Your level of critical analysis will be marked using a scale adapted from Patricia Benner’s ‘From Novice to expert’ (Benner, 1982), outlined in the scale below. To analyse is to “identify all the components and the relationship between them”. To ‘critically analyse’ is to “provide a level of depth, accuracy, knowledge, questioning, reflection and quality to your analysis (Benner, 1982).
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The Australian First People have been subjected to poor healthcare outcomes, which are as a result of history and colonialism. Historically, the First People were subjected to increased systematic and structural exclusion, which subjected their community to lack of healthcare and communal development. Also, the cultural practices have restricted access to healthcare, as they continue to prefer their age-old tradition to proper healthcare. In this regard, the following article examines the effect of historical and colonial practices on contemporary First People health outcomes, and how it impacts respectful and trustful relationships.
Almost, since the start of colonization, the First People were subjected to the introduction of diseases, and the loss of their livelihood and land. The imperial colonialists introduced diseases, such as, Small Pox, which wiped out entire tribes. However, in spite of the high loss of life, little was done to offer medical care and aid to the populations (Baeza and Lewis, 2010). In 1837, decades after the first frontier violence from the imperial colonialists, the protection policy was enacted. The protection policy remained in effect for the next century, and as a result, reserves were created, the First People populations were segregated on government settlements and missions, and it was to prevent the widespread of contagious diseases to the population (Bourke et al., 2012). Throughout this era, the prevailing attitude is that the First People were inferior to the white population, and would eventually die out. From the 19th to the late 20th centuries, legislations were enacted to empower the ‘protectors’ and separate the mixed race, and also, remove children from their families was progressively passed to the Northern Territory and other states. In some states, the mixed race people were forced to leave their reserves (Davidson et al., 2010). There have been direct effects of colonial policies, and colonialism of Indigenous health outcomes, for instance, the introduction of contagious disease, like Small Pox, the extinction of Beothuk4, and the adverse experiences of the educational and healthcare system, has resulted in the lack of trust in the existing practices. The lack of trust in the First People society is as a result of, structural and systematic approaches, which were created to continue to subject them to a poor state of health (Day and Francisco, 2013).
It is essential to understand their history and cultural ways of life to recognize the cultural adaptations of the contemporary first people. The Australia’s first people have deep roots in the past, which continues to be unrivalled anywhere across the globe (Durey, 2010). However, far from signifying the end of the First People Indigenous Australian cultures and traditions, a new type of adaptations are resulting in new vitality to older cultures and values, which need to be addressed. The contemporary First People face significant challenges in health outcomes, as a result of their cultural history. The cultural practices of the First People do not support proper health (Durey et al., 2011). As a result, the First People are subjected to increased health risks. Furthermore, the lack of access to educational and health has subjected First People to age-old medical practices. The First People do not have equal access to primary health care facilities and infrastructure, which includes efficient sewerage systems, safe drinking water, healthy housing, and rubbish collection (Freeman et al., 2014). Hence, a majority of the First People live in circumstances, which do not support proper healthcare practices. The lack of healthcare facilities have limited the access to medical care, and thus, subjected them to age-old practices.
The health status of the Australia’s First People is poorer when compared to the rest of the population. There is a large inequality gap in the Australian society across all health sectors. For instance, the life expectancy gap between the First People and the rest of the Australian community is 17 years (Day and Francisco, 2013). Also, the mortality rate First People below the age of 65 years is twice as much as the rest of the population. The First People do not have the same opportunities to be healthy as the rest of the population. The relative socio-economic disadvantage subjected to the First People during the colonization period resulted in a lack of adequate investments in education, healthcare, and infrastructure in their areas. The lack of investments placed the First People has increased their susceptibility to health risks (Marmot, 2011). The inequality of the health outcomes experienced by the First People can be linked to the cultural history and systematic discrimination as a result of colonialism. Thus, present healthcare approaches were created during the colonial era, and thus, it is not suited to enhance the healthcare outcomes of the First People. Historically, the First People have not been offered the same opportunity to advance their healthcare outcomes, like the rest of the population (Williamson and Harrison, 2010). It is as a result of the lower access to healthcare, and in access to mainstream medical services, including inadequate provision of infrastructure to First People and primary healthcare. Thus, the current healthcare problems can be described as cultural, systematic, and avoidable. This legacy remains a problem in the contemporary First People, and subsequent governments have failed to address this problem, to the full enhancement of healthcare outcomes to the First People (McBain-Rigg and Veitch, 2011).
However, although there has been an improvement in the First People healthcare outcomes, they have failed to match the rapid gains made by the entire population in Australia. For instance, the prevalence of death from cardiovascular disease in the general population, since 1991, have reduced by 30% and 70% in the past three decades, while the First People have not made any significant reduction in death rates over a similar period (Baeza and Lewis, 2010). Hence, to improve the healthcare outcomes of the First People society, much needs to be carried out to compensate for the systematic and structural disadvantages that they have been subjected to (Durey, 2010). In this regard, the state must change its structural and systematic policies, and tailor it to improve access to healthcare in their communities. Addressing the physical and economic barriers to health care, such as, offering medical care locally helps to improve the level of trust and respect (Davidson et al., 2010). The localization of healthcare at the First People communities enhances their response to health care. Also, the level of trust and respect to health care can be improved through addressing cultural competence, suitability, and acceptability through strategies like developing services around the holistic healthcare model of wellbeing and respects that are indigenous specific healthcare. Working through the kinship and elder networks, the healthcare approaches can be adapted to healthcare to suit the First People in both non-indigenous and indigenous settings (Day and Francisco, 2013).
The colonial and historical practices have subjected the First People to increased poor health outcomes. The First People experience poor healthcare outcomes when compared to the other population. The poor health outcomes are inherently linked to the colonial practices, which have been propagated to the contemporary society. The current systematic and structural approaches to healthcare have restricted their access to healthcare, and thus, have not improved medical care. Also, the colonial practices, such as, introducing small pox, have lowered the trust and respect that the communities have on governmental approaches. Thus, the government must adopt measures that alleviate economic and physical challenges, and culturally appropriate, competent, and acceptable strategies to enhance trust and respect to the healthcare.
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