Sorry+is+the+first+step

Sarah Dunk Student number: 8832404 Tutor: Steve Badman



**Present the artefact**
The artefact above is the light display placed in front of parliament house by the aboriginal people at the time when Kevin Rudd apologised to the aboriginal people for the miss-treatment by the Australian government over the past 200 years. The words “sorry is the first step” represents the beginning of the process of acknowledging the wrongs committed against the aboriginals and the beginning of the “Closing the Gap” process.

**Name the public health issue central to your analysis**
The aboriginal people are an important part of Australian history and culture. Their history out dates the European history by what is estimated by over thousands of years. Even though this is the case the aboriginal people as a whole are some of the unhealthiest people within the country having a lower life expectancy of 10 years less than non-aboriginals (Australian Bureau of Statistics, 2013). The “Closing the gap” program was brought in by the Australian government in 2008 to address this issue.

**Literature review**
The aboriginal people were the first known inhabitants of Australia, despite this their average life expectancy is approximately 10 years less than non-indigenous Australians (Aboriginal males 67 years, compared to non-aboriginal males 78 years, Aboriginal females 72 years, compared to non-aboriginal 82 years) (Australian Bureau of Statistics, 2013). The “Closing the gap” program was implemented in 2008 by the Australian government to close this morbidity and mortality difference and improve the overall health of the Aboriginal population in Australia (Biddle & Wilson, 2008).

There are several main contributing factors that have an effect of the health of the aboriginal population in Australia. The oldest contributing factor is the European settlement within Australia. When the European settlement was first established in Australia, the aboriginals were forced out of their native lands and either killed or enslaved. Since then they have been miss-treated by the Australian government by discrimination not having the same rights as white people, the time of the stolen generation and even in recent time’s discrimination when it comes to attaining employment (Biddle & Wilson, 2008 & Paradies, 2005). The geographic location of aboriginal people is another factor affecting their overall health as most 68% live in regional and remote areas (Australian Bureau of Statistics, 2011). Because of this, access to health care facilities, education facilities are limited and employment opportunities are scarce. Due to this there are a large number of aboriginals in these rural areas who are unemployed and engaging in potentially harmful health behaviours (ABS, 2013 & Whelan & Wright 2013).

The health of the aboriginal people has been a large concern for the government since the public apology by Prime Minister Kevin Rudd in 2008. With his public apology to the aboriginal population he declared that he would implement certain health improvement strategies catered to the aboriginal population (The Australian, 2008).



This is in response to the previous strategies that were used by the government to improve aboriginal health. These were undertaken by the previous Prime Minister John Howard in 2007. These approaches were defined as “business like” and were not catered specifically to the cultural and social behaviours of aboriginal life (Biddle & Wilson, 2013). Alcohol abuse and domestic violence are a key issues within the aboriginal communities of the Northern Territory. Another difficulty was the public housing of these rural communities. These health issues were addressed by the government by bringing in troops to “supervise” and watch for any violence while doctors were brought in to assess the health of the community. Funds were allotted to improve the schools and public housing of the community. Another strategy that was used was to bring in alcohol bans within the rural aboriginal communities. These strategies were implemented without guidance of the local elders of the aboriginal community or without the government knowing in depth the region in which they visiting. For these reasons these approaches were not as successful at improving aboriginal health. And as stated by Martin (2012), the aboriginal people saw this intervention as more of an invasion and simply as a return of older forms of domination by the government. These approaches were accessed by examining the health practices of the aboriginal communities to identify if there was an improvement as well as measuring risky behaviours within health statistics (ABS, 2013 & Biddle & Wilson, 2008).

Prior to 2008 it seemed that the aboriginal people were rejecting all forms of help given to them by the government. When the government improved their homes, they tore up floorboards for use as fire wood. Then the government banned alcohol in areas in their community they left their community and sat on the borders of the community drinking until they ran out of alcohol. A question then being asked by the community was then, “Why are we helping them if they aren’t accepting our help?” This the case until 2008 when the government changed there was a change in the approach to aboriginal health and instead of the “one size fits all” previously in place, the needs of the aboriginal community were actually considered when planning strategies to improve overall health (Martin, 2012).

Improving aboriginal health is a major concern of the Australian government. But is the government really considering all of the needs of the Aboriginal people when implementing their health programs?

Due to 68% of aboriginal people living in regional and remote areas their access to health care is not as easily accessible as those who live in the city or suburban areas. Research has shown that the aboriginal people in remote areas do use the health facilities nearest to them however due to the low numbers of these facilities there are waiting lists to gain access to the health care provided to them. As well as this, only basic health care is provided at these facilities and if additional treatment is required they must then travel further and receive the treatment under private health. Due to the low income levels, private health insurance is un-affordable and treatment is not possible (Boffa, 2008).

The full extent of this issue cannot be fully understood without visiting these aboriginal communities. Most of the research conducted is based on the statistics provided by the Australian Bureau of Statistics. The question then being considered is, are all aboriginals within these regional and remote areas being counted in these statistics? Are the health conditions of only those who attend health facilities being counted? What about those who aren’t attending these health facilities? By visiting or reporting from within the actual aboriginal communities a greater gauge of the health practices of the Aboriginal people could be ascertained. Although some research is conducted using this method most is based on statistics (ABS, 2013 & Martin, 2008).

The morbidity and mortality difference between aboriginal and non-aboriginal people in Australia is slowly decreasing as aboriginal health is starting to be improved. Social, environmental and geographical factors need to be considered and implemented into these health interventions if this “gap” is truly going to be closed.

**Cultural and social analysis**
The Australian Aboriginal culture is individual, unique and ancient. To understand the true behaviours and beliefs of the Aboriginal people this culture needs to be recognised and understood. Health interventions need to be developed with this culture in mind. A large factor to consider as well when it comes to the social influences behind Aboriginal behaviour is the original domination of the Europeans throughout history. Europeans came to their country, brought foreign items such as alcohol, killed or enslaved their people and years later stole and relocated their children (Australian Government, 2009). Aboriginal values, attitudes and beliefs were marginalised during this time. With the colonisation of European people, the Europeans tried to abolish this culture and try to stop Aboriginal dreaming practises being practised throughout the country. This resulted in some aboriginal people being lost and resentful of the government, leading to mistrust (Martin, 2008).

The colonisation of Europeans in Australia have had damaging affects for the aboriginal people and overtime these negative effects have had damaging mental effects on the aboriginal people leading to damaging physical effects on their health (ABS, 2013 & Shepherd 2013). Social theory of Marxism ties in here with the mistreatment of the Aboriginal people over time and how this mistreatment has negatively affected the health and life outcome. The social theory of “otherness” also relates to the aboriginal people versus non-aboriginal as within history the government counted the aboriginal people as a “problem that needed to be addressed” or a group of people who were “different”. To have a successful health intervention of improving the aboriginal people these social, cultural and historical determinants need to be considered (Biddle & Wilson 2013).

Previous health interventions not considering these determinants have failed to be successful in affecting positive outcomes. These interventions have had negative effects on the aboriginal community with feelings that the government is once again trying to dominate their communities without having any real insight. Due to the health interventions failing there are still the negative health consequences on aboriginal health and risk factors leading to poor health are still apparent and the aboriginal people continue to suffer. Failed health interventions then negatively effecting the rest of the Australian community with tax money being spent on failed health interventions and resentment towards Aboriginal people for thinking that their tax payer funds have been wasted when the problem lies more in poor planning for health intervention solutions (Martin 2008).

Current interventions have been tailored to consider these social and cultural determinants and there has been a small success with the morbidity and mortality difference between indigenous and non-indigenous Australians slowly closing. Other cultural and social factors such as geographical location and low income levels need to now be considered if health interventions are expected to work with 68% of Aboriginals living in regional and remote areas therefore having limited access to employment (ABS, 2013 & Biddle & Wilson, 2013 & Boffa, 2008).

The elders of the community also have a high level of influence and respect among the Aboriginal people within their community. Due to the fact that they also reside within the community they know their community personally and know the full extent of the issues among the community. To incorporate the elders into the health intervention programs would have positive outcomes on the intervention (Martin, 2008).

This artefact represents a historical day for the Aboriginal People. After years of being neglected, discriminated against and mistreated by the Australian Government they received an apology for the wrongs committed against them. This apology by the Prime Minister Kevin Rudd, stated the terrible mistakes the previous Australian government had made by forcibly relocating Aboriginal children to care other than their own biological parents in the time of the “Stolen Generation”. The artefact represents the acknowledgement of the aboriginal people as the true first people of Australia and an important part of Australian history and culture. It also represents the improvement of the Australian society in acknowledging that they have committed wrong and that they are working towards improving the future.
 * Analysis of the artefact and analysis of your own learning reflections**

Personally, this artefact represents the ability of the government to be able to admit that they have wronged a particular part of Australian society. I feel that shows that the people of Australia are equal to those in power and the government makes mistakes just like everyone else. It also means that the government is acknowledging there is a problem within the aboriginal community reflected by their health and this is something that needs addressing. The artefact definitely represents the topic of this wiki, being an image that represents the government apology to the aboriginal people and also represents the beginning of the “closing the gap” program to address poor health within aboriginals.

This topic has definitely positively affected my future learning and thinking process. After having conducted large amounts of research on this topic I have learnt that health interventions need to be catered towards the individual or individuals rather than a “one size fits all” approach. This is reflected in previous government attempts to improve the health of the aboriginal people and reflects in current work.



**Reference list**
Australian Bureau of Statistics. (2013). 2076.0- Census of Population and Housing: Characteristics of Aboriginal and Torres Strait Islander Australians, 2011. Retrieved September 24, 2013 from http://www.abs.gov.au/ausstats/abs@.nsf/Latestproducts/2076.0History%20of%20Changes02011?opendocument&tabname=Summary&prodno=2076.0&issue=2011&num=&view

Australian Bureau of Statistics. (2013). 3302.0.55.003- Experimental Life Tables for Aboriginal and Torres Strait Islander Australians, 2005-2007. Retrieved September 24, 2013, from http://www.abs.gov.au/AUSSTATS/abs@.nsf/ProductsbyTopic/CF0C0E3E7B18A649CA2575BE0012A78B?OpenDocument

Australian Bureau of Statistics. (2013). 4704.0 The Health and Welfare of Australia’s Aboriginal and Torres Strait Islander Peoples, Oct 2010. Retrieved October 27, 2013 from http://www.abs.gov.au/AUSSTATS/abs@.nsf/lookup/4704.0Chapter210Oct+2010

Australian Government. (2009). Sorry Day and the Stolen Generations. Retrieved September 25, 2013, from http://australia.gov.au/about-australia/australian-story/sorry-day-stolen-generations

Biddle, N. & Wilson, T. (2013). Indigenous Australian population projections: problems and prospects. //Journal of Population Research.// doi: 10.1007/s12546-013-9104-2

Boddington, P. (2009). Theoretical and Practical Issues in the Definition of Health: Insights from Aboriginal Australia. //Journal of Medicine and Philosophy, 34//(1) 49-67. Doi: 10.1093/jmp/jhn035

Boffa, J. (2008). Cancer care for Indigenous Australians. //Medical Journal of Australia, 188//(10) 560-561. Retrieved from http://search.proquest.com.ezp01.library.qut.edu.au/docview/235683066/abstract?accountid=13380

Brown, A., Walsh, W., Lea, T. & Tonkin, A. (2005). What becomes of the Broken Hearted? Coronary Heart Disease as a Paradigm of Cardiovascular Disease and Poor Health among Indigenous Australians. //Heart, Lung and Circulation, 14//(3) 158-162. Retrieved from http://www.sciencedirect.com.ezp01.library.qut.edu.au/science/article/pii/S1443950605000727

Gwynn, J., Flood, V., D’Este, C., Attia, J., Turner, N., Cochrane, J., Louie, J. & Wiggers, J. Poor food and nutrient intake among Indigenous and non-Indigenous Australian Children. //BMC Paediatrics, 12// 12. doi: 10.1186/1471-2431-12-12

Kenworth, C. (2000) Re-presenting colonisation: a post-colonial reading and Aboriginal reconciliation in the Australian secondary classroom. //Social Educator, 18//(1) 37-53. Retrieved from http://search.informit.com.au.ezp01.library.qut.edu.au/fullText;res=AEIPT;dn=118751

Martin, J. (2012). Intervention in Aboriginal Life. //New Blackfriars 93//(1047) 505-515. Doi: 10.1111/j.1741-2005.2011.01469.x

O’Sullivan, D. (2012). Justice, culture and the political determinants of Indigenous Australians health. //Ethnicities 2012, 12// 687. doi: 10.1177/1468796811432697

Paradies, Y. (2005). Anti-Racism and Indigenous Australians. //Analyses of Social Issues and Public Policy, 5//(1) 1-28. doi: 10.1111/j.1530-2415.2005.00053.x

Shepherd, C., Li, J. & Zubrick, S. Social Gradients in the Health of Indigenous Australians. //American Journal of Public Health, 102 (1)//107-117. Retrieved from http://search.proquest.com.ezp01.library.qut.edu.au/docview/1004791526/abstract?accountid=13380

The Australian. (2008). Full transcript of PM’s Speech. Retrieved October 20, 2013, from http://www.theaustralian.com.au/news/nation/full-transcript-of-pms-speech/story-e6frg6nf-1111115543192

Whelan, S. & Wright, D. (2006) Health services use and lifestyle choices of Indigenous and non-Indigenous Australians. //Social Science & Medicine, 84// 1-12. Retrieved from http://www.sciencedirect.com.ezp01.library.qut.edu.au/science/article/pii/S0277953613000865?np=y

=**Reflection Task**= “Close the gap, a campaign 200 years late” http://healthcultureandsociety2013.wikispaces.com/Close+The+Gap%2C+A+Campaign+200+Years+Late Your wiki was an enjoyable and informative read. I especially liked that not only did you incorporate statistics regarding the current health practices of the Aboriginal people to confirm your point but you also mentioned the reasons why the aboriginal people have such poor health. I also think that people who read this who weren’t aware of this health issue and the historical factors behind it would realise why there is that level of mistrust between indigenous against non-indigenous people. I also agree with you that this close the gap program was implemented 200 years too late and that the aboriginal people were treated so poorly that it’s surprising that an apology was not given to them sooner for their mistreatment. After looking at statistics from previous years you are able to see how much of an impact (even though it’s only small) the close the gap campaign is having. Great job. Fantastic read.

“Overconsumption kills” http://healthcultureandsociety2013.wikispaces.com/Overconsumption+Kills Your wiki was incredibly informative and quite enjoyable. I also share the same opinion of that eating meat should definitely not be stopped as I thoroughly enjoy my steak. Not only have you outlined that you don’t have to not eat meat to be healthy you have also outlined that even cutting down on intake of meat will be overall, better for society. When reading up on this topic as well I couldn’t help but think of the limitations in evidence which you have also outlined in your page regarding portion sizes and that obesity within those consuming meat could also be due to other factors such as insufficient amounts of physical exercise rather than just consuming meat. Your wiki has looked at the view of meat consumption from a different angle. I would definitely rather support flexitarianism rather than the vegetarian/vegan approach. Good job and it was a fantastic engaging read.