Smoking+out+a+Generation

Tutor: Mangalam Sankupellay
Smoking out a Generation



= The Artefact =

The Kimberly Aboriginal Medical Services Council produced this anti-smoking campaign that was aimed directly to Indigenous Australians. This poster depicts the traditional Indigenous culture in an educational way to entice the indigenous population to stop smoking and understand that it is bad for your health. Smoking is a big killer for the indigenous population with high percentages of smokers between adult and children. This artefact portrays a less mainstream approach to an anti-smoking campaign. It has been established purely for the indigenous population with the hope that portraying the traditions of Indigenous Australians can help decrease the amount of smokers.

= Public Health Issue =

Smoking within the indigenous population is the public health issue that this artefact deals with. This issue is one of many health issues that affect the life expectancy and illness rates among the indigenous population. Reducing the percentage of smokers can help in closing the gap as the health risks that are associated with smoking can be reduced The amount of indigenous Australians who smoke is high considering the size of the indigenous population. It is not just adult who are smoking but children and adolescents and even pregnant women. Education about the public health issue needs to address all age groups to be able to try to reduce the cycle of indigenous Australians and smoking.

=Literature Review =

====The indigenous population is at about 520,00, which is only 2.5% of the total Australian population (ABS,2007), yet 45% of the indigenous population are smokers (ABS,2011). This high level of smokers directly contributes to the gap in life expectancy for the indigenous population. Tobacco smoking is the highest contributor towards the gap and is also the most preventable risk that is associated to the high mortality rate for the indigenous (AIHW, 2011). ==== ====Smoking can cause lung diseases, cardiovascular diseases and many types of cancers (Queensland Government, 2013). These diseases can all be prevented when they are associated with tobacco use. ====

====Unfortunately, the number of indigenous women who smoke during their pregnancy is quite high. Smoking when pregnant can cause a great deal of harm to the unborn baby. This harm can also affect the health of the child right through to adulthood. This includes ectopic pregnancies, miscarriages, premature labour, Sudden Infant Death (SIDS) and asthma and other respiratory problems (State Government of Victoria, 2013). Compared to the level of non-indigenous Australian women who smoke, indigenous women who smoke is significantly higher. In 2003 alone, 53% of women who gave birth said that they had smoked during their pregnancy, up from 14% for non- indigenous women (Woods, et al, 2008) ====

====In the last 15 years, the Australian Government has only really started to try to significantly make the health care for the indigenous people better. The Australian Government endorsed the Closing the Gap strategy in 2008. It aims to achieve health equality for the indigenous people of Australia within 25 years (Australian Indigenous Healthinfonet, 2010). In regards to tobacco smoking, in 2008 the Australian Government invested $14.5 million to the indigenous tobacco control initiative (Australian Government, 2011). This money was to use during a 4 year duration aimed to find effective measure deal with the high levels of smokers within the indigenous population. ====

====Under the closing the gap scheme, the government also said that they would aim to aid in decreasing the smoking rate. This included: ====
 * ====Recruitment and training of a new tackling smoking workforce ====
 * ====Working with communities to establish relevant marketing campaigns and activities ====
 * ====Enforce training program for health workers and educators ====
 * ====Provide more culturally aware quit lines for the indigenous culture. ====

====In 2010 the government included in the National Health Reform, 27.8 million to reduce high level smoking in disadvantaged groups who are difficult to reach through mainstream ways ( Australian Government, 2010). This disadvantage group includes many indigenous people due to the lack of the effectiveness that most mainstream campaigns have towards the indigenous population. ====

====Before recent years, addressing the issues in regards to indigenous health was very poor. It was only in 1967 when aboriginals and islanders where included on the census and in 1973 that the first Plan for indigenous health was made by the government ( NACCHO, 2012). Before then and up until recent years, not much significant and ongoing attempt was made by the government to help the health of the indigenous population. ====

====With the information out about the health risk associated with smoking, how is it possible for the statistics to be so high for the indigenous population compared to the non- indigenous population? Campaigns and advertising measures need to be tailored towards the indigenous culture to help provide the information to them to help them with their smoking levels. With the recent laws in place that limits almost all forms of advertisement of cigarettes, this has made Australia one of the leading countries for tobacco control (Bond, C at al, 2012). Unfortunately, this tight control hasn’t significantly budged the rate of indigenous smokers. Therefore, it is seen that changing anti-smoking campaign from a mainstream form to a more unique form is needed to cut down the rate or smokers. ====

====<span style="font-family: Arial,Helvetica,sans-serif;">Out of all of the health workers in Australia, only 1% identifies themselves as being an Indigenous Australian (ABS, 2008). Together with providing knowledge about indigenous health to all those in the health industry, increasing the amount of indigenous health workers can help improve the over all health. (Anderson, I at al, 2009). Increasing the amount of indigenous health workers would have a great affect on decreasing the smoking rate. With more indigenous health workers, more of the population will be comfortable in going to seek help and support. With the money that the government has promised to use to help closing the gap, it is important that effective measures are used to allow this money to be used in an effective way that helps the overall health. ====

=<span style="color: #ff0000; font-family: Arial,Helvetica,sans-serif; font-size: 12pt;">Cultural and Social Analysis =

====<span style="font-family: Arial,Helvetica,sans-serif;">Evidence shows that tobacco smoking in the indigenous population is related to their socio-economic status(Australian Government, 2011).Who you live with, if you work and where you live are all factors to smoking levels within the indigenous population. <span style="font-family: Arial,Helvetica,sans-serif; font-size: 1.066em; line-height: 1.5;">Although most indigenous people smoke for the same pleasures as non-indigenous people, there are some other reasons that cause them to smoke. These are both in regards to past and present situations. The colonisation, racial discrimination and lack of education, employment, housing and health care are some added reasons that makes the indigenous population at a higher risk of smoking( Woods, et al, 2008). The theory of ‘otherness’ can be a dominating influence on the health of the indigenous population. Are the smoking levels higher for the indigenous due to societies viewing them as others? Is it the government’s fault that the overall health of the indigenous population is significantly worse then non- indigenous due to lack of care? To be able to help the indigenous population to be healthier, a shift in ideology is needed. It is vital that cultural and socio-economic issues that indigenous face are tackled to allow for a more balanced society. Thus, providing an overall better health for the indigenous allows for a greater chance at reconciliation of indigenous and non-indigenous. ====

====<span style="font-family: Arial,Helvetica,sans-serif;">Indigenous Australians are one of the most disadvantaged groups in Australia, with a lot living in poverty, unemployed, homeless or growing up in a broken home. All of these social factors would have a great effect on someone’s overall health. For indigenous people, social and culture has made tobacco use the norm and as a coping mechanism for stress (Woods, et al, 2008). <span style="font-family: Arial,Helvetica,sans-serif; font-size: 1.066em; line-height: 1.5;">Geographically, many indigenous people have limited access to healthcare. Due to remoteness around 35-40% of the indigenous population have an insignificant or absolutely no health services in their area (ABS, 2011). Even with those who do have the services available, may not be using them in an effective way. In the indigenous culture, those who do live in one household may include immediate relatives, distant relatives and even friends. Therefore, if the majority of those living in one household do smoke, then the likelihood that others would start to smoke could potentially be very high. Unemployment in the indigenous population is very high (ABS, 2010), which in turn would lead to more socialising within the community. This extra free time could potentially lead people to participate in risky health behaviours. ====

====<span style="font-family: Arial,Helvetica,sans-serif; font-size: 1.066em; line-height: 1.5;">Like for anything in life, education is essential in getting people to learn about a problem. Therefore, to tackle the smoking problems that face the indigenous population, it all starts with providing education and support towards the communities. Children grow up seeing their parents and other family members smoking, which in turn can be a reason that they begin to smoke. Breaking this cycle and providing education to show the risk that come with smoking is vital to help close the gap. To educate from a young age, the importance that not smoking has to a persons health, can lead to them teaching others in their community the health risk that these behaviours could have on them. ====

====<span style="font-family: Arial,Helvetica,sans-serif;">In the Australian constitution, Indigenous Australians are still not recognised as being the first people of Australia (Oxfam, n.a). This alone would have a great effect on someone’s mental health. The fact that our own country doesn’t recognise that the indigenous Australians were the first people shows that society still has a long way to go to recognising the issues that face the health of the indigenous population. Even non-indigenous Australians need to be educated on the health issues that the indigenous population face. In today’s Australian society, we do not know much about what the indigenous population had to face in the past that lead to the present issues. In school we were only taught about the dreamtime and the traditions of the indigenous culture. We know more about the poverty and health issues of people living in other countries then we do of the first people of our own country. This lack of knowledge can partially be from the ‘otherness’ that society has put on Indigenous Australian and what we are shown through the media. ====

=<span style="color: #ff0000; font-family: Arial,Helvetica,sans-serif; font-size: 12pt;">Analysis of Artefact =

====<span style="font-family: Arial,Helvetica,sans-serif;">This artefact depicts the importance of providing an accurate and culturally adapted campaign for the indigenous population. This artefact depicts smoking, which is one of the major preventable health risks for the indigenous population. For me personally, I find it quite surreal that the health of the indigenous population is so poor compared to the rest of Australia. This artefact appealed to me as I like how to try and stop people from smoking, an indigenous organisation has been able to provide a non-mainstream approach to it. It irritates me when I hear people talking about indigenous health saying phrases such as, “we have tried helping them and they don’t want help”, “ they are putting this on themselves”. As a non-Indigenous Australian, I don’t think that our society could even comprehend how all of the past issues towards the indigenous can effect today’s generations. I don’t think I could say that this assessment piece will affect my future thinking. For me, it has more opened my eyes all the issues that the indigenous population face that I honestly had no clue about. I feel that it is a bit disappointing that we are not taught more about the aboriginal history in school and through mainstream media. ====

= References =

https://www-mja-com-au.ezp01.library.qut.edu.au/journal/2009/190/10/indigenous-medical-workforce-development-current-status-and-future-directions?0=ip_login_no_cache%3D174aef4cedfa72068d149094c044fca6
 * Anderson, I., Ewen, S., Knoche, D, (2009). Indigenous medical workforce development: current status and future directions. **** //The Medical Journal of Australia//. 190 (10), pp.580-581. Retrieved from: **


 * Australian Bureau of Statistics (2007). **** //Population Distribution, Aboriginal and Torres Strait Islander Australians, 2006// . Retrieved from: http://www.abs.gov.au/ausstats/abs@.nsf/mf/4705.0 **


 * Australian Bureau of Statistics (ABS) (2008). **** //The Health and welfare of Australia's Aboriginal and Torres Strait Islander Peoples 2008//. Retrieved from: http://www.ausstats.abs.gov.au/ausstats/subscriber.nsf/0/51B575E133A75C6DCA2574390014EDFE/$File/47040_2008.pdf **

http://www.abs.gov.au/websitedbs/cashome.nsf/4a256353001af3ed4b2562bb00121564/3fa8ec177831c470ca25758b001232d2!OpenDocument
 * Australian Bureau of Statistics (2010). //Indigenous statistics for schools//. Retrieved from: **


 * Australian Bureau of Statistics (2011). **** //ACCESS TO HEALTH AND COMMUNITY SERVICES: ACCESS TO HEALTH SERVICES//. Retrieved from: http://www.abs.gov.au/AUSSTATS/abs@.nsf/lookup/4704.0Chapter955Oct+2010 **


 * Australian Bureau of Statistics (2011). **** //The Health and Welfare of Australia's Aboriginal and Torres Strait Islander Peoples, Oct 2010.// Retrieved from: http://www.abs.gov.au/AUSSTATS/abs@.nsf/lookup/4704.0Chapter755Oct+2010 **


 * Australian Institute of Health & Welfare (AIHW) (2011). **** //Anti-tobacco programs for Aboriginal and Torres Strait Islander people// . Retrieved from: https://www.aihw.gov.au/uploadedFiles/ClosingTheGap/Content/Publications/2011/ctgc-rs04.pdf. .  **


 * Australian Government (2010). **** //A National health and Hospital Network for Australia's Future.// Retrieved from: http://www.yourhealth.gov.au/internet/yourHealth/publishing.nsf/Content/DeliveringTheReforms/$FILE/DeliveringTheReforms.pdf **

http://www.health.gov.au/internet/publications/publishing.nsf/Content/health-oatsih-pubs-framereport-toc/$FILE/HPF%20Report%202010august2011.pdf
 * Australian Government (2011). **** //Aboriginal and Torres Strait Islander Health Performance Framework// . Retrieved from:  **


 * Australian Indigenous Healthinfonet (2010). **** //What is closing the gap?// . Retrieved from: http://www.healthinfonet.ecu.edu.au/closing-thegap/key-facts/what-is-closing-the-gap  **


 * Bond, C., Brough, M., Spurling, G., Hayman, N., (2012). ‘It had to be my choice’ Indigenous smoking cessation and negotiations of risk, resistance and resilience. **** //Health, Risk & Society//. 14 (6), pp.pages 565-581. **DOI:**10.1080/13698575.2012.701274**


 * National Aboriginal Community Controlled Health Organisation (NACCHO) (2012). **** //A brief overview of Aboriginal Health to 1967// . Retrieved from: http://www.naccho.org.au/aboriginal-health/overview/.  **

https://www.oxfam.org.au/explore/indigenous-australia/recognising-aboriginal-and-torres-strait-islander-people-in-the-australian-constitution/
 * Oxfam (n.a). **** //Recognising Aboriginal and Torres Strait Islander People in the Australian Constitution// . Retrieved from:  **


 * Queensland Government (2013). **** //Smoking Information// . Retrieved from: http://www.health.qld.gov.au/quitsmoking/smoking_info.asp#2.  **


 * State Government of Victoria (2013). **** //Pregnancy and smoking// . Retrieved from: http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Pregnancy_and_smoking.  **


 * Wood, L., France, K., Hunt, K., Eades, S., Slack-Smith, L., (2008). Indigenous women and smoking during pregnancy: Knowledge, cultural contexts and barriers to cessation. **** //Social Science & Medicine//. 66 (11), pp.2378–2389. Retrieved from: ** []

= Learning engagement: =

Link one: http://healthcultureandsociety2013.wikispaces.com/%27Rip+%26+Rolled%27+Practicing+Safe+Sex

Link two: http://healthcultureandsociety2013.wikispaces.com/%27The+Junkie%27+Moral+panic%2C+stigma+and+the+road+to+recovery