Historical and Current Social Determinants of Health for Indigenous Australians

Health and well-being disparities have characterized Australian communities for a long time now with the members of the Aboriginal and Torres Strait Islander People contending with the most adverse healthcare outcomes (Australian Human Rights Commission, 2007). Indeed, the United Nations have since dared to label these disparities a human rights issue in Australia and the Australian federal, state and territorial governments accepting it as such (Dudgeon, et al., 2010). A great deal of historical and current social determinants of health, as well as existing health care policies and services, explain the emergence and progress of this situation. Against this backdrop, this paper will endeavor to extrapolate though comparison the historical and current events as well as healthcare policies and service provision impacting health risks factors and/or influencing health and wellbeing outcomes of two diverse Australian groups: Indigenous Australians and Chinese Immigrants.

The plight of Aboriginal and Torres Strait Islander People relating to their continuous adverse health and wellbeing outcomes dates back to the colonial period when the British Empire first set foot on the Australian soil in 1788 (McBain?Rigg, & Veitch, 2011). These indigenous groups who were then and still significantly are hunters and gatherers were pushed from their ancestral homes to remote regions of Australia by the British colonizers. These remote regions where most indigenous Australians still reside today have been left behind both socially and economically creating an ample platform for long-term health and wellbeing plight (Commonwealth of Australia, 2013). Moreover, due to their perceived timidity and cultural orientation, these people have further been subjected to more suffering as they are stereotypically seen to be primitive and backward (Waterworth, et al., 2015).

The British empire immediately declared Australia as devoid of human inhabitants and pre-existing civilization and moved ahead to settle and possess it despite the presence of Aboriginal and Torres Strait Islander People. This was declared under the doctrine of terra nullius. The British Empire instituted perceived human occupancy and developed western culture civilization (O’Dowd, 2011). Any resistance from indigenous Australians was met by punitive massacres like the 1838 one that saw 300 Aborigines lose their lives in just three days while those living in Tasmania being literally wiped out altogether (Pilot Guides, 2018). Through the Assimilation policy, the Australian government sort to eliminate the indigenous people in 1900s by removing and separating indigenous children from their parents to acquire white culture on the premise of “white supremacy” over “black supremacy” leading to “Stolen Generations” emergence (Home, 1997). Stolen Generations descendants continue to suffer adverse health and wellbeing related to the atrocities their fore generations were subjected to.

Impact of Healthcare Policies on Indigenous Australians

In the 1800s, indigenous Australians were locked in reserves where they would live in deplorable and abusive conditions and subjected to forced labor besides being locked out from national census. Exemption policies of the 1940s and 1960s acted to break indigenous families more as they involved conditions of denying association with indigenous communities and cultures. This effectively took away the indigenous community’s self-esteem and trust tying them together as communities (Australian Indigenous HealthInfoNet, 2017). Despite there being tremendous efforts to change this adverse historical narrative including the abandonment of the assimilation policy,  citizenship status acquisition, and recognition of Australia under the Native Title, and a public apology, the Indigenous People continue to suffer adverse determinants of health today (Human Rights and Equal Opportunity Commission, 2008).

Australian Institute of Health and Welfare (2018) indicate that indigenous people today continue to face humiliation episodes of discrimination, intimidation, abuse, physical violence, sexual harassment, police brutality, and incarceration which further promote their adverse health outcomes. They are also likely to be involved in drugs and substance, uneducated and underemployed or completely locked out of formal employment.

The healthcare policies currently operating in Australian are high of a Western Culture with the biomedical modeling being the prime means of delivering healthcare services. Though relevant to the contemporary Australian society, Herring, Spangaro, Lauw, & McNamara, (2013) assert that indigenous people do not only attach significance to modern healthcare strategies and approaches but also attach a lot of importance to holistic health and wellbeing facets. These include community self-esteem and dignity; physical environment; connection to spirituality, body, mind, emotions, family, kinship, ancestors; and social justice. As such, mismatches between this sociocultural orientation and modern healthcare policies and healthcare service delivery explain the continuousness of negative healthcare outcomes within Indigenous communities (First Peoples Disability Network, 2017).an primarily motivated by trade and gold mining in Bendigo and Ballarat. The Chinese arrived in Australians early as the 1800s and their numbers swelled besides the passing of policies restricting immigration into Victoria in 1855 owing to porous borders (Bagnall, 2011). The Chinese immigrants faced many challenges and hardships in the goldfields including prejudice and general discrimination. However, their influence in this period marked a long-term effect in Australian history through the establishment of Chinatowns in most Australian cities which greatly impacted their general health and well-being positively. Moreover, at the end of the gold rush in the 1880s, many Chinese immigrants remained in Australia where they continued in business especially in banana trade and others took jobs in different fields further strengthening their positive social determinants of health (Cooke, Zhang, & Wang, 2013).  

Historical and Current Social Determinants of Health for Chinese Immigrants

In fact, the 1898 Tung Wah Newspaper and the increasing number of Chinese immigrants led to the reintroduction of the Immigration Restriction Act restricting non-Europeans to enter Australia in 1901. This same year marked the federation year of Australia. The Australian government feared possible Chinese inversion. However, non-Europeans immigration policies were lifted between 1949 and 1973 with the Racial Discrimination Act being passed in 1975 making it unlawful successfully marking the end of “White Australian Policy” (Bagnall, 2011).  Following this milestone, Chinese immigrants have continued to settle in Australian until today. The Chinese history in Australian is greatly punctuated by events that marked great achievements in securing their overall health and wellbeing status through the strengthening of their socioeconomic footing.

The Chinese constitute some of the most educated groups in Australia with formal employment. They are less likely to be involved in crime or face humiliation, discrimination, abuse, physical violence, sexual harassment, police brutality, and incarceration. This aspect places them at ample position of optimizing positive health outcomes from available health care systems. However, a lot of Chinese immigrants works for longer hours than average and likely to contend with adverse determinants of health like poor housing, unemployment, language barrier limitation and some form of racial discrimination.

Although the Chinese were discriminated upon based on their unique cultures including the use of Chinese medications during the gold rush; the Australian healthcare system has since incorporated/aligned some form of Chinese medicine into its current healthcare policies and healthcare service provision (State of Queensland; Metro South Health, 2015)The Chinese herbal medicine practitioners were practicing Chinese medicine on Victorian goldfields as early as 1887 and actually in 1911 the Chinese herbal remedies were seen in Australian streets labeled in English (Garvey, 2011). Chinese medicine gained more recognition in the Australian mainstream healthcare system upon the establishment of Australian-Chinese diplomatic relations in 1970 which saw the beginning of Sydney acupuncture training. With regard to health care service provision, the Chinese attach a lot of significance to the family to help them with recovery since most Chinese assume the sick role. Healthcare practitioners are perceived as uncaring when independence is emphasized. The Chinese utilize both Chinese medications alongside Australian system medication and policies (Garvey, 2011).

While the Indigenous Australians has had a rough history right from the moment when they were first colonized by the British who disposed them and subjected them to subsequent extreme humiliation, the Chinese immigrants were at this time building their socioeconomic platform in Australia through gold mining and business. This explains the transgenerational passage of adverse social determinants of health among the Indigenous Australians than is the case among Chinese Immigrants. Though both faced some form of discrimination and intimidation from their European counterparts, this was more pronounced within Indigenous communities since the Chinese enjoyed some privileges such as the free visit to public spaces like hospitals.

Impact of Healthcare Policies on Chinese Immigrants

This social exclusion menace is exhibited today through the high poverty rates, homelessness, incarceration, poor education, and high unemployment rates which explain indigenous peoples’ deplorable health and wellbeing status today. Moreover, indigenous Australians continue to contend with adverse social determinants of health today than their Chinese immigrant counterparts owing to current events such as negative public portrayal by the media, unfair institutionalized discrimination, intimidation and unfair incarceration by the state, and extrajudicial killings (Garvey, 2008). The more than 200 years of humiliation, murder, abuse, displacement, assimilation, culture extinction, spiritual upheaval and the current low standards of living explain the current adverse healthcare conditions of indigenous people that is the case with Chinese immigrants (Aboriginal and Torres Strait Islander People Social Justice Commissioner, 2005)

Upon the introduction of British rule, modern health and wellbeing policies were introduced favoring western civilization and other cultural orientations including the Chinese Immigrants. This has greatly disadvantaged Indigenous Australians than is the case with Chinese Immigrants who practiced their Chinese medicine from the very beginning. Indeed, Chinese medicine has more or less been incorporated/ aligned to the mainstream healthcare policies of Australia giving them an opportunity to exploit either the same or the Australian biomedical services. Paradies, Harris, and Anderson, (2008) posit that modern healthcare policies and healthcare delivery services fail to align with the health and wellbeing needs of Indigenous Australians as well as their sociocultural orientations explaining the reason why they are unable to fully exploit them like the Chinese Immigrants. This is because indigenous Australians attach their health and wellbeing more on their land, spirituality, community attachments, and self-esteem, environment, and cultures than mare medical services (Calma, Dudgeon, & Bray, 2017). Chinese

Conclusion

 By and large, the Australian historical and current events have overly disadvantaged Indigenous People extensively with non-indigenous groups such as Chinese Immigrants benefiting more in all spheres of Australian social life including health care access and coverage. The Australian government must endeavor to amicably solve the social determinants of health disparities to allow all Australian communities equally and fairly access healthcare regardless of their socioeconomic and cultural orientations. This includes formulating healthcare policies and healthcare service provision strategies that equalize healthcare services access and consumption by both indigenous Australians and Chinese Immigrants. Both Indigenous Australians and Chinese Immigrants have a strong attachment to their traditional medication and culture and therefore respecting their dignity as a people and their sociocultural integrity and beliefs can go a long way in merging healthcare access and consumption disparities (Close the Gap Campaign Steering Committee, 2012).

Comparison of Health and Well-Being Outcomes of Indigenous Australians and Chinese Immigrants

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