Week 14 ~ Aboriginal Health ~ PBL J

1. Week 14 ~ Aboriginal Health ~ PBL J

3. Education - Jess

4. Employment - Raph • In 2010, 202,700 indigenous people in labour workforce (this represents 56% of population) • 18% unemployed (36,600) • 46% employed (166,100) • Participation in labour workforce declines with remoteness • Unemployment gap between indigenous and non-indigenous people 12.6% • In 2009, 63% of indigenous employees at lower salary levels while only 4.8% at upper salary level Schemes to Help • Public Calling • Making it Our Business • Aboriginal Employment Strategy • Community Development Employment Projects

5. Socioeconomic status - Hannah

6. Housing Taken from ‘Australia’s Health 2010’ • There is strong evidence that low socioeconomic status is associated with poor health and increased risk factors • Overcrowding • 14% of Aboriginal dwellings were considered ‘overcrowded’ in 2006 • This corresponds to 27% of the population living in overcrowded conditions • Factors affecting overcrowding were • Remoteness • Aboriginal community housing • Poor quality • Shelter • Safe drinking water • Adequate waste disposal • Houses in remote areas tended to be in the poorest condition • 31% of Aboriginal community houses needed repair or replacement

7. Housing Implications for health & wellbeing: Consider: • 1/3 of the Indigenous health gap is due to disability • Non-communicable disease accounts for 70% of the observed health gap • Mental health • Chronic respiratory disease • Asthma – 1.5 times as likely to have it as non-Indigenous Australians • COPD • 27% of Aboriginal and Torres Strait Islander people reported having a respiratory disease in 2004 • Communicable disease

8. Transport (Access to health Services) • Remoteness: 26% Ind v 2% N/I • Med Practitioners: 281/100k v 312 metro. • Specialists: 29 v 114/100k • 78% of communities > 78k from hospital 50% > 25k from Community Health Centre • Vehicular access/ability: 60% Ind v 85% N/I Remote = 48% Ind (? N/I)

9. Transport (Access to Health Services) • “transport difficulty” (getting from A to B) • 12% Ind v 4% N/I Reference: http://www.aihw.gov.au/access-to-health-services-indigenous/

10. Discrimination (1) What is it and what are the facts? • Refers to self-reported situations/places in which the person received unfair or racist treatment. • Major contributing factor to poor Abs. health as studies have shown it to be directly associated with various adverse health conditions. • In 2008, 27% of Indigenous adults (aged 15 years and over) reported experience of discrimination in the previous 12 months. Most commonly experienced in the: • general public (11%), • police/security personnel/courts of law (11%), • at work or when applying for work (8%). • More specifically, discrimination was more common among those who: • Have even displaced from their natural families 45% compared to 26% • Are unemployed 41% compared tp those who are employed 25%. • Had a disability or long-term health condition 32% compared to those without disability 22%.

11. Discrimination (2) • Effect of discrimination: • Recent research suggests that experiencing racism and discrimination can negatively affect areas of wellbeing such as mental and physical health • Indigenous Australians who had experienced discrimination were: • More likely to report higher levels of psychological distress (44% compared with 26%), • Be in fair/poor health (28% compared with 20%). • More likely to engage in binge drinking (42% compared with 35%) • To have recently used illicit substances (28% compared with 17%) • These victims of discrimination were less likely to trust the police, their local school, their doctor and/or hospital and other people in general. Problems? • Need for change • Has adverse impacts on health + hinders equal access to healthcare. • Improving community awareness • Strengthening political will • Improve cultural competence among healthcare workers • Health service redesign to facilitate optimal access to BOTH Aboriginal AND Torres Strait Islanders.

12. Cultural Identity • Difficulty with measurement: criteria developed in consultation with ATSI peoples: • Connectedness to country • Culture and identity • Resilience • Leadership • Role/Structure/Routine • Feeling Safe • Vitality • Improvements in these areas promotes the cultural identity of the Aboriginal and Torres Strait Islander Peoples • *Taken from Aus. Government: The Health and welfare of Australia’s Aboriginal and Torres Strait Islander people – an overview 2011

13. Cultural Identity Language • 11% ATSI peoples (>15y/o) speak LOTE at home • 42% Rural / 2% Urban • 40% possess some command of ATSI languages: remote > urban > regional Cultural connectedness • 73% <15y/o and 63% >15y/o involved in cultural events • 2/3 identify with clan/tribe/group • 25% ATSI peoples lived on tribal homelands Leadership: • 42% 3-14y/o spent time with elder • 1 in 4: elders support weighs heavily on decisions to complete schooling Stability & Routine: • 78% in stable dwelling • Informal learning in 0-14y/o ~94%

14. Implications for health: • Disease as a psycho-spirituo-socio-somatic entity (Peck) • Speculating on consequences:

15. Leadership/role/structure– Vic/Peanut/Duffer

16. And Rebecca will be reflecting 