Essay on Wiki Assessment 3 – PUN 106 Kate Pham – ID: 10568603 - 2534 words At the time of Census 2016, the population of Aboriginal and Torres Strait Islander (Indigenous people) in Queensland is 186,482, which made up 4,0% of Queensland residents (ABS, 2016). The census count of Aboriginal and Torres Strait Islander Queenslanders increase significantly by 30,658 (19.7%) from 2011 to 2016 (QGSO, 2016). Inala, a suburb located in Brisbane’s outer South-West, is home to the largest community of 810 Aboriginal and Torres Strait Islander people in Brisbane (5.5% of Queensland population) with 46.8% males and 53.2% females (Census 2016). The name of Inala itself is an Indigenous word meaning ‘resting place’, named in 1953 by Jagara traditional tribe on the way of travel from the east to the Moreton Bay region prior to colonisation (Greenop, 2008). In colonial period, Inala was used as grazing and farming land then was converted to soldier’s housing estate in the post of World War II (Memmott, Birdsall-Jones & Greenop, 2012). Later on, the suburb was taken by the State and have been developed to a modern suburb with housing and commercial areas (Greenop, 2008). Indigenous people were amongst the first people who settle in the region in the early of 1960s (Wangarra, n.d). While the majority of Inala’s Indigenous residents are not traditionally from Inala and have migrated to the suburb since its development, Inala’s traditional Jagara people still demonstrate their traditions of ownership in the right of ‘speak for’ the community (Greenop, 2008). For Indigenous residents in Inala, the suburb affiliation is important, which makes a strong Indigenous community. Inala Indigenous community housing is being adjusted to fit the Indigenous cultures and also to display identity to the suburb. Indigenous culture is expressed through external decoration and internal displays within the house (Greenop, 2009). There are also several additional services such as Indigenous Health centre, Indigenous Learning Engagement, Cultural Studies Centre, Centrelink and other Indigenous community organisations. Social Indigenous events such as NAIDOC, Urban Dreaming Art exhibition, Stylin’UP youth festival, football and netball fixture, and carnivals (Greenop, 2008). However, the colonisation significantly changed traditional Indigenous diet from varied and nutrient diet to westernised diet with high energy-dense, fat and sugars (Whalan et al., 2017). Indigenous peoples have been greatly affected by new lifestyles and other factors such as environment, socio-economic and geography. Food and beverages at shops and supermarkets almost completely replace traditional foods, which result in a high proportion of energy-dense and nutrientpoor (Whalan et al., 2017). Inala Indigenous people have also witnessed a hardship of financial with the median weekly household income was $739, whereas the median total weekly household income of Indigenous people over Queensland was $1,222 (ABS, 2016). Indigenous households living in rental accommodation accounted high proportion (42.3%) compared to non-Indigenous households (29.9%). The smallest proportion of Indigenous households (10.3%) owned their home outright compared to other households (29.3%) (QGSO, 2017). The gap between Indigenous people and non-Indigenous people in terms of education has been narrowed from 19.4% to 18.5% from 2011 to 2016. More than half of Aboriginal and Torres Islander Queenslanders aged 20 to 24 years has completed Year 12 or equivalent (QGSO, 2017). The proportion of unemployed Indigenous people participating in the labour force was 20.1% while 46.8% of people worked full time and 27.1% of people worked part-time. (QGSO, 2017). The high level of mental health conditions, self-harm and suicide among Aboriginal and Indigenous people is also complex and hard to explain due to the vast region and communities. The gap in health and socioeconomic outcomes between Indigenous and non-Indigenous people can be explained by ‘racism’ - a key determinant of health. This essay will firstly discuss how racism influences the health outcomes of Inala Indigenous people by its interaction with health care policies, psychological factors and health behaviours of Inala Indigenous community. Secondly, the current implementations being done to address racism within Inala Indigenous community will be assessed. Finally, recommendations to improve the health of Indigenous people in Inala will be given as additions to current efforts. Racism can be broadly defined as the behaviours, practices, beliefs that cause avoidable and inequalities across racial or ethnic groups (Kelaher et al., 2014). Racial discrimination including acts that “offend, insult, humiliate or intimidate” a person based on the person’s race, skin colour or ethnic origin is defined in the Racial Discrimination Act 1975 (Bond, Spurling & Askew, 2014). It is reported that most Indigenous people experienced racism which included jokes, stereotypes and verbal abuse (Kelaher et al., 2014). According to the Australian Indigenous Doctors’ Association (AIDA), racism can be classified into three levels. First, ‘internalised racism’ maintains a negative self-image through selfdenial, resignation, impotence, and hopelessness. Second, ‘interpersonal racism’ is associated with prejudice and discrimination, devaluation and disrespect, and distrust and apathy. Third, ‘systemic racism’ affects access to “housing, education, employment, and living conditions, as well as information, resources, influence and representation, and medical facilities and services” (AIDA, 2019). From the 1960s, Indigenous people have asserted their autonomy with supports from the Australia government and people in general (Paradise & Cunningham, 2009). Varied efforts have been made to address the disadvantages that Indigenous people suffered from by specific programs and funding as well as Indigenous health service establishments. Also, this period is also saw widespread support for the mediation movement in Australia that honours Indigenous people’s status as Australia’s primary guardian through social justice policies or symbolic recognition (i.e. convention, recognition in the Constitution) (Paradise & Cunningham, 2009). In the context of the need to "narrow the gap" for Indigenous Australians, public health policies and initiatives and providing indigenous peoples with access to health care wêre also of concern. Despite these positive changes, racism still exists in many aspects of society such as health, politics and education. Thus, the Australian government's commitment to addressing the disadvantages of Indigenous people is apparently insufficient. Psychological factors and health awareness of indigenous peoples have a significant influence on the ability of supportive policies applied. A high degree of racial awareness was noted in the research of Paradies and Cickyham (2009), which is a manifestation of internalised racism. It means most of the indigenous peoples constantly feel unconfident about their indigenous identity being recognized through language, homeland, or as part of the Stolen Generation (Paradies and Cickyham, 2009). Lack of confidence of Aboriginal and Torres Islander origins is also one of the possible explanations for their higher probability of being racist. Negative self-assessments of health conditions have also been reported with similarly high results in indigenous Australian men and women at Inala Indigenous Health Services (Spurling & Hayman, 2010). This high level can be linked to health infrastructure which means that if indigenous people have better access to primary health care, the negative self-awareness of health status will be improved. Some factors from other social determinants that can affect indigenous self-assessment health status include low socioeconomic status, number of children, tribal identity or arrested as a child, etc. (Spurling & Hayman, 2010). Therefore, there is a need for concern about the existence of systemic racism in health services. The disadvantage of accessing the health care systems may be affected by poor transportation services at the place of residence. Indigenous Australians are classified as a transport disadvantaged group (Rosie & McDonald, 2011). More than a quarter of Indigenous people cannot access vehicles when needed (NCOSS, 2012). Some Indigenous people experience discrimination in the use of transportation services and are often denied buses, taxis, or other services (Markwick, 2019). Community transportation services may also be culturally inappropriate or inadequate for Indigenous disabilities. Financial pressure also makes it difficult for young indigenous people to own a car or apply for a driver's license (NCOSS, 2012). There is an interaction between health behaviours and racism. People who “smoked, were underweight or obese, or were physically inactive” were more likely to be victims of interpersonal racism (e.g. being discriminated, insulted or unrespected) (Markwick et al., 2019). Moreover, racism was witnessed by Indigenous people more frequently at work and educational settings as well as from the police, security personal or in a court of law (Paradise & Cunningham, 2009). Racism provides a major barrier to health care access, which prevents Indigenous people from getting the equal quality of health care services as non-Indigenous ones. Because of the fear of the past experience of racism in the health system, Indigenous people may hesitate to access to health care (AIDA, 2019). This probably builds the resultant lack of trust in mainstream services. The Inala Indigenous Health Central General is taken as an example, in 1994, it is reported that local Indigenous community was not accessed this mainstream practice because they felt humiliated and insulted by staffs (Bond et al., 2014). The impacts caused by racism in health settings are various, which may contribute to poorer mental health and physical health outcomes. The study of Kelaher et al. (2014) showed the association between racism and mental health such as psychological distress, depression and anxiety. The health inequality between Indigenous and non-Indigenous is contributed by the outcomes of racism. According to Improving Aboriginal and Torres Strait Islander Social Queensland discussion paper (2016), 29.4% of Indigenous Australians reported high levels of psychological distress which is approximately three times higher than non-Indigenous people (10.8%). It is also be seen that 30.3% of Aboriginal and Torres Strait Islander Queenslanders experienced high or very high levels of psychological distress compared to 11.5% non-Indigenous Queenslanders (Beyondblue , 2016). As mentioned evidence, racism against Indigenous Australians is an issue that needs to be addressed by promoting protective policies, priority conditions campaigns or education for disadvantaged groups. Moreover, changing beliefs and behaviours of the non-Indigenous population towards Indigenous communities in workplaces, schools, government and society is apparently necessary. Improving the gap of health inequality access caused by racism requires an appropriate intervention. The campaign called ‘Invisible Discriminator’ set up by Beyond Blue is an instance for efforts to eliminate racism towards Queensland Indigenous people (Beyond Blue, n.d). This campaign highlights the impact of racism on the Aboriginal and Torres Strait Islander people’s social and emotional well-being. The campaign has been successful in developing plans related to building positive relationships between Indigenous people and the broad Australian community in the workplace. It helps to connect people through shared experiences, expectations and knowledge while educating people about the history, culture, identity and success of Aboriginal and Torres Strait Islander. For instance, the Reconciliation Action Plan (RAP) is a practical action plan aimed at building relationships, respect and opportunities, which creates social change and economic opportunity for Australians and Torres Strait Islander people (Beyond Blue, n.d). In education settings, the race resources has been provided by the Australian Human Rights Commission in the classroom from Years 6 to 10, which focus on racism and further knowledge of Aboriginal and Torres Strait Islander cultures, histories and traditions. The ‘National Anti-racism Strategy’ was also enforced by the AntiDiscrimination Commission Queensland (The Human Rights Commission, 2018). Five projects have been developed and completed with this strategy: “Building Belonging (2016), Building Inclusive Communities (2017), Inclusion, Racism and Discrimination in Rugby League (2018)” (The Human Rights Commission, 2018), National Youth Anti-Racism Leadership Initiative (2018), and Seeing the Unseen (2018) . ‘It Stops with Me’ campaign continued to be supported by more than 360 organisational supporters. Those campaigns delivered a number of priority activities relating to education, research, promoting community awareness, building and strengthening partnerships. It was reported that the campaigns successfully attracted diverse participation. For example, there were more than 50,000 times of early childhood education resource that was downloaded; videos raising awareness of everyday racism were viewed in 1.6 million times by more than 3.5 million users, etc (The Human Rights Commission, 2018. This reflects the broad impact of these campaigns on promoting concerns about closing the gap and combating racism. The provision of enhanced cultural competencies in key services and capacity building in organizations and communities Indigenous peoples have been adopted to address the issue of racism and discrimination (Bluebeyond, 2016). An excellent example is Dr. Noel Hayman's work in establishing a culturally safe health service in Inala, Queensland (Bond et al., 2016). Residents have previously reported discomfort of treatment of this health care centre before. Dr. Hayman has attempted to change the management strategy by working directly with Indigenous people in the health field. In addition, the training on cultural awareness is strictly conducted at this facility. This practice has increased from 12 indigenous patients in 1995 to more than 4,500 in 2011 and has become a Center for Excellence in Indigenous Primary Care (Bond et al., 2016). Improved relationships between health workers and indigenous patients are key to addressing health inequalities. It can be said that the combination of providing safe and culturally appropriate health services along with raising awareness about inequality in the community on a large scale is very important. That is the key to address the issues of discrimination and inequality in access to service systems. For instance, it is recommended that creating the campaign of anti-racism including organizations such as the Inala Anti-Discrimination Committee. Indigenous peoples should be involved in or comment on the proposals or programs and services provided in relation to Indigenous communities. Legitimate agencies should cooperate with indigenous communities in controlling local health organizations, and recording the cases of racism occurring in the current location. For Indigenous peoples to achieve the same health outcomes as non-indigenous peoples, they may need more of the same programs and services similar to non-Indigenous communities. Also, Indigenous peoples should be supported to develop management skills or provide programs and services for Indigenous communities. This support should include ongoing education, mentoring and creating roles in the health workforce including Indigenous health care workers. At the same time, building the skills and capacities of providers to better understand Aboriginal health and provide community-wide care is essential. In conclusion, Indigenous people were amongst the first people who settle in the region of Inala. Varied efforts have been made to address the disadvantages of health inequality of Indigenous people. Racism is a health determinant being of concern, which has caused poor mental health and physical harm for Indigenous people. Many strategies and campaigns were conducted in efforts to eliminate the racism and its health outcomes such as the ‘National Anti-racism Strategy’ and the ‘Invisible Discriminator campaign’. Addressing the health inequality issues of indigenous communities is a long-term competition that requires the coordination of individuals, communities and organizations. A strong community will help ensure and build positive relationships between Indigenous people and the broader Australian community. This will address the issue of racial discrimination, and facilitate equitable access to cultural, social and economic opportunities (Beyond, 2016). Strong institutions will help to strengthen indigenous workforces, support the capacity of health organizations and further improve the ability of mainstream services to provide fair access culturally, relevant services and supports. 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