Aboriginal health

While Canada, the United States and New Zealand have managed to lift the health standards in their Indigenous communities since the 1980s, Australian Aboriginal people suffer a worsening health crisis.

To us, health is about so much more than simply not being sick. It's about getting a balance between physical, mental, emotional, cultural and spiritual health. Health and healing are interwoven, which means that one can't be separated from the other.—Dr Tamara Mackean, Australian Indigenous Doctors' Association [13]

Aboriginal health overview

Check out these numbers of Aboriginal health:

Australia is the only place on the planet where Indigenous health and wellbeing are going backwards.—Sydney Morning Herald [23]

Wide health gap for Aboriginal people

As the health statistics above suggest there is a huge gap between the health of Indigenous and non-Indigenous Australians. This gap is reflected in the money spent on health for either group.

About A$1.22 is spent on the health and aged-care needs of every Indigenous person for every dollar spent on non-Indigenous people in 2006/07 [24]. And the gap widens. Two years earlier it was A$1.77.

The spending rate reflects also the higher cost of delivering health services in remote communities. "Aboriginal and Torres Strait Islander Australians generally use more public hospital and community health services than non-Indigenous Australians, but fewer medical, pharmaceutical, dental and other health services, which are mostly privately provided," explains Damian O'Rourke, senior economist of the Australian Institute of Health and Welfare (AIHW) [24].

Eradicated illnesses alive in Aboriginal communities

Some illnesses have been eradicated in white Australia, for example trachoma. Trachoma is an infectious eye disease that can lead to blindness. As it is easily treated with antibiotics, trachoma is regarded as a disease of poverty and is now unknown in developed countries—except Australia. Children are the most susceptible to this disease.

Trachoma was eradicated in the 1920s but remains endemic in many Aboriginal communities [3], with 'endemic' meaning that over 10% of the population are infected [8]. The rate among children can be twice as high.

The trachoma infection is mainly spread through poor hygiene and living conditions.

According to Professor Hugh Taylor, head of the University of Melbourne's Centre for Eye Research Australia, "a lack of government commitment and a lack of targeted resources on the ground" are the main impediments to eliminating the disease among Indigenous Australians [11].

"We know how to eliminate the disease," Taylor says. "If Morocco can eliminate trachoma in 10 years, then [Australia] should be able to."

Professor Jonathan Carapetis, director of the Menzies School of Health Research in Darwin, agrees. "If you look at all these diseases that the Aboriginal people suffer from, they are the same diseases that were prevalent in [white] Melbourne a hundred years ago... The difference is in overcrowded housing, income, hygiene and sanitation conditions." [18]

The difference between the often-cited 'third-world' conditions of Aboriginal people in Australia and people in third-world countries is that theoretically Aboriginal people have access to high-quality medial care in Australia.

If we think we can provide medical care and expect people to live healthy lives in communities where there is poverty, and overcrowded housing, and where people don't even finish school then we are kidding ourselves. —Prof Jonathan Carapetis, director Menzies School of Health Research, Darwin [18]

Over 30 years on, despite the successful NTEHP, Australia is the only developed country to still have the preventable disease [11].

Snake—An Aboriginal condom brand

On December 1st, 2008, an unusual website was launched. It promotes 'Snake' condoms in the colours of the Aboriginal flag: red, yellow and black.

"Snake Condoms is Australia's first and only Indigenous-friendly, socially marketed condom brand."

With teenage pregnancies five times higher amongst Aboriginal women and sexually transmitted diseases more prevalent in Aboriginal communities, Snake condoms hit a nerve.

The brand targets Aboriginal people with humorous, witty slogans like A trouser snake is the deadliest! ('Deadly' meaning 'great', 'wonderful', 'excellent') or Cover its head and it won't bite you!.

The company's website provides useful information on contraception, pregnancy and 'sex stuff' and reminds young Aboriginal people that 'it's okay to say no'.

Check out their website at www.snakecondoms.org.au

Smoking a serious health problem

Smoking rates in Australia continue to decline. According to Maari Ma Health Aboriginal Corporation [7], over 17% of New South Wales' population were current smokers in 2008, while Aboriginal people continue to smoke much more with rates between 43% and 54% [7,12] and in some communities up to 80% [16].

Indigenous people begin smoking at a younger age and are less likely to successfully quit smoking than non-Indigenous people [21].

Many health workers, before heading off to see Aboriginal people, stand around their four-wheel-drives "having a puff" [17].

This high smoking rate is one of the reasons why Aboriginal infants are six times more likely to suffer a sudden unexpected death than non-Aboriginal children [9]. 50% of Indigenous mothers smoked during pregnancy, but only 14% of non-Indigenous mothers did in 2009 [15].

When pregnant women smoke, they inhale carbon monoxide, which reduces the amount of oxygen their baby receives and in turn causes a trail of health problems even before it is born.

Female smokers put themselves at risk of developing lung cancer but also cancer of the cervix because viruses present in the cervix are no longer cleared by the body. Regular pap tests are essential to protect against developing cervical cancer.

Smoking causes 20% of deaths in Aboriginal communities [19].

The high number of smokers comes partly from Aboriginal people not identifying tobacco smoking as a health issue, partly from anti-smoking campaigns failing to reach Aboriginal people because such campaigns need to be developed at 'ground level' for Aboriginal people, by Aboriginal people themselves [16].

If you quit smoking today...

Smoking subjects the body to severe changes which take a long time to neutralise. If you stopped smoking today [7],

• within two months your blood pressure would return to normal
• blood circulation to hands and feet would improve
• within a year your risk of dying from coronary heart disease would halve
• after five years your risk of mouth or throat cancer would have halved
• after 15 years your risk of coronary heart disease and stroke would be almost back to that of a non-smoker.

A quitter's story

Positive role models within Aboriginal communities can significantly contribute towards Aboriginal people quit smoking.

Carol Martin, Aboriginal woman, West Australian Labor MP and a smoker for 39 years, quit smoking in 2009.

"I have to say I thought I'd never pull this off because the only time I didn't smoke was when I was pregnant and had little breast-feeding babies, but once they were off the boob I was back on the fags," reveals Carol [19].

"I had a bit of a sore throat when I gave up and I remember getting desperate to go and get a smoke but I resisted and I'm glad I did."

"I've got diabetes and hypertension, so my smoking was actually masking my illnesses. So giving up made me realise I had to get a handle on my health," Carol says.

The best part about giving up smoking, according to Carol, was the money she has saved in the half year following her abstinence.

"I've saved more than A$2,000 since I gave up because I would keep giving them out to my mates. But since I gave up, I notice I haven't got so many mates around anymore, but that's just a laugh."

"So giving up will allow me, as a mother and grandmother, to take my place in the community and have a major impact on their future and push them to be the best that they can. I enjoyed smoking, but I enjoy not smoking even more."

Giving up [smoking] will allow me, as a mother and grandmother, to take my place in the community and have a major impact on their future—Carol Martin, West Australian Labor MP [19]

To raise Aboriginal people's life expectancy it is very important to get them to give up smoking.

For help to quit smoking in Queensland call SmokeCheck, a program tailored for Indigenous people, on 07-3238 4072.

Simple recipe for better health

A stunningly simple recipe improved the children's health at Baryulgil Public School, 80km from Grafton, NSW [5]. Health officers discovered that all children were deficient in iron and vitamin C and had developed ear (50%) or skin (25%) infections as a consequence.

The simple remedy was fresh fruit and vegetables and a strict regimen to ensure they were eaten. Six months later the skin infections were gone and the hearing loss caused by the infection was drastically reduced.

Under a Shared Responsibility Agreement families contribute some dollars to the food packages which are now delivered to their communities. "Health problems are way down. The savings in health costs far outweigh the outlay for the scheme," says a campaign leader.

Psychology

In 2006, Dr Helen Milroy of the Palyku people of Pilbara, Western Australia, was Australia's only Aboriginal psychiatrist. Her research found 24% of Aboriginal children aged 14-17 were at high risk of clinically significant emotional or behavioural difficulties compared with 15% in the non-Aboriginal population [6].

Children exposed to high stress events such as illness, family break-up, arrests or financial difficulties are most likely to be in this group. More than one in five children lived in families where there had been seven or more such high stress events in the preceding 12 months.

About 12% of these children were being looked after by a parent who had been forcibly removed from their natural family (Stolen Generations). 33% of these children were in the care of a sole parent.

Out of respect for Aboriginal culture I use Indigenous sources as much as possible.
www.hollows.org [1] Koori Mail 394 p.11 [2] Koori Mail, 413, p.6 [3] 'Insiders' story of trachoma program', Koori Mail 442 p.54 [4] National Indigenous Times 135 p.12 [5] Koori Mail 385, p.36 [6] Koori Mail 385, p.13 [7] 'Maari Ma seeking quitters', Koori Mail 427 p.62 [8] 'Prevalence of trachoma in Aboriginal communities in the Katherine Region of the Northern Territory in 2007', The Medical Journal of Australia, 2008; 189 (7): 409 [9] 'NSW child deaths fall; Indig health still behind: report', NIT 159, 7/8/2008 p.10 [10] 'National Trachoma Eye Health Program', www.hollows.org/NTEHP [11] 'Trachoma programs fail Indigenous Australians', www.abc.net.au/science/articles/2007/12/19/2114236.htm [12] 'Quitting smokes the goal of calendar', Koori Mail 417, p.40 [13] 'A column by our own doctors', Koori Mail 438 p.54 [14] 'Dementia a problem in WA - study', Koori Mail 439 p.53 [15] 'Pregnant smokers targeted', Koori Mail 445 p.47 [16] 'Smokers urged to butt out', Koori Mail 448 p.49 [17] 'Smokers and pedophiles spoken of in same breath', SMH 3/3/09 [18] 'Working towards good health', NIT 6/8/2009 p.30 [19] 'WA MP a quitter-and proud of it', Koori Mail 458 p.51 [20] 'Gains, but the gap is still wide, study finds', Koori Mail 463 p.9 [21] 'Quitters get more help', Koori Mail 463 p.10 [22] 'Message delivered', Koori Mail 463 p.15 [23] 'A shamed nation turns a blind eye', SMH 16/11/2009 [24] 'Report shows more spent', Koori Mail 467 p.46