Reducing the health disparities of Indigenous Australians: time to change focus.

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  • Author(s): Durey A;Durey A; Thompson SC
  • Source:
    BMC health services research [BMC Health Serv Res] 2012 Jun 10; Vol. 12, pp. 151. Date of Electronic Publication: 2012 Jun 10.
  • Publication Type:
    Journal Article; Research Support, Non-U.S. Gov't
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: BioMed Central Country of Publication: England NLM ID: 101088677 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-6963 (Electronic) Linking ISSN: 14726963 NLM ISO Abbreviation: BMC Health Serv Res Subsets: MEDLINE
    • Publication Information:
      Original Publication: London : BioMed Central, [2001-
    • Subject Terms:
    • Abstract:
      Background: Indigenous peoples have worse health than non-Indigenous, are over-represented amongst the poor and disadvantaged, have lower life expectancies, and success in improving disparities is limited. To address this, research usually focuses on disadvantaged and marginalised groups, offering only partial understanding of influences underpinning slow progress. Critical analysis is also required of those with the power to perpetuate or improve health inequities. In this paper, using Australia as a case example, we explore the effects of 'White', Anglo-Australian cultural dominance in health service delivery to Indigenous Australians. We address the issue using race as an organising principle, underpinned by relations of power.
      Methods: Interviews with non-Indigenous medical practitioners in Western Australia with extensive experience in Indigenous health encouraged reflection and articulation of their insights into factors promoting or impeding quality health care to Indigenous Australians. Interviews were audio-taped and transcribed. An inductive, exploratory analysis identified key themes that were reviewed and interrogated in light of existing literature on health care to Indigenous people, race and disadvantage. The researchers' past experience, knowledge and understanding of health care and Indigenous health assisted with data interpretation. Informal discussions were also held with colleagues working professionally in Indigenous policy, practice and community settings.
      Results: Racism emerged as a key issue, leading us to more deeply interrogate the role 'Whiteness' plays in Indigenous health care. While Whiteness can refer to skin colour, it also represents a racialized social structure where Indigenous knowledge, beliefs and values are subjugated to the dominant western biomedical model in policy and practice. Racism towards Indigenous patients in health services was institutional and interpersonal. Internalised racism was manifest when Indigenous patients incorporated racist attitudes and beliefs into their lived experience, lowering expectations and their sense of self-worth.
      Conclusions: Current health policies and practices favour standardised care where the voice of those who are marginalised is often absent. Examining the effectiveness of such models in reducing health disparities requires health providers to critically reflect on whether policies and practices promote or compromise Indigenous health and wellbeing--an important step in changing the discourse that places Indigenous people at the centre of the problem.
    • References:
      Issues Ment Health Nurs. 2005 Dec;26(10):979-99. (PMID: 16283995)
      Med J Aust. 2008 May 19;188(10):560-1. (PMID: 18484925)
      Med J Aust. 2004 May 17;180(10):517-20. (PMID: 15139829)
      Am Indian Alsk Native Ment Health Res. 2006;13(3):1-22. (PMID: 17602406)
      Am J Orthopsychiatry. 2006 Oct;76(4):423-433. (PMID: 17209710)
      Aust Health Rev. 2009 Nov;33(4):549-57. (PMID: 20166903)
      Aust N Z J Public Health. 2007 Aug;31(4):322-9. (PMID: 17725009)
      Med J Aust. 2009 May 18;190(10):574-9. (PMID: 19450207)
      Australas Psychiatry. 2009 Aug;17 Suppl 1:S41-6. (PMID: 19579105)
      Can J Public Health. 2010 Mar-Apr;101(2):143-8. (PMID: 20524380)
      Australas Psychiatry. 2009 Aug;17 Suppl 1:S24-7. (PMID: 19579101)
      J Paediatr Child Health. 2011 Jan;47(1-2):12-7. (PMID: 20973859)
      Lancet. 2006 Jun 3;367(9525):1859-69. (PMID: 16753489)
      Int J Qual Health Care. 2011 Jun;23(3):247-57. (PMID: 21467076)
      J Transcult Nurs. 2006 Jul;17(3):266-71. (PMID: 16757666)
      Med J Aust. 2006 May 15;184(10):502-5. (PMID: 16719748)
      Lancet. 2009 Jul 4;374(9683):65-75. (PMID: 19577695)
      Issues Ment Health Nurs. 2005 Dec;26(10):1001-24. (PMID: 16283996)
      Am J Orthopsychiatry. 2005 Oct;75(4):684-94. (PMID: 16262524)
      Milbank Q. 1998;76(3):493-505, 306-7. (PMID: 9738172)
      BMC Health Serv Res. 2009 Jul 31;9:132. (PMID: 19643031)
      Lancet. 2005 Jul 2-8;366(9479):10-3. (PMID: 15993213)
      Health Educ Res. 2009 Apr;24(2):318-29. (PMID: 18463411)
      Soc Sci Med. 2011 Feb;72(3):355-64. (PMID: 21036444)
      Collegian. 2009;16(2):63-9. (PMID: 19583175)
      Soc Sci Med. 2012 Feb;74(3):408-415. (PMID: 22204840)
      Med J Aust. 2005 May 16;182(10):498-9. (PMID: 15896175)
      Aust J Rural Health. 2011 Aug;19(4):166-70. (PMID: 21771156)
      Aust N Z J Public Health. 2008 Dec;32(6):549-53. (PMID: 19076747)
      Ann Intern Med. 1978 Feb;88(2):251-8. (PMID: 626456)
      Am Psychol. 2004 Oct;59(7):614-625. (PMID: 15491256)
      BMC Res Notes. 2011 Mar 14;4:62. (PMID: 21401923)
      Soc Sci Med. 2006 Sep;63(6):1428-41. (PMID: 16740349)
      Aust N Z J Public Health. 2010 Jul;34 Suppl 1:S87-92. (PMID: 20618302)
      BMC Med Res Methodol. 2010 Dec 30;10:111. (PMID: 21192809)
      Soc Sci Med. 2011 Oct;73(7):1045-53. (PMID: 21835522)
      Kidney Int. 2009 Sep;76(6):659-64. (PMID: 19553910)
      BMC Psychiatry. 2009 Aug 03;9:47. (PMID: 19646284)
      Nurs Inq. 2012 Jun;19(2):144-52. (PMID: 22530862)
      Int J Epidemiol. 2009 Apr;38(2):470-7. (PMID: 19047078)
      J Ethnobiol Ethnomed. 2010 Jun 23;6:18. (PMID: 20569478)
      Aust N Z J Public Health. 2009 Aug;33(4):325-31. (PMID: 19689592)
      J Epidemiol Community Health. 2010 Feb;64(2):117-23. (PMID: 20056966)
      Heart Lung Circ. 2010 May-Jun;19(5-6):344-50. (PMID: 20359951)
      Aust Health Rev. 2010 Nov;34(4):423-9. (PMID: 21108902)
      Soc Sci Med. 2010 Feb;70(3):401-411. (PMID: 19906478)
      Health (London). 2005 Apr;9(2):145-67. (PMID: 15788431)
      Diabetes Care. 2010 Jul;33(7):1463-70. (PMID: 20357367)
    • Publication Date:
      Date Created: 20120612 Date Completed: 20121127 Latest Revision: 20221207
    • Publication Date:
      20240104
    • Accession Number:
      PMC3431273
    • Accession Number:
      10.1186/1472-6963-12-151
    • Accession Number:
      22682494