Journal 3

Inequalities in health and longevity occur in many populations worldwide. In

Australia, health inequalities are particularly evident between Indigenous
Australians and white settler Australians.
The dramatic difference in health impacts life expectancy. As Germov (2013)
explains, the average life expectancy for male and female indigenous
Australians, on average is 11.5 and 9.7 years less, than that of white Australians
(p.149).
In the 2013 documentary Utopia by John Pillage, David Smith, a Health Care
Centre Manager at Ampilatwatja, is quoted were meant to be doing primary
health care, when we havent even got the basic needs of a human under wraps
yet. He goes on to explain the basic human needs as sanitation, clean water
and shelter. This particular quote stuck out to me, as we live in a wealthy, first
world or developed country, yet many people are living in third world conditions
and not having basic human rights met.
Pilger (2013) states that the footage collected in 2012 resembles the footage he
shot 28 years ago. The community has the same shacks, same basic health care
and same preventable diseases. To me this indicates that over a period of 28
years, nothing at all has been done to improve living standards in these remote
communities.
My sister Brianna Summers is currently working as a Remote Area Nurse in the
Aboriginal community of Blackstone, located on the border of WA and NT. I
recently asked her how it compares with working in her previous role in the
Emergency Department of the Royal Adelaide Hospital for many years. She
stated
The biggest difference Ive noticed is the advanced stages of chronic
diseases that affect aboriginal people in my community. You dont see that
kind of advancement in city hospitals, rarely anyway. And even then Id only
see it in people who really dont or cant take care of themselves, for
example long term homeless or people with severe drug and alcohol
addictions. In the community its amazing to see how many people under 35
are on a huge amount of chronic illness medications- where youd normally
see that amount in a really unwell 60+ year old in the city (Summers,
2016).
I asked what kind of chronic diseases these were and if there was a simple
solution. She stated the major chronic diseases are renal failure and type 2
diabetes. Im not sure about a long term solution, but stocking the store with
healthy eating options, such as a sandwich rather than pies and pizzas would be
a start.
This seems like a simple step so I am surprised it has not been undertaken.
The film Utopia shows that in 2012, the government funded 80 million dollars on
surveillance and removing children from their homes, and a mere $500,000 was
spent on supporting impoverished families. This statistic shocked me, as it seems
to me that the money would be more effectively spent on improving the living
standards, revamping homes and shelters, supplying more taps and sanitation,

and providing healthier eating options, rather than removing children from their
families.
Utopia also touched on the fact that Australia still has no treaty to recognise the
rights of Indigenous Australians.
Recently the program HACK on Triple J, did a segment about an Australian Treaty.
One reporter Joe Lauder states that a treaty would be a signed agreement
between the government and indigenous Australians declaring clear rights and
responsibilities for both parties, and it would give indigenous people more power
over their own futures (ABC, 2016). It saddened me to hear that Australia is the
only commonwealth country that has not signed a treaty to recognise their
indigenous people.
In the early 1970s Prime Minister Gough Whitlam created a policy of Self
Determination for Aboriginal Australians and in 1988 Prime Minister Bob Hawke
promised there would be a treaty within his government term. 28 years later
there is still no treaty. In 2017 there will be a referendum to vote on changes to
the Constitution, to recognise that aboriginal people as people and to change
some of the racist provisions within the Constitution. Jason ONeil a 21 year old
indigenous law student stated that Constitutional recognition is a fig leaf that
lets politicians say theyre acting on indigenous affairs without addressing social
disadvantage (ABC, 2016). I agree with him. As weve seen so far, politicians
and government policies and indeed the Australian Constitution have not been
enacted favourably for Aboriginal peoples.
It is clear that within Aboriginal communities health promotion is lacking. In the
chapter A Sociology of Health Promotion, Germov (2013) explains the different
types of health promotion- individualist and structuralist and their positive and
negative effects.
To me it seems that neither approach is perfect and neither is better than the
other, it is all dependant on the circumstances of the community or population.
The individualist approach supports health education about lifestyle and needs to
be self-motivated. This is only effective if the individual sees enough benefits to
sustain their motivation. Whereas the structuralist approach is bigger picture and
involves the community, legislation and bureaucratic interventions.
As a future health professional, I would look towards combining the two
strategies in order to maximise health promotion. In relation to the individualist
approach, Germov (2013) states health education approaches cannot assume
people have adequate literacy to understand, evaluate and act on health
information (p.477). I found this interesting and can certainly see it will affect
health promotion in aboriginal communities. Brianna recently shared that often I
will have to drive around the community, using hand gestures to indicate glasses
on the face to let community members know that the eye doctor is here,
because they cannot read the poster and flyers provided throughout the town
(Summers, 2016).
In a community like this there needs to be individual interest and motivation
along with structures that suit the education and resources available. For
example if I was to run a cooking class, providing information about healthy
eating, it would be a hands on, learning experience. I would encourage people to

bring their own traditions and ideas for food preparation and use their methods
whilst incorporating healthy ingredients. I will engage whole communities, and
provide the opportunity for individuals to take on a leadership role to help
overcome language barriers.
This brief health promotion strategy also applies to all action areas of the Ottawa
charter. Germov (2013) explained the 5 action areas and this health promotion
applies to them by (p.466):
-

Strengthen community action- community participation

Develop personal skills- educating on health eating and
behavioural/lifestyle change
Creating supportive environments- allowing each other to share their own
recipes, creating wider social support systems
Reorient health services- leans towards prevention- by eating healthy to
prevent disease such as type 2 diabetes
Build healthy public policy- aims to make living conditions better by eating
right

I found it interesting to learn these two topics after each other, because it made
me wonder how and what strategies could be implemented to improve the
health of indigenous Australians. For example, if we were to focus on the
upstream methods of preventing the problem, less money could be spent on
attempting to fix a diagnosed problem. In relation to overall wellbeing and health
of indigenous Australians, by looking upstream we can see that there is massive
problems in housing, sanitation, food and water, and the intervening of
individuals and unrecognition of government.
Health promotion seems to have transitioned in the last few decades from just
diagnosing the problem, to preventing the problem from occurring. As mentioned
earlier, it seems that health promotion and many promotional strategies are
literacy based. This assumes that everyone these strategies are targeting have
literary skills. This appears a little redundant to me. As weve learnt health is
dramatically altered in low SES areas, thus being the prime audience for health
promotion strategies. We also know that along with lower living standards, there
is a lower rate of education. Therefore, how can Government funded
organisations justify implementing strategies where they will not be utilised or
understood. Health promotion needs to be able to offer individuals with
knowledge on how government policies and resources are there to help, how
different agencies can work together to improve overall health, and how to spark
individuals to take control over their own life and their own health.
In reference to my previous journals and HLPE1540 as a whole, to me health
education is one of the most important aspects of education, yet there will
always be controversy and ineffectiveness. What works for one group of people,
may not work for the other. As health professionals and educators we cannot
standardise our teaching practises, our health promotion strategies and we
cannot assume everything is fixable through a prescription. But we can engage
with communities, listen to them and do our best to lobby the government, local
community services and providers to support the health needs of the people.