The indigenous Australians populate what is considered isolated land, but a large group of this population has relocated to urbanized locations. According to the Australian Bureau of Statistics, a substantial health crisis is affecting both the rural and urbanized indigenous Australian population (Australian Bureau of Statistics 2002). In addition, these health affects are present in all age groups. Furthermore, death rates among the younger indigenous populations are up to four times higher then that of the non-indigenous Australians (Australian Bureau of Statistics 2002). There are numerous historical, cultural, and socio-economical factors that contribute to the crisis in indigenous people of Australia.
Prior to colonization, the indigenous males of Australia had meaningful and active roles with authority and status within the indigenous community (Adams, 2001). The elder males were primarily responsible for the management and maintenance of the indigenous community. They, also, provided a leadership role. Now, an imposition of non-traditional existence has had a detrimental impact on the health of the indigenous population, more particularly in indigenous men. Indigenous men have the lowest life expectancy, poorest health, and the highest incarceration rates of indigenous and non-indigenous Australians (National Aboriginal and Torres Strait Islander Health Council 2003). A great majority of indigenous males experience many obstacles, when trying to access proper health services, predominantly in remote areas.
The indigenous male counterparts experience many challenges with their health and are a result of colonization (Australian Indigenous 2006). The indigenous perceptions of health are comprehensive of overall function, spirituality, and connections to family and community (Australian Indigenous 2006). In 1995, a national health survey reported that indigenous women are less likely to consume alcohol than non-indigenous women; however, those that do consume are more likely to do so at harmful levels (Australian Bureau of Statistics 1999). Furthermore, the well being of indigenous women is directed to the intricacy of their caring roles and the early age at which many women begin their families. In 1998-200, according to the Australian Bureau of Statistics , the average age on a indigenous women was 24.7 years of age opposed to 29.2 years for a non-indigenous women; for instance, 79 percent of indigenous mothers were under 30 years of age, while compared to 52 percent of non-indigenous mothers (Australian Bureau of Statistics 2003).
Indigenous people have a hereditary autosomal dominant condition of acute pancreatitis, which is characterized by recurrent episodes of acute pancreatitis (McGaughran et al., 2004). A young girl of 11 years was presented with an episode of acute pancreatitis. Her father and many other family members had recurrent stints of acute pancreatitis, as well. Genetic testing had revealed a pathohenic mutation in the cationic trypsinogen gene in the proband – her father and paternal grandmother (McGaughran et al., 2004). This is an important diagnosis in a patient with recurrent pancreatitis with no apparent precipitating cause.
In rural communities, lower back pain (LBP) is a prevalent musculo-skeletal condition. It is also true that substance abuse, physical inactivity, and obesity are prevalent within the indigenous community (Vindigni et al., 2005). Age and gender characteristic of 189 indigenous Australians were comparable to an Australian Bureau of Statistics study on the broader indigenous population (Vindigni et al., 2005). Individuals reporting high levels of back pain were often overweight or obese. Obesity was associated with self-reported lower back pain. Common obstacles to medical management of lower back pain included poor health and the lack of affordable and appropriate health care facilities (Vindigni et al., 2005). While addressing the modifiable risk factors of lower back pain, may also prevent a higher range of illness imposed by cardiovascular conditions and type II diabetes.
In 1923, the first case of diabetes in the indigenous population was in Adelaide. Though, records prior to this time show that the indigenous people were lean and fit. They showed no signs of any metabolic disorder – largely believed to be characteristic of European populations (Australian Indigenous 2006). Type II diabetes studies were not carried out onto the indigenous population until the early 1960s. These studies found a significant association between the type II diabetes in the indigenous population and the development of a westernized lifestyle (Australian Indigenous 2006). Numerous studies noted high levels of obesity inside the indigenous population. It has been suggested that this may be linked to genetic factors. Nevertheless, the contemporary indigenous diets and levels of physical activity are critical factors in the elevated levels of obesity (Australian Indigenous 2006).
The “westernization” of the indigenous has seen the replacement of a varied nutrient-dense diet with an energy-dense diet, high in fat and refined sugars (Australian Indigenous 2006). There has been an increase on the consumption of snack foods, fruit-flavored juices, sugar-sweetened sodas, refined bread (white bread), sugar and canned meats in many indigenous communities, which shown evidence of high-blood pressure (Australian Indigenous 2006).
Substance abuse in the Aboriginal sectors are the direct link to several contributing factors. Such contributing factors include poverty, unemployment, and loss of cultural identity (Brady, 1991). The Aboriginal communities suffered greatly in the 1980’s by the overwhelming use of illicit drugs, heroin in particular (Brady, 1991). Fewer studies have been conducted since then to determine whether or not the trend of injecting drugs has decreased amongst the Aborigines. A study was, however, done using the Aboriginal population in the Lower Murray region of South Australia. The use of illicit drugs such as heroine was attributed to their poor health and negative social behavior amongst the members of the community (Indigenous Inhalant Misuse 2006). Included in the poor health category was an increase in the number of cases of people having received blood born viruses being transmitted through the sharing of needles. Also noted was the number of assaults, violent acts, and increase of suicidal behaviors (Australian Indigenous 2006). In conjunction to the more frequent use of injected illicit drugs, were higher rates of unsafe practices of sharing needles and other drug paraphernalia when compared to their non-Aboriginal counterparts (Australian Indigenous 2006). The practice of sharing fell in tune with traditional Aboriginal concepts of sharing belongings even if it was unsafe in nature. Injecting drug use is noted as being more prevalent within urban indigenous communities more so than rural indigenous groups. Therefore, the majority of studies conducted were done using the urban Aboriginal communities.
In 2001, the Aboriginal Drug and Alcohol Council (ADAC) established that heroin and speed were the two most frequently stated as having been the drug of choice to inject (Australian Indigenous 2006). There is a widespread belief amongst the peers of the ADAC that injecting drugs has impacted the whole indigenous community. It has led to the increasing social disadvantage, the Aboriginals’ low self worth, overall poverty, and poor health. A cultural hindrances of the Aboriginal society is their apparent inability to maintain a functioning communication base and relation with the local police force. This in turn impedes their willingness to make phone calls to local authorities for help and intervene in the resuscitation process when injecting drug use has taken its toll (Madden, 1995). Another socio-economic factor effecting the Aborigines is in the field of education. Many of the indigenous people lack the knowledge of life saving and emergency techniques that would help in resuscitating a person in jeopardy from dying from a drug overdose. Those who inject the drugs also lack information on overdose prevention or fail to acknowledge it. Another factor attached to the Aboriginal injected drug use is that there is a high overdose number associated with it in comparison to their non-Aboriginal counterparts. The high overdose rate is a trend resulting for lowered tolerances found in Aboriginal communities due to their multi-drug usage (Madden, 1995).
Alcohol use amongst indigenous Australian groups have been labeled as the primary public health problem (Summary of Alcohol Use 2006). In a national survey of indigenous Australians ages 13 years and older, 59% stated alcohol as the number one health problem while 39% stated drug use as the number one health problem (Summary of Alcohol Use 2006). Alcohol abuse is speculated to be a result of the Aboriginal society not originally including alcohol as part of their traditions in cultural identity. Therefore, gluttonous and abusive behaviors stemmed from its introduction to the indigenous groups. In 1788, the “First Fleet” in the European colonization process would bring rum and wine as part of its contraband. Shortly afterwards, alcohol became the currency of New South Wales ( Lewis, 1992). Within five years, rampant changes were noted amongst the indigenous groups as a result of the presence of alcohol. Throughout the history of Australia alcohol legislation, objections have been made while attempting to control alcohol use and sales to the general population. However, no such objections were made on behalf of the Aborigines when attempting to apply the same limitations to the indigenous people (Dingle, 1980). The skewed application of the legalities with the use of alcohol was the first sign of the inequalities distinguishing the indigenous people from the general population. As alcohol misuse is a leading health concern amongst indigenous people of Australia, the Commonwealth government has attempted to provide programs to educate and reroute the need to use alcohol in their lives. Due to varying rules and regulations, implicating programs in certain areas is difficult due to the geographic lay out of Australia. Therefore, access to these programs is not always easy to obtain. Money is the major dividing line between those able to obtain help and those without access. This socio-economic factor keeps the Aboriginals at bay with alcohol intervention programs.
Therefore, the indigenous people of Australia are impacted greatly in regards to health issues from use of drugs injected into the body, alcohol , and problems stemming from the use of the previous two influences (Brady, 1991). Socio-economic factors lend to the idea that education levels are lower because they do not have the same quality or availability to the programs as do their non-Aboriginal counterparts. Typically seen in conjunction with the lowered education rates of the indigenous communities are higher death rates and lower life spans. Money effects their ability to receive health care in a timely manner and to receive the same quality as that offered to the general population. The historical presence of the Europeans has put a strain between the non-indigenous people and the indigenous communities in all of the aforementioned concerns.
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