How Cultural Identity and Understanding Influence Health Equity Essay

Part 1: Presentation

The Defying Empire exhibition showcases the works of tens of Aboriginal and Torres Strait Islander artists from all over Australia (National Gallery of Australia [NGA], 2017). Held to commemorate the 1967 referendum that allowed indigenous people to be included in the national census, the exhibition is aimed at celebrating the cultural identity and historical tribulations of the Aboriginal and Torres Strait Islander people. Indigenous communities in Australia have historically been subjected to racism and discrimination, experiences which have negatively affected their health wellbeing.

Of the several artworks presented during the exhibition, one that stood out is the Black Dog, a work produced by Archie Moore. The image embodies the racism faced by Aboriginals and Torres Strait Islanders. As Moore explains, the dog’s skin was not dark enough; hence, boot polish was applied to make it blacker. This further enriches the racial connotation intended to be projected by the image. As seen in the image, the dog “sits awkwardly on the floor, staring up at you with accusatory eyes as an indictment of past mistreatment of an individual but also of a marginalised group” (Moore, 2017). Also, the dog has a name tag on its neck, further depicting the subhuman treatment experienced by indigenous communities. In essence, the dog projects the discomfort, cruelty, and dispossession experienced by the Aboriginal as well as Torres Strait Islander people. It appears to accuse the majority of the inhuman treatment indigenous communities were subjected to. These aspects make the image quite distinctive from the rest.

Black Dog: By Archie Moore

The history exemplified in Black Dog remarkably relates to the health and wellbeing of Aboriginal and Torres Strait Islander people. Indeed, in his message, the artist acknowledges the link between racism/discrimination and mental illnesses such as depression (Moore, 2017). This amplifies the connection between cultural/racial background and wellbeing. In fact, cultural background is one of the social determinants of health (Australian Indigenous HealthInfoNet, 2015).

Mental illness is a common phenomenon among the Aboriginal and Torres Strait Islander people. According to statistics from the Australian Bureau of Statistics (ABS), in 2008, approximately 32% of Aboriginals and Torres Strait Islanders aged 18 years and above were victims of high psychological distress (ABS, 2012). This was more than two times the prevalence for non-indigenous populations. Statistics further indicate that depression and anxiety constitutes about 16% of the overall disease burden among indigenous communities in Australia (Mindframe, 2014). Psychological distress among Aboriginals and Torres Strait Islanders is attributable to, among other factors, discrimination (Balaratnasingam et al., 2015). Indigenous communities continue to experience grief, trauma, and distress owing to colonisation, displacement from their traditional lands, oppression, imprisonment, injustice, exclusion, and racism (Mental Health Coordinating Council [MHCC], 2015). The problem is further compounded by other factors specific to indigenous people such as poverty, inaccessibility to healthcare, lack of proper housing, high incarceration rates, alcohol and substance abuse, as well as a disproportionately high morbidity and mortality burden (Mindframe, 2014; Australian Indigenous HealthInfoNet, 2015).

The unique history of the Aboriginal and Torres Strait Islander people requires healthcare professionals to work in a culturally sensitive manner when treating their conditions (MHCC, 2015). To effectively address the health needs of indigenous communities, healthcare professionals must have a comprehensive understanding their culture and history, which affects their wellbeing in one way or another (Chalmers et al., 2014; Balaratnasingam et al., 2015). With this understanding, healthcare professionals acknowledge that mental illness among Aboriginals and Torres Strait Islanders is an outcome of racism and cultural oppression. Culturally sensitive care also requires the involvement of indigenous people in the formulation and delivery of service. Involvement is especially crucial as far as the delivery of mental healthcare is concerned (MHCC, 2015).

Understanding the culture of indigenous people enables healthcare professionals to not only make sense of their needs, but also communicate and interact with them in an effective manner (Mental Health First Aid Australia, 2008). As explained by Parker & Milroy (2013), miscommunication between Aboriginal patients and non-Aboriginal physicians is pervasive. This is particularly true in remote areas where majority of indigenous communities are concentrated. Without knowledge of the Aboriginal culture, healthcare professionals can easily misinterpret behaviours and symptoms when handling Aboriginal patients with mental illness. This can undermine the delivery of service to the disadvantage of the patient, underscoring the need for effective communication strategies when dealing with mental health patients from indigenous backgrounds.

Part 2: Reflective Essay

To this end, I have acquired valuable knowledge on the experiences of the Aboriginal and Torres Strait Islander people. This knowledge has changed the way I view these communities, especially with respect to healthcare. In this essay, I reflect on what I have learned this semester regarding the experiences of indigenous communities in Australia. In the reflection, I particularly discuss how cultural identity influences health equity, clearly supporting my arguments with relevant literature.

As I have learned throughout this semester, Aboriginals and Torres Strait Islanders are an especially unique group of people. These communities have a distinctive cultural history that has shaped virtually every aspect of their life. For many years, indigenous communities in Australia faced displacement, racism, discrimination, and oppression (Taylor & Guerin, 2014). Due to their skin colour, the majority treated them as sub-humans. They were driven away from their traditional lands, used as slaves, imprisoned, and secluded from the mainstream society. In fact, until 1967, indigenous communities were not counted in the national census. Whereas they are now recognised as Australians, Aboriginals and Torres Strait Islanders are still disproportionately disadvantaged compared to the majority, with traces of socioeconomic injustice still evident.

The historical experiences of indigenous people in Australia have had significant implications for their social, economic, and physical wellbeing (Balaratnasingam et al., 2015). In comparison to non-indigenous communities, indigenous communities in the country grapple with higher levels of poverty, poorer access to healthcare, more deplorable housing, and greater prevalence of disease and deaths (Mindframe, 2014). More importantly, the Aboriginal and Torres Strait Islander people are traumatised by the brutal experiences of colonisation. They encounter grief, psychological distress, and feelings of marginalisation, and feel treated like lesser human beings. These experiences have imposed a great deal of mental health issues on these communities. Anxiety, depression, stress, and psychosis, among other mental issues, are common conditions among Aboriginals and Torres Strait Islanders (Taylor & Guerin, 2014).

From my understanding, the Aboriginal as well as the Torres Strait Islander communities should be treated as a unique cultural group as far as healthcare delivery is concerned. The Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM) (2015) recognises the significance of cultural safety when dealing with cultural communities. The notion of cultural safety denotes a philosophy. It is a philosophy that influences how healthcare professionals deliver or practice care. The philosophy places emphasis on structural and systemic issues in the society and their connection to wellbeing. As per the philosophy, health and wellbeing are significantly influenced by social and cultural factors (Kruske, Kildea & Barclay, 2006). Accordingly, healthcare professionals must recognise these factors in the delivery of care. They must acknowledge a community’s unique needs and be familiar with their cultural and historical background. This approach to care is imperative for ensuring quality care. For Aboriginals and Torres Strait Islanders, “cultural safety provides a decolonising model of practice based on dialogue, communication, power sharing and negotiation, and the acknowledgement of white privilege” (CATSINaM, 2015).

The importance of cultural safety stems from the link between cultural identity and health equity. This link is extensively supported by literature. According to Unger (2011), cultural identity – the characteristics and experiences shared by a given group of people – influences how people behave, think, and make decisions. Ultimately, these thoughts, behaviours, and decisions influence their health. They influence how people perceive disease, protective health behaviours, and treatments for disease (Geronimus et al., 2016). Cultural identity also affects the kind and incidence of illnesses a given community experiences. For Aboriginals…