Indigenous Health

By AMA President Dr Steve Hambleton, Chair of the Taskforce on Indigenous Health

The AMA believes that good health is all about people being able to participate fully in social and economic life. This is also the AMA’s perspective on the health of Indigenous Australians. The poor health of Australia’s Indigenous peoples is a major barrier to social and economic participation. Low participation in Australia’s economy, welfare dependence and disengagement, in turn, entrench the poor health of Indigenous Australians. This intergenerational cycle of poor health and dependency must be broken.

A two-pronged approach is needed to break this cycle. Indigenous Australians, like all other Australians, need appropriate opportunities for genuine engagement in Australia’s economy. This means, for example, real jobs, real training and real business opportunities so Indigenous people can be owners and employers, as well as employees. The AMA believes that a lot more thought and effort needs to be put into developing these opportunities.

The AMA also recognises that it is crucial for individuals to have a full capacity, from the point of view of their health and wellbeing, to take advantage of opportunities to participate. When individuals are in the grip of substance abuse, experience poor sanitary conditions, have no private place to sleep, cannot hear because of ear disease, or become pregnant in their early teens, they are in no position to grasp life’s opportunities, or even to recognise they are there to be taken. When the communities these individuals live in lack cohesion, reflect low aspirations, lack knowledge, resources and a skill-base, and are marginalised by the rest of society, those communities cannot support individuals to move forward in their lives. Individuals and communities need to build the capacity to recognise and address the health barriers they confront.

The AMA’s Taskforce on Indigenous Health has concluded that health-related capacity-building is key to breaking the cycle of dependency and poor health among Indigenous communities. A greater focus should be placed on supporting Indigenous people’s health at critical stages along the life continuum, from early childhood to adulthood, to ensure full participation in social and economic life. For example, everyone is at risk of health setbacks in infancy and early years if they aren’t immunised or have poor nutrition or if their parents have low parenting skills. Similarly, in the transition to schooling, children will not do the best they can if they have poor hearing health, have nowhere private to sleep, have poor nutrition, and so on. These are all health-related problems. Health-related capacity building means supporting families and communities and individuals to become aware of these risks and their importance, and to develop their own ways of making sure those risks are averted and existing problems are addressed. This can mean, for example, local Indigenous communities developing parenting skills groups, or schools having their own vegetable plots, or councils taking steps to provide sanitation facilities.

The Taskforce on Indigenous Health believes that, when it comes to social and economic participation, pre-teens and adolescence is a particularly critical stage in life for Indigenous people – the risks and potential setbacks that can be experienced at this time are imminent (consider experimentation with sex and substances), and good health, resilience and wellbeing are crucial. A whole range of individual and community strengths and capacities is needed to support young people at this stage (from sexual health and relationship literacy through to strong links between parents and schools, and options of community engagement for young people, as well as role modelling).

Adolescence is a time of questioning, seeking identity and independence, and having a go. If supported in the right ways – through building sustainable capacities for good health among individuals and communities – this can be channelled into a resilience against substance abuse, against premature parenthood, and against apathy. It can be a start to breaking the intergenerational cycle of dependency, and the beginnings of full participation in Australia’s economic and social life, and full appreciation of what Aboriginal cultures have to offer.

The AMA, through the Taskforce on Indigenous Health, will continue to explore and advocate ways of making health-related capacity-building a reality for Indigenous people and communities.