When compared to non-Indigenous Australians, Aboriginal and Torres Strait Islander people, also known as Indigenous Australians, are disadvantaged across a number of health and socioeconomic indices. Indigenous health refers to Torres Strait Islander people’s social, cultural, emotional, and physical well-being. Many Indigenous Australians have lower health than non-Indigenous Australians and often die at far younger ages as a result. Mental health issues and chronic diseases such as respiratory disorders, cardiovascular disease, diabetes, and chronic kidney disease are more common in Indigenous Australians than in non-Indigenous Australians. There is also a persistently high prevalence of diseases — and the symptoms that emerge from them — that are now essentially unknown in the non-Indigenous community.
Aspects such as the lack of social privileges, in particular access to health care, low education, bad habits, low physical activity, and poor nutrition, result in the health of the Aboriginal population being much lower than that of non-indigenous Australians. Indigenous Australians are also more likely to live in rural areas of the country in comparison to non-Indigenous Australians. Indigenous Australians are hesitant to participate in population screening programs for bowel, breast, and cervical cancer (Ristevski et al., 2020). Indigenous Australians are more frequently diagnosed with cancer and die from it than non-Indigenous Australians for all cancer types combined. The low level of survival of the Indigenous people also determines the low prevalence statistics in comparison with the non-Indigenous population.
Discussion
In Australia, cancer is a leading cause of death and has a significant impact on families and communities. Cancer refers to a group of diseases that cause healthy body cells to be damaged, causing them to develop abnormally and spread to other parts of the body (National Cancer Institute, 2015). Cancer can evolve practically anywhere in the body, and there are over 200 different forms of cancer (Haigh et al., 2018). The type of cancer is usually determined by the body part that has been affected, for example, lung cancer affects the lungs. The process of cancer cells moving and spreading to different places in the body is called metastasis.
The cancer disease cases among Indigenous Australians are relatively high. There were 8,447 cancer hospital admissions registered in Australia among Indigenous populations in 2017–18 (Australian Institute of Health and Welfare, 2018). This number represents 3% of all hospitalizations among Aboriginal and Torres Strait Islander persons. Overall, Aboriginal and Torres Strait Islander individuals are less likely to be sent to hospital because of cancer than non-Indigenous people (Australian Institute of Health and Welfare, 2018). The average length of stay in hospital for Aboriginal and Torres Strait Islander persons is proven to be longer than for non-Indigenous individuals (Australian Institute of Health and Welfare, 2018). This could be explained in part by the difficulty they face in obtaining suitable health services, as well as issues associated with the necessity to travel to receive treatment.
Certain lifestyle risk factors are more prevalent among Aboriginal and Torres Strait Islander peoples, which may help to explain some cancer incidence and death trends. Indigenous Australians are three times more likely than non-Indigenous Australians to get liver cancer, are 3.3 times more likely to die from it, and have a reduced chance of surviving another year (Australian Institute of Health and Welfare, 2018). Indigenous people are more likely to take dangerous doses of alcohol, which contributes to the development of a tendency to infection with hepatitis B, which affects the development of liver cancer. Indigenous women are two times more likely than non-Indigenous women to have cervical cancer, three times more likely to die from it, and have a decreased chance of surviving another five years (Jaenke et al., 2021). This tragic statistic is also due to the much less frequent servical screening for this population (Hall et al., 2018).
Indigenous Australians are statistically more likely to develop lung cancer, with relatively high mortality rates. Smoking is more common among Indigenous Australians than among non-Indigenous Australians, which could be a contributing cause (Australian Institute of Health and Welfare, 2013). Indigenous women who were diagnosed with breast cancer between 2003 and 2007 had a 100% higher mortality risk from any cause by 2010 than non-Indigenous women (Diaz et al., 2019). The reason for this is much less attention paid to disease monitoring compared to non-indigenous populations (Banham et al., 2019). Both external causes and cultural beliefs contribute to late diagnosis and difficult treatment.
Risk factors for developing the disease, such as active and passive smoking, overweight and obesity, are significantly more common among Aboriginal people than in the rest of Australia. Changes in behavior and lifestyle, such as stopping smoking, eating a nutritious diet, and increasing physical activity, can all help to reduce these risk factors (Thurber et al., 2021). Alcohol intake, viral disorders, environmental conditions, and radiation are all risk factors. However, one should take into account the element of chance, in which the absence of risk factors does not guarantee the absence of the disease, and vice versa, the presence of these factors does not necessarily start the disease process.
In general, there are a significant number of aspects influencing such a wide spread of cancer among Aboriginal and Torres Strait Islander people. Cancer risk is determined not only by a person’s age, family history, and behavior but also by elements from their past, such as their social and socioeconomic condition, cultural background, and where they originate from and live (Youlden et al., 2021). Cancer kills more Aboriginal and Torres Strait Islander people than it does non-Indigenous people (Australian Institute of Health and Welfare, 2018). Cancer claimed the lives of 2,917 Aboriginal and Torres Strait Islander persons between 2012 and 2016, an average of 583 per year (Australian Institute of Health and Welfare, 2018). Lung, trachea (windpipe), and bronchus (major airways to the lungs) malignancies were the fourth greatest cause of mortality for Aboriginal and Torres Strait Islander persons in 2018 (Australian Bureau of Statistics, 2019). Diseases such as bowel cancer, pancreatic cancer, or blood sarcomas are also common causes of death among Indigenous Australians.
This deplorable situation stems directly from the socio-historical conditions that shaped the culture and beliefs of the Aboriginal people. For thousands of years, Aboriginal and Torres Strait Islander people have resided on their ancestral grounds across Australia, including the Torres Strait islands (Butler et al., 2019). Prior to colonization, these peoples lived in a nomadic state of hunters-producers, changing the land in accordance with weather conditions and the requirements of the season. Around 1788, Australia was colonized, resulting in major changes in the lives of Aboriginal and Torres Strait Islander people. These modifications had a big influence on people’s health and happiness (Prehn and Ezzy, 2020). The social, emotional, and cultural well-being of Aboriginal and Torres Strait Islander peoples, as well as their ability to contribute to the community, are all factors derived from the demographics.
Aboriginal and Torres Strait Islander health attitudes are heavily influenced by social identity. The traditional bias of some Aboriginal and Torres Strait Islander people prevents them from participating in cancer screening programs or agree to receive treatment (Chynoweth et al., 2020). There has been much shame about cancer and a lack of faith in health services (Haigh et al., 2018). In 2019, Australia’s Aboriginal and Torres Strait Islander population was estimated to be 847,190 persons, accounting for 3.3 percent of the overall population (Australian Bureau of Statistics, 2019). New South Wales (NSW) and Queensland were home to the bulk of Aboriginal and Torres Strait Islander people (Qld). The Northern Territory had the largest proportion of Aboriginal and Torres Strait Islander people (32%) despite its smaller population (NT). In 2016, it was projected that over 60% of Aboriginal and Torres Strait Islander people lived outside of large cities, with over 19% residing in rural and distant areas (Australian Bureau of Statistics, 2019). Young people constitute a bigger part of the Aboriginal and Torres Strait Islander population, whereas senior people make up a lesser fraction.
Health-care services that incorporate Aboriginal and Torres Strait Islander socio-demographic factors can help these patients live longer and healthier lives. As a result, health care workers who understand Aboriginal and Torres Strait Islander cancer beliefs and views will be better equipped to care for patients. In Australia, there are numerous cultural awareness training programs aimed at educating health professionals about the requirements of their Aboriginal and Torres Strait Islander patients.
The National Aboriginal and Torres Strait Islander Cancer Framework was established in 2015 as the first national strategy to enhance cancer outcomes for Aboriginal and Torres Strait Islander people. Individuals, communities, organizations, and governments can all benefit from it (Cancer Australia, 2018). The Framework includes most of cancer care services, such as prevention, screening, early detection, diagnosis and treatment, as well as supporting policies, research, and infrastructure. It identifies priority areas for action and gives communities and organizations the freedom to work in ways that best suit their local context and needs, which are regularly neglected (Lisy et al., 2019).
The Framework was developed with the help of health experts who deal with Aboriginal and Torres Strait Islander peoples, as well as cancer patients. The Optimal care route for Aboriginal and Torres Strait Islander individuals was produced by Cancer Australia in 2018, and it advocated innovative ways to cancer care for Aboriginal and Torres Strait Islander persons with cancer (Cancer Australia, 2018). It demonstrates how health services and professionals may ensure that services are culturally safe and sensitive to Aboriginal and Torres Strait Islander people’s needs. A number of patient resources were also made available. They lay out what patients can expect throughout the cancer journey, from tests and diagnosis to treatment and care, cancer management, and end-of-life care.
Early identification of cancer in Aboriginal and Torres Strait Islander people is hampered by a number of barriers. First, historic causes such as colonization (including racism), political and social disadvantages had long-term consequences, including a lack of faith in healthcare providers. Second, there are difficulties accessing health treatments due to long distances to travel and a lack of resources, especially cancer services, in rural places. In comparison to non-Indigenous people, Aboriginal and Torres Strait Islander people live in greater numbers in rural places, putting them at a disadvantage (Australian Bureau of Statistics, 2019). Next is extended waiting time, which means that Aboriginal and Torres Strait Islander individuals are less likely to receive cancer treatment such as surgery, chemotherapy, and radiotherapy, and they also wait longer for an operation.
There are not enough Aboriginal and Torres Strait Islander health professionals, and there’s a lot of turnover in Indigenous-specific jobs and organizations. Another barrier is delays in seeking medical help may be caused by a lack of awareness of cancer symptoms or denial of symptoms. Further challenges to Aboriginal and Torres Strait Islander individuals using cancer health services include fees for drugs, consultations, lost wages, transportation, and a lack of cooperation among different segments of the healthcare system.
Conclusion
Despite advancements in cancer detection and treatment in recent decades, Aboriginal and Torres Strait Islander cancer patients have inferior results than non-Indigenous patients. Statistics demonstrate that, despite lower rates of frequency and hospitalization, Aboriginal and Torres Strait Islander individuals die at a higher rate than non-Indigenous people from cancer. There are many different factors such as lifestyle and behavior that contribute to the high rates of cancer disease among Indigenous Australians. However, one of the specific factors is the socio-demographic factor. The influence of the socio-demographic factors on the beliefs and mental state of the people leads to the increased risk of cancer occurrence. In addition, there are many barriers that Indigenous people face when combatting the health problem. They include poor medicine systems, incompetent health care providers, and financial difficulties. In order to make improvements in health outcomes, it is critical to reducing the burden of cancer on Aboriginal and Torres Strait Islander people. It is worth emphasizing the importance of removing obstacles to screening and other health services for Aboriginal and Torres Strait Islander people. The barriers related to the access to healthcare for Indigenous Australians should be addressed. Any strategy for Aboriginal people should aim to give them more power and knowledge to take care of their own health and well-being.
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