Health issues of Aboriginal people have gained immense media attention due to the inadequacy of the healthcare facility provided to them. The media has reported that the health issues of Aboriginal people in Australia are hundred years behind the rest of Australia (Hewett, 2007) even though indigenous people account for 2.4 percent of the total population (Young, 2007). Media reports suggest that the lack of proper care by the government regarding health issues of Aboriginal people has reduced their life expectancy for both men and women as compared to the whole Australian population.
The problems that have repeatedly come across regarding aboriginal health are a smoking problem, drug abuse, cancer, and obesity. This paper tries to enumerate the incidence of cancer in Aboriginal people and the difference in reporting of the incidence of the media and that by the government. Then the paper also discusses the socio-economic conditions, which have increased the incidence of cancer among Aboriginal people in Australia.
The report relies on data from newspapers like The Age, Sydney Morning Herald, The Australian, etc., and internet sources like Australian Indigenous Health Infonet for data on media’s views and representation of the health issue. The government’s side of the representation is derived from the website of the Australian Bureau of Statistics. A more academic view is derived from the analysis of the research article in the peer-reviewed journal Critical Public Health (Newmana et al., 2008).
Cancer kills more people than any other cause of death in Australia (Australian Bureau of Statistics, 2005). However, according to government reports the incidence of death rates due to cancer has been on the decline for the whole of Australia from 1984 to 2002. According to this report, cancer causes 17 percent of indigenous deaths (Australian Bureau of Statistics, 2006). It has been noted by the report that cancer has accounted for hospitalization of 1 percent of the Indigenous population, which amounted to 1,070 and 1,344 of Indigenous males and females respectively in 2003-04. In each age group under study, each age group, the rate of hospitalization of Aboriginal people was lower as compared to non-Aboriginal people (Australian Bureau of Statistics, 2006).
According to government reports, hospitalization of Indigenous Australian cancer patients is lower than that of non-Indigenous Australians.
However, the report fails to compare the absolute incidence of cancer among Aboriginal people and that among non-Aboriginal people. The Australian has reported that the health issues faced by Aboriginal people are similar to those faced by them in the colonial years 150 years ago (Cresswell, 2007). The article states that the health facilities available to Aboriginal people are scant and the reason cited for poor health conditions among aboriginal people in Australia are poverty, poor living conditions, and social inequality. Therefore, there exists a gap in the actual number of Aboriginal people afflicted with cancer patients and the people who are hospitalized for treatment.
Australian Indigenous Health Infonet (2009) suggests that cancer among Aboriginal people has not been properly reported in Australia. The report suggests that the degree of notification to Aboriginal people suffering from cancer is poor. Another problem identified is in reporting of cancer as a proportion of deaths it causes instead of rates which have provided erroneous results which given the impression that incidence of cancer among Aboriginal people is not such a great concern.
According to The Age, the survival rate of indigenous people diagnosed with cancer is less than non-indigenous people (The Age, 2006). Indigenous people are 30 percent more likely to die of cancer than non-Indigenous people are. According to the report, Indigenous people are less likely to get treatment and their disease recorded in health data. The low record of Indigenous people in Medical charts is due to less Indigenous cancer stage recorded, especially fewer cases at an early stage of cancer.
The brief review above shows that the government data on cancer and that by the media differ in its presentation. The former concentrates more on the causes of death rather than on the incidence of cancer among aboriginals. While the latter shows the number of cases of cancer among aboriginals. For the report, the sources of data collection are mainly secondary.
Cancer is a disease, which accounts for the maximum share of deaths among Aboriginal people in Australia. Media reports show that people in the bush have a higher rate of cancer than those living in cities (Catalano, 2007). The report states that the reason shown by government reports indicate the reasons for the higher incidence of cancer among rural people, which are “increased sun exposure, higher smoking rates and delaying visits to a doctor”. The reason for this inability of the people residing in remote localities to avail of hospital facilities has been attributed to their poverty, unawareness, and unavailability of regional cancer research centers.
Newmana et al. (2008) conducted a meta-analysis of the literature available on the incidence of cancer on Aboriginal people in Australia and the causes behind it. They argue that Aboriginal people have undergone “dispossession, cultural genocide and social dislocation” (66) since the time of the European invasion of the country. The continued dramatic effect is observed on the economic, social, and health inequities of aboriginals until date.
The study of cancer reveals that there are no suitable data on aboriginal or national cancer incidence and mortality, which could be used to draw a comparison between the Aboriginal and non-Aboriginal people (Newmana et al., 2008). Due to the paucity of clear data on cancer incidence of Aboriginal people, it has become difficult to determine the degree of risk that these people are exposed to. Small studies in urban and rural areas like Queensland, South Australia, Northern Territory, and Western Australia, have shown a pattern of incidence and mortality rate of cancer among Aboriginal people. The studies have shown that cancer-related to smoking, liver, and cervical are more common among Aboriginal people.
The incidence of cancer in rural areas is twice as likely as compared to those in urban areas of Queensland (Newmana et al., 2008: 67). On the other hand, more curable forms of cancer such as breast, colorectal, prostate, and skin cancer are lower among Aboriginal people.
The study also relates that the mortality rate among aboriginals is higher as compared to non-Aboriginals. For example, in Queensland, the death rate of Aboriginal people is expected to be 30 percent higher than that of non-Aboriginal people. Another study conducted in Northern Territory suggests that the mortality rates among Aboriginal people due to smoking almost doubled between 1977 and 2000. The increase was from 57.4 per 100,000 in 1977–1982 to 117.3 per 100,000 in 1997–2000 (Newmana et al., 2008: 67).
Aboriginal women in Western Australia had twice the chance of dying of ovarian cancer as compared to non-Aboriginal women in the region. Women living in rural areas throughout Australia had 9 times the risk of dying due to cervical cancer as compared to non-Aboriginal women. Furthermore, there remains the fact that the risk incidence of death due to cancer among Aboriginal people remained higher than that in non-Aboriginal people at any stage of diagnosis (Newmana et al., 2008: 67).
A more recent study of the incidence of cancer among Aboriginals reveals that in 2000-2004, 3,083 Aboriginal people have been diagnosed with cancer (Australian Indigenous Health Infonet, 2009). The study also shows that most common cancers diagnosed among Indigenous males were of the “lung, bronchus and trachea (19% of all male cancer reported), prostate cancer (10%), colorectal cancer (10%), cancer of unknown primary site (6%), and lymphomas (5%)”.
Among Aboriginal women, the most common cancer diagnosed were “breast cancer (25% of all female cancer cases reported), cancer of the lung, bronchus and trachea (12%), colorectal cancer (9%), cancer of the cervix (7%) and cancer of unknown primary site (6%)”. Moreover, Aboriginal females were more prone to be infected with cancer than the non-aboriginal population.
Newmana et al. (2008) argue that the health services could provide a better service to the Aboriginal people. The study reveals that screening of cancer among aboriginals is low. The diagnosis of the disease is usually late, and referral for treatment and specialized care is poor. Another problem that has been observed is compliance and follow-up of cancer-infected aboriginal patients. In addition, there is a lack of proper communication between primary health units or hospitals with specialist service centers.
As cancer prevalent among Aboriginals are that related to lungs, liver, etc. there are chances of reducing mortality rate due to cancer to a great extent if proper treatment is provided to the aborigines. Therefore proper cancer screening is one area, which requires considerable attention. Another aspect, which may have prevented proper health care facility being availed by aboriginals, is related to their socio-economic condition. It is believed that cultural factors may be a clear deterrent to uptake cancer screening. The reason for the lack of screening can be removed by proper information flow to these people.
The problem of cancer treatment of Aboriginal people is related to the general healthcare problems associated with them. As has been reported by The Age the Australian government must work with Aboriginal people to improve their health to make the health program successful (Anderson, 2007). According to the newspaper report, political interest runs higher than true intentions to improve health facilities for Aboriginal people. Thus, it states, “Aboriginal health has been in the national spotlight for more than three decades. There has been gain over that time in life expectancy and death rates. The disparities remain. They are significant.
Yet we now know where to invest to make a difference. Aboriginal health will benefit from a commitment to health system reform that is underpinned by values such as quality and equity. To improve outcomes for Aboriginal Australians we need a policy commitment to the provision of effective quality health-care services based on need.” (2007) Therefore, media reports show that aboriginal people have not received the proper healthcare services that other Australians receive.
One reason, which is apparent in the media reports, is the lack of political will and intention of political leaders to improve healthcare gaps among non-Aboriginal Australians and Aboriginal Australians (Anderson, 2007; Hewett, 2007). The media reports that indigenous Australians have not benefited from the government-sponsored health facilities enjoyed by other Australians. A report by the National Aboriginal Community Controlled Health Organisation and Oxfam found that Australia even though being a first-world country fails to provide sufficient health care for the wellbeing of first-nation people (Hewett, 2007).
However, the article criticized Australia for being wealthy as well as incompetent in solving the “health crisis affecting less than 3 percent of its population”. Media reports suggest that Aboriginal Australians even though the government may suggest that even though they intended to do everything to help the Aboriginal Australians it was they at fault for not being able to reap the benefits.
However, the newspaper report suggests that the lack of health care facilities for indigenous people was a result of the lack of governmental leadership’s intention to revamp the health care programs to facilitate the Aboriginal Australians more.
Another reason, which has been cited as the possible cause of lack of health care facility, is “linguistic and cultural barriers” (Newmana et al., 2008: 69). Thus, there is a need for health care facilitators to be able to communicate properly with the aboriginals and the patients. Further, there is a need to increase appreciation of aboriginal culture among non-Aboriginal health care facilitators. Thus, there is a need to increase greater cultural compatibility among healthcare service providers.
There has arisen Aboriginal Community Controlled Health Services (ACCHSs) which has been successful in removing these barriers related to cultural difference and has gained immense acceptance among aboriginals. However, these are limited in number and face financial constraints. In 2008 130 ACCHS centers were operating in Australia. The services range from large services including medical practitioners to small services, which have health education in their focus. However, the main quotient for the success of these services is help from the local Aboriginal community and active participation of all Aboriginal people in service delivery as well as development.
However, media reports suggest that ACCHS is usually faced with financial insecurity, which becomes a barrier to providing optimal service. Further ACCHS is not a full-proof solution to health care against cancer as they are competent until cancer prevention and screening is concerned, however, have to “refer on” for treatment. It is believed that these patients seldom like to leave the trusted facilities at ACCHS and venture out to unfamiliar hospitals or health services (Newmana et al., 2008: 69).
There are various factors, which have deterred the actual access of aboriginals to proper health care services in Australia. The ardent neglect of the Aboriginal people has increased the stress on aboriginals. As the incidence of cancer has increased over the years among aboriginals and has started claiming more and more lives, the clear focus on the cancer-related health issues among aboriginals has become apparent. Socio-cultural factors have become one of the main reasons behind the differential experience of aboriginals and non-aboriginals experience of cancer. One effective measure of preventing cancer among aboriginals is to understand their ideas of health and disease, which will help to develop a more effective health care program:
“While some issues may be broadly relevant to others of the many ethnic and cultural groups that make up the Australian population many issues will be differently experienced or expressed by Aboriginal people. In addition, while there may be considerable differences between ‘traditional’ Aboriginal health beliefs and biomedical precepts, they are not necessarily mutually exclusive” (Newmana et al., 2008: 71).
Therefore, it must be kept in mind while designing a proper healthcare system for aboriginals, which is cultural diversity and beliefs of the indigenous people. An appreciation of the socio-cultural situation of aboriginals will help in improving medical health facilities for Aboriginal people.
Reference
Anderson, I. (2007) Aborigines need more than platitudes. Web.
Australian Bureau of Statistics (2005) Cancer trends. Web.
Australian Bureau of Statistics (2006) Cancer in Australia: A Snapshot, 2004-05. Web.
Australian Indigenous Health Infonet (2009) Review of cancer among Indigenous peoples. Web.
Catalano, C. (2007) Cancer takes more rural men. Web.
Cresswell, A. (2007) Breaking the cycle. Web.
Hewett, A. (2007) Lift the death sentence on indigenous lives. Web.
Newmana, C., Butowb, P., Knightc, R. and McMilland, K. (2008) ‘Cancer and Aboriginal people in Australia: A review of the literature’, Critical Public Health, vol. 18, no. 1, p. 65–75.
The Age (2006) Lower cancer survival rate in indigenous. Web.
Young, E. (2007) Aboriginal health lagging 100 years behind. Web.