HGA246 Aboriginal and Torres Strait Islander Health and Wellbeing Assessment

Introduction

In Australia, the healthcare requirements of Aboriginal and Torres Strait Islander communities are met by the Aboriginal Community Controlled Health Services (ACCHS). These services provide culturally sensitive and holistic healthcare that recognizes the tremendous effect of historical, social, as well as cultural determinants of health on Indigenous peoples' well-being (Pearson et al., 2020). A prime example of an ACCHS is the Aboriginal Medical Service Redfern (AMS Redfern), which was established in the center of Redfern, New South Wales in 1971. AMS Redfern was founded in response to an urgent demand for accessible and culturally relevant healthcare services for the local Aboriginal people (Marles et al., 2012). Their purpose is to provide comprehensive health services while also encouraging the target community to engage actively in decision-making processes. In this essay, the clinical effectiveness of AMS Redfern will be explored, examining the features that make it successful in improving the Aboriginal community’s health.

Body

The clinical effectiveness of chosen Aboriginal Community Controlled Health Services (ACCHS), AMS Redfern is strongly entrenched in a set of essential features that distinguish them as highly successful providers of healthcare to Aboriginal communities.

Cultural competence : Their continuous dedication to cultural competence constitutes a pillar of the clinical efficacy of ACCHS, particularly AMS Redfern (AMS Redfern., 2021). Their employees often hail from Indigenous backgrounds or have received in-depth training in cultural competency (Kuipers et al., 2014). This commitment ensures that healthcare services are delivered with a deep understanding of the cultural nuances, beliefs, and practices of the Aboriginal and Torres Strait Islander peoples (Bainbridge et al., 2015). As a result, patients feel heard, appreciated, and understood in the healthcare setting, establishing trust and a greater willingness to engage with the services provided (Bainbridge et al., 2015).

Holistic Care : The chosen ACCHS acknowledges a fact that health goes beyond physical well-being. A holistic approach to healthcare is adopted by AMS Redfern recognizing that social and emotional well-being, mental health, and the social determinants of health are all interconnected and important to the overall well-being of patients (Davy et al., 2016). This ACCHS ensures that healthcare is comprehensive and well-rounded by addressing these factors in addition to physical health and meets the complete heath needs of Aboriginal communities (Davy et al., 2016).

Community engagement : The community-driven approach of ACCHS is one of its distinguishing features. The local Aboriginal community is actively involved in decision-making procedures at AMS Redfern, giving community members a voice in their healthcare. This approach empowers individuals and families, enabling them to take ownership of their health and well-being (Davy et al., 2016). It promotes a sense of community ownership and involvement, which is essential for improving health outcomes.

Integrated Services : The ACCHS, particularly AMS Redfern often provide a diverse range of healthcare services under a single roof (AMS Redfern., 2021). These services could include medical care, dental care, mental health counseling, and chronic illness management (AMS Redfern., 2021). By streamlining the healthcare processes for patients, this integrated approach makes it more practical and effective. This approach offers convenience and efficiency by reducing the need for multiple appointments at different facilities (Davy et al., 2016). It also promotes continuity of care, which is very crucial in chronic illness management.

The health and well-being of Aboriginal and Torres Strait Islander peoples in Australia are profoundly influenced by historical, cultural, and social determinants of health.

Historical Determinants: The health disparities that Aboriginal people endure are firmly rooted in historical causes. These determinants include the effects of colonization, such as land dispossession, the forced removal of children (known as the Stolen Generations), and the implementation of policies such as assimilation (Davy et al., 2016). During colonization, the violent upheaval of traditional lives, cultural traditions, and communal structures inflicted permanent wounds. It has resulted in a loss of cultural identity, a diminished feeling of self-worth, and severe psychological anguish (Griffiths et al., 2016). The negative health consequences of these historical injustices reverberate in Indigenous communities, with greater incidences of mental health difficulties, substance misuse, and chronic diseases.

Cultural determinants : Cultural determinants are at the heart of Indigenous communities' well-being, providing as the foundation for both physical and mental health (Green and Minchin, 2014). They include the fundamental significance of cultural identity, historical bonds to ancestral places, and the healing effects of ancient traditions (Davy et al., 2016). Indigenous groups were often forcibly displaced from their native lands, resulting in historical injustices (Green and Minchin, 2014). Their rich cultural traditions and knowledge were purposefully suppressed, resulting in a loss of traditional wisdom that is essential for both physical and mental health (Davy et al., 2016). This cultural detachment has left an indelible mark on the health of Aboriginal and Torres Strait Islander peoples, as cultural link restoration is critical for their healing and overall well-being (Davy et al., 2016).

Social Determinants : Social determinants, comprising access to education, employment, housing, and nutritious food, exert a substantial influence on the health of Aboriginal communities (Pearson et al., 2020). Barriers to quality education continue to exist, resulting in inequities in health literacy and career prospects. Historical disempowerment through inadequate educational access has resulted in lower levels of health literacy, reducing persons' ability to make educated health decisions and advocate for their well-being (Griffiths et al., 2016). Poor housing conditions often stem from the historical impact of colonization, with overcrowding and inadequate sanitation contributing to the spread of infectious diseases (Mazel, 2016). In addition, the consequences of colonization also disrupted traditional food sources, contributing to dietary issues and exacerbating health disparities (Griffiths et al., 2016).

Within the Aboriginal community, the AMS Redfern has created a multidimensional strategy to address and lessen the impact of historical, cultural, and social determinants of health.

Mental Health Services : AMS Redfern provides crucial assistance for mental health through collaborating with groups such as Beyond Blue, the NSW Mental Health Line, and Thirrili (after-suicide support). These collaborations enable community members to gain access to critical mental health treatments, which are especially important in resolving the emotional pain and trauma produced by historical determinants (Marles et al., 2012).

Public Health Programs : The public health initiatives focused on men's and women's health, fitness, and community events are instrumental in addressing the social determinants of health. They actively engage Aboriginal community members in health education and social activities, promoting a healthier lifestyle and addressing social disparities (AMS Redfern., 2021).

Aged Care Program : Through conducting events like elders' luncheons, excursions, and aqua aerobics, this program addresses the cultural determinants of health and promotes social connections and Aboriginal community participation (Griffiths et al., 2016). This program recognizes the importance of cultural connections for the well-being of the aged population.

Screening of Sexual Health : In order to address the social determinants of health, screening of sexual health and treatment is crucial (AMS Redfern., 2021). It ensures that community members have the knowledge they require to make informed sexual health decisions (Griffiths et al., 2016). This, in turn, serves to mitigate the impact of sexual health-related social inequities, such as restricted access to excellent healthcare and sexual education.

Conclusion

Throughout the study, it is understood that AMS Redfern is a prime example of Aboriginal Community Controlled Health Services in Australia, representing a critical paradigm to improve healthcare services for the Aboriginal communities. The curative success of AMS Redfern is predicated on its cultural competence, comprehensive therapy, community engagement, as well as integrated services. These characteristics enable the population to take control of their health, leading to better health outcomes. In addition, it is acknowledged that the ongoing influence of colonization on health is profound, owing to historical, cultural, and social factors. These determinants are addressed thoroughly by AMS Redfern through a variety of programs and services, contributing to improve health outcomes of the community.

References

Aboriginal Medical Service Redfern (AMS Redfern), 2021. Our Services. Assessed on: 17.10.2023. Available at: https://amsredfern.org.au/services/

Bainbridge, R., McCalman, J., Clifford, A. and Tsey, K., 2015. Cultural competency in the delivery of health services for Indigenous people. Closing the Gap Clearinghouse . https://researchonline.jcu.edu.au/39726/1/Cultural_Competency_delivery.pdf

Davy, C., Harfield, S., McArthur, A., Munn, Z. and Brown, A., 2016. Access to primary health care services for Indigenous peoples: A framework synthesis. International Journal for Equity In Health , 15, pp.1-9. https://doi.org/10.1186/s12939-016-0450-5

Green, D., and Minchin, L., 2014. Living on climate-changed country: Indigenous health, well-being and climate change in remote Australian communities. Eco Health , 11, 263-272. https://doi.org/10.1007/s10393-013-0892-9

Griffiths, K., Coleman, C., Lee, V., and Madden, R., 2016. How colonisation determines social justice and Indigenous health—a review of the literature. Journal of Population Research , 33, 9-30. https://doi.org/10.1007/s12546-016-9164-1

Kuipers, P., Harvey, D., Lindeman, M. and Stothers, K., 2014. Aboriginal and Torres Strait Islander health practitioners in rural areas: credentialing, context and capacity building. Rural and Remote Health, 14(4), pp.164-169. https://search.informit.org/doi/pdf/10.3316/informit.312046388287527

Marles, E., Frame, C., and Royce, M., 2012. The Aboriginal Medical Service Redfern: Improving access to primary care for over 40 years. Australian Family Physician , 41(6), pp.433-436. https://www.racgp.org.au/getattachment/40ccd675-a964-4a7c-9b09-098bc5daa0e9/The-Aboriginal-Medical-Service-Redfern.aspx

Mazel, O., 2016. Self-determination and the right to health: Australian aboriginal community controlled health services. Human Rights Law Review , 16(2), pp.323-355. https://doi.org/10.1093/hrlr/ngw010

Pearson, O., Schwartzkopff, K., Dawson, A., Hagger, C., Karagi, A., Davy, C., Brown, A., Braunack-Mayer, A. and Leadership Group guiding the Centre for Research Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange (CREATE), 2020. Aboriginal community controlled health organisations address health equity through action on the social determinants of health of Aboriginal and Torres Strait Islander peoples in Australia. BMC Public Health , 20, pp.1-13. 

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