Essay on Review of National Aboriginal and Torres Strait Islander Health Plan Policy

Introduction

The Aboriginal and Torres Strait Islanders are ingenious Australians who have a familial heritage to communities that occupied Australia before it was colonized by the British. Excluding the Torres Strait Islanders, the Aboriginals are indigenous groups tied to mainland Australia and its islands. Aboriginals encompass many regional groups that identify with a common language, locality, or neighboring group (Ring & Griffiths, 2021). The Torres Strait Islanders have a different cultural history and heritage from the Aboriginals. However, years of oppression and mistreatment have led to extensive cultural and connection losses to the country (Ring & Griffiths, 2021). The Indigenous Australians continue to face health inequalities and socioeconomic disadvantages despite the protective laws (National Aboriginal and Torres Strait Islander Health Plan, 2013). The Australian government established the National Health Plan for Aboriginal and Torres Strait Islanders. This essay will analyze the National Aboriginal and Torres Strait Islander Health Plan Policy by reviewing its main elements, general goals, strengths, and limitations towards achieving equity in the health sector.

Overview of Policy

The Australian government has been committed to enhancing Indigenous Australians’ health status and mental well-being, specifically the Torres Strait Islanders and Aboriginals. It has strived to close the gap and disparities in health outcomes between indigenous people and non-indigenous (National Aboriginal and Torres Strait Islander Health Plan, 2013). A framework was established in 2018 to address the disadvantages faced by the Torres Strait Islanders and the Aboriginals by formulating six targets to close the existing health gaps (HealthInfoNet, 2021). Additionally, the Torres Strait Islanders and the Aboriginals were granted collaborative opportunities to formulate the health plan which laid the direction of the health policy.

The plan outlines an evidence-based policy to be implemented in the long term as part of the approach to breach the gap per the Council of Australian government’s strategy. Two out of the six targets set in the health plan directly address the health outcomes, closing the gap in life expectancy and halving the child mortality rates (National Aboriginal and Torres Strait Islander Health Plan, 2013). The other four targets are concerned with determinants of health in society, such as employment and job opportunities. In addition, the health plan complements the UN Declaration on Indigenous People Rights (HealthInfoNet, 2021). The health plan is conscious of the role of culture in the Indigenous Australians health and their rights to healthy, safe and empowered life.

Key Elements of the Policy

The vision of the National Aboriginal and Torres Strait Islander Health Plan Policy is to ensure the health sector is racism and inequality-free. It also underscores the need for all Torres Strait Islanders and Aboriginals to have equal access to effective, high-quality, and affordable healthcare (Gerrard et al., 2021). Further, the goal of the health plan is to create a targeted and evidence-based practice that will help achieve equality in life expectancy and health status between the non-indigenous Australians and the Aboriginal and Torres Strait Islanders (National Aboriginal and Torres Strait Islander Health Plan, 2013). The six targets to be achieved in closing the gap are; halving of indigenous children below five years mortality rates, closing the gap between life expectancies by 2031, enabling all four-year-old children in remote indigenous communities can access early education, halving the reading, writing, and numeracy gap for indigenous children and cut the gap in job outcomes between non-indigenous and indigenous Australians by half.

An important element of the health plan is the principles used in the approach. The first principle is the human rights and health equality approach. The approach based on the UN Declaration on the Rights of Indigenous People is concerned with equal health opportunities in access, availability, quality, and acceptability of health services (National Aboriginal and Torres Strait Islander Health Plan, 2013). The second principle is the community control and engagement of the Torres Strait Islanders and Aboriginal people(Fisher et al., 2019). All decision-making levels require full and continuous input by the indigenous groups and their organizations to provide holistic and culturally appropriate health services (Fisher et al., 2019). Partnership and accountability are the last principles applied in the plan with partnering aim to eliminate health barriers.

Strengths of the Policy

Continuous monitoring of the health plan’s implementation has been a major factor in tracking the health plan’s success. There have been significant improvements in the health status of Torres Strait Islanders and Aboriginal people (Ring & Griffiths, 2021). The report card for the implementation process shows a decline in overall mortality rates by 14 % between 1998 to 2017, a 35% decline in child mortality rate over the same period. According to the data collected on the progress, the implementation yields positive results in most of the goals, and about twelve objectives are on course to be realized by 2023 (Ring & Griffiths, 2021). The data also shows improvements in various social and health outcomes. Data collected also shows a decline in the rate of people smoking among the Aboriginal and Torres Strait Islanders, from 51 to 42%.

Research has shown that the health status of an individual is associated with their economic and social status. Therefore, an effective strategy in addressing the economic, social, and environmental inequalities is key to attaining equality in health (Fisher et al., 2019). The National Aboriginal and Torres Strait Islander Health Plan Policy have effectively achieved most of its targets over the years because it addresses the social determinants of health. Further, the plan considers the multiple factors contributing to ill health and outside the mandate and roles of the health providers (Ring & Griffiths, 2021). The health plan has aligned its goals and programs with key social determinants of health, including education, employment, and housing (Fisher et al., 2019). The plan’s strength also lies in its health program and evidence-based policies derived from wide health research and informed data systems.

Limitations of the Policy

Despite the improvements made in the health outcomes of the Aboriginal and Torres Strait Islander people, more needs to be done to reduce the health inequality gap. Although the life expectancy of Indigenous Australians has increased, it is not sufficient to breach the existing gap (Griffiths et al., 2019). Since 1998, the mortality gap has not changed significantly due to the continued decline in mortality rates in indigenous and non-indigenous populations. In the Aboriginal and Torres Strait Islanders population, mortality rates in cancer between 1998 and 2017 have increased by 25% and are still widening (Ring & Griffiths, 2021). Although the rates of chronic diseases are improving, they remain the biggest contributors to the mortality rates gap between non-indigenous Australians and the Aboriginal and Torres Strait Islander peoples.

The health plan policy’s limitations can be attributed to the multiple concern areas that are yet to be improved. Further action is needed in efforts that support good health and give children a good start from preconception to late childhood (Griffiths et al., 2019). More also needs to be done to reduce the rate of smoking among pregnant women. The plan should have emphasized initiatives that encourage Torres Strait and Aboriginal mothers to breastfeed well, maintain healthy behaviors during pregnancy and improve healthy infant nutrition (Ring & Griffiths, 2021). Additionally, the foundations built for improved cultural safety were not embedded across the healthcare sector, specifically across the mainstream (Ring & Griffiths, 2021). Cultural safety should be the priority for all jurisdictions because the system levers are distributed across the states and commonwealth.

Areas of Debate

The correlation between the Torres Strait Islander and Aboriginal people and the health liberty at international law perspective illustrates how human rights frameworks were influenced and appropriated by indigenous social movements. The indigenous groups were pushing for rights recognition in the international human rights while also using the existing domestic frameworks to pursue local causes (Mazel, 2018). There is debate about human rights’ value and impacts at local levels and for the indigenous Australians because they depend on the government acting as a social change agent. The has been a poor record of implementation of international laws by the Australian legislature (Ring & Griffiths, 2021). Similarly, critics are wary of the effectiveness of the National Aboriginal and Torres Strait Islander Health Plan Policy and its intended health outcomes.

Although there have been significant developments in information regarding the health of Aboriginal and Torres Strait Islanders, many challenges exist. The accuracy of the reported measures and summary estimates of life expectancies, mortality rates, and methods used to estimate the associated changes over time have uncertainties and reliability issues (Gerrard et al., 2021). The available wealth of information is not used sufficiently, and the system that allows formal use of the data is vestigial to unavailable. Moreover, the available data mainly focuses on traditional biomedical topics and limited attention to availability, expenditure, and access to healthcare services (Griffiths et al., 2019). A renewed focus is necessary for the health plan to effectively engage the young Aboriginal and Torres Strait Islander people to support their positive mental and physical well-being (Gerrard et al., 2021). Therefore, more needs to be done to boost employment and education outcomes that enhance health status.

Conclusion

The Australian government has been committed to enhancing Indigenous Australians’ health status and mental well-being, specifically the Torres Strait Islanders and Aboriginals. It has strived to close the gap and disparities in health outcomes between indigenous people and non-indigenous as stated in the National Aboriginal and Torres Strait Islander Health Plan Policy. The policy aims to ensure the health sector is racism and inequality-free and underscores the need for all Torres Strait Islanders and Aboriginals to have equal access to effective, high-quality, and affordable healthcare. It outlines an evidence-based policy to be implemented in the long term as part of the approach to breach the gap per the Council of Australian government’s strategy, with two out of the six targets set in the health plan directly addressing the health outcomes; closing the gap in life expectancy and halving the child mortality rates. Continuous monitoring of the health plan’s implementation has been a major factor in tracking the health plan’s success. It has effectively achieved most of its targets over the years because it addresses the social determinants of health. Although the life expectancy of Indigenous Australians has increased, it is not sufficient to breach the existing gap.

References

Gerrard, J. M., Godwin, S., Chuter, V., Munteanu, S. E., West, M., & Hawke, F. (2021). Release of the National Scheme’s Aboriginal and Torres Strait Islander Health and Cultural Safety Strategy 2020-2025; the impacts for podiatry in Australia: a commentary. Journal of foot and ankle research, 14(1), 38. https://doi.org/10.1186/s13047-021-00466-8

Griffiths, K., Coleman, C., Al-Yaman, F., Cunningham, J., Garvey, G., Whop, L., … & Madden, R. (2019). The identification of Aboriginal and Torres Strait Islander people in official statistics and other data: Critical issues of international significance. Statistical Journal of the IAOS, 35(1), 91-106.

HealthInfoNet, A. I. (2021). Overview of Aboriginal and Torres Strait Islander health status 2020. Edith Cowan University.

Fisher, M., Battams, S., Mcdermott, D., Baum, F., & Macdougall, C. (2019). How the social determinants of Indigenous health became policy reality for Australia’s National Aboriginal and Torres Strait Islander Health Plan. Journal of Social Policy, 48(1), 169-189.

National Aboriginal and Torres Strait Islander Health Plan 2013–2023. (2013). Retrieved 26 October 2021, from https://www.health.gov.au/resources/publications/national-aboriginal-and-torres-strait-islander-health-plan-2013-2023

Mazel O. (2018). Indigenous Health and Human Rights: A Reflection on Law and Culture. International journal of environmental research and public health, 15(4), 789. https://doi.org/10.3390/ijerph15040789

Ring, I., & Griffiths, K. (2021). Australian Aboriginal and Torres Strait Islander Health Information: Progress, Pitfalls, and Prospects. International journal of environmental research and public health, 18(19), 10274. https://doi.org/10.3390/ijerph181910274