Institutional racism in Australian healthcare: a plea for decency

Henry, Barbara R.; Houston, Shane; Mooney, Gavin

doi:10.5694/j.1326-5377.2004.tb06056.x

Cited by 146 publications

(124 citation statements)

References 3 publications

(3 reference statements)

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“…For instance, Schepper’s (2006) adaptation of Andersen’s model [19] does not address racism as a barrier to HCU among ethnic minorities, even though it is noted that such populations are often victims of discrimination and segregation. Institutional racism in the Australian health care system has previously been documented [31,32] and our findings demonstrate that patients or stories of significant others who experienced racism are less likely to use health services in the future. Similarly, issues such as previous experiences, mistrust, fear and competing priorities are not included in the above-mentioned HCU frameworks.…”

Section: Discussionmentioning

confidence: 50%

Factors influencing health care utilisation among Aboriginal cardiac patients in central Australia: a qualitative study

Artuso

Cargo

Brown

et al. 2013

BMC Health Serv Res

109

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BackgroundAboriginal Australians suffer from poorer overall health compared to the general Australian population, particularly in terms of cardiovascular disease and prognosis following a cardiac event. Despite such disparities, Aboriginal Australians utilise health care services at much lower rates than the general population. Improving health care utilisation (HCU) among Aboriginal cardiac patients requires a better understanding of the factors that constrain or facilitate use. The study aimed to identify ecological factors influencing health care utilisation (HCU) for Aboriginal cardiac patients, from the time of their cardiac event to 6–12 months post-event, in central Australia.MethodsThis qualitative descriptive study was guided by an ecological framework. A culturally-sensitive illness narrative focusing on Aboriginal cardiac patients’ “typical” journey guided focus groups and semi-structured interviews with Aboriginal cardiac patients, non-cardiac community members, health care providers and community researchers. Analysis utilised a thematic conceptual matrix and mixed coding method. Themes were categorised into Predisposing, Enabling, Need and Reinforcing factors and identified at Individual, Interpersonal, Primary Care and Hospital System levels.ResultsCompelling barriers to HCU identified at the Primary Care and Hospital System levels included communication, organisation and racism. Individual level factors related to HCU included language, knowledge of illness, perceived need and past experiences. Given these individual and health system barriers patients were reliant on utilising alternate family-level supports at the Interpersonal level to enable their journey.ConclusionAboriginal cardiac patients face significant barriers to HCU, resulting in sub-optimal quality of care, placing them at risk for subsequent cardiovascular events and negative health outcomes. To facilitate HCU amongst Aboriginal people, strategies must be implemented to improve communication on all levels and reduce systemic barriers operating within the health system.

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Section: Discussionmentioning

confidence: 50%

Factors influencing health care utilisation among Aboriginal cardiac patients in central Australia: a qualitative study

Artuso

Cargo

Brown

et al. 2013

BMC Health Serv Res

109

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“…Recognising and addressing entrenched and institutional racism is an important first step in ensuring the needs of Indigenous children are addressed [59]. …”

Section: Discussionmentioning

confidence: 99%

Childhood disability in Aboriginal and Torres Strait Islander peoples: a literature review

DiGiacomo

Davidson

Abbott

et al. 2013

International Journal for Equity in Health

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IntroductionAboriginal and Torres Strait Islander children have higher rates of disability than non-Indigenous children and are considered doubly disadvantaged, yet there is very little data reflecting prevalence and service access to inform design and delivery of services. Failing to address physical, social, and psychological factors can have life-long consequences and perpetuate longstanding health disparities.MethodsA narrative literature review was undertaken to identify peer reviewed literature describing factors impacting on the prevention, recognition, and access to support and management of disability in Indigenous Australian children.ResultsTwenty-seven peer-reviewed journal articles met inclusion criteria. The majority of articles focused on the hearing loss and learning disabilities consequent of otitis media. Few articles reported data on urban or metropolitan Indigenous populations or described interventions. Individual/community-, provider-, and systems level factors were identified as impacting on recognition and management of disability in young Indigenous children.ConclusionsGiven the burden of childhood disability, the limited literature retrieved is concerning as this is a barometer of activity and investment. Solutions addressing childhood disability will require collaboration between health, social and educational disciplines as well as an increased investment in prevention, identification and promotion of access.

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“…A general lack of trust in mainstream services by the Indigenous community and previous experiences of racism and discrimination can draw individuals away from these services (Eley et al . 2007; Henry et al . 2004; McKendrick 2007; Wenitong 2002).…”

Section: Contacting the Mental Health Servicementioning

confidence: 99%

Barriers and facilitators to the utilization of adult mental health services by Australia's Indigenous people: Seeking a way forward

Isaacs

Pyett

Oakley‐Browne³

et al. 2010

Int J Mental Health Nurs

105

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Mental disorders are the second leading cause of disease burden among Australia's Indigenous people after cardiovascular disease. Yet Indigenous people do not access mental health services in proportion to their need. This paper explores the barriers and facilitators for Indigenous people seeking mental health services in Australia and identifies key elements in the development and maintenance of partnerships for improved service delivery and future research. The process of seeking help for mental illness has been conceptualized as four consecutive steps starting from recognizing that there is a problem to actually contacting the mental health service. We have attempted to explore the factors affecting each of these stages. While people in the general population experience barriers across all four stages of the process of seeking treatment for a mental disorder, there are many more barriers for Indigenous people at the stage of actually contacting a mental health service. These include a history of racism and discrimination and resultant lack of trust in mainstream services, misunderstandings due to cultural and language differences, and inadequate measures to reduce the stigma associated with mental illness. Further research is required to understand the mental health literacy of Indigenous people, their different perceptions of mental health and well-being, issues around stigma, and the natural history of mental illness among Indigenous people who do not access any form of professional help. Collaborations between mainstream mental health services and Aboriginal organizations have been promoted as a way to conduct research into developing appropriate services for Indigenous people.

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Institutional racism in Australian healthcare: a plea for decency

Cited by 146 publications

References 3 publications

Factors influencing health care utilisation among Aboriginal cardiac patients in central Australia: a qualitative study

Factors influencing health care utilisation among Aboriginal cardiac patients in central Australia: a qualitative study

Childhood disability in Aboriginal and Torres Strait Islander peoples: a literature review

Barriers and facilitators to the utilization of adult mental health services by Australia's Indigenous people: Seeking a way forward

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