Introduction: Barriers and Service Access for Aboriginal Communities

This case study report is adequate in its focus on one of the endangered communities of Australia, the Aboriginal one. Aboriginal Australians are the Indigenous peoples of the Australian mainland and several of the islands it surrounds, and they are one of the oldest surviving civilisations in the world. This particular case includes a brief description of certain key community services that this group is trying to acquire and certain limitations to those services. However, there are solutions that can reduce one of those barriers and challenges.

The vulnerable group in Australian society

Demographic discussion

The 983,700 Aboriginal and Torres Strait Islander population was 3.8% of the total population of Australia as of June 30, 2021 (Abs.gov.au, 2023). Of those, approximately 33.1% were below fifteen years of age. Altogether, New South Wales, Queensland and Western Australia represented 74.5% of the population. 91.7 % of the 983,700 Aboriginal and Torres Strait Islander peoples of the year 2021, responded that they were Aboriginal, 4.0% as Torres Strait Islander and 4.3% as both (Abs.gov.au, 2023). There are approximately 339,500 Aboriginal and Torres Strait Islanders in New South Wales, 273,200 in Queensland and 120,000 in Western Australia. Based within the states and territories there are 78,600 Aboriginal and Torres Strait Islanders in Victoria, 52,000 in South Australia, 33,800 in Tasmania and 9,500 in the ACT among others (Humanrights.gov.au, 2021). Although the Northern Territory has the highest number of Aboriginal and Torres Strait Islander peoples constituting 76,700 of the population, it has the highest percentage at 30.8% of the entire population. There are at least 250 dialects of the Aboriginal languages spoken on the continent (Britannica.com, 2024). In age groups above 35, women outweigh men. For instance, women made up 73% of those over 85 and 57% of those in the 50-54 age group in 2021. As per Abs.gov.au (2024), compared to 45.4% in 2001, 60.3% of Aboriginal and Torres Strait Islander children between the ages of 11 and 18 attended secondary education in 2021.

Figure 1: Aboriginal and Torres Strait Islander and non-Indigenous populations by age groups

(Source: Humanrights.gov.au, 2021)

Factors that make this group vulnerable

According to Ncbi.nlm.nih.gov (2023), Aboriginal and Torres Strait Islander people who reside in remote regions are at a higher risk of contracting the virus because most of them live with chronic diseases, have frequent mobility, have restricted options of consultation with a doctor as well as rely intensely on outreach services. Despite the social diversity that cuts across the various groups, Indigenous people have a higher proportion of internal displacement, starvation, extreme poverty and also landlessness. Besides, they often rank high when it comes to unemployment, illiteracy and jail prisoners. Further, they have a mortality rate that is up to 20 years earlier than that of Australia’s non-indigenous population.

Specific community services that the group is trying to access

In Australia, the minority Aboriginal and Torres Strait Islander people fight for service subsidies, for a number of specialised community services, which are needed to satisfy their needs. The Indigenous are often in a challenging situation when it comes to accessing the appropriate first level of care in the mainstream. Aboriginal Australians visit Aboriginal Medical Services for culturally appropriate care that holds culturally sensitive and understandings of the patients’, and their people’s, values and beliefs (Beks et al. 2023). AMS offers preventive healthcare, chronic disease management and maternity and childcare (Fox et al. 2021). The Aboriginal society seeks mental health services that consider the dependency of colonisation, the stolen generations and continued racism. In passing, substance misuse services are often accessed by Indigenous Australians to try to combat comparably high levels of drug and alcohol dependency linked to trauma, mental health concerns and socioeconomic disadvantage. In order to escape from a crowded and unsuitable environment and to mitigate high levels of homelessness, several Aboriginal people go in search of a safe and inexpensive housing service. Furthermore, in the attempt to look for temporary and permanent housing options, which are badly needed, those people try to access Homelessness Support Services. The parents take their children to Early Childhood Education Programs because they also feel that early childhood is pivotal to the future success of the child. Aboriginal people, on the other hand, get legal aid from Aboriginal Legal Services, particularly in relation to family and criminal laws.

Analysis of common barriers and challenges

Barriers faced by Aboriginal individuals

Barrier 1: Place-based isolation and limited access to medical facilities -

Several clusters of Indigenous peoples reside in remote areas that contain limited or no access to health care services. Often the absence of even the minimum level of health care provision results from the considerable distance to the nearest clinic or hospital. Furthermore, because of the geographic isolation of their communities, the Aboriginal people have to cover large distances to access healthcare and often cannot do so during an emergency (Ncbi.nlm.nih.gov, 2021). This results in a very long time for the patients to be diagnosed and treated for the illnesses. Chronic illnesses that would require early diagnosis and proper management are rendered worse due to their inability to access proper health care that is easily accessible. For instance, diseases and conditions that could have been checked can progress to the extent that they significantly contribute to the total health status. This situation is also made worse in such places since reliable transport and communication networks are also lacking (Indigenoushpf.gov.au, 2024). For example, it may not be feasible to ensure that particular regions of the world can always depend on costly and occasional means of transport in medical emergencies. In addition, the access to daily health services, which can be called the effort to fill the healthcare deficit in rural areas by suggesting the use of phone and web-based facilities, is limited due to the absence of stable phone and internet connection. At present, the Aboriginal Australians living in rural places have the worse health status because they are geographically isolated. Besides, they are vulnerable to developing treatable illnesses and diseases such as infection, chronic diseases and issues to do with the health of mothers and their children when they do not receive timely and adequate health care.

Barrier 2: Cultural barriers and mistrust towards mainstream services -

Mainstream social services and healthcare providers often operate in contexts that are diametrically opposed to the Aboriginal culture, their value systems, worldview, and practices. For example, while general mass focuses on one-on-one and tangible aspects of treatment, aborigines have a much broader and comprehensive view of health and human welfare as being a combination of physical, and emotional, but also spiritual, and communal welfare. This could cause poor communication, people feeling uncomfortable and would not wish to engage in the services. A considerable number of people in the Australian continent do not understand English as their first language, especially those who live in rural areas (James et al. 2024). General social isolation, misdiagnosis, or communication barriers resulting from the absence of language assistance might make people even less inclined to seek care. The established welfare stations involve a great deal of scepticism in mainstream services since the government has a history of the poor treatment of the Aboriginal people and this has been evidenced by things like ‘The Stolen Generations’ and forced assimilation. Moreover, when accessing the services much more Aboriginal Australians fear prejudice, criticism, and disregard for their Aboriginal identity. Even there where such services of social kind and organised and standardised healthcare are provided. This scepticism manifests itself in the form of avoiding their use. Aboriginal people often delay seeking medical treatment, even if there is a worse condition, that is bad for their health. It aggravates reluctance by fueling the idea that commercially available services are indifferent to the patient’s welfare.

Challenges faced by service providers

Challenge 1: Insufficient funding as well as resources -

The availability of the range of calibre of services that is provided may be significantly constrained by lack of money. For example, Aboriginal Medical Services might struggle to provide adequate primary care, perform preventative care and manage long-term illnesses without adequate funding (Dwyer et al. 2020). This results in underinsurance and virtually no availability of services that are required most often in remote areas. The crucial amenities, for example, healthcare facilities, transport systems, and telemedicine accessibility hindered by the lack of finance for emergent development. For instance, exposure to modern diagnostic equipment and even simple treatment centres may not be easily available in such regions and this may lead to a delay in the delivery of treatment and in turn a poor quality of health. The delivery of such relevant services often requires extra resources to be available for the development of the program, recruitment and training of Indigenous staff. The problem is that the implementation of these components does not have enough financing, and it can result in services that can be not enough sensitive to the cultural needs and wants of the Aboriginal Australians. Lack of funds leads to a high turnover in employees with short business hours and fewer services to be offered to the public. Aboriginal Australians are attending in larger numbers, but it is more difficult for them to obtain ongoing efficient help because of this volatility regarding the efficiency and reliability of the treatment.

Challenge 2: Insufficient workforce and cultural competence -

There is a scarcity of the employment of Aboriginal and Torres Strait Islander nurses, physicians and mental health therapists. The need to establish rapport with the Aboriginal patients and culturally appropriate care majorly relies on staff recruitment and retention of natives from the community. Of course, these shortages are aggravated by a lack of career and educational opportunities for indigenous peoples and less financial attraction in rural areas. The cultural competence with which non-indigenous healthcare providers engage with Aboriginal patients is often lacking. Self-awareness, tolerance to cultures, effective communication and being culturally sensitive in delivering care that is congruent with Indigenous spirituality are some forms of cultural competency. Also, necessary non-indigenous staff training is often underfunded or undertaken ineffectively. Lack of cultural sensitivity leads to poor communication and treatment that is not responsive to the needs of the Aboriginal patients (Socha, 2021). It is fitting to note that the effects of miscommunication, distrust, and willingness not to use care are felt in health disparities. Also, due to inadequate professional staff and due to the need to meet different needs of the community as well as pressure from the government to provide services, service providers are overworked and stressed. This leads to burnout, and therefore poor quality of the services, and this can impact the effectiveness of the service as a whole. Challenges to achieving the development of a rapport with the Aboriginal group are driven by the fact that trust forms a strong part of health system engagement due to cultural differences and thus the weakness of qualified culturally appropriate workers.

Solutions for the selected barrier

In order to address mistrust and cultural barriers, consciousness and campaigns must be done to implement cultural competence training for all community service and healthcare workers. It is important that this program includes the effects of colonisation, historical contexts, and cultural references of the Aboriginal people. For purposes of relevance and effectiveness, aboriginal tribes should be enlisted in the design of the programs. Besides, the country has to offer opportunities for continuous learning to brief medical staff members about culture and awareness. Such activities as the various cultural sensitivity training workshops, seminars, and internet resources that are helpful in effective interpersonal communication with the Aboriginal clientele are considered to fall in this category (Wylie, McConkey & Corrado, 2021). In order to raise the portion of Aboriginal people within healthcare and community service professions, there is the requirement to construct proper recruiting strategies. Career prospects, scholarships, internships and other career advancement programs that are planned uniquely for the Indigenous people might be under this classification. In this case, measures such as monitoring programs on the employment of Indigenous people, opportunities for career advancement and accommodation to their cultural values of the Indigenous employees are very important. Besides, there is a deficit of health programs and their implementation that originated and are designed according to Indigenous communities’ needs and in accordance with cultural differences. Thus, to ensure that these activities are liked and accepted by the community, they should incorporate traditional knowledge, the community’s cultures as well as the involvement of elders.

Conclusion

One of the most disadvantaged groups of people is the Aboriginal people in Australia and they are the main subject of this case study report. In this case study, brief information about the specific community services this group is trying to attend to and the challenges they face is given. However, it is also important to note that some of those challenges and barriers are easy and can be minimised to some extent.

References

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