Aboriginal Community Health and Well-Being - Essay Example

? Aboriginal Community Health and Well-Being Aboriginal Community Health and Well-Being From scholarly research, Aboriginal means the first known, or the earliest to come into existence. First used in Italy and Greece, it symbolized the native communities and the old residents, not the newcomers and intruders. Several regions of the world have aboriginals like Australia and Canada (Hazlehurst, 1995). Just like other communities, aboriginal has controlled health organizations whose duty is to ensure the delivery of holistic and culturally appropriate health care. Worth noting, aboriginal community health represents not only the physical well-being, but also cultural, social and emotional as well (Eckersley et. al. 2001). However, analysts believe that the trend of rearing aboriginals has changed drastically since today many of them are reared without their cultural believes. Through this provision, individuals achieve full potential ultimately contributing to the overall well-being of their community. Section A, Question 1. Poor health is a biological manifestation of inequality among the Aboriginal in Canada. In this community, health and medical beliefs are social and spiritual. Aboriginal community in Canada experience poor health outcomes, which reflects on their knowledge about biological health. Diseases such as chronic disease, accidental disease, post neonatal mortality, and mental illness are common in Aboriginal reserves (Waldram, et.al., 2006). For example, health report in 1999 alludes that Aboriginal living in the reserves recorded the highest number of suicide. Further, aboriginals in the reserves have high percentage of diabetes and other attacks. The above health figures support the argument of Physician Paul Farmer. Inequality refers to non-uniform distribution of essential needs in the society. For instance, non-uniform health care policies influence the distribution and administration of healthcare in the society. Non-uniform social and legal policies influence social status of individuals in the community. Social factors contribute to health inequality in aboriginal community. Emotional, physical, spiritual, and mental dimensions of Aboriginal health among children and youths indicate that social determinants contribute to inequality in health. Social determinants that influence health fall under the following categories distal (e.g. political, historical, economical and social context), proximal (e.g. social and physical environment, health behaviors), and intermediate (e.g. resources, community infrastructure, capacities and systems) (Waldram et.al. 2006). Social determinants affect health behaviours, health vulnerability and capacity, and health management. Due to the many imbalances of life and need for healing such problems, sweat lodge is used extensively to assist since it occurs in the mind, spirit, emotions, and the body as well. Further, social determinants would influence circumstances that contribute to alleviation of health problems. For example, aboriginals who lead a low-income life experience diseases and illnesses. Like other communities, they are entitled to medication. However, in the provision of the medication, the healers are not regulated by an institution or law, but rather unwritten ethical standards of practise and community support. This in turn reflects to the social status, which links inadequate opportunities to raise income to good health. Inadequate employment opportunity influence income of an individual, which further contributes to poverty level in the society. In essence, poverty is a factor that contributes to health condition of the community. Fighting poverty or developing ways of fighting poverty contributes to health improvement in the society (Hazlehurst, 1995). Researchers in health argue that social factors contribute to the health inequality of the Aboriginals. Socio political factors in Canada are major factors that contribute to health inequality among the Aboriginal communities (White, et. al. 2003). Historically, colonization of Aboriginals influenced their lifestyles through the imposition of the colonial rules. In addition, policies enacted in neo colonial era influence the relationship between the Aboriginal community and the incumbent government (Knopf, 2008). Largely, policies in the society dictate the kind of services that the government would offer. Sometimes, these policies influence distribution of infrastructure and other key issues that influence social development. For instance, Raphael (2007) believes that the Indian act has contributed to the health disparity to the people of Canada. The provision of the Indian Act influenced health care provision of the First Nation. Historians believe that a policy introduced and adopted in the society would influence the life status of people within that community. It further influences economic status of the community since it dictates the distribution of major component of the economy. For instance, most Aboriginals have limited education, which in turn influence health behaviour, economic capability among other social factors. Historians attribute social injustices to the Aboriginal communities in Canada as a factor that has influenced their health conditions. Arguably, Inuit, First Nations, and partly Metis people devised policies during colonial period, which undermined the importance of the Aboriginals and their communities (Waldram, et.al., 2006). It is evident that the colonial masters took the land of the Aboriginals. Further, the Aboriginals suffered lose of their language, cultural resources among others. Racism, social exclusion, and discrimination are some of the factors that have perpetrated inequality among the Aboriginals of Canada. History reveals that Metis people also suffer the same fate. Social exclusion influence social development in the community. Colonial administration devised social policies that promoted social inequality in Canada (Kalbach, et. al. 2000). For instance, disparity in allocation of health facilities influence health outcome. Cultural inclination of Aboriginals is another factor that contributes to health inequality. Indigenous ideologies of the Aboriginal community embrace holistic approach to matters of health that reflects spiritual, physical, emotional, and mental attitudes. The interrelation between this dimensions influence the approach adopted by the aboriginals when handling issues of health (Kennedy-Dubourdieu, 2006). Cultural practices fail to embrace scientific approach of handling issues in health. The notion largely, applies to Aboriginals who live in the reserves and believe on collectivist ideas. The response that a community gives to health problem dictates the number of people that are likely to succumb to death from a particular illness. Historically, the Aboriginals administered their own concoction, which define the number of health problems associated with the Aboriginal communities. Environmental factors that lead to disease outbreak depend on population and living standards of the community. It is eminent that densely populated places with low living standards contribute to frequent attacks by diseases. Research on the health status of the Aboriginal indicates that children are prone to diseases associated to poor environmental conditions than adults. In line to this argument, Jepson et. al. (2004) argues that most Aboriginal communities in Canada lead their lives in poor environment, overpopulated shanties that manifest the disease attack reflected in health records. Physical environment with over crowded houses diminish air circulation, which is responsible for most airborne diseases. Interaction between people in the society lies on social factors. Low quality of life promotes substance abuse, which leads to mental illness as reflected in health report that indicated an increase in number of Aboriginal suffering mental illnesses. Overcrowding is a recipe of poverty in the society. Reports on poverty survey, indicates that large percentage of the Canadian Aboriginals are poor (Raphael, 2007). From, this report, one is able to adduce the social disparity in Canadian society that contributes to health inequality among the communities. Knowledge is essential factor that contributes to disease attacking pattern in the society. Communities that have developed capacity have minimal number of illnesses that result from adequate knowledge (Kalbach & Kalbach, 2000). For instance, chronic diseases result from poor hygienic conditions which knowledge can help to eradicate. Notably, education system defines the amount of knowledge that an individual would have in the society. Aboriginal communities in Canada have limited education, a factor that defines the capacity of the community. Knowledge would influence policy administration and administration of health programs in the society. Section B, Question 3, Part I Self-determination is generally the fundamental right and freedom to all people to decide and choose their political status as well as pursue their own economic, social, and cultural development based on free will. The theory of self-determination is very essential in the well-being and community health of Aboriginal individuals as the central goal of Aboriginal well being is motivation (Kuhse &Singer, 2006). The theory of self-determination represents a framework of human personality and motivation study. The theory incorporates a meta-theory that frames motivational studies with definition of intrinsic and extrinsic motivational sources, with a comprehensive description of the roles of extrinsic and intrinsic roles and types in social and cognitive development and their differences individually (AIAS, 2003). The Self-determination theory most importantly focuses on how cultural and social factors undermine or facilitate people initiative and volition, as well as their health and well-being, and quality of their performances. In the theory, the conditions supporting the people’s experience in autonomy, relatedness, and competence foster the volitional and quality forms of engagement and motivation for activities, which include persistence, creativity, and performance. In general, the self-determination theory states that the unsatisfactory degree of the three psychological needs (persistence, creativity, and performance) within a social or community context will have negative impacts on the health and well-being of that particular community. This is where the importance of self-determination to the health and well-being of Aboriginal communities becomes significant. The theory of self-determination, which in essence concerns motivation, is very important considering that the Aboriginal communities are indigenous. The studies of the factors that hinder the health and well-being of the Aboriginal community effectively follow the guidelines of the theory of self-determination. This means that the dynamics of psychological need thwarting and need support within the community’s families, teams, organization, cultures, and clinics follow specified proposition details in accordance with the theory (Briskman, 2007). This therefore implies that the self-determination theory focuses on the broad behaviour specific implications that provide the understanding practice that diminish or enhance the satisfaction of needs and the consequential full functionality of individual, thus determining their status of well-being. The self-determination theory concept follows the dialectical approach, which begins with the assumption that individuals are organism with tendencies to evolve towards growth, conceiving challenges, and applying the new challenges into their sense of self (Ed Diener, 2009). The implication is that these tendencies to develop do not occur automatically but rather require a continuous social support and nutriments. This essentially means that the social context may either thwart or support the natural tendencies that enhance psychological and engagement growth, or act as a catalyst for the lack of defence, fulfilment, and integration of needs. Thus, the dialectic between the social context and organisms forms the basis for the theory’s prediction about development, behaviour, and experience (Bonesteel, Sarah and Erick, 2006). Applying the self-determination theory to the Aboriginal communities, concerned parties may be able to determine the nutriments for healthy functioning and development following the concepts of psychological needs for competence, relatedness, and autonomy (AIAS, 2003). This is relatively easy, as the considerations to the extent on which these needs are satisfactorily met will result to the well-being of these aboriginal communities, while their non-optimal performance and ill-being represent the thwarting of the needs. In order to understand the causes of unhealthy and ill-being of the aboriginal communities, the individuals concerned must analyze dark side of human experience and behaviour, which includes several types of prejudice, psychopathology, and aggression, which are part of the conceptual framework of the self-determination theory (Ed Diener, 2009). The understanding of these causes has a profound importance on the design and implementation of health policies that enhance the well-being of such communities. The self-determination theory incorporates five mini theories with each explaining a different set of motivational phenomena resulting from a field and laboratory research (Fletcher, 1994). They include Cognitive Evaluation Theory that focus on intrinsic motivation, Organismic Integration Theory that focus on extrinsic motivation, Causality Orientations Theory, Basic Psychological Needs Theory, and Goal Contents Theory. Self-determination is thus very essential in very essential in health care in determination of the well-being of the Aboriginal communities through researches that focus on how autonomy versus controlled-supported environments affect the wellness, functionality, performance, and persistence (Clarke, 2007). Part II The most inherent challenge facing transfer of health policies at the provisional and federal levels is that of pragmatism and ideology. The first axis concerning federalism concerns ideologies. Both ends of the axis have complex and strong political values and related beliefs concerning what is to be to create human well-being (Banting & Corbett, 2002). The right axis of the transfer structure poses the systematic mistrust of government, particularly the powerful and distant federal government. At this point, there are four beliefs. One is the belief that individual freedom is the foundation to a good life and government. Second, free competition is a source of human happiness. Third, government intervention is very undesirable, particularly in the form of distributive health policies, and lastly, is the belief that loyalty to a state transcends national citizenship (Morone, Litman & Robins, 2008). The other left axis of the ideology tends to favour government action that aim to enhance the citizens’ welfare. The core values in this section of the axis focus on the community, thus the government receives appreciation for promoting the well-being of communities and reducing inequalities. Here, the advocates of this ideology uphold the individuals’ rights in controlling their own health care but point out that rights without the necessary resources are meaningless, thus, they embrace the transfer of health policies aiming to improve the individual autonomy while seeking health care. Pragmatism is the second axis (Banting & Corbett, 2002). The effectiveness of health policies are dependant on the location of policy issue. Pragmatists favour the performance, thus, they consider the goals of the health policy as given then decide which government level may be able to achieve them, as effective as possible. In real case scenarios, a government must maintain the balance between social citizenship and respect for cultures and communities while planning to transfer health policies. Social citizenship revolves around the similar functionality of the selected health policy across a nation, or regional diversity (Morone, Litman & Robins, 2008). The major concern is whether the citizens of a particular region of the same social and economic status will receive equal treatment as the citizens of another region irrespective of the location in the country (Banting & Corbett, 2002). Interregional transfer of health policies usually takes two forms, implicit and direct delivery to the central government because of different effects on common taxes and benefits across regions with uneven economic status, and delivery of programs by other authorities, which takes an explicit nature. Section B, Question 6, Aboriginal population in Canada experiences various forms of health inequities and disparities. Analysts using the structural concept structure examined and provided a more nuanced understanding of causes of diseases and how socially and politically grounded basis influence implementation of effective health promotion policies and programs (Knopf, 2008). These people consume foods with a lot of sugar that raises their sugar levels in their bodies. In effect, they contract disease like type 2 diabetes. It affects most of them at disproportionately high rates compared to their mainstream counterparts. The rate of diabetes in Aboriginal population in is 3to 5 times high than the non-aboriginal population. This is so because they develop diabetes early in life since the environmental conditions they are born and raised in are highly volatile with diabetic contraction (Ed Diener, 2009). Other factor that leads to diabetes in Aboriginal population is that they face more rapid and onset related complications of diabetes. This might in be relation to facts like; off springs are born by parents with high sugar levels in their blood streams, they are breast fed from the milk generated out of digested foods full of sugar, hence feeding on sugary foods is inevitable. In addition, Aboriginals suffer poorer results of treatment. The relative ability to get qualified personnel to test and eventually provide effective treatment of diabetes in their community is adversely unavailable. Evidence based on clinical practices and guidelines outline that, optimal management of diabetes could help reduce the disease and significantly control its onset together with its sovereignty of complications. Clinical guidelines in Canada underlie management of chronic diseases, which necessitates the substantial literacy of health and day-to-day self-management by the patient in view of effectively preventing or rather delaying disease complications (White, et. al, 2003). In order to provide a nuance understanding of why Aboriginal populations in Canada are in critical in juncture of diseases, we ought to first explore several socio-political factors that may inhibit the ability to provide effective type 2 diabetes care as an example. When analysts drew the structural violence concept, they found that, the politically and socially arranged measures that can put Aboriginal populations diabetic free are in most cases interfered by the government (Knopf, 2008). It fails to highlight the key components that practices healthy diabetic living and daily self-management behaviours followed by self-management education. As a result, most Aboriginals lack awareness on basic concepts of causes of diabetes and its subsequent prevention or treatment. Therefore, this structural violence against the Aboriginal population is merely a probable negligence by their government. Analysts sought to establish political and social factors that Aboriginals perceive as determinants that form barriers in self-management behaviours of Aboriginals living with type 2 diabetes in Manitoulin Island, Ontario, Canada (Bonesteel, Sarah and Erick, 2006). Their intension was to get Aboriginal’s personal perspective on type 2 diabetes and what they think of their personal care providers. They also sought to initiate a discussion whose intention was to get political forces that are way beyond personal or individual patients but reflect on management of diabetes. Their consistent and cooperative participation in the research brought together several bases of interdisciplinary collaborations of elderly, community leaders, care providers, and people living with type 2 diabetes (Jepson, et. al, 2004). During the research, analysts questioned participants on factors that affect diabetes care in that region. The factors included; experience and expertise in diabetes, their growing knowledge and understanding of diabetes, and evidence that shown prevalence of diabetes in that area. Consistent spirit of participation provided unique bases of analysis with both political and social barriers prevailing throughout. After research, analysts transcribed sessions and thematically analyzed the data independently. Analysts mapped self-management education and self- management behaviours evidence. On triangulation of research and discussions, analysts found that; socially, determinants of type 2 diabetes fell categorically on barriers of effective self-management education, balanced diet, physical exercise, and ability to establish general personal care. Analysts drew all these conclusions from the voices of the participating groups (Eckersley et. al. 2001). Congruent evidence exhibiting political role that affects diabetes care and management is lack of a system that can educate the Aboriginals on hazards of diabetes, ways to prevent and treat it. Even though they can communicate in English, non-Aboriginal system of governance acts as an obstacle while dealing with matters pertaining to structural violence in Aboriginals population (Dupuis, et. al., 2002). They marginalize the Aboriginals and segregate them in cases of race and ethnicity; hence, they fail to provide type 2 diabetes self-management education or press hard on importance of self-management behaviours. Furthermore, percentage of illiteracy in Aboriginals population is practically high. Thus, they cannot obtain and put into practice appropriate information about health, although greatly influenced by language and cultural practices. As discussed, prediabetes screening is vital and can help prevent the onset of diabetes at an early stage. Therefore, with proper knowledge and education on type 2 diabetes, Aboriginals can prevent its impacts if health they can implement their lifestyle. Policies to promote healthy diet and nutrition that can help reduce cases of high sugar levels in Aboriginal’s bodies. According to Australian Institute of Aboriginal Studies (2003), getting nutrition therapy can help reduce glycated hemoglobin and replace it with low glycemic index of carbohydrates, which controls type 2 diabetes in people. However, Aboriginals face food shortages that hamper their choices of food. This in return, causes consistent contraction of the disease or severe results. In this community, healthier foods are scarce, expensive, and inaccessible and sometimes they are unavailable making the people living with type 2 diabetes run out of options. Lacking all the above vital ingredients, Aboriginals face many challenges when health issues arise. From lacking education to food insecurity, but above all the vices, barriers to physical activity also, affect them (Bonesteel, Sarah and Erick, 2006). They fail to balance levels of physical exercise and fitness that causes accumulation sugars in the body leading to diabetes. This is in line with individual and community poverty levels that impede their ability to engage in regular physical fitness due to lack of exercising equipment such as gym, inadequate funds to help obtain membership and participation chances to sports. Arguably, physical exercise does not only involve money as there other forms of physical activities that can help gain physical fitness like brisk walking. However, road safety and infrastructural development hinders their freedom to exercise effectively since in Aboriginals population roads become impassable during winter (Lee, 2003). Bibliography Australian Institute of Aboriginal Studies 2003 Australian Aboriginal Studies: Journal of the Australian Institute of Aboriginal Studies, Issue 1. New York: AIAS. Banting, Keith & Corbett, Stan 2002 Health Policy and Federalism: An Introduction. Retrieved on 12 December 2011, from http://www.queensu.ca/iigr/pub/archive/socialunionseries/BantingCorbett.pdf. Briskman, Linda 2007 Social Work with Indigenous Communities. Sydney: The federation Press. Bonesteel, Sarah and Erick Anderson 2006 Canada’s Relationship with Inuit: A History of Policy and Program development. Ottawa: Indian and Northern Affairs Canada. Clarke, A. P. 2007 Aboriginal people and their plants. New York: Rosenberg. Dupuis, R. et. al. 2002. Justice for Canada's Aboriginal peoples. Washington D.C: James Lorimer & Company. 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