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'Aboriginal people living in remote communities have much worse health status and longevity than other Australians and this imbalance will not be remedied until governments work with Aboriginal leaders and communities to address inequalities in education, economic opportunities, and housing.' stated Professor Lesley Barclay who is the Director of the Centre for Rural Health in her conversation with Tricia Nagel, who has a fellowship from the National Health and Medical Research Council (NHMRC).
Professor Barclay who has recently been working on a project aiming to inform improvements in maternal and infant health care, and Tricia Nagel who has been exploring Aboriginal and Torres Strait Islander perspectives of mental health stated 'Poorly-designed mental and child health service models and the lack of adequately specialised staff is compounded by the absence of Aboriginal community leadership. And without leadership, Aboriginal people struggle to access effective and culturally safe treatment.'
Their views of Aboriginal health and wellbeing is that complex chronic disease starts in the womb and social distress contributes to mental illness and self-harm. Aboriginal infants in northern Australia still begin life lighter than other Australian babies and nearly 30% require admission to a neonatal nursery for care. This figure is more than double the rate of other babies elsewhere in Australia. At six months, 68% of Aboriginal infants are anaemic, and 86% show faltering growth in their first 12 months.
They also acknowledged that rates of anxiety and depression symptoms among Aboriginal people are between twice and three times higher than for non-Indigenous Australian adults. Surveys of Aboriginal and Torres Strait Islander people show consistently higher rates of psychological distress; their rates of anxiety and depression symptoms are between twice and three times higher than for non-Indigenous Australian adults.
Their combined research showed many Northern Territory clinicians struggle to identify and treat anaemia and low weight in infants. Nor are they able to deal adequately with the persistent grief and mental and social distress of many Aboriginal people. This is a poor reflection on the health system's performance. They went on to say 'A poor start to life can be modified, to an extent, by natural resilience, and at least some individuals do have the ability to bounce back. But good quality health care is essential.'
Professor Barclay and Tricia Nagel believe that there has been positive news in that, despite facing the same challenges as the rest of northern Australia, the Northern Territory's health system has considerably improved how it deals with chronic disease, maternity care and substance use recently. They affirmed that the continuity of care is improving the quality of anetnatal and post-natal care in the Northern Territory, where midwives now work with pregnant women and new mothers in larger communities in the territory.
There is also positive improvement in the areas of substance use and chronic disease. The remote substance misuse workforce receives daily supervision from staff in health centres, as well as face-to-face supervision, training and advocacy support from specialist alcohol and other drug-use nurses and psychologists and a specific chronic disease worker role has recently been established, alongside improved data monitoring and skilled clinical governance. This appears to be making a significant difference in the quality of care by using locally-managed treatments.
Professor Barclay and Tricia Nagel concluded their conversation with a view on the underlying issue that the Northern Territory health system has made good progress in chronic disease management and maternity care, and is investigating better ways to provide child health services, but there is still a long way to go to improve infant care and promote mental health and well-being.
Source: The Conversation