Research and provide a brief description of three major historical or ongoing impacts of colonisation affecting Aboriginal and/or Torres Strait Islander Peoples (including a bibliography)Describe how

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Introduction:
As a medical professor, it is important to not only teach medical content, but to also educate students on the historical and ongoing impacts of colonisation on Aboriginal and Torres Strait Islander Peoples. Additionally, it is important to understand the social determinants that impact their health and ways that transgenerational trauma may affect them.

1. Research and provide a brief description of three major historical or ongoing impacts of colonisation affecting Aboriginal and/or Torres Strait Islander Peoples:

– Stolen Generations: From the late 1800s to the 1970s, Aboriginal and Torres Strait Islander children were removed from their families and communities and placed in institutions or with non-Indigenous families. This led to the loss of cultural identity, connection to family and country, and trauma for both the children and their families. (Rose, 2021).
– Land Dispossession: Through European settlement, Aboriginal and Torres Strait Islander Peoples were dispossessed of their land, which resulted in loss of access to traditional food sources, cultural sites, and economic opportunities. This has led to ongoing socio-economic disadvantage, particularly in remote areas (AIHW, 2020).
– Racism and Discrimination: Aboriginal and Torres Strait Islander Peoples have experienced systemic racism and discrimination, which has resulted in poorer health outcomes and decreased access to services and opportunities. This includes discrimination in the workplace, education, and healthcare (Australian Human Rights Commission, 2018).

2. Describe how Aboriginal people’s relationship with the land ensured economic survival:
Aboriginal and Torres Strait Islander Peoples have a deep connection to their country, which includes traditional land management practices. These practices involve controlled burning, hunting, fishing and gathering, and have been sustainably managed for thousands of years. This allowed for economic survival, as it ensured a reliable source of food and resources for the community. (Kinchin, 2020).

3. Describe how improved Aboriginal and/or Torres Strait Islander empowerment can lead to greater engagement with services (in no more than 80 words):
Empowering Aboriginal and Torres Strait Islander Peoples to take ownership and control of their health and wellbeing can lead to greater engagement with services. This can involve involving the community in the development of health policies and programs, providing culturally appropriate care, and recognising and addressing systemic inequalities. Empowerment also involves acknowledging and valuing their cultural practices and beliefs, and ensuring that services are accessible and appropriate for their needs (AIHW, 2020).

4. Provide two examples of how western systems and structures impact Aboriginal and/or Torres Strait Islander peoples engagement with services:
Western systems and structures can impact Aboriginal and Torres Strait Islander peoples engagement with services in a number of ways, including language barriers, cultural differences, and lack of culturally appropriate services. Two examples are:

– Residential mobility and the lack of continuity of care: Aboriginal and Torres Strait Islander peoples often move frequently and frequently have to access healthcare through different services leading to discontinuity of care and lack of trust between the patient and healthcare provider. (AIHW, 2020)

– Lack of Cultural Safety: Cultural safety refers to the need for healthcare providers to be aware of and responsive to the cultural background of the person receiving care. Western biomedical systems may not recognise or value traditional healing practices or fail to communicate in ways that are culturally safe, leading to a lack of engagement with services by Aboriginal and Torres Strait Islander peoples. (Australian Health Practitioner Regulation Agency, 2020)

5. Identify the social determinants that impact Aboriginal and/or Torres Strait Islander health and provide an example of a health issue for each determinant:
The social determinants that impact Aboriginal and Torres Strait Islander health include factors such as education, employment, housing, and access to services. Examples of health issues related to these determinants include:

– Education: Low levels of education can impact access to employment, which can lead to poverty and poor health outcomes. Low education attainment has been linked to higher rates of smoking, alcohol and drug use, and chronic diseases such as diabetes (Biddle et al., 2019).
– Housing: Overcrowding and poor housing conditions have been linked to poor health outcomes, including respiratory infections and skin infections. Additionally, homelessness is linked to poor mental health outcomes (AIHW, 2020).
– Access to Services: Limited access to services is linked to poorer health outcomes, including higher rates of unmet healthcare needs, and higher rates of preventable hospitalisation (AIHW, 2020).

6. Provide one example of how transgenerational trauma may impact (Aboriginal):
– Decision making: Transgenerational trauma may impact decision making by reducing trust in external sources of information, including healthcare providers. This can result in lower rates of health service utilisation and a reluctance to engage with activities or interventions that are perceived to be imposed (Kaplan et al., 2014).

– Communicating: Transgenerational trauma may impact communication by making it difficult to articulate experiences and feelings or to access appropriate support. This can lead to difficulties in accessing care or in developing trusting relationships with healthcare providers (Wright et al., 2019).

– A person’s interpretation and understanding of service delivery: Transgenerational trauma may impact a person’s interpretation and understanding of service delivery. They may perceive services as not being culturally safe, relevant, or responsive to their needs, leading to poor engagement with healthcare providers and poorer health outcomes (Wright et al., 2019).

– A person who is experiencing high-level trauma: Transgenerational trauma may result in higher rates of mental health issues, including anxiety and depression. These issues can lead to poor engagement with healthcare providers, difficulty in trusting external sources of support, and an increased risk of suicide and self-harm (AIHW, 2019).

Bibliography:
– AIHW (2020). “Overview of Aboriginal and Torres Strait Islander health status 2020,” Australian Institute of Health and Welfare, Retrieved from https://www.aihw.gov.au/reports/indigenous-australians/overview-aboriginal-torres-strait-islander-health2020/contents/indigenous-populations.
– Australian Health Practitioner Regulation Agency (AHPRA). (2020). Cultural Safety: Working with Aboriginal and Torres Strait Islander Health. Retrieved from https://www.ahpra.gov.au/Publications/Resources/Cultural-safety-working-with-Aboriginal-and-Torres-Strait-Islander-health.aspx
– Australian Human Rights Commission (2018). “Wiyi Yani U Thangani (Women’s Voices): Securing Our Rights, Securing Our Future,” Retrieved from https://humanrights.gov.au/our-work/aboriginal-and-torres-strait-islander-social-justice/publications/wiyi-yani-u-thangani

– Biddle N, Edwards B, Gray M, Sollis K. (2019). “Growing up in Australia’s remote areas.” Longitudinal Study of Indigenous Children. Research Report No. 2. Melbourne: Telethon Kids Institute, Retrieved from https://www.growingupinaustralia.gov.au/sites/default/files/rlsc_w8_australias_remote_areas_2020.pdf
– Kaplan I, Strehorn K, Sarnyai Z. (2014). The cultural interface of resettlement: traditional healing for Australian refugees. Contemporary Nurse, 48(2), 146-158, doi: 10.1080/10376178.2014.11081907.
– Kinchin, I. (2020). Aboriginal Land Management, Becker’s Hospital Review, Retrieved from https://www.beckershospitalreview.com/population-health/aboriginal-land-management-lessons-for-health-care.html
– Rose, D. B. (2021). “Aboriginal Stolen Generations,” Encyclopædia Britannica, Retrieved from https://www.britannica.com/event/Aboriginal-Stolen-Generations
– Wright, J.H., Isaacs, A.N., Otto, C., Roberts, M., & Newman, L.K. (2019) “Engaging with Indigenous Australians living with or beyond cancer: A systematic review of the healthcare system.” Healthcare, 7(3), 1-12, doi: 10.3390/healthcare7030109.