Removing Ethnocentrism and Discrimination from Australia's Healthcare Systems

Week Two Task

Australia is a multicultural country made up of a multitude of Minority Population Groups (MPGs); therefore, it is integral that the Australian healthcare system is culturally responsive and free from ethnocentrism and discrimination. Ethnocentrism is the inherent prejudicial belief that one’s own culture, values and beliefs are superior to others (New World Encyclopedia, 2017). Ethnocentrism is commonly expressed through prejudice, bigotry, racism and discrimination. Moreover, discrimination is the unjust or prejudicial treatment of different groups of people; such as MPGs (Merriam-Webster, 2019). Therefore, it is vital that the Australian health care system practice culturally competent care to prevent the Negative Health Effects (NHEs) associated with ethnocentrism and Perceived Discrimination (PD).

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Moreover, PD and ethnocentrism toward MPGs are strongly associated with anxiety, stress, depression, suicide and racially motivated violence; which have detrimental effects on psychological, physiological and physical health. Furthermore, PD leads to growing feelings of anger, fear, hostility and mistrust; which in turn, lead to anxiety and feelings of exclusion and isolation from society (Rebelo, Fernandez & Achotegui, 2018; Schmitt, Branscombe, Postmes & Garcia, 2014). Moreover, these feelings lead to a reluctance to seek medical advice, adhere to treatment and access services which subsequently worsens the health of MPGs and increases preventable hospitalisation (Bastos, Harnois & Paradies, 2018; Rebelo et al., 2018; Ben, Cormack, Harris & Paradies, 2017). Furthermore, constant PD can lead to NHEs associated with chronic anxiety which increase the risk of high blood pressure and heart disease, excretory and digestive issues, lowered immunity, stress and depression (Schmitt et al., 2014; Paradies et al., 2015). Furthermore, anxiety leads to a reluctance to use health services due to the anticipation of discrimination which further worsens MPG health (Bastos et al., 2018; Ben et al., 2017; Rebelo et al., 2018; Ben et al., 2017). Moreover, PD leads to increased risk of NHEs associated with stress such as high blood pressure, heart disease, obesity, diabetes, anxiety, substance abuse and depression (Schmitt et al., 2014; Paradies et al., 2015). Furthermore, stress decreases motivation to participate in healthy behaviours such as sleep and exercise; and increases the development of unhealthy behaviours such as over-eating and alcohol and illicit substance abuse (Schmitt et al., 2014; Paradies et al., 2015). Furthermore, PD leads to increased risk of NHEs associated with depression such as heart disease, lowered immunity, low self-esteem, poor life satisfaction and suicide (Paradies et al., 2015). Moreover, PD lowers self-esteem as it devalues and disempowers MPGs; which in turn, decreases life satisfaction and increases risk of suicide (Schmitt et al., 2014). Furthermore, poor life satisfaction is significantly associated with substance abuse, self-harm and suicide. Furthermore, in extreme cases ethnocentrism and PD can have negative physical effects on health through racially motivated violence (Paradies et al., 2015). Furthermore, experienced racially motivated violence can lead to post-traumatic stress (PTS) and post-traumatic stress disorder (PTSD) (Schmitt et al., 2014; Paradies et al., 2015). Moreover; research suggests, that PD and witnessing discrimination in the health care system can exacerbate PTS and PTSD, prevent adherence to treatment, and prevent future access to services (Paradies et al., 2015). Therefore, it is vital that culturally responsive care is instilled in the health care system to prevent the anxiety, stress, depression and suicidal effects associated with ethnocentrism and discrimination.

Week Three Task

Indigenous Australians (IA) are one of the most disadvantaged groups in Australia and experience more health disparities than non-Indigenous Australians. In order to eliminate these health disparities and attain health equity, it is important to determine and address the social determinants of health that affect the IA community. The social determinants of health are the socioeconomic conditions that influence the health of people and communities (World Health Organisation, 2008). Two major social determinants of health that affect IA are health literacy and unemployment. Health literacy is the degree to which individuals have the capacity to find, process, understand and utilise health information and services (Huhta, Hirvonen & Huotari, 2018). Furthermore, IA with Low Health Literacy (LHL) are more likely to be uncertain of when to access the health care system; and access primary health care services when their health has deteriorated significantly. Subsequently, this delayed access to primary and preventative services increases the incidence and prevalence of common illnesses and chronic conditions amongst the IA community. Furthermore, IA with LHL are more likely to have trouble understanding health information regarding their condition; which in turn, increases the risk of uniformed medical decisions, which can be detrimental to health. Consequently, IA who have poor knowledge of their condition are more likely to have poor health-management strategies; low levels of adherence to treatment; and unsafe medication administration. Which result in, an increase in hospitalisation and re-admission, longer stays in hospital, and avoidable mortalities.

Secondly, unemployment is a social determinant that affects the IA community and is strongly associated with economic hardship, low levels of income and an inability to afford basic living necessities such as; food, adequate housing, medical expenses and access to health services. According to Australian Institute of Health and Welfare (2017), the rate of unemployment in the IA community is higher than non-Indigenous Australians. Subsequently; IA are at a higher risk of economic hardship, which is significantly related to anxiety, psychological distress, stress-relate chronic conditions, low levels of self-esteem and self-worth; loss of purpose and identity within the community, social exclusion and isolation, depression and suicide (Goodman, 2015). Moreover, these negative health effects subsequently impede IA ability to attain employment due to poor health conditions. Additionally, unemployment is associated with low income and an inability to afford basic living necessities which result in poor nutrition, inadequate housing, and reduced access to necessary medication and healthcare. Poor nutrition and inadequate housing can contribute to stress and developing illnesses and chronic conditions that further reduces IA capacity to work (Ride. 2018; AIHW, 2017). Furthermore; the Australian Institute of Health and Welfare (2014) reported, affordability as a barrier to accessing healthcare for IA. Moreover, the costs associated with healthcare can discourage IA to seek medical care and specialist care; and purchase necessary medication. This in turn, increases the risk of illness and chronic conditions, hospitalisation, and mortality. Therefore, in order to attain health equity, it is integral to address social determinants of health affecting Indigenous Australian communities in Australia.

Week Six Task

Australia is a culturally diverse country; therefore, it is integral that the health care system incorporate diversity in the workplace that reflects the Australian community and will understand and meet the needs of the people. Diversity and inclusion in the workplace involve acknowledging and respecting individual differences; and encouraging an inclusive environment where Health Care Professionals (HCPs) and patients are valued and can participate and contribute (Department of Human Services, 2016; Berman, Kozier & Erb, 2014). There are a multitude of benefits that arise through the implementation of a diverse workplace: The two most integral benefits are improved relationships between HCPs; and improved relationships between HCPs and their patients. Firstly, the benefits associated with promoting a culturally diverse workplace that improves the relationships between HCPs are increased innovation; improved multidisciplinary communication, collaboration and practice; increased job satisfaction and lower employee turnover. Diversity in the workplace increases innovation and creates an environment that encourages learning and the exchanging of different perspectives and ideas (Davis, Frolova & Callahan, 2016; O’Callaghan, Loukas, Brady & Perry, 2019). Furthermore, constant communication and discussion within the multidisciplinary team strengthens relationships, enables HCPs to have a better understanding of each other and different cultures, and ensures culturally responsive and competent care (O’Callaghan et al., 2019). Moreover, diversity within the workplace increases efficiency through collaboration and the utilisation of HCPs different skills and abilities and applying them in practice (Biedermann & Burnes, 2015; Davis et al., 2016). Furthermore, creating an environment that encourages learning, communication and collaboration for its members produces a fulfilling workplace that will retain employees, decrease employee turnover, and maintain knowledge and skills within the workplace (Davis et al., 2016).

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Secondly, the benefits associated with promoting a culturally diverse workplace that improves the relationships between HCPs and patients are increased communication, increased patient involvement in their health care, and improved patient satisfaction and cultural safety. A diverse workplace creates an inclusive environment where a patient who might have experienced prejudice or discrimination in the community can feel comfortable to communicate freely with an HCP of the same background or culture. Furthermore, a workplace that is culturally diverse and inclusive will apply culturally safe practice when caring for patients of different backgrounds or cultures which will make the patient feel more comfortable. Moreover, through open communication HCPs can receive a better understanding of the patient and provide care that supports the patient’s values, beliefs and attitudes; improves patient health outcomes; and reduces disparities in health care (Berman, et al., 2014; Delaney, 2018). Furthermore, communication and collaboration with HCPs increases the patient’s involvement in their care, improves patient satisfaction, strengthens HCP and patient relationships, and ensures culturally responsive, efficient and safe care (Delaney, 2018). Moreover, increased patient satisfaction encourages patients to access health care resources, services and facilities in the future without fear of prejudice or discrimination. Furthermore, an increase in accessing health care promotes better patient health outcomes. Therefore, it is integral to promote a culturally diverse workplace as the benefits of improved relationships between HCPs; and their patients, ensures culturally competent and safe practice and care.

References

• Australian Bureau of Statistics. (2017). Census of population and housing: Reflecting Australia, 2017 (cat. no. 2071.0). Retrieved from http://www.abs.gov.au
• Australian Health Minister’s Advisory Council. (2015). Aboriginal and Torres Strait Islander health performance framework 2014 report. Retrieved from https://www.pmc.gov.au
• Australian Institute of Health and Welfare. (2017). Australia’s welfare 2017: In brief. Retrieved from https://www.aihw.gov.au
• Bastos, J.L., Harnois, C.E., & Paradies, Y.C. (2018). Health care barriers, racism, and intersectionality in Australia. Social Science and Medicine, 199, 209-218. https://doi.org/j.socscimed.2017.05.010
• Ben, J., Cormack, D., Harris, R., & Paradies, Y. (2017). Racism and health service utilisation: A systematic review and meta-analysis. Public Library of Science One, 12(12), 1-22. https://doi.org/10.1371/journal.pone.0189900
• Berman, A., Kozier, B., & Erb, G. (2014). Values, ethics and advocacy. In A. Berman, S. Snyder, T. Levett-Jones, T. Dwyer, M. Hales, N. Harvey, . . . D. Stanley (Eds.), Kozier & Erb’s Fundamentals of nursing (3rd Australian ed., Vol. 1., pp. 90-94). Frenchs Forest, NSW: Pearson Education Australia
• Biedermann, N., & Burnes, D. (2015). Diversity and inclusive practice in the workplace. In Davis, J., Birks, M., & Chapman, Y. B., Inclusive practice for health professionals (1st ed., pp. 84-106). South Melbourne, Victoria: Oxford University Press
• Davis, P.J., Frolova, Y., & Callahan, W. (2016). Workplace diversity management in Australia. Equality, Diversity, and Inclusion: An International Journal, 35(2), 81-89. https://doi.org/10.1108/EDI-03-2015-0020
• Delaney, L.J. (2018). Patient-centred care as an approach to improving healthcare in Australia. Collegian, 25(1), 119-123. https://doi.org/10.1016/j.colegn.2017.02.005
• Department of Human Services. (2016). Workplace diversity an inclusion strategy 2016-2019. Retrieved from https://www.humanservices.gov.au
• Goodman, N. (2015). The impact of employment in the health status and health care costs of working-age people with disabilities. Retrieved from www.leadcenter.org/system/files/resource/downloadable_version/impact_of_employment_health_status_health_care_costs_0.pdf
• Merriam-Webster. (2019). Discrimination. Retrieved from https://www.merriam-webster.com
• New World Encyclopedia. (2017). Ethnocentrism. Retrieved from https://www.newworldencyclopedia.org
• O’Callaghan, C., Loukas, P., Brady, M., & Perry, A. (2019). Exploring the experiences of internationally and locally qualified nurses working in a culturally diverse environment. Australian Journal of Advanced Nursing, 36(2), 23-34. Retrieve from http://www.ajan.com.au
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• Rebelo, M.J.D.S., Fernandez, M., & Achotegui, J. (2018). Mistrust, anger and hostility in refugees, asylum seekers, and immigrants: A systematic review. Canadian Psychology, 59(3), 239-251. http://dx.doi.org/10.1037/cap0000131
• Ride, K. (2018). Major review of Aboriginal and Torres Strait Islander nutrition. Retrieved from https://www.ruralhealth.org.au
• Schmitt, M.T., Branscombe, N.R., Postmes, T., & Garcia, A. (2014). The consequences of perceived discrimination for psychological well-being: A meta-analytic review. Psychological Bulletin, 140(4), 921-948. doi:10.1037/a0035754