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Editor's Note: Since the Rudd Labour government was voted in, a greater focus has occurred in repect of Indigenous health.
Rollo Manning could well be regarded as the pharmacy expert in indigenous health and he vigorously defends their rights of indigenous people to enjoy good health - just like the rest of the Australian community.
Rollo's sympathetic insights reflect his long association with, and understanding of, the issues surrounding indigenous health.
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Please – look beyond doctors and nurses
The headline of the story in The Age on 20th March 2008 said “Sharing a load to close the health gap”. The opening par read “… Prime Minister Kevin Rudd and Opposition Leader Brendan Nelson signed the Close the Gap Statement of Intent along with a coalition of health leaders. The statement committed Australian governments to close the indigenous health gap by 2030.”
But please, will someone tell the policy makers, speech writers and “health leaders” that improving the health of Aboriginal people goes a lot further than doctors and nurses, signed statements and extra funding to Aboriginal health services.
The real risk factors that are keeping the life expectancy down to a 20 year plus difference to mainstream Australia lie in the fundamental provision of adequate housing, good personal hygiene, better domestic hygiene, improved diet, exercise and above all improved education.
It is all very well to improve infant mortality and have more children living to age five but of little sustainable help if by that age they have had a scabies infection that settles in the kidney or heart muscle to go on to cause end stage renal failure or rheumatic heart disease. This is the reality of Aboriginal disadvantage. Bigger and better housing will result in a clean living environment devoid of mangy dogs, mattresses on the floor, malfunctioning toilets and with food security.
It matters not how good the primary health care service is in a community if these external environmental factors are left unattended. It is the opinion of this writer that unless the environmental factors are fixed the downward spiral in Aboriginal health will continue.
Education of children (and adults) has got to improve to a point where this marginalised population in Australia can understand the consequences of their actions and are able to take an informed view of their living environment.
When bad health is normal it is hard for anyone to understand what good health means. It will take a generation to make a difference and that is assuming the education of children takes on a new meaning. When the majority of primary school age children fail to attend school it is hard to see this happening.
The health policy planners must come out of their silo and place pressure on the nearby cells of government administration to encourage them to adopt a “housing for health” policy. Social marketing strategies need to be boosted and programs such as the WHO “hand washing” campaign given a lot more exposure. It is futile to expect a change in behavior when the advertising industry is so heavily sponsored by unhealthy choices. Any Saturday afternoon during the football season the household is bombarded with ads for fast foods at a time when most are watching their favorite team.
Unless there is a concerted effort towards the environmental factors causing long term ill health no agreement towards the year 2030 will work.
It’s more than doctors and nurses and new health clinic buildings. More and better housing to suit the lifestyle of the people is the biggest factor that needs fixing along with better education.
Rollo Mannin...April 2008
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