Experiences of racism in health services are a significant barrier to Aboriginal and Torres Strait Islander people receiving appropriate healthcare.
The health system needs to be more proactive in addressing racism, according to a submission made by the RACGP National Faculty of Aboriginal and Torres Strait Islander Health to the Australian Human Rights Commission National Anti-Racism Partnership and Strategy (available in full here).
Some discussion of how to tackle racism in health services is expected at a session on Closing the Gap at the RACGP’s conference on the Gold Coast tomorrow (declaration: I’m facilitating the session).
In the article below, Jill Dixon and Board members of the RACGP National Faculty of Aboriginal and Torres Strait Islander Health encourage health services and professionals to make use of resources such as those listed on the Australian Human Rights Commission website that offer effective and appropriate ideas about how to respond to racist acts or comments.
Tackling racism in health services
Jill Dixon and Board members of the RACGP National Faculty of Aboriginal and Torres Strait Islander Health write:
In early 2010, the Royal Australian College of General Practitioners (RACGP) established the National Faculty of Aboriginal and Torres Strait Islander Health, to help ‘close the gap’ in health inequities experienced by Australia’s First Peoples.
In its Position Paper on Aboriginal and Torres Strait Islander health (available from here), the RACGP made a public statement apologising for the consequences of previous discriminatory policies on Aboriginal and Torres Strait Islander people, and acknowledging that, in the past, many health professionals failed to provide optimal health care to their Indigenous communities. It encouraged GPs to challenge racism in the context of general practice.
Since 2010, the RACGP National Faculty of Aboriginal and Torres Strait Islander Health has undertaken a range of initiatives to enhance understanding and correct misperceptions by GPs and their practice team about Aboriginal and Torres Strait Islander culture, health and life circumstances, and health services.
Faculty response to National Anti-Racism Strategy
In March 2011, a further opportunity to help combat racism in primary health care services was presented with the announcement by the Australian Government of a new multicultural policy, a key component of which was a National Anti-Racism Strategy.
This strategy is intended to ‘address racism experienced by Aboriginal and Torres Strait Islander peoples in addition to people from culturally and linguistically diverse backgrounds’.
In response to the release of a National Anti-Racism Partnership and Strategy discussion paper the Faculty made a submission, available from the ‘Racism: it stops with me’ website.
The Faculty submission was in part prompted by findings referred to in the discussion paper that three out of four Aboriginal and Torres Strait Islander people regularly experience race discrimination when accessing primary health care, leading to some people not being properly diagnosed and treated for disease.
These findings are consistent with other anecdotal and research evidence that some Aboriginal and Torres Strait Islander patients and communities experience various forms and degrees of racism in their access to, and experiences with, primary health care services.
There is further evidence that racism and unequal access to health care exists in all parts of the health care system. For example, there is research suggesting that some Indigenous hospital patients receive lower levels of stroke identification or early intervention in cardiac treatments and other conditions, and that racism expressed towards pregnant Aboriginal and/or Torres Strait Islander women affects the birth weight of their babies, and leading to ongoing health complications.
Because all patients require safe and high quality health service delivery along the whole health care continuum, the Faculty argues that the wider health system is invited to join forces to address racism in all steps of the patient journey.
The COAG Indigenous Reform Agreement (better known as ‘Closing the Gap’) asks all jurisdictions to improve their procedures for collecting Indigenous status information in health data. In general practices, this means that GPs and practice staff need to ask all patients if they are of Aboriginal or Torres Strait Islander origin, and to record the response. This allows health professionals to provide targeted health services to their patients who identify as Indigenous.
While, historically, a very small proportion of general practices have recorded Indigenous status, this will improve over time. However, there is a real need for GPs and practice staff to be culturally respectful when ‘asking the question’, to avoid a a rise in the experience of racism by Aboriginal and Torres Strait Islander people in primary health care setting.
On 24 August 2012, the ‘Racism. It stops with me’ strategy was launched by the Australian Human Rights Commission. This strategy is being led by Australia’s Race Discrimination Commissioner, Dr Helen Szoke, and supported by a National Anti-Racism Partnership. This strategy provides a very clear opportunity for all health care providers to become involved.
The Faculty believes that many GPs and practice staff, like many Australians, feel unsure about what constitutes a racist remark or action, and would feel powerless to act, even if they witnessed and recognised racism in their clinic or waiting room. In the absence of appropriate guidance, and encouragement to act, racism can make bystanders of us all.
Resources such as those listed on the Australian Human Rights Commission website offer effective and appropriate ideas about how to respond to racist acts or comments.
We believe that health professionals would be receptive to leadership on this issue, responsive to discussions about racism and its effects, and that they would value the opportunity to develop effective ways of helping their staff to avoid racist acts and to deal appropriately with racist comments or behaviours made in a primary health care setting.
• Meanwhile, the RACGP has unveiled new ceremonial gowns and sashes that pay tribute to Aboriginal and Torres Strait Islander people.