With the Northern Territory’s anti-discrimination commissioner Sally Sievers warning this week that casual racism could literally make people sick, we’ve taken a look at some of the health group submissions to the government’s inquiry into amending section 18c of the Racial Discrimination Act.
Aboriginal health groups have rejected the proposed changes, warning that physical harm from race discrimination begins at an early age – “quite literally can get under the skin and make our children and young people sick” – with racism a key determinant of access to and experiences of health.
We’ve digested some of the major submissions, which make for compelling reading in full, and present a summary below.
National Aboriginal Community Controlled Health Organisation (NACCHO)
Pointing to the Aboriginal definition of health as the “social, emotional and cultural wellbeing of the whole community in which each individual is able to achieve their full potential”, NACCHO argues that any watering down of hate speech legislation will work in direct opposition to existing government programs and strategies to improve Indigenous health.
It describes combating racial discrimination as a key strategy in closing the gap on health outcomes, and details key evidence on the link between racism and health including:
- Link between racism and reduced access to education, employment, housing and medical care, especially the deterrent effect of institutionalised racism in the health care system
- Association between racism, psychological distress and risk behaviours such as substance abuse and self-harm, as well as physical injury from race-motivated assaults
- Stress and cortisol dysregulation resulting from experiences of racism leading to mental health problems and physical impacts to the immune, endocrine & cardiovascular systems, beginning in childhood
- Discriminatory health policies and practices including lack of language & culturally competent care, excessive wait times and unequal access to emergency and other services
Young people who experience high levels of racial discrimination were also found to have increased sleep difficulties, cellular ageing, inflammation and psychological wear and tear… Racial discrimination quite literally can get under the skin and make our children and young people sick.
NACCHO said surveys suggested racism was already a near-universal experience for Aboriginal and Torres Strait Islanders, with 97% having experienced it in the past year and more than 70% reporting eight or more incidents in that period. Almost one-third said they had experienced racism in the health setting.
By settings standards of conduct, NACCHO said the law had an important role in containing the spread of racism and race hate, and described the watering down of sections 18c & d of the RDA as a “major risk” for the effective implementation of the National Aboriginal and Torres Strait Islander Health Plan 2013-2023.
The Plan envisages a health system free of racism, offering effective, high quality, appropriate and affordable health services to Indigenous Australians:
“Together with strategies to address social inequalities and determinants of health, this provides the necessary platform to recognise health equality by 2031.”
The Lowitja Institute echoes NACCHO’s concerns, saying the 2013-2023 health plan “went a significant way in identifying racism as a social determinant for Aboriginal and Torres Strait Islander health” and amendments to 18c would undermine “hard fought policy gains”.
It said institutionalised racism, lack of cultural safety and distrust in the health sector was already affecting access and outcomes for Indigenous people, with high rates of discharge against medical advice contributing to chronic ill health including diabetes, kidney disease and cancer.
Asking at what cost so-called free speech:
Allowing people to ‘offend, insult, humiliate or intimidate another person or another group of people’ based on race can potentially cause harm and thus widen the health gap between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians.
Changes to the Act could cause potential erosion of hard-fought health policy gains for Aboriginal and Torres Strait Islander peoples.
As a nation together we should strive for dignity, respect, equity and a deeper understanding of one another.
National Health Leadership Forum
NHLF describes racism as a key social and cultural determinant of health and said legislative protections were an essential component in addressing it.
It said freedom from racism and right to the highest attainable standard of health were fundamental human rights, and racism not only undermined health (noting a 17-year gap in life expectancy) but the realisation of these rights for Indigenous Australians.
NHLF also quoted from the government’s 2013-2023 health plan, and described the proposed RDA amendments as counterintuitive to its bipartisan support:
Racism is a key social determinant of health for Aboriginal and Torres Strait Islander people and can deter people from achieving their full capabilities by debilitating confidence and self worth which in turn leads to poorer health outcomes.
cohealth, Australia’s largest non-for-profit community health service, says health is impacted by many factors including social inclusion and participation, with stigma and racism contributing to health inequalities.
It cited Australian and global research identifying:
- The link between self-reported discrimination and depression & anxiety, both of which are major contributors to disease burden
- Emerging evidence linking race-based discrimination with poor physical health including diabetes,obesity and hypertension
- Association between discrimination, stress and chronic conditions (diabetes, cardiovascular disease, cancer), as well as smoking, substance use, harms from abuse and violence, poor self-assessed health status and high psychological distress among Indigenous Australians
Importantly, cohealth noted that research had also shown that state intervention such as legislative change and the signalling that discriminatory behaviour was acceptable itself contributed to poor health:
The very holding of this inquiry, and the questioning of whether race hate protections should be reduced, sends a message to ethnic and racial groups that in the eyes of the government they are less important, less included, less valued and less protected than other members of Australian society. This has the potential to contribute to significantly reduced health and wellbeing.
Media, Entertainment & Arts Alliance
The peak professional group for Australia’s media questions the government’s “free speech” motivations for the RDA inquiry, arguing that it occurred against a backdrop of much graver threats (many directly due to government legislation), including:
- Persecution and prosecution of whistleblowers in the public and private sectors and threat of up to 10 years jail under the ASIO Act
- Anti-corruption bodies’ “star chamber” powers bypassing journalist shield laws
- Use of warrants to secretly access journalists’ information and discover confidential sources
- Use of defamation, contempt of court and suppression orders to intimidate or muzzle legitimate public interest reporting
- The veil of “operational security” by government ministers & departments to refuse disclosure of information or to answer questions and narrowing of application of FOI laws
MEAA Media members are left to ponder the apparent limitations of the Parliament’s free speech agenda.
It said the rise of digital technology had seen hate speech increase in Australia since the 1995 introduction of the RDA, and described such speech as “antithetical to ethical journalism”.
We believe media outlets should take appropriate measures to speedily and thoroughly deal with complaints from the public, and to do so publicly. Too often the public turns to a third party without first raising a complaint with the specific media outlet that has published or broadcast the item in question. Media outlets must be willing to be held accountable for their failings by the consumers who put their trust, and their time and money into supporting the media outlet.