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Explain how structural disadvantage affects rural Aboriginal communities in Australia?
Solution
INTRODUCTION
Social justice involves life and death. It deeply affects people’s living conditions, their chance of falling ill as well as the underlying risk of premature death. Healthy living conditions and life expectancy continue to increase in some parts of the society and alarmingly they fail to improve in others sections. Today a girl born in certain countries can expect to live for more than 80 years – but sometimes less than 45 years if she is born in elsewhere. Even there are vivid significant differences in health parameters within countries and those have a close link with the extent of socio-economic disparity. Disparity of such magnitude, between and within countries, simply should never take place (Commission on Social Determinants of Health, 2008).
These disparity in health conditions and facilities show up because of the situations in which people live, grow, work, and age, and the surrounding system available for the public to tackle diseases. The conditions in which people survive and die are, in turn, shaped by social, economic and political forces. Economic and social policies present a deterministic impact on whether a child can sustain the growth and develop to its workable potential and lead a prosperous life, or whether his life will succumb to failure in terms of contribution to the society. The type of health issues that the poor and rich nations have to resolve are increasingly converging. The development of a socio-economic system, poor or rich, can be tested by the attributes such as its population health quality, how equitably health provisions are distributed across the social classes, and the degree of prevention and protection facilities provided to the disadvantaged section as a result of deteriorating health conditions.
Aboriginal Australians are a linguistically, culturally and experientially diverse population group, for which national statistics may not clearly indicate significant geographic differences in their health conditions and the social determinants of their health. A research study by Markwick et al. in 2014 sought to identify the health determinants of Aboriginal adults who were residents of the state of Victoria, compared with their non-Aboriginal counterparts (Markwick, et al., 2014). Disparity in health provisions between Torres Strait Islander people and Aboriginals and their Torres Strait Islander counterparts and non-Aboriginals is identified by the World Health Organization (WHO) to be the largest in the world (Commission on Social Determinants of Health, 2008). At a national level, life expectancy for the Torres Strait Islander population and the Aboriginal born in 2010-2012, was estimated to be 10.6 years lower than that of the Torres Strait Islander counterparts and non-Aboriginal in males and 9.5 years lower in females (Australian Institute of Health & Welfare, 2015). Non-communicable diseases contribute for 70% of the health inequality, leading with cardiovascular disease (23%), followed by mental disorders (12%), diabetes (12%) and chronic respiratory diseases (9%) (Vos, et al., 2007).
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GLOBALIZATION
Globalization puts forward a logical explanation for the increase in inequality levels in developed countries. Both opponents and proponents of globalization come up with such similar arguments. Proponents claim that globalization is an indicator of a changed and continuously changing world, where the past goal of government to equitably redistribute the results of growth is no longer possible to materialize or even desired by the parties. Instead, governing growth in a globalized economy implies governments’ intervention in market processes will be less (Friedman, 1999). Opponents claim that globalization gives rise to inequitable distribution and that better results are only achievable if countries take a backward step from liberal capitalism and globalization (Germain, 2000). Several others, less certain about benefits and costs, still argue that governments are more constrained by forces and global developments (Greider, 1997).
Although globalization in the shape of trade and finance has put substantial stress on governance and policy-making, it has also presented a significant justification for, and explanation to the increase in disparity levels. In Australia and other countries, globalization has been an important component in explaining why governments need to restrict their roles. Liberalization and globalization have not led to a decrease in the size of the government, in terms of spending and taxation, which indicates the regular implications of rising social expenditure and other beneficiary policies and programs that would desirably improve social outcomes.
INEQUALITIES IN LIVING CONDITIONS
Inequalities in health arise from inequalities in the society. Disparity in access to health provisions are quite significant, as do disparity in lifestyle, but the major determinants of social differences in healthcare lie in the factors in which people go through the cycle of life, i.e. born, grow, live, work, and age. These, in turn, result from differential access resources and power (Marmot, 2011).
The heavily-discussed 17-year gap in life expectancy level between non-Indigenous and Indigenous Australians talks about substantial social disparities. One can point to two types of influence to which the remarkably poor health of Torres Strait Islanders and Australian Aboriginals can be correlated. The first is social disparity level and the second (common to other Indigenous groups) is the social relationship between Indigenous Australians and the mainstream society.
It is reasonably difficult to bring in fundamental changes, but change is a realistic outcome and it can happen fast. Considering the example of educational facilities, it took additional 116 years from the creation of the first Australian university in 1850, when the first Australian Aboriginal, Charles Perkins, graduated in 1966. On the other hand, in 1991 (less than 30 years later), as per the report, the number of Indigenous Australian graduates was more than 3,600, and this number had risen to over 20,000 in 2006 (Lane, 2009). Another factor that influence the poor health of Indigenous Australians is their marginal association in relation to the mainstream society. If they are denied health and other basic facilities such as early child development, education and skills development, employment and working conditions, minimum income for healthy living, sustainable communities and a social-determinants approach to prevention, then their health conditions are expected to deteriorate (Marmot, 2011).
INEQUALITIES IN POWER, MONEY, RESOURCES
There is huge controversy about the measurement of poverty and inequality in Australia. At a broad level, there has been a substantial reduction in the wage to profit ratio. As per the statistical data, the share of wages in total factor income was 54.4% in 2002-03 compared to 61.5% in 1974-75. The share of profits was 25% in 2002-03, the highest level since 1959-60 (Australian System of National Accounts 2002-03, 2003). These trends were governed by the Labor Government with the active collaboration from the Australian union leadership (Dabscheck, 1995).
Despite the arguments of many proponents that globalisation would force a reduction in the role of the state, it is clear that this is not valid. Government’s ability to tax has not been cut down. Today, the power and pertinence of fiscal policy remains in the globalized economy of Australia.
CONCLUSION
Policy-makers have long been pushing Australians to accept that they are a section of the global economy, which means an acceptance of a whole range of new themes. One of the major trends of the pro-globalization position is that Australian government has accepted these new realities and adjusted well to globalization by embracing economic liberalism. The outcomes have been substantially beneficial. John Howard claims that the Australian economy has grown for fourteen years straight, which is definitely an achievement by any standards. However, this success story of growth has resulted in overriding more dispersed, negative analyses of social outcomes in Australia. Another part of this new globalized ‘reality’ appears to be an acceptance of increasing inequality level. It is often implied that increasing disparity level spurs growth. The proposition is that everyone is better off, it is just that some people are better off than others (Conley, n.d.).
Advocating greater equality levels does not imply being in favor of slowing the growth trends. Instead, the principal argument is that the growth should imply lower levels of inequality and poverty. Opponents of economic liberal reforms claim that policy changes brought in response to globalisation and structural economic weaknesses have led to an increase in inequality and to increased insecurity for those less able to take advantage of the opportunities provided by globalization. They also claim that attempts to compensate the losers, so integral to Labor’s reform agenda, have been inadequate (Conley, n.d.).
The fact that government in Australia has abandoned the attempt to increase equality is more important than any impact of globalisation. Globalisation as an ideological and political construction is important as a constraint, but also as a framework to make the case that egalitarian policies are no longer possible. Such aspects of globalisation are, of course, much more difficult to ‘measure’, but are no less important because of this. Attempts to improve social outcomes have given way to attempts to explain inequality.
Several initiatives (Commission on Social Determinants of Health, 2008) that can bridge the divide are as follows -
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Improve daily living conditions: Improve the standards of living for women and the atmosphere in which their children are born, put major emphasis on early child development and education for boys and girls, improve living and working conditions and create social protection policy supportive of all, and create conditions for a healthy older life. Policies to achieve these goals will involve governments, civil society and global institutions.
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Tackle the inequitable distribution of power, money and resources: In order to address inequality, a strong public sector is needed that is capable, committed and adequately financed. To achieve that requires more than strengthened government: legitimacy, support and space for civil society, for an accountable private sector, and for people across society to agree public interests and reinvest in the value of collective action.
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Measure and assess the impact of the problem: Acknowledging that there is a problem, and ensuring that health disparity is measured – between and within countries – is a vital stage for action. International organizations and national governments, supported by WHO, should set up global and national health equity surveillance systems for routine monitoring of the social determinants of health and health inequity, and should evaluate the health equity impact of policy and action.
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Australian Institute of Health & Welfare, 2015. Mortality and life expectancy of Indigenous Australians: 2008 to 2012, s.l.: Canberra: AIHW.
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Australian System of National Accounts 2002-03, 2003. Australian Social Trends, 2003, s.l.: Australian System of National Accounts 2002-03.
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Commission on Social Determinants of Health, 2008. Closing the gap in a generation: health equity through action on the social determinants of health, s.l.: World Health Organization.
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Conley, T., n.d. Globalisation and Rising Inequality in Australia: Is Increasing Inequality Inevitable in Australia?, s.l.: Griffith University.
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Dabscheck, B., 1995. The Struggle for Australian Industrial Relations, Melbourne: Oxford University Press.
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Friedman, T., 1999. The Lexus and the Olive Tree: Understanding Globalisation, New York: s.n.
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Germain, R., 2000. Globalization and Its Critics: Perspectives from Political Economy, London: Macmillan.
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Greider, W., 1997. One World, Ready or Not: The Manic Logic of Global Capitalism,, New York: Simon and Schuster.
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Lane, J., 2009. Indigenous participation in university education. Centre for Independent Studies.
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Markwick, A. et al., 2014. Inequalities in the social determinants of health of Aboriginal and Torres Strait Islander People: a cross-sectional population-based study in the Australian state of Victoria. International Journal for Equity in Health, 18 October.
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Marmot, M., 2011. Social determinants and the health of Indigenous Australians. The Medical Journal of Australia, 194(10), pp. 512-513.
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Vos, T., Barker, B., Stanley, L. & Lopez, A. D., 2007. The Burden of Disease and Injury in Aboriginal and Torres Strait Islander peoples 2003, s.l.: School of Population Health, The University of Queensland, Brisbane.
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