It seems incredibly antiquated that in this day in age people are still discriminated against based on the colour of their skin, however unfortunately racism is globally pervasive. It dehumanises those it reaches and ultimately affects their overall health. Racism can be defined as “any distinction, exclusion, restriction or preference based on race, colour, descent or ethnic origin with the purpose of nullifying or impairing the recognition of human rights and fundamental freedoms in the fields of public life” (UNESCO, 2017). It occurs when a person is exposed to prejudice, discrimination or hatred, treated less favourably or not given equal opportunities because of their race, origin, ethnicity or skin colour. Overtime, the level of perceived equality in Australia has levelled itself out to an extent, however the psychosocial stressor of racism can still be seen in everyday situations. Racism plays a negative role in individuals, society and the community as a whole. This can affect an individual's behavioural and mental health (NACCHO, 2018). The estimated 649,171 (2016) Indigenous Australians comprise 2.8% of the Australian population and are the most disadvantaged group in current Australian society (ABS, 2016). They suffer from high rates of unemployment and incarceration, low income, substandard housing, and a high burden of ill health and mortality, including a life expectancy that's 17 years less than other Australians (Anderson, Paradies and Harris, 2018). Health inequities in Australia, according to Kellie Horton, Manager of VicHealth, occurs when the “determinants of health aren't distributed evenly between populations.” (2011). These inequities are beyond any individual's control, unfair and unjust, creating uneven playing fields for different groups of Australian society. There's no shortage of evidence that racism persists, where “three out of four Indigenous Australians experience racism in their everyday lives” (Central Australian Aboriginal Congress, 2015). Racism isn't rare, nor harmless, but deeply embedded events and behaviours that significantly contribute to the ill-health suffered by Indigenous Australians today.
The prevalence of racism directed towards our Indigenous population is incredibly alarming. As the first descendants of Australia, Indigenous peoples have suffered deplorable accounts of racism as far back as when the first fleet of European settlers came to Australia in 1788 (Australian Human Rights Commission, 2009). The Stolen Generations, Australia's most reprehensible mistreatment and discrimination towards Indigenous peoples, occurred between 1910 and 1970. Children of Indigenous descent were forcibly removed from their parents by Federal government agencies (ABS, 2010). These acts were intended to give ‘disadvantaged' Indigenous children a better chance at life by living with white families where they spoke the English language, acted like white people and were forced to disregard their Indigenous culture altogether. February 13th, 2008, Prime Minister Kevin Rudd moved a motion of apology to Indigenous Australians for the debilitating acts of the Stolen Generations in a moment of reconciliation for Australia. In a YouTube video titled, I'm Aboriginal, But I'm Not, various Indigenous Australians defy many common misconceptions and stereotypes they are often labelled as (BuzzFeedYellow, 2015). This powerfully demonstrates how many Indigenous citizens are vilified against and judged. The video included various Indigenous people repeating “I'm Aboriginal, but I'm not…”, filling the blanks with common stereotypes such as stealing, uneducated, drug abuse, welfare benefits, violence, ignorance of other cultures, imprisonment, etc. (BuzzFeedYellow, 2015). Most Australians acknowledge that discrimination has insidious effects on the lives of minorities, even if unintentional. Racism can be divided into intentional and unintentional discrimination. Majority of racism in Australia towards Indigenous people is “unconscious unthinking discrimination” (Martin, 2017).Racism is inexcusable, although much of the stereotypes and unintentional discrimination occurrences originate mostly from learnt behaviours, whereby ‘monkey see monkey do' (Martin, 2017). Acommon stereotype of Indigenous Australians is their lack of trust of others and their inability to mix with other races. This, if true, stems as far back as the first European settlers in Australia who invaded Indigenous Australia, without reason. Additionally, the Stolen Generations of Australia could've caused Indigenous people to fear the actions of white people. This ‘white supremacy'described as ‘domestic terrorism'has shaped the mistrust that many Indigenous have towards other Australians today (The Conversation, 2018). Non-Indigenous Australians must consider whether they're knowingly or unknowingly racist, if they perpetuate stereotypes, if they obtain any subtle attitudes or behaviours that contribute to racism, and if they're part of the problem.
The health margin between Indigenous and non-Indigenous Australians is alarmingly poorer than many expect. It's well known that Indigenous Australians have much lower life expectancy than other Australians and have disproportionately higher rates of diseases and other health problems. Could this in part be due to racism?Indigenous Australians are losing 2.3 times the number of healthy years to death and disease than their non-Indigenous counterparts, according to the Australian Institute of Health and Welfare (Koziol, 2016).Life expectancy is affected by disease incidence and prevalence, health behaviours such as smoking, social determinants such as education, income and employment and access to health services (AIHW, 2016). Figure 1shows the life expectancy at birth between Indigenous and non-Indigenous Australians in 2010-2012 is significantly different (ABS, 2013). The Australian Bureau of Statistics recorded that Indigenous men had a life expectancy of 10.6 years lower than non-Indigenous males and Indigenous women had a life expectancy of 9.5 years lower than non-Indigenous females (2013).
Racism has lasting harmful effects on people's feelings and emotions which can lead to major reductions in physical health. According to the National Aboriginal Community Controlled Health Organisation (NACCHO), “On an individual level, exposure to racism is associated with psychological distress, depression, poor quality of life, and substance misuse, all of which contribute significantly to the overall ill-health experienced by Aboriginal and Torres Strait Islander people”(NACCHO, 2018).Constant exposure to discrimination can provoke stress and adversely affect an individual's psychological and physiological functioning (NACCHO, 2018). Prolonged experiences of stress can also negatively impact different parts of the body such as the immune, endocrine and cardiovascular systems (NACCHO, 2018). Stress which often arises due to racial abuse can cause victims to engage in unhealthy activities such as smoking, alcohol and drug abuse, and disengage from healthy activities like sleep, exercise and socialising, instigating and perpetuating the very stigma associated with many Indigenous peoples.Internalising racial discrimination has led to behavioural conditions linked to anger and conduct problems, leading to poorer self-esteem and higher levels of hopelessness(Miller, Lane and Cooks, 2013).“As a life stressor, racism directly and negatively affects the cardiovascular system causing high blood pressure/hypertension and heart disease. It seriously affects mental health causing depression, anxiety and other psychological and psychiatric disorders and racism contributes to low birth weight of newborns, as well as premature birth”, said CEO Donna Ah Chee of the Central Australian Aboriginal Congress (CAAC, 2015).For Indigenous peoples, unlike white Australians, racism is a fundamental driving force of health.
Abraham Maslow stated that we're motivated by a hierarchy of needs which allows us to reach our full potential. Maslow detailed that we must satisfy the deficiency needs (physiological, safety and security, love and belongingness, and self-esteem needs) before satisfying the growth needs (knowledge and understanding, aesthetic, self-actualisation and transcendence needs) (McLeod, 2018) as depicted in figure 2alongside (Pinterest, 2018). Racism in Australia relates to Maslow's hierarchy whereby non-Indigenous Australians gravitate towards racism as a quick fix of fulfilling their needs to be safe, belong and strengthen their self-esteem. The concept of racism is a psychological narcotic that gratifies the social conscious of its users, ever increasing its user's dependency and absolute lust for it. It's viral, spreading via ignorance, seeping deep into generation after generation. It "feels good" for some people to put down others, feeding that insatiable hunger of the ‘self-esteem' level. This dynamic exists among members of the same group, when "light skinned" Indigenous people are compared to "dark skinned" ones (Finley, 2016). Often racism is unintentional due to a lack of people believing that they're racist, compared to those who are intentionally derogatory towards Indigenous people. Ignorance can play a part in feeding people's racial attitudes. Racism isn't always malicious, but harm can be done innocently because someone may not know better. A common misconception is that any racism towards Indigenous Australians is regrettable, but that such incidents are minor, inconsequential and essentially harmless. Racist ideas and attitudes aren't innate, they're learnt. Regrettably a minority of people believe some races are superior to others. Most Australians today accept diversity within our society, yet some inexplicably still believe racial groups shouldn't mix.
Prejudice and racism is often seen in health or social services. According to Pat Anderson of the Lowitja Institute, “there are lots of scenarios of Aboriginal people being considered perhaps seriously intoxicated when in fact they are seriously ill”(NACCHO, 2018). This prejudgement makes Indigenous people feel unwelcome or not deserving of aid, making them reluctant to seek much needed health, housing, welfare or other services from providers they perceive as unwelcoming or feel may hold negative stereotypes about their race (NACCHO, 2018). Within hospital systems,Indigenous people face racist barriers to gaining appropriate health care, contributing to Indigenous Australians' low level of trust for hospitals. The 2008 National Aboriginal and Torres Strait Islander Social Survey found little more than 60% of Indigenous people said they felt hospitals could be trusted (CAAC, 2015). This is reflected in the fact that Indigenous Australians are critically five times as likely to leave hospitals against medical advice or be discharged at their own risk compared to other Australians. Little daily indignities like being treated with less courtesy and respect than others, and receiving poorer service at restaurants or stores, affect many Indigenous peoples' health. Research shows pregnant women who report high levels of discrimination give birth to babies who are lower in birth weight (Martin, 2017). Compared to non-Indigenous patients with identical medical needs, Indigenous patients were one-third less likely to receive appropriate medical care across all conditions, particularly lung cancer and coronary procedures (Anderson, Paradies and Harris, 2018). Indigenous Darwin singer Gurrumul Yunupingu told 105.7 ABC Darwin that he nearly bled to death in Royal Darwin Hospital after languishing with internal bleeding for eight hours relating to an ongoing liver condition. It was discovered later that he was written off as “a drinker”, when the condition actually resulted after having had Hepatitis B as a child. Yunupingu's doctor, Dr Paul Lawton, said the experience was infuriatingly endemic of a broader problem across Australian health care. Dr Lawton added, “Aboriginal people admitted to hospital are much less likely to get a procedure for that condition than non-Aboriginal people in Australia. The idea isn't that individual people are racist but that the whole system is designed with certain assumptions that lead to people not receiving appropriate treatment for their conditions because of issues related to race” (ABC News, 2016).
Social justice declares rights for all people in a community to be considered in fair and equitable manners (CheckUp Australia, 2011).Social justice specifically targets marginalised and disadvantaged groups in society, particularly Indigenous Australians and people from culturally and linguistically diverse backgrounds. A socially just society consists of health policies which ensure all peoples have equal access to quality health care services, and people in remote areas being given the same access to fresh water and sanitation as in a metropolitan areawould. Social justice principles work together to manage health inequities based on morbidity and mortality rates and cultural, social, economic and political factors. Social injustices occur when a particular group are treated inferiorly or deprived of services that others are provided with. Deeming someone inferior due to their race directly violates social justice.Discrimination can be considered a mild/serious form of suffering, which is why racism is considered a primary cause of social injustice issue. Social injustices can cause health inequities in Australian society. Lack of income, unemployment and inadequate housing causes stress. Unemployment may lead to poor health, but poor health may lead to unemployment (ClickView, 2011).Discrimination, social exclusion and stereotypes provoke health dilemmas of social withdrawal, leading to mental health issues and worsening health due to lack of exercise and alcohol/substance misuse (NACCHO, 2018). Regular exposure to racism has led people to withdrawing from work, study or reduced and unequal access to societal resources required for health (e.g. employment, education, housing, medical care, social support), diminishing their overall quality of life. The largest ABS national Indigenous health survey found 11% of metropolitan Indigenous Australians aged 15 years and over had never visited a dentist (or other health professional) about their teeth and in remote areas, almost 24% (Australian Human Rights Commission, 2018). These shocking figures indicate many Indigenous find it difficult to reach out to health services compared to non-Indigenous Australians. Social justice links to the Indigenous peoples' right for land as European settlers invaded their land and forced them to feel a strong sense of loss. Positively, the Indigenous acknowledgment of land (Guarna Statement) is recited more prevalently in formal events, ensuring white Australians pay their respects to the traditional land of the Indigenous. A society lacking in social justice, with an abundance of racist views and attitudes towards Indigenous people, creates social justice inequalities and barriers to Indigenous Australians improving their health. Racism directed at Indigenous Australians needs addressing to eliminate social injustices, which will lessen the health inequalities present in Australia today.
An alarming Victorian study (figure 3) (Human Rights, 2018), found that of the 755 Indigenous Victorians surveyed, 97% had inappropriately experienced racism in the previous year, 92% were subjected to racist name calling, jokes or comments based on stereotypes, 84% had been sworn at or verbally abused, 67% had been spat at or had something thrown at them, 66% were told they don't belong in Australia and they should “go home” and 55% had their property vandalised because they're Indigenous (NACCHO, 2018). Racism unbecomingly prevails all around us in Australian society however is exemplified in Australian Rules Football. Racism in Australian Rules Football has been an issue the AFL has been battling for many years. In 1995, a Collingwood player who fought Indigenous Essendon players Michael Long and Che Cockatoo-Collins yelled at Long, “Get off me, you little black c**t”. Officials, within earshot, did nothing. More recently, Sydney Swans player Adam Goodes heard a young girl call him an “ape”. “To hear a 13-year-old girl call me an ape … was shattering,” Goodes said, “racism has a face. It's a 13-year-old girl” (Safi, 2015). For weeks every time Goodes went near the ball, large amounts of the crowd would erupt in relentless booing. Even when Sydney Swans officials said the booing was an expression of racism, people booed even louder.“Given the attention that the issue of racism is now getting as a result of the racist treatment of Adam Goodes, there is an opportunity for the Australian community to gain a deeper understanding of the harm caused by racism, to Aboriginal health and well-being”, said the CEO of the Central Australian Aboriginal Congress Aboriginal Corporation, Donna Ah Chee (CAAC, 2015).In 2016, during Showdown 41, a Port Power fan was caught on video throwing a banana at Crows player Eddie Betts. The incident was taken seriously with a Port Adelaide investigation deeming it was “clear the offender's behaviour was racially motivated.” Betts stated “enough is enough. It's racism and we want to stomp it out of the game. It affects me, but it affects people around me more. We want to make footy an enjoyable place to go and support your team. There is racial abuse and it's not kid-friendly, it's just not a great place to be” (HuffPost Australia, 2017). From July 2014, BeyondBlue began a national campaign highlighting impactsof racial discrimination on the social and emotional wellbeing of Indigenous peoples. 1,000 non-Indigenous Australians aged 25–44 years were surveyed to gain insight into attitudes, beliefs and behaviours in relation to discrimination against Indigenous Australians. Shockingly, 21% admitted they would move away if an Indigenous Australian sat near them, 42% believe Indigenous Australians are given unfair governmental advantages, 37% believe Indigenous Australians are lazy, 31% believe Indigenous Australians should behave more like “other Australians”, 20% believe racist terms used to describe Indigenous Australians aren't that bad, 21% believe it's hard to treat Indigenous Australians in the same way as everyone else and 24% believe that not hiring an Indigenous Australian would be an automatic/unconscious action by the discriminator (BeyondBlue, 2018). With these outrageous attitudes and beliefs, it's little wonder there's so much racism in Australian society and why the health gap and social inequities between Indigenous and non-Indigenous Australians is still so significant.
The Human Rights Commission are a national institution in place to ensure the Racial Discrimination Act (RDA) is being followed in Australian society. In 1975, the RDA was implemented, finally making discriminationindifferentpartsofpubliclifeillegal, protecting people from racial hatred and discrimination in employment, education, getting or using services, renting or buying a house, and accessing public places. Racial discrimination in employment includes insisting that all employees speak English at all times, not employing someone from a particular racial group, or not employing or promoting someone because of assumptions that they wouldn't ‘fit in' (Australian Human Rights Commission, 2018). The RDA appropriately makes it unlawful to discriminate in the provision of services, such as banking and insurance, government departments, transport or telecommunication, professionals like lawyers, doctors or tradespeople, and services provided by restaurants, shops or entertainment venues because of their race. It's unlawful to do/say something in public that's reasonably likely to offend, insult, humiliate or intimidate a person or group because of their race, colour, or national or ethnic origin. Examples include racially offensive material in print/online, or racially offensive behavior/language like calling people racist names, making racially offensive comments/jokes/gestures.The Act sends strong messages about ourcommon commitment to racial equality and the importance of a fairgoforall. Despite this legal protection, too many people in Australia continue to experience prejudice and unfair treatment because of how they look or where they comefrom. Thankfully most Australians (86%) support action totackle racism inAustralia, see figure 4(Human Rights, 2018).
The Australian Government has fittingly helped raise awareness regarding discrimination in Australia and the importance of not suffering in silence. They've developed many programs and campaigns to address the ongoing issue of racism aimed towards Indigenous Australians, including Closing the Gap, Racism… It Stops with Me, and Racism No Way. Close the Gapcampaign is Australia's largest public movement for health equality, with almost 200,000 Australians having formally pledged their support (Human Rights, 2018). The campaignaims to close the unacceptable health and life expectancygap between Indigenous people and other Australians within a generation, by addressing racism directly. The goal is that “by 2030 any Aboriginal or Torres Strait Islander child born in this country will have the same opportunity as other Australian children to live a long, healthy and happy life” (Human Rights, 2018). Racism… It Stops with Me, was introduced by the Human Rights Commission to help Australian society respond to prejudice. It strives to ensure more Australians recognise the unacceptable nature of racism in our community, also empowering organisations to prevent and respond effectively to racism. More than 400 organisations and thousands of people have come on board. After the banana incident,Eddie Betts memorably said, “no one is born racist. It's ingrained in them somewhere down the track. It all comes down to that, to be educated.” Australians can be taught the impact of racism and the detrimental effects it has on a person's health. The Australian government has recognised the importance of racial education and implemented an anti-racist program into all Australian schools, known as Racism No Way. This program is designed to recognise illogical and racist attitudes that many young Australian students and even teachers, have been taught, and to correct these attitudes in hopes of ceasing racism. Aligned with Australian laws, it imposes an obligation on all Australians within the education system to be vigilant regarding racism and to take action when racism occurs. These three initiatives share their overall virtuous goals and the positive impact they all created regarding social justice. As all three government-funded services are accessible to all Australians, Indigenous and non-Indigenous people are given an opportunity to express their passion for racial equality while taking a stand forward, wherever they may be without barriers of location.
Racism is a serious problem that Australia is yet to properly address, despite substantial amounts of funding and government initiatives. It should never be trivialised, it needs to be dealt with. Although there are many initiatives to eliminate racism in Australia, the health issue is incredibly complicated and cannot be fixed overnight. Barriers include strong mindsets of individuals and not understanding how to do it. The government needs to acknowledge and address the clear occurrence of racism within the health and services field, identifying the impact that it has on the overall health of many Indigenous peoples. Cultural awareness training for health and community professionals could help in reducing cases of racism. Indigenous Australians must feel they're in a safe environment. These services must create staff that have a strong understanding of Indigenous cultures, history, lived experiences and common health concerns they might have, in order to work competently and ethically with the Indigenous. Then, Indigenous people will feel a connection to these services and hopefully not avoid them (NACCHO, 2018).Development of educational initiatives like Racism No Way, need to be incorporated into all factors of Australian lives, not just within the education systems. Anti-racist education should be incorporated in workplaces and throughout newspapers, television and social media ensuring all Australians are receiving adequate racial equality education. Especially older/middle-aged Australians, if as Eddie Betts said racism is ingrained/learnt then these people tend to have strong mindsets and lack understanding of racial issues due to their upbringing. All Australians must be educated that discriminatory remarks and stereotypes, however casual or light-hearted, have implications on others' health. There needs to be recognition and understanding that individuals cannot prosper if they feel unconnected. Indigenous Australians need to be connected with their own families, communities and cultures, as well as a connection to the rest of society. Racism creates a strong barrier to that connection. Racism is a pernicious issue that's apparent in today's society. Australia has a long sad history of racism directed at its Indigenous peoples and this needs to be properly addressed in order to take a step towards reconciliation.