No better day to post these

[seeingred]

Making progress: the health, development and wellbeing of Australia's children and young people. Australian Institute of Health and Welfare report, 24 September 2008

The report found that Indigenous Australian infants were three times as likely as other Australian children to die in the first year of life.

Aboriginal and Torres Strait Islander

Comments

[hiraethin]

Indeed - "...higher in remote and very remote areas (8.7%) and the most socioeconomically disadvantaged areas (7.2%)." So, indigenous, poor, remote area - the trifecta.

Seems to me that what is needed is a combination of more services - education and medical assistance - and economic improvement. Work, or opportunities for work or business. It's contrary to traditional practice and no doubt destructive of traditional society, but like the greater cost per capita of service delivery to remote areas, it's part of the price that needs to be paid. I don't think traditional indigenous culture is entirely congruent with access to modern opportunities and services. While both worlds coexist the border lands will I think always feature those who reject one or more aspects of both. So the border land inhabitants are added to those who by choice or chance fall into one or more high risk categories for teenage pregnancy and infant mortality.

I guess my point is that we can work to reduce the disparity in teenage pregnancy and infant mortality, and should, just as we work to reduce teenage pregnancy and infant mortality overall; but I think that there will always be a disparity.

[seeingred]

It's certainly true that rural Australians of all races get a raw deal when it comes to medical services. But have you got any sources on this Indigenous incompatability with employment and modern medicine?

[hiraethin]

No evidence, just my own theory. As I said, I don't think traditional indigenous culture is entirely congruent with access to modern opportunities and services. I am not suggesting that indigenous Australians are incompatible with employment and modern medicine; I am suggesting that indigenous Australian culture is not entirely compatible with access to modern opportunities and services. What I mean is that access to the latter tends to corrupt, if you like, or certainly transform, the former. I vaguely recollect an old assertion that when two cultures collide, the less advanced one is doomed. I think that's true.

If every indigenous Australian is educated to understand that legal stimulants should be enjoyed in healthy moderation and that illegal or unsafe stimulants should not be enjoyed, that sex should be enjoyed in healthy moderation by consenting adults in a manner that prevents unplanned pregnancies and the transmission of disease, and so on and so forth, and if they are provided with the benefits of a modern technological society such as government assistance and entry to the rat race, I suspect that not many indigenous Australians will choose to remain living on the land in the traditional manner. I think some will augment their way of life with one or more elements of modern culture, like cars or phones or houses or junk food or television, and some will fall prey to the lotus-eater's trap constituted by a compassionate society's attempt to reduce the misery of those at the bottom of the socioeconomic ladder. The trends of a society, after all, are the aggregate of thousands of individual life choices.

Ultimately the best that can be hoped for is that indigenous Australians will choose the best aspects of both modern and traditional cultures, or at least discard the bad aspects of both.

[seeingred]

... yah, 'cos I'm looking through the second of those reports, and I'm not seeing a lot of stuff about how Indigenous culture is incompatible with good health, or anything about reluctance or refusal to use health services. Rather, the report describes a serious lack of access to those services. How do you "reject" something you haven't got in the first place?

Certainly factors such as smoking and alcohol don't stem from Indigenous culture. What's more, a traditional diet would actually be far healthier - Indigenous foods have some of the lowest Glycemic Indices in the world, which is why a Western diet results in obesity and diabetes.

So yah, I'm very curious as to where your thinking has come from on this point.

[hiraethin]

See, I really think you're missing my point. On rejection, I said "While both worlds coexist the border lands will I think always feature those who reject one or more aspects of both." I think it should go without saying people can't reject what they don't have. But they can reject what they do have, and some people do.

I am well aware tobacco and alcohol are introduced evils.

I know that a traditional diet *can be* more healthy. (Some westerners have died from it.) I challenge your assertion that the lower GI index of indigenous foods is responsible for western diets resulting in obesity and diabetes, but I suspect you didn't mean quite how that sounds. Yes, westerners have high incidences of obesity and diabetes, in part because market-driven demand for prepackaged foods, foods high in sugar, salt and fats has made it cheap and easy even for the poor to subsist excessively on such foods, and in part because modern technology has reduced the physical effort required in the average job. This is all beside the point.

[seeingred]

My bad! Obesity and diabetes in Indigenous Australians and Pacific Islanders is linked to the change from the low-GI diet to which they were adapted to a high-GI Western diet.

I think we may have a couple of red herrings here.

Firstly, I don't believe that Indigenous people reject health services to any significant extent. I'm not an expert, but I've never seen any evidence to that effect. There may well be some individuals who won't take themselves to a doctor; but surely their signal must be swamped by that of people who want a doctor and can't get to one. So I disagree with your suggestion that, because of a resistance to Western medicine in Indigenous culture, a disparity in health outcomes is inevitable.

Secondly, what proportion of Indigenous Australians actually live in something like the traditional manner right now? (If any colonial introduction makes their lifestyle non-traditional, it must be pretty much zero.)