Cultural safety needed to prevent Aboriginal people receiving poorer health treatment
05-Jul-2017 6:15 AM
An article authored by Prof Dennis McDermott (Flinders University), Prof Tom Calma (Reconciliation Australia) and Martin Laverty (Royal Flying Doctor service of Australia) has just been published in the Medical Journal of Australia.
The article details that Aboriginal people receive poorer treatment in mainstream health services than non-Aboriginal people.
As an example of the need to improve equity, a South Australian study found that Indigenous people presenting to emergency departments with acute coronary syndrome were half as likely as non-Indigenous patients to under angiography. More broadly, Indigenous people admitted to hospital are less likely to have a procedure for a condition than non-Indigenous people.
Cardiovascular disease is the leading cause of death in Indigenous Australians. Cancer is the second biggest killer; the mortality rate for some cancers is three times higher for Indigenous than for non-Indigenous Australians. Clinical leaders in these two disease areas have identified the need for culturally safe health care to improve Indigenous health outcomes.
Cultural safety is an Indigenous-led model of care. It acknowledges the barriers to clinical effectiveness arising from the inherent power imbalance between provider and patient and moves to redress this dynamic by making the clinician’s cultural underpinning a critical focus for reflection. Culturally safe care results where there is no inadvertent disempowering of the recipient, indeed where recipients are involved in decision-making and become part of a team effort to maximize the effectiveness of the care.
Cultural safety, if embedded in health care standards would require clinicians to provide more equitable care leading to better health outcomes. Such investment will need investment in clinician education and professional development, together with measures for accountability.
The stewards of the National Aboriginal and Torres Strait Islander Health Plan (ie. the Federal Department of Health and their expert implementation advisory group), accreditation bodies and monitors of the existing frameworks for safety and quality standards in health care need to formally collaborate on a systematic revision of standards to embed culturally safe practice and develop health settings free of racism.
The full article in the Medical Journal of Australia can be found at: https://www.mja.com.au/journal/2017/207/1/improving-indigenous-health-through-education