Critical Analysis Of Low Birth Weight Among Indigenous Australians
Understanding Low Birth Weight
Low Birth Weight is a situation in which babies are born weighing less than 2500 grams. Babies with low birth weight looks smaller than babies of normal birth weight, and have higher risks of long term health conditions such as hypertension, diabetes, cardiac problems, pulmonary complications and renal diseases. Higher risks of various types of infections such as chickenpox, toxoplasmosis and rubella is associated with low birth weight (Ghahfarokhi et al., 2018). Additionally, low birth weight can also cause developmental disorders among the children and fetal growth restrictions due to which the infants are not able to gain weight normally and they grow up to be underweight children and adolescents. Studies show that the low birth rates can increase the risks of long term developmental outcomes and neurodevelopment problems (such as Autism and ADHD) which can reduce their overall health and wellbeing (Dudova et al., 2014; Franz et al., 2018).
In Australia, significant number of children born in Aboriginal and Torres Strait Islander communities with a low birth weight, compared to non indigenous Australians. According to statistics from the Australian Institute of Health and Welfare, 11.2% of live born singleton babies born in the Indigenous Australian Communities were of low birth weight (as of 2011) which was 2.5 times higher compared to child births from Non indigenous communities (4.6%) (aihw.gov.au, 2014; Martinson & Reichman, 2016). Additionally, according to Aboriginal And Torres Strait Islander Health Performance Framework 2017 Report, the rates for low birth weights among Indigenous Mothers were at the top of the list in the most remote areas (12.1%) and remote areas (11.7%) and the mean birth weights of babies (3217 grams) born to Indigenous mothers were found to be lesser than babies born to non indigenous mothers (3356 grams) (pmc.gov.au, 2017; Sayers et al., 2017). This information clearly shows that the problem of low birth weight among Indigenous Children is significantly higher compared to Non Indigenous children, making them more prone to health conditions in later life (Kildea et al., 2017; Dossetor et al., 2017).
The aim of this study is to analyze four media articles which discusses the problem of low birth weight among indigenous Australians and how the articles relate to the modules and topics taught during the learning sessions.
Maguire, G., & Robson, B. (2016). Aboriginal – M?ori: how Indigenous health suffers on both sides of the ditch. The Conversation [Parkville]. Retrieved from https://theconversation.com/aboriginal-maori-how-indigenous-health-suffers-on-both-sides-of-the-ditch-48238
Summary To Key Issues:
Health Disparities Among Indigenous Australians
In this article written by Maguire and Robson (2016), titled “Aboriginal – Maori: how Indigenous health suffers on both sides of the ditch”, published on The Conversation on April 21, 2016, the authors points out that the health gap between the Indigenous and Non Indigenous people in Australia and New Zealand still keeps on expanding and the Indigenous people are seen to suffer more compared to Non indigenous people. The authors have studied the life expectancies, infant mortality rates, birth weight, maternal mortality rates, nutritional status and educational status of both Indigenous and Non Indigenous people, comparing the statistics in both Australia and New Zealand to understand the drawback related to health between the Non Indigenous and Indigenous communities in there two countries. From the studies the authors concluded that across all the measures (mentioned above) the Indigenous people fared less than the Non Indigenous people thereby showing a significant health disparity between these people. One of the biggest disparity have been found to be in the birth weight, with more Indigenous babies being born under the weight of 2500 grams, making them underweight and increasing their risks to different health conditions compared to non indigenous children. Moreover, the health discrepancies are further increased due to lesser accessibility to proper education, and have higher risks of the babies born with low birth weight towards mental health issues and exposure of high levels of alcohol consumption and different communicable and chronic diseases (Saigal et al., 2016). According to their studies, the life expectancies of Indigenous children (69.1 years for males and 73.7 years for females) were significantly less compared to non indigenous children (79.7 years for males and 83.1 for females). Similarly, risks of diabetes and suicide rates were also higher among the indigenous people. According to Maguire and Robson, these higher risks of mortality and health risks were significantly contributed by the low birth weight among the Indigenous babies (Martinson & Reichman, 2016).
A complex interplay of various determinants of health can be related to the health discrepancies between Non Indigenous and Indigenous people (Corpeleijn et al., 2016). This complex interaction of different determinants creates a challenge to address the health discrepancies, which have been discussed through the learning outcomes covered in the first topic of Module 1. In the topic various factors or social determinants of health such as access to proper education, poverty and unemployment were discussed and how its interplay can affect the health and wellbeing of the Indigenous people. Through the studies were able to learn how these factors can lead to Indigenous people living in below standard housing, lave limited access to proper nutrition and healthcare and also reduce accessibility to proper education among the youth, increase risks of addiction related problems, which moreover can reduce employability rates and thus their socioeconomic standards (Kader & Perera, 2014; Rahman et al., 2015; Demelash et al., 2015). The lack of access to healthcare also reduces effective prenatal and antenatal care for the indigenous mothers, thereby increasing the risks of low birth weight for their children.
Media Articles on Low Birth Weight among Indigenous Australians
These studies support debates which argue that the lack of prenatal and antenatal care among the indigenous mothers would result in the continuance of the physical health discrepancies between the non Indigenous and Indigenous children, and would result in the prevalence of high mortality rates, lower life expectancies and higher risks of infections and chronic health conditions, increasing the health related drawback between the Non Indigenous and Indigenous Australians (Xaverius et al., 2016; Martinson & Reichman, 2016).
Personal Reflection:
Reflecting upon the above findings and opinions of the authors, it can be stated that in order to reduce the health discrepancies between indigenous and non indigenous Australians, it is vital to improve their accessibility to healthcare, especially towards prenatal and antenatal care and steps must be taken to reduce the incidence or prevalence of indigenous mothers giving birth to children with low birth weight. I believe that by improving access to prenatal and antenatal care, the vicious cycle of low birth weight, poor health outcomes and socioeconomic conditions can be broken and the wellbeing of the indigenous people improved.
Aubusson, K. (2018). Aboriginal children healthier than ever but generations behind peers. Retrieved from https://www.smh.com.au/national/nsw/aboriginal-children-healthier-than-ever-but-generations-behind-peers-20180621-p4zmxm.html
In this news article titled “Aboriginal children healthier than ever but generations behind peers” by Kate Aubusson in the newspaper The Sydney Morning Herald on June 21st, 2018, the author points out towards an improvement in the health of the Indigenous children from the Aboriginal Australian communities over the last few decades. The author however shows concern that the health of the Indigenous children still lags behind their Non Indigenous peers, and thus there still exists a health discrepancy between the Indigenous and Non Indigenous populations (Delany et al., 2018). According to the authors, even though the rates of teenage pregnancies and rates of smoking among pregnant Indigenous women have reduced over the years, these rates are still more than six times higher compared to Non Indigenous people, showing that the improvement in the health and wellbeing of the Indigenous people are not at par with the improvements seen among the non indigenous population, and thus the health gap is not being overcome. The report also shows that the disadvantage faced by the indigenous pregnant women were more than the non indigenous pregnant women, due to which the rates of low birth weights for Indigenous children have not reduced since 2012 and one in every three indigenous children have developmental vulnerabilities (Ghahfarokhi et al., 2018; Mitrou et al., 2014).
Social Determinants of Health and Low Birth Weight
During the topic one of module 3, it was discussed how the poorer health outcomes for Indigenous neonates are caused due to several risk factors and social determinants of health which compromises the cultural, social as well as emotional wellbeing of the indigenous people, and low birth weight is one of these determinant which impacts the overall health and wellbeing of these people (Lee et al., 2018). Due to this, it is vital that an immediate intervention be implemented to address these social determinants and strategies to address the problem of low birth weight among Indigenous neonates be identified as soon as possible to prevent further widening of the health gap and health discrepancies between the Indigenous and Non-Indigenous people (Mitrou et al., 2014). Discussion about the Steering Committee for the Review of Government Service Provision report, it was clearly understood that necessary precautions were not being implemented and proactive measures were not taken to address the existing disparities in health between the Indigenous and Non Indigenous people, especially in the context of higher rates of low birth weights among indigenous neonates compared to non indigenous neonates, due to which the health discrepancies still exist (directory.gov.au, 2017). This have also been supported by studies that show that a lack in maternal and childcare programs for Aboriginal and Torrest Strait Islanders is one of the biggest contributors in the incidence of premature births and babies born with low birth weights (Delany et al., 2018; Grant & Greenop, 2018).
The article clearly supports the discussions made during the different modules on how the social determinants of health such as access to healthcare as well as teenage pregnancies and incidence of smoking among pregnant women can increase the risks of adverse health effects for the children (Blakely et al., 2015). Additionally, although the report supported the view that the wellbeing of the Indigenous people have improved over the last few decades, the rate of improvement have not been at par with that of the non indigenous people, as a result of which the health related drawback between the non- indigenous and indigenous people still exist in Australia (Greenwood et al., 2015).
I believe that no excuse can exist for the maintenance of such health gaps and health discrepancies between the people living in the same country. This health discrepancy still shows that the Indigenous people are still not over the historic inequalities faced by them through the history of Australia.
Wahlquist, C., & Davidson, H. (2017). Drop in birth weights and school attendance could be linked to NT welfare restrictions. Retrieved from https://www.theguardian.com/australia-news/2017/dec/08/drop-in-birth-weights-and-school-attendance-could-be-linked-to-nt-welfare-restrictions
The article titled “Drop in birth weights and school attendance could be linked to NT welfare restrictions” by Wahlquist and Davidson, posted on The Guardian on December 8th, 2017, discusses about how the Northern Territory welfare restrictions have resulted in a drop in the birth weights as well as attendance is schools. The authors pointed out that between September 2007 to October 2008, attendance in schools from approximately 73 Indigenous communities in Australia have dropped by almost 4% along with a proportional increase in the incidence of birth of children with low birth weights from these communities. The authors have argued that these were interring related outcomes, since the low birth weight increases the risks of health problems among the children, due to which their attendance in schools gets lowered. It has also been pointed out that inappropriate welfare strategies is one of the most significant causes of financial stress among the indigenous people living on state support (Kallankari et al., 2015). The inadequate welfare, which only covers their ‘basic’ expenses which are disbursed fortnightly have led to an increase in conflicts in households, while poor implementation and income management strategies have effectively rendered the welfare support systems ineffective to address the health discrepancies. According to the authors, these financial stresses among the indigenous people have increased the incidence of smoking and alcoholism especially among the Indigenous mothers, which also a significant risk factor for the low birth weight (Serido et al., 2014). The financial problems and incidence of domestic stressors have also resulted in the reduction in school attendance among the indigenous children, which additionally affects their educational levels and also employability rates, thereby causing the maintenance of the financial stressors. The authors pointed out that the strategies to restrict the welfare of the people by allocating them fortnightly instead of a large sum at one time can prevent the incidence of smoking in the communities (Zhao et al., 2015).
In the news article, the author discussed the efficacy of welfare strategies such as income management programs for the Indigenous people that can help them to overcome dependencies on alcohol and tobacco through the allotment of welfare that can only cover the basic expenses and prevent the welfare money to be spent of smoking or buying alcohol (Martinson & Reichman, 2016). The strategy to promote the wellbeing through reduction in smoking and alcohol dependency can be supported through studies that show a clear link between these risk factors with several health conditions including low birth weight. Statistics from Tobacco In Australia also shows a higher prevalence of low birth weight among for children whose mothers smoked during their pregnancy, which affected size and growth of the fetus in the womb, and also increased the risks of stillborn births as well as sudden infant death syndrome (SIDS) (tobaccoinaustralia.org.au, 2015; Zhao et al., 2016).
Such aspects have also been discussed in the topics from second module in which the risk factors such as smoking has been discussed which adversely affects the health and wellbeing of the Indigenous people. Through the module, it was clearly understood that addressing the problems of smoking was important to overcome several health conditions such as lung diseases, hypertension, diabetes and low birth weight as well as congenital defects (US Department of Health and Human Services, 2014). During the debates it has been proposed that by reducing the rates of smoking among the indigenous people, the health discrepancies between the indigenous and non indigenous people can be reduced. The article by Wahlquist and Davidson (2017) clearly supports such a view, which points towards the strategy by the Northern Territory to curb tobacco dependency among pregnant women from the Indigenous communities.
The article shows how it is vital to restrict the incidence of smoking among the indigenous communities to prevent low birth weight for children. However, it was also clear that an improper implementation of the strategy can have an opposite effect, increasing the financial stress among the indigenous people and instead of reducing the rates of smoking and alcohol dependency, can increase the risks and thus become ineffective in improving their health conditions, especially the rates of low birth weight.
Barclay, L., & Nagel, T. (2013). Improving Aboriginal health and well-being: a view from the north. Retrieved from https://theconversation.com/improving-aboriginal-health-and-well-being-a-view-from-the-north-18522
In the article titled “Improving Aboriginal health and well-being: a view from the north”, the authors Lesley Barclay and Tricia Nagel in the news journal The Conversation on September 25th, 2013 pointed out that indigenous Australians who are living in the remote communities fare much worse than other Australians in terms of their life expectancies. The authors also gave a stern render that the health discrepancies are unlikely to be reduced without proper support from the government as well as the leaders from the Aboriginal and Torres Strait Islander communities (Delany et al., 2018). According to the authors, the differences and discrepancies between prenatal care for the indigenous women and non indigenous women have resulted in the prevalence of low birth weight among the indigenous children. Moreover, the author also pointed out that the prenatal care were not adequately being utilized by the indigenous mothers mainly because of several social determinants such as the socio economic status and a lack of trust on the healthcare system (Mitrou et al., 2014). Thus the authors recommend that the government should take more careful and proactive steps to ensure better utilization and accessibility of prenatal care among the indigenous Australian communities. Also, according to the authors, improving the continuity of care through antenatal care strategies and utilization of midwives to help the pregnant women to prepare for childbirth can also help to address this health issue and help the government to close the health gap between indigenous and non indigenous people.
During the Modules 1 and 2, it was discussed how the progression in the health and wellbeing between the indigenous and non indigenous people were disproportional, due to which the health gap between the people are never fully covered. In the topic 1 on module 1, it was discussed how there exists a wrong perception among the healthcare workers that ‘poor health’ is a common factor for the indigenous Australian population (Kader & Perera, 2014). This creates a sense of complacency among the healthcare workers to promote the wellbeing of the people. This have been supported by the news article. During the module 3, topic 2, it was also emphasized that there has been an improvement in the health of indigenous people, which can be seen through a reduction in the infant mortality rates and improvement in the life expectancies among the indigenous people due to the expansion of the indigenous maternal health services (Dossetor et al., 2017). However, still the non indigenous mothers are more than twice likely to deliver healthy babies compared to the indigenous mothers, showing that more needs to be done to bridge this health gap. Thus improvement in service delivery is still required to address this gap (Lee et al., 2018).
Reflecting upon this article, it can be clearly summarized that even though there is an improvement in the overall wellbeing among the indigenous people, the health gap still exists due to ineffective healthcare delivery system, which fails to address the health needs especially in the remote indigenous communities and due to the poor reach of healthcare delivery for indigenous mothers. I completely agree with the author’s conclusion that more needs to be done to bridge the health gap.
Conclusion:
The incidence of low birth rates have reduced among the indigenous communities, however the rates are still far greater compared to the non indigenous Australians. The low birth rates have been influenced by several key health determinants such as socioeconomic conditions, access to healthcare, financial strain, education levels and employment levels. Moreover, smoking, alcoholism, teenage pregnancy have also led to the higher incidence of low birth weight among the indigenous people. Through this essay, it was highlighted how it is vital to prioritize the addressing of these risk factors in order to increase the health and wellbeing of the Indigenous Australian people. The four media sources helped to understand the continued health gap between the indigenous and non indigenous people exhibited though the higher rates of low birth weight. It can be concluded that the government should approach this problem by addressing these determinants, helping to increase use of healthcare programs for prenatal and antenatal care for the indigenous mothers and helping to overcome smoking and alcoholism to ensure better outcomes.
References:
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Aubusson, K. (2018). Aboriginal children healthier than ever but generations behind peers. Retrieved from https://www.smh.com.au/national/nsw/aboriginal-children-healthier-than-ever-but-generations-behind-peers-20180621-p4zmxm.html
Barclay, L., & Nagel, T. (2013). Improving Aboriginal health and well-being: a view from the north. Retrieved from https://theconversation.com/improving-aboriginal-health-and-well-being-a-view-from-the-north-18522
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