Aboriginality, Poverty and Health-Exploring the Connections

History and the Social Determinants of Health
1999,"Winch, J., and Hayward, K.",,"Doing It Our Way'- Can Cultural Traditions Survive in Universities?","New Doctor","Vol 62 pp25-27","Journal","Curriculum Development",,,, 1994,"Woodward, A",,"Public health has no place in undergraduate medical education","Journal of Public Health Medicine","Vol 16. No 4, pp389-392","Journal","Culture, Knowledge and Education",,,"http://jpubhealth.oxfordjournals.org/cgi/content/abstract/16/4/389","Summary: It is time to review the reasons for including public health in medical education. Undergraduate medical students are interested above all in the diagnosis and treatment of individual cases of disease; population-based health care means little to most students, and is seldom regarded as important. Should public health teachers concentrate their efforts in other areas, where students are more receptive? This paper presents arguments for and against the proposition that public hearth has no place in the undergraduate medical course. In favour of the proposition, it is argued that the clinical imperative is so firmly entrenched in the minds of students and in the cultures of medical schools that public health will always be diminished and elbowed to one side in medical curricula. Moreover, the major gains in the health of populations will be won in other arenas. Therefore public health should rupture the links with medical schools that were formed in another age and, in any event are now weakening as public health strikes a new identity. The effort that currently goes into teaching unwilling medical students would have better returns if it was invested elsewhere. Against the proposition, it is argued that the health of populations will not be improved without participation of all groups with an interest in and an influence on health care. No group is more influential in the organization and delivery of hearth services than the medical profession, so it would be foolish for public hearth to withdraw from medical education. Moreover, effective medical practice requires an ability to think in terms of populations as well as individuals. Public health cannot be taken out of medical education - it is just a question of whether or not it is done well. " 2007,"Wilczynski, A., Reed-Gilbert, K., Milward, K., Tayler, B., Fear, J and Schwartzkoff, J.","Young, UK.","Evaluation of Bringing them home and Indigenous Mental Health Programs","Evaluation of Bringing them home and Indigenous Mental Health Programs",,"Report","Policy and Practice","Department of Health and Ageing",,"http://www.quitnow.info.au/internet/main/publishing.nsf/Content/health-oatsih-pubs-bth-eval", 2007,"Young, J., Stupans, I., Scutter, SS and Smith, L.",,"Retaining Indigenous students within health sciences courses at the University of South Australia","Focus on Health Proffessional Education","Vol 9 No 1 pp33-43","Journal","Training Indigenous Health Practitioners",,,,"Background: Increasing the number of Indigenous health professionals is seen as one of the key strategies needed to work towards improving health outcomes for Indigenous Australians. Concerns over attrition rates in health science courses at the University of South Australia led to a qualitative research project being undertaken, focusing on an exploration of the reasons as to why this was occurring. Method: Telephone interviews were conducted with 33 people who had been, or were currently enrolled between the years 2000 and 2005. Results and Conclusions: For people who were no longer enrolled, the reasons for this, apart from having graduated successfully, included work/life balance issues, and reading and writing concerns. Positive outcomes for individuals were also cited, such as enrolment at the University of South Australia leading to them being able to undertake alternative programs of study that had been their first preferences, Some individuals Simply stated that a particular career was ""not right for me"". People were very positive about scholarships and flexible modes of enrolment. However more personalized forms of support had variable responses. Several key subpopulations emerged as particularly vulnerable. These included people who were studying externally (particularly full-time); older students, and those who had to experience structured change. " 2010,"Hayman, N",,"Indigenous primary health care research and health care reform: Improving care","2010 Primary Health Care Research Conference",,"Presentation",,"Inala Indigenous Helath Service ",,"http://www.phcris.org.au/phplib/filedownload.php?file=/elib/lib/downloaded_files/conference/presentations/6958_conf_abstract_.pdf", 2010,"Snowdon, W",,"Chronic Disease and Indigenous Health","Australia New Zealand Journal of Public Health","Vol 34 Supplement 1 ","Journal","Policy and Practice",,,"http://onlinelibrary.wiley.com/doi/10.1111/j.1753-6405.2009.00544.x/abstract", 2010,"Craoger EJ., Eades, T., Pratt, IS., Slevin, T., ",,"Impact of a short, culturally relevant training course on cancer knowledge and confidence in Western Australia’s Aboriginal Health Professionals","Australia New Zealand Journal of Public Health","Vol 34 Supplement 1 ","Journal","Training Indigenous Health Practitioners",,,"http://onlinelibrary.wiley.com/doi/10.1111/j.1753-6405.2010.00558.x/abstract","Objective: To develop, deliver and evaluate a cancer education course for Indigenous Health Professionals. Method: The cancer education course combines expert presentations, interactive sessions and visits to local cancer treatment centres. Three four-day courses have been run, in both metropolitan and regional Western Australia (WA). Cancer knowledge and confidence were measured at baseline, course completion and at follow-up (six to eight months). Data were analysed within subject. Results: Thirty-five Aboriginal Health Professionals have completed the program, most from rural or remote WA. All confidence items significantly improved at course completion (p<0.005), but improvements for only two items, ‘I know what cancer is’ and ‘I can describe the different common cancers’, were sustained at follow-up (p<0.05). Knowledge of treatment (p<0.05), screening (p<0.05) and the most common cancers in women (p<0.005) were significantly greater after course completion, but increased knowledge was not sustained at follow-up. Conclusion: Demand for places suggests that Aboriginal Health Professionals are interested in developing knowledge, skills and confidence in cancer control. Attendance increased understanding of cancer and improved cancer knowledge however this was not maintained. Attendance increased understanding of Implications: A short, culturally relevant training course increases cancer knowledge and confidence, however, ongoing education is needed to maintain this." 2006,"Bean, R",,"The Effectiveness of Cross-Cultural Training in the Australian Context","The Effectiveness of Cross-Cultural Training in the Australian Context",,"Report","Medical Professionalism and Cultural Safety",,,"http://www.immi.gov.au/media/publications/research/cross_cultural/Contents_Executive_Summary.pdf", 2006,"Betancourt, J.",,"Cultural Competence and Medical Education: Many Names, Many Perspectives, One Goal","Academic Medicine","Vol 81 No 6 pp499-501","Journal","Medical Professionalism and Cultural Safety",,,,"Two contemporary reports from the Institute of Medicine—Crossing the Quality Chasm and Unequal Treatment— highlighted the importance of patient centered care and cultural competence training as a means of improving the quality of health care for all and eliminating racial/ethnic disparities in health care. Previous efforts in cultural competence have aimed to teach about the attitudes, values, beliefs, and behavior of certain groups. A more effective approach is to learn a practical framework to guide inquiry with individual patients about how social, cultural, or economic factors influence their health values, beliefs, and behaviors. Rather than learning about individual cultures and their characteristics, this approach focuses on the issues that arise most commonly due to cultural differences, and how they may affect a physician’s interaction with any patient. At the end of the day, physicians need a practical set of tools and skills that will enable them to provide quality care to patients everywhere, from anywhere, with whatever differences in background that may exist, in what is likely to be a brief clinical encounter. Call it what you will, the field of cultural competence aims quite simply to assure that health care providers are prepared to provide quality care to diverse populations." 2008,"Delphin, M, Rowe, R.",,"Continuing education in cultural competence for community mental health practitioners","Professional Psychology: Research and Practice","Vol 39 No 2 pp182-191","Journal","Medical Professionalism and Cultural Safety",,,"http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6X00-4SBKGMJ-B&_user=559483&_coverDate=04%2F30%2F2008&_rdoc=10&_fmt=high&_orig=browse&_srch=doc-info(%23toc%237200%232008%23999609997%23687179%23FLP%23display%23Volume)&_cdi=7200&_sort=d&_docanchor=&_ct=18&_acct=C000028178&_version=1&_urlVersion=0&_userid=559483&md5=27da54601e3e4e5f2d801c1e2e205752","Continuing education in cultural competence is a key strategy for enhancing provider effectiveness in working with culturally diverse clients. In the mental health field, a majority of published works address training issues related to students in graduate programs. Few articles, however, discuss specific models or methods of continuing education for practitioners working in community-based settings. The authors present a case example of an interactive workshop in cultural competence for community mental health practitioners. They discuss key modules of this workshop, including (a) cultural competence and outreach principles, (b) cultural identity and worldview, (c) stereotyping and automatic thinking, (d) dynamics of difference, and (e) application exercises. Recommendations are offered for administrators, direct care staff, trainers, and researchers who may be interested in undertaking or participating in cultural competence continuing education efforts." 2006,"Mak D, Plant A, Toussaint S.",,"I have learnt . . . a different way of looking at people’s health’’: An evaluation of a prevocational medical training program in public health medicine and primary health care in remote Australia. ","Medical Teacher","Vol 28 No 6 pp148-155","Journal","Medical Professionalism and Cultural Safety",,,"http://informahealthcare.com/action/doSearch?searchText=I+have+learnt+.+.+.+a+different+way+of+looking+at+people%E2%80%99s+health%E2%80%99%E2%80%99%3A+An+evaluation+of+a+prevocational+medical+training+program+in+public+health+medicine+and+primary+health+care+in+remote+Australia.&type=simple&restrict=all&filter=multiple&categoryId=allJournals","The purpose of this study was to gain insight into what prevocational medical practitioners (PMPs) learnt during a six-month public health medicine and primary health care training program (the Program) in remote Aboriginal Australia in 2001–2002. The Program’s curriculum objectives included clinical and public health management of sexually transmitted infections, immunization, clinical audit and quality improvement, primary health care in remote Aboriginal communities, and working as part of an interdisciplinary team with health and nonhealth professionals, and lay people. The mode and location of delivery of these objectives was determined by the healthcare needs of the Kimberley population, and availability of safe, supported workplaces. Qualitative data from a variety of sources, including PMPs’ reflective journals, were examined in the context of the Program’s curriculum objectives and by conducting a content analysis of journal notes. Findings are presented using the curriculum objectives and other comments that emerged while examining the data. Preliminary data indicated that PMPs gained knowledge and practical experience in clinical and public health management of sexually transmitted infections, immunization and primary health care in poorly resourced remote Aboriginal settings. Deeper understandings of health and illness in a cross-cultural setting also developed, along with professional and personal growth, as illustrated by the following quotations from PMPs: ‘‘I have learnt . . . a different way of looking at people’s health . . . I was encouraged to think more deeply than before about the whys and wherefores of medical practice, and thus consider the most effective ways of influencing patients’ behaviours for the better.’’ ‘‘I was encouraged to examine the thought processes behind the ways . . . healthcare was provided . . . [after leaving the Kimberley] I am constantly questioning the reason why we are practising medicine in a certain way in the big city hospitals— much to the consternation of my colleagues . . . .’’ The Program was successful in teaching its first four PMPs the basic tools of public health medicine and remote area primary health care." 2008,"Sonn C.",,"Educating for anti-racism: Producing and reproducing race and power in a university classroom","Race, Ethnicity and Education","Vol 11 No 2 pp155-166","Journal","Medical Professionalism and Cultural Safety",,,"http://www.informaworld.com/smpp/content~db=all~content=a794475781~frm=abslink","In this paper I explore some of the issues associated with teaching about race, culture, and ethnicity in a psychology program. These curriculum initiatives are part of a broader agenda of raising awareness about racialised oppression and exclusion and contributing to the development of ways of researching and practicing psychology that are transformative and culturally sensitive. I overview the broader context and describe our subject and the guiding principles. This is followed by a description and analysis of two events in the classroom that illustrate the ways in which students differentially respond to the challenges posed by writings that challenge taken-for-granted understandings of race. Part of the analysis shows that students can often engage in the reproduction of oppressive practices and invest in whiteness. It is suggested that more than single semester subjects are required to promote and support the development of critical capacities for anti-racism practice."