Good health is more than just the physical well-being of an individual but entails the entire community’s cultural, emotional and even social wellbeing where persons would be able to obtain a complete prospective as human beings thus resulting in the total prosperity of the entire community. Using health promotion, the target people will be able to reach a state of social, physical and mental beings and this would be possible by being able to determine and realize the aspirations to satisfy one’s needs and adjust to the environment (Gubhaju et al., 2013, p. 11). Health promotion of the indigenous people in Australia ought to take into consideration their diversity, cultures, socio-economic situations, language, and dialects, consequences of colonization that influenced their physical, economic and social living conditions in addition to geographic location. An indigenous baby raised in an Aboriginal community is expected to live about 20 years less compared to other babies. Based on this, it is a clear indication of the relative health status of the ingenious population in Australia as poorer compared to the rest of the Australia population (Australian Bureau of Statistics (ABS), (2010a), n.p). The paper will focus the aboriginal Australians living in the remotes areas and how different factors have denied them the opportunity to access health literacy then evaluate the use of interactive health literacy posters as an intervention to create health awareness on diabetes among these communities. According to a study by Tsey et al., (2010, p. 169), in Australia, the Aboriginals have been reported to still have a shorter life expectancy and at the same time. They often experience the higher burden of disability and ill-health although their life course. In Australian, just like every other developed nation, on average the population enjoys a longer life expectancy and live healthier lives, but this is only for the non-indigenous. Such a variation on health situation is attributed to various factors which include socio-political, historical, intermediate, and distal (Scrimgeour & Scrimgeour, 2007, p. 23). The start and the most of the socio-political factors contributing to the aboriginal health crisis is partly attributed to the historical effects of colonization that caused the erosion of traditional ways of life, culture, and self-determination of the native population. Some of these acts were perpetrated by their colonial masters whose consequences affect the current health situation of the aborigines include racism, marginalization from the society and discrimination (Lee et al., 2010, p. 530). The effects of these acts are on the emotional, social, and physical well-being of aboriginal people. According to Australian Bureau of Statistics (ABS) (2010a), it was reported that the life expectancy of the aboriginals was at 67.2 years for the males and about 72.9 for the females and such expectancy average was less by 11.5 for men and 9.7 for women that of non-aboriginals. According to Vos et al., (2007, p. 21), the if injuries and diseases burden for the aboriginal people was at the same rate as that of the non-aboriginal people, then 59% of the entire diseases and injuries burden among the indigenous population could be eliminated. The apparent health gap between the aborigines and the non-aborigines is primarily from non-communicable conditions, and they occurred mainly among the middle-aged generation (35-54 years).
The aboriginals in Australia around 2002 were shown to be less than half as likely to have attended and complete a post-secondary educational qualification of certification level and above to non-aboriginal individual (Tsey et al., 2010, p. 171). Such a level further entails the post-graduate degree, bachelor’s degree, an advanced diploma or even certificate. Based on a study carried out by Hallett, Chandler & Lalonde, (2007, p. 392), by the end of the year 2004, at the national level, the aboriginals students on average were reported to be half as probable as the non-aboriginal student to continue to year 12. It is therefore evident that the aboriginal population has a small percentage of the mainstream education. Compared to the non-aboriginal people, the indigenous people are less educated, and this is considered to be one of the factors contributing to the aboriginal health crisis (Australian Bureau of Statistics, 2010b), n.p). It is true that education is a critical aspect of social, economic status hence plays a crucial role in determining health in various ways. For instance, the uneducated indigenous often experiences higher rates of poor literacy that apparently affects their capability to obtain information on proper nutrition or even the appropriate way to prepare healthy food. Further, inadequate education reduces the human resource skills hence making it hard for them to secure a better employment thus remain plunged into poverty while experiencing social exclusion (Lee et al., 2010, p. 530). It has a high probability of resulting in a vicious cycle of poverty that leads in increased cases of school dropout, diminishing employability of the aboriginals.
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The entire medical process from diagnosis to treatment of diseases in the mainstream healthcare system requires a literate person. The inadequate education levels among the aboriginal, especially the rural and elderly aboriginals is a significant factor causing the indigenous health crisis (AHMAC, 2012, n.p). The majority of these people does not understand the early diagnosis of diabetes and may avoid seeking health care not until diseases are at critical levels. Moreover, due to the knowledge and communication gap due to low literacy level, it is hard to communicate the symptoms with healthcare providers. Lack of healthcare practitioners who are natives in the healthcare system has to make the aboriginals to consider the care system as foreign and therefore, not for them hence; some will shun healthcare interventions and prefer the native medicine provided by native doctors (Centre for Epidemiology and Research, 2010, n.p).
Research has shown that both income and employment among the Aboriginals are among the socio-economic elements which have impacted them regarding systematic racism, colonization and even discrimination where these individual are denied access to vital resources essential to improve their social, economic status. Based on the statistics presented above, it is clear and convincing that aboriginal communities are ranked lower in the economic ladder (Clelland, Gould & Parker, 2007, p. 209). The direct impact of low income on this community is poor housing, low literacy, and meager community economic resources. The significant effect of poverty on their health crisis is lack or insufficiency of material resources which include nutritious foods, continuous consumption of the appropriate foods, and inhibited access to high-quality care. Poverty is also associated with low social cohesion, social exclusion, and increased crime which are a combination of health crisis and injury. More importantly, poverty results in lack of control as a result of anxiety, insecurity, in addition to self-esteem (Nagel et al., 2009, p. 174). Poverty has also been attributed to being the primary cause of substance abuse among the aboriginal population. According to De Leo, Milner & Sveticic, (2012, p. 174), poor health conditions increase with increasing remoteness and these may be linked to geographical or environmental facts which may include long distances from health care centers, the aboriginal population being cut off on an occasional basis due to flooding. The variation in the health circumstances between aboriginal and non-aboriginal communities is also attributed to the population’s features in the very remote regions. For instance, the association between socioeconomic status and health is strong.
Remoteness and health are more pronounced for aboriginal people as the majority of indigenous Australians live outside the metropolitan areas as compared to the non-indigenous Australian population. According to AHMAC (2012, n.p), the reasons aboriginal do not use the mainstream healthcare include long waiting time, lack of care, unavailability of health services in their local areas, long distance, unable to afford the health services, and health care provided in hospitals being not in line with their culture. Lack of or insufficient access to efficient health services by the indigenous community is a significant factor that underlies the comparatively higher rates of hospitalizations from diabetes that is preventable (Begg et al., 2007, p. 21). Research has further pointed that around the years 2010 and 2012, the aboriginal communities were reported to be approximately 3.5 times more probable to get hospitalized for diseases that can prevent such as diabetes compared to the non-aboriginal population (Gubhaju et al., 2013, p. 12). Access to health care is also affected by other factors that are not restrictive, but somewhat diverging. Among these in access to traditionally right conditions, for example, access to traditional land that has food, shelter, and water (Tsey Et Al., 2010, p. 173). Such is common among aboriginal people who are living in the very remote areas, are illiterate, and are highly skeptical of the mainstream health care system. Ordinarily, indigenous people believe that they are responsible for their health and that, whenever they suffer from a disease, they need to rectify their living or visit a traditional healer. An example of this belief is in the behavior of elderly persons seeking to be returned to their homes during their last days.
It is evident that the indigenous communities in Australia lack appropriate and critical awareness on health and this has continued to increase mortality and morbidity compared to the non-aboriginals. Due to lack of health literacy, numerous preventable diseases such as diabetes have continued to pose a greater threat on the aboriginals’ life. Diabetes has turned out to be an epidemic among the aboriginals, and this has led to mounting total national cost of diabetes in Australia. Diabetes is a type of disease where an individual’s blood glucose level becomes too high (American Diabetes Association, 2010, n.p). It is true that most of the glucose in the body originates from the foods that we consume. In a situation of type 1 diabetes, the human body does not release any insulin, and with type 2 diabetes the body does not release or even use insulin. Lack of adequate insulin in the body would imply that the glucose would have to stay in the blood of an individual (American Diabetes Association, 2010, n.p). The Type 1 diabetes is often considered as childhood diseases and has been associated with serious health consequences among the aboriginals. On the other hand, Type 2 diabetes is often diagnosed among the population of ages between 40 and above, but in the recent years, it has been shown to pose a greater threat to the indigenous’ children and youths. An individual can further develop prediabetes where the blood sugar becomes higher than usual but at the same time, not high enough to be considered as diabetes (Vos et al., 2007, p. 14). In general, when an individual has too much glucose within his or her blood steam he might develop severe conditions such as damaging the nerves, eyes and even kidney. There are other cases where diabetes has been reported to cause stroke, heart diseases and in other instances has led to the amputation of limbs. The indigenous pregnant women in Australia are at a risk of having diabetes known as gestational diabetes. Lack of literacy on health has thus posed a serious threat to these communities in Australia hence the need to carry out awareness creating on diabetes to ensure that the aboriginals live the life free from diabetes like the non-aboriginals in Australia.
Therefore, to increase the health literacy on diabetes of the indigenous Australians the strategy adopted will entail creating interactive health posters. Interactive posters were the most appropriate intervention to build health literacy among the aboriginals because it is age and culturally relevant prevention education program for the low-income communities. The interactive poster will be comprised the definition of diabetes and its types which are type 1 and type 2. It will emphasize on the threats caused by diabetes which occurs when the hormone insulin fails to produce insulin (Vos et al., 2007, p. 21). Next, the posters will address the major causes of diabetes ranging from lack of participation in the physical activities and poor nutrition. It will state that Type 1 diabetes is triggered by diet or viral infection and affects both the adults and children and it is mostly inherited. On type 2 diabetes, the posters will highlight that it is primarily caused by genetics and lifestyle factors and is common among adults. Further, it will outline the significant signs and symptoms of diabetes. Under this section, substantial signs and symptoms that will be included are increased hunger, increased urination, increased thirst. The part of a diagnosis will entail information on how diabetes is diagnosed clinically and the need for the aboriginals to take the initiative to visit a healthcare institution whenever they experience any signs and symptoms that characterize diabetes. The significance of early diagnosis will be focused as the only efficient way to manage and delay diabetes become they signs and symptoms worsens. In the prevention section, the posters will cover specific activities and aspects that would help to prevent r delay diabetes through maintenance of a healthy body weight, consuming health and nutritional food and engaging actively in various physical activities (Rabi et al., 2006, p. 27).
On the management of diabetes section, the poster will stress that diabetes is a chronic illness and there is no precise cure except in certain circumstances. Management will thus focus on ways to keep the blood sugar level to near normal without having to cause low blood sugar. Therefore, to manage diabetes, the section will emphasize on the healthy diet, using proper medication, weight loss in addition to exercise (American Diabetes Association, 2010, n.p). There will be a section on lifestyle which will analyze the importance of changing one’s lifestyle including adopting proper nutrition, achievement of healthy body weight and ensuring to keep the blood glucose levels within accepting ranges both in the present and in the future. On medication, the posters will focus on existing medications that can be used in the treatment of diabetes by lowering the levels of blood sugar. Different classes of anti-diabetic drugs will be outlined including those available by mouth like metformin and those administered by injection such like GLP-1 agonists. Lastly, it will indicate that type 1 diabetes can efficiently be treated with the use of insulin together with a regular and NPH insulin. The worst case scenarios will be analyzed including the need for surgery for patients diagnosed with type 1 diabetes and have severe disease complication such as end-stage kidney condition that will demand kidney transplantation. A weight loss surgery might also be applied to individuals with type 2 diabetes and are obese (Rabi et al., 2006, p. 27).
These posters will be placed in hospitals, community health centers and Doctor's surgeries in communities where this population group prevails. Awareness of both signs and symptoms of diabetes in addition to encouraging the aboriginals to have an early diagnosis will influence the course of diabetes. Further, appropriate life practices such as physical activities and healthy diet might help to delay the development of type 2 diabetes (National Institute of Diabetes And Digestive And Kidney Diseases, 2011, n.p). The use of interactive health posters will help create and increase knowledge and awareness of different types of diabetes, their symptoms, and treatment and prevention interventions among the low-income and illiterate indigenous communities in Australia. Diabetes awareness posters, in this case, will significantly help to educate the aboriginals on ways to live a healthy life with diabetes and strategic measures to prevent diabetes. The posters will further teach the community various topics such as how they can quickly count the amount of carbohydrate, measures to adopt in the prevention and management of cholesterol, ABCs of A1C, and Blood Pressure (American Diabetes Association, 2010, n.p). Diabetes awareness posters will thus help those individuals who are believed to be at risk for diabetes and those who have reported having prediabetes to ensure that they take greater control of their health. Research has shown that the quality of care in addition to the degree of complications will be affected by the awareness and knowledge of diabetes. Rabe, Ohri-Vachaspati, & Scheer, (2006, p. 21). It is evident that the aboriginals have little or no background knowledge of diabetes which ultimately places them at higher risks for further complication but using the healthcare awareness creation posters the community will benefit greatly.
In conclusion, the paper has critically analyzed the aboriginal Australians especially those living in the remote regions. It is clear that these indigenous faces increased rates of health illiteracy that affects their quality of life since they cannot access the fundamental healthcare information and quality healthcare. The poor literacy influences their capability to obtain vital information on proper nutrition and the importance of physical activities that would have helped in managing and delaying the signs and symptoms of diabetes. Lack of better employment and poor incomes are the main consequence of poverty to the aboriginal health crisis is lack or insufficiency of material resources which include nutritious foods, continuous consumption of the appropriate foods, and inhibited access to high-quality care. Indigenous Australians living in the remote areas of the commonwealth have a higher risk of ill health behavior for example smoking, poor access to healthcare, and experience health compared to persons living in regional and metropolitan areas. Inadequate access to quality health serves promptly is the reason given by aboriginal people for not using the mainstream healthcare. The development of interactive health awareness on diabetes will be a suitable intervention to create diabetes awareness among the aboriginals.
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