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http://www.abc.net.au/news/stories/2008/04/08/2210455.htm?section=wa?section=wa :

A health economist has calculated that the government should be willing to spend $15 billion a year to bridge the gap in life expectancy between Indigenous and non-Indigenous Australians.

Curtin University's Gavin Mooney has estimated the government should spend $340 billion over 22 years, based on the government's spending elsewhere in the health service.[...] He has calculated that the government spends $40,000 per person subsidising a drug that increases life expectancy by one year.

You know, I think if you just paid matching salary to each of Australia's 400,000 Aboriginals of up to $40,000 per year, you'd actually do a lot better job of increasing life expectancy than medicating them. Money for nothing is a recipe for trouble, but doubling income gained from other sources could produce some exciting results, especially if some of that money went into local community trust funds for housing and the like.

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Personally putting money into "Aboriginal Health" makes me mad. The only aspects of the health system that should be improved specifically for Aboriginals are bridging the cultural gap and the remoteness gap. Other than that is shouldn't be called an "Aboriginal health problem" but a "people with a high risk of diabetes health problem" or a "alcoholics/people at risk of alcoholism problem" or a "poverty and low education health problem" and if an individual falls into each category, a "poverty, low education, alcoholism and diabetic risk health problem blah blah" Yes, most people in such a category will probably be Aboriginal, but some will not. More importantly, some Aboriginal people will NOT fall into this category.

So few Aboriginal people will fall in the low-risk category.

More importantly, by trying not to deal with it as a community problem (which it is), your efforts are doomed to fail.

I'm sure you agree that simply dealing with them as a community by medicating them isn't going to help. Fostering community economic development will go a long way towards helping with health issues.

It's also important to recognise that aboriginal people the world over are well screwed in terms of health and economic development. All through the Americas, both North and South, and into asia, the native populations are still screwed in so many ways.

I agree that only providing medications won't help. But I also think that if you only provide "economic development" you're not solving the problem either. It's damn hard to achieve things when you're suffering easily preventable health problems.

"Aboriginal" doesn't refer to a community but to a racial group.

In many Aboriginal-majority communities there are community problems but that doesn't make them "Aboriginal" problems and often the best way to solve them is different from the next Aboriginal-majority community with their own community problems.

Racial groups are bullshit social constructions.

Being part of a smaller community doesn't prevent you from being part of a wider community.

If racial groups are bullshit social constructions why do you insist on using the label for one to group people in relation to their needed health care?

I think the only health factor that can be associated with Aboriginal people being a part of a wider community of all Aboriginal people is that PEOPLE TELL THEM THEY HAVE A PROBLEM, JUST FOR BEING ABORIGINAL.

Right! I'll just start telling my Aboriginal patients that they're not at any higher risk of renal disease, heart disease or diabetes. That will solve all their problems.

I wish I had thought of this earlier.

You would tell them, just as you would tell a white person who was at a greater than average risk of any disease.

You wouldn't tell them "You're aboriginal and thus are less healthy than the white person in the bed next to you"

If you're talking to an obese, white person will you tell them they must be aboriginal for being at risk of these aboriginal diseases?

If the government put more money into Aboriginal care OR non-aboriginal care, two people could be in hospital with identical diseases but one would get treated differently because of their race. If, instead, this money was put into heart disease treatment/research/care (or any other disease which could be better treated with more money) then an Aboriginal person and a non Aboriginal person with the same disease could both receive the same care that they deserve.

Finally, explaining to somebody the reasons for their greater risk of certain diseases is entirely different to calling it an Aboriginal Problem on a political and financial scale.

If an Aboriginal person fronts up to hospital with, say, a broken leg, it makes sense to offer them more screening for diabetes and renal problems than you might offer a white person in the same situation.

Diabetes isn't an "Aboriginal" disease, in the same way that it's not an "obese" disease. I wouldn't tell Aboriginal people that they must be obese because they're at risk of diabetes... I'm not sure what you're getting at here.

If, instead, this money was put into heart disease treatment/research/care (or any other disease which could be better treated with more money) then an Aboriginal person and a non Aboriginal person with the same disease could both receive the same care that they deserve.

We already know that the way we normally distribute health care resources leads to Aboriginal people being disadvantaged. More attention, not less, needs to be paid to the disparity. Feigning colourblindness doesn't fix racism.

Diabetes isn't an "Aboriginal" disease, in the same way that it's not an "obese" disease exactly... you might screen an apparently healthy Aboriginal person for something like diabetes as you would/should ANYBODY who for WHATEVER reason might have a higher risk for it, or likewise for any disease. None of them are "Aboriginal" diseases but rather have many potential factors which will increase risk and they should all be taken into account when distributing health care and funding, not just race.

And Aboriginal people are disadvantaged in the health system because of cultural divides* and many of them living in remote areas, and I have said that these ARE issues that should be viewed partly as "Aboriginal" issues. Other than that the only reason Aboriginal people would be treated differently than non Aboriginal people would be from racist actions by health workers which is hopefully minimal and if not isn't going to be solved by putting more money into the system, anyway.

As a slight aside, you bring up the point "Racial groups are bullshit social constructions" which is true because we draw imaginary lines around the world to group people, when the within-group differences are significantly greater than the between-group differences that we create. I would like to point out that this is THE SAME for your point "the way we normally distribute health care resources leads to Aboriginal people being disadvantaged". There are many Aboriginal people who are not disadvantaged in the health system and many non Aboriginal people who are. Yes there is a difference between the health advantage of being Aboriginal or not Aboriginal but the differences WITHIN those two groups are more significant. This is my entire point with all this argument... "The Aboriginal Health Problem" is as bullshit a construct as any other imaginary racial dividing lines we choose to create.

*Cultural divides that talking about "The Aboriginal Health Problem" will only increase.

No, there really aren't many Aboriginal people who aren't disadvantaged* in the health care system. If you are Aboriginal, you can count on getting not only poor care in a systemic sense, but poor, rude and oblivious care from the individual health care workers.

ETA: * to be more clear, the vast, vast majority of Aboriginal people are disadvantaged in the health care system, whether they are dark or pale, remote or urban, poor or wealthy and educated or not.

Edited 2008-04-08 09:38 (UTC)

Aren't you an individual health care worker?

Yes. And while I try not to provide poor or rude care, I am painfully aware that I'm pretty oblivious to a lot of the cultural differences and difficulties.

Others that I work with have more extreme views.

As I said, racism from health care workers isn't something that throwing more money in the system is going to help.

I am surprised if it is really that significant... admitedly I do have very little experience with health care in general especially the treatment of various groups of people in terms of health care. However, I would be surprised to find that people involved in health care are more racist than the average population, which I don't see as being bad enough to really cause serious problems. I guess it could be a bit worse in rural areas but that comes down to either the cultural divide or rural health services being crap in general and needing improvement.

No, you don't work in healthcare, and I suspect you don't talk to many Aboriginal people on a day-to-day basis.

You might feel differently if you were on the receiving end of the racism.

ETA: Not all extra healthcare funding has to be more hospitals for Aboriginal people or whatever- a significant part needs to be training Aboriginal people to provide healthcare within and outside the mainstream health care system.

Edited 2008-04-08 11:33 (UTC)

There's a drug that increases life expectancy by a year? Those wacky doctors!

I think that should be taken more statistically (though I have no idea what it is) but think if a drug increases life expectancy of 1 in 10 people by 10 years (say by curing/delaying a disease that 1 in 10 people get) then it increases everybody's life expectancy by one year, statistically (Or in this case, Aboriginal life expectancy).

Also one more year isn't much... penicillin/antibiotics would increase life expectancy much more than that (I assume)

It's probably a medicine in a very specialised group, which has a mean increase in life expectancy of about a year.

Flouride, Iodine, Folate.

It is however, a bullshit idea and statement from top to bottom. Instead of adding drugs to the aboriginals, we should be removing them.

Of course in 30 years we can then look forward to the next lot of claims of aboriginals complaining about the ones they love being taken from them. Vic, Fosters and little EB.

So for a radical plan that would actually do something to fix aboriginal disadvantage: An outright ban on all sales of alcohol, cigarettes and solvents to anyone who looks like they have too much of a tan.

Ridiculous isnt it? After all people have the right to destroy themselves.

Jeebus, why does no-one understand me on the internet lately?

I... I just don't know how to rephrase that to make it clearer. Like in computer games, when you get an extra guy; you take a tablet and *ding* you get another year of life.

I think I understand you...

Did you mean as if it were a drug that didn't actually DO anything (ie didn't target a specific illness or whatever) other than... give people another year... and maybe if you take it twice... DING DING ?

Yep, that's it. Just a drug that makes your body live another year. Woo!

When i said bullshit idea and statement i meant the govt, not you. Sorry for confusion, i see how i could be taken the other way.

I got that you were talking about the hilarity of a magic pill giving you an extra year.

I kinda of got that from the linked article too

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