Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Impact of Colonialism on Maori and Aboriginal Healthcare Access: A Discussion Paper [Dagger]

Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Impact of Colonialism on Maori and Aboriginal Healthcare Access: A Discussion Paper [Dagger]

Article excerpt


Processes of colonialism have resulted in Indigenous people being subject to land dispossession, acculturation, social marginalisation, political oppression and devastating population decline with increased morbidity and decreased life expectancy. Although there are universal commonalities for Indigenous people, each nation has its own unique history which has been shaped by historical, societal and political factors which greatly influence the contemporary context. Socio-political deficits produce inequity in the determinants of health for Indigenous people who experience higher rates of morbidity and mortality in comparison to their non-Indigenous counterparts (Commonwealth of Australia, 2013; Ministry of Health, 2010). In addition to poorer health, there is often poor utilisation or delayed presentation to the appropriate healthcare facility by Indigenous people, increasing the burden of disease and mortality for these vulnerable groups. International literature identifies, most commonly, socio-economic factors and racial discrimination as the major barriers to the utilisation of healthcare and the major contributor of poorer health outcomes. This paper focuses on the Aboriginal Australians and the Maori of New Zealand because of the commonalities they share in being minority groups within dominant settler societies with comparable although unique histories.

This discussion paper explores the impact of colonialism on the accessibility of healthcare and outcomes for New Zealand Maori and Aboriginal Australians. Databases CINHAL and Proquest Central were searched for relevant peer reviewed articles published in the English language after 2000 using the key words Maori, Aboriginal, Indigenous, health, barriers, healthcare and discrimination. The search was restricted to the past 15 years to reflect contemporary understanding of the consequences of colonialism on healthcare access within the current healthcare systems in both countries.

Background: consequences of colonialism

The consequences of colonialism have been numerous for the Indigenous populations of Australia and New Zealand. Initially colonialism resulted in widespread and significant morbidity and mortality due to the introduction of foreign infectious diseases, poor living conditions, warfare and violence (Anderson et al., 2006; Durie, 2004). Despite overwhelming adversity, the Indigenous communities survived and re-established themselves as distinct groups within the limitations imposed by their colonial governments.

Although many Indigenous people have been fighting colonialism since the beginning, it was not until the 1960s that international recognition of Indigenous suffering and rights were acknowledged (Durie, 2004). By then substantial cultural trauma and loss had already occurred affecting many generations of Indigenous people (Farrelly, Rudegeair, & Rickard, 2006). The consequences of colonialism were and continue to be profound (Gracey & King, 2009). International statistics show that Indigenous people are some of the most marginalised people in the world, with some of the poorest health outcomes when compared to non-Indigenous groups. In Australia, the age-standardised death rate for Indigenous people between 2006 and 2010 was 1.9 times the rate for non-Indigenous people (Australian Indigenous HealthInfoNet, 2014). Similarly in New Zealand, the age-standardised death rate for Maori in 2010 was 1.6 times the rate for nonMaori (Statistics New Zealand, 2011). Although the statistics for various diseases differ, the consensus is that Indigenous people of Australia and New Zealand suffer significant health inequality compared to their non-Indigenous counterparts (Anderson et al., 2006; Gracey & King, 2009). They now have some of the highest rates of kidney and cardiovascular disease (CVD), metabolic disorders, alcohol and drug abuse, mental distress and deaths by cancer (Kritharides et al., 2010; White et al. …

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