Indigenous Health Issue: A Case Study On Diabetes


1.0 Introduction:

Indigenous health is commonly known as Aboriginal health show in this Case Study On Diabetes,  According to Association et al. (2013), indigenous health is not to focus related to the physical well-being of an individual person, rather it is very much focused regarding the cultural, social and emotional well-being of an entire society or community. With help of strong cultural, social and emotional well-being, the communal people can maintain decent communal recognition and helps to make enrich the community. It is a long-term process and throughout the entire life, this Indigenous health related issues in this Case Study continue among the communal people (, 2014). Moreover, the service care providers help to eradicate those issues from the communal people. In this study, Diabetes has been chosen, as it is also an example of Indigenous health issue. In Australia, although most of diabetes possess people have type II diabetes so for that reason the people are not dependent on Insulin.

Case Study On Diabetes

The Case Study report states that 10 to 30% indigenous Australians are suffering from diabetes where this rate is four times higher among non-indigenous Australian. As opined by Moss (2010) there are several factors those are responsible for high rate diabetes such as diet, obesity, genetic susceptibility, Gestational diabetes (Diabetes in pregnancy) poor living standard, lack of adequate medical care etc. In

The Case Study report states that 10 to 30% indigenous Australians are suffering from diabetes where this rate is four times higher among non-indigenous Australian. As opined by Moss (2010) there are several factors those are responsible for high rate diabetes such as diet, obesity, genetic susceptibility, Gestational diabetes (Diabetes in pregnancy) poor living standard, lack of adequate medical care etc. In case of this disease, there are several perceptions and beliefs related to the Diabetes are observed those are also discussing in this Case Study.

1.1 Discussion and analysis:

Specific culture beliefs and perception related to the Diabetes:
The research referred by Taylor & Guerin (2010) stated that, poor living style, improper diet, present sedentary life style, obesity moreover heredity are the most risk factors under this indigenous disease, although sedentary life style and improper diet have indicated the main risk factors. This Case Study beliefs and perception thus blames that individual person for developing diabetes in their body who is suffering from Diabetes. This is the reason the persons who possess diabetes; they can identify a specific period or specific reason when developing this disease in their body (International Diabetes Federation, 2014). As for example, in present situation, the people are maintaining either hectic life style or sedentary life style. For hectic life style, the people do not get enough time to make their own food and on the other hand, some people are very lazy so they spend sedentary life style. In both cases people used to intake fast foods, those are full of fat and contain with low carbohydrate and other nutritional value. This is the reason of Diabetes. Apart from that, Gestational diabetes occurs during pregnancy, as in this time less physical work drive to gain weight. Moreover, stress and nervousness is accelerating this factor and developing diabetes (King, M., Smith & Gracey 2009).

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Without above mention classic risk factors one important risk factor is there and that is related to the hereditary reason. Generally, the persons who are suffering from diabetes, they possess thrifty genotype that is mainly responsible for storing fat portion of the food for future use. As viewpoint of Trauer (2010), the body those possess thrifty genotype cannot tolerate glucose and high cholesterol in their body. However, the indigenous people are used to intake readily available food those are fat included. Thus, diabetes is very normal of their body.
The social people believe that diabetes is genetic disease, so the person whose previous generation has suffered from diabetes, their present and future generation possesses very high risk because of Diabetes. On the other hand, those persons have very little risk related to developing diabetes whose previous generation did not possess diabetes (Vos et al. 2009).

Health seeking practices and behaviour related to the diabetes:

Health seeking practices and behaviour related to the diabetes explained that an individual possesses diabetes tries to seeking way in order to get higher level of health and eradicate the bad effect of diabetes from life in the course of changing personal bad habit and environment. Type II diabetes mellitus is now fatal disease and cause of death of numerous people in Australia. As suggested by Taylor & Guerin (2010) diabetes is one types of chronic disease so it affect micro and macro vascular organ such as kidney, heart, lower extremity etc. Thus, in the course of glycaemic control the patients can try to get healthy life.

According to Gracey & King (2009), following a holistic approach, the patients have to accumulated knowledge regarding diabetes and its affects. After that the patients should espoused proper diet, medication and follow up in regular basis. The nurses and the medical professionals help the patients by providing knowledge related to the diabetes so that the patients learn self-management for eradicating the bad effect of the disease. In order to eradicate the bad effect of diabetes from patients the patients have to treat so that the extreme sugar level of blood is decreased. In case of diabetes type 1 the medical professionals treat with insulin, whereas for diabetes type II patients the medical professionals prescribed diabetic diet and weight reduction (, 2014).

The research referred by Whiting, Unwin & Roglic (2010) stated that for treating the patients who are suffering from diabetes type 1 most of the physician provide insulin therapy. However, for diabetes type II the physician suggested healthy eating (such as whole grain, fruit and vegetables), physical activity (such as swimming, cycling, walking or aerobic exercise and yoga) along with medication or insulin therapy. Although some diabetes patients give good responses, only treating by proper diet and exercise, but several times medication includes Insulin therapy is required, and that depends on sugar level in blood. On that situation, suggesting Metformin (Glocophage, Glumetza), sulfonylureas, meglitinides and insulin therapy the physician helps the patients (, 2014). Apart from that, several time the physician prescribed for Bariatric surgery so that with weight loss surgery the patients can control sugar level.
Contributing social determinants related to the Diabetes:
As opined by Usher & Marriott, (2011), there are four factors such as poor socio-economic status, relation between chronic stress and perception of control, indigenous community control of health services, traditional ownership of land and health status act as social determinants for diabetes (, 2014).

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The report states that, the average gross household income of indigenous people is $364 per week. Moreover, 20% indigenous people are unemployed. In this context, those indigenous people are poor in socio-economic status. Thus, those people have very limited knowledge related to the diabetes and its affect (, 2014). Poor people cannot maintain proper diet and provide extreme stress. Thus, the indigenous people make habit of smoking and other this types of addiction. Saleh, Amanatidis & Samman (2002) opined that, due to limited earn the poor people cannot maintain healthy life-style. Apart from that, chronic mental stress is main reason to decrease immunity power of body system. Thus, poor socio economic condition is one of the social determinants of diabetes (Vos et al. 2009).

As per National Aboriginal Health Strategy (1989), because of poor socio economic condition the indigenous people do not have control over their life. In this situation, stress is increasing and decreasing immunity power. Improper diet is one common reason among those people. Apart from that, after diagnosis of diabetes the poor people cannot treat properly for eradicating the disease as the Diabetes is chronic disease and it needs lump sum amount of monetary factors. Moreover, the indigenous people also used to stay unhygienic social and cultural environment. These all are the reason of diabetes (International Diabetes Federation, 2014).
All the indigenous people have their right to dispose all the natural wealth and resources belongs to them. As per different legislation related to aboriginal land and rights in Australia, the people can maintain their traditional culture. On that context, the legislation aligns the indigenous people in order to improve the health of the people who used to stay in remote communities (Hasan et al. 2009).

1.2 Application to health care provision:

Role of individual health care service provider within an ethical scope of practices and cultural framework:

In order to provide adequate amount of guidance towards the diabetes patients as per ethics and cultural framework the care service provider such as physician, nurses, midwife, dietician, pharmacist, occupational therapist provide service following specific cultural framework and ethics. Generally, the medical professionals provide service following a holistic approach (Usher & Marriott, 2011).
Among all types of medical professionals, at first the phycian assess the patients’ condition through accumulating all-important information regarding past illness, social position, and entire physical condition. After assessing above mention factors, the physician provides care towards for the patients (King, Smith & Gracey, 2009). As the diabetes is chronic disease and cost consuming process, so the physician should provide all the facilities with free of cost for the indigenous people under ethics and holistic approach.
Apart from the physician, the nurses also provide care under ethics and social framework. The nurses are providing adequate care and making awareness regarding the diabetes and its effectiveness (, 2014). Moreover, all the medical staff including nurses is doing very friendly behaviour with the patients and their family members. Continuous monitoring is the responsibility of the nurses so through effective pharmacological intervention the nurses help the diabetic people for self-management (Hasan et al. 2009).
In case of Gestational diabetes, the midwives are providing service under social framework and ethics. During Gestational diabetes, means during pregnancy the women gain huge weight and may arise diabetes on that time. Moreover, pregnancy is very critical situation. In this context, monitoring the pregnant women continuously, the midwife provides pre-natal education in order to improve health related condition (Taylor & Guerin, 2010).

Dietician play an important role during provides service for diabetic patients of indigenous Australian as poor diet is one of the classic reason of developing diabetes. As earlier discussed that, in present situation, people are used to intake food more fat containing and less carbohydrate and other nutritional substances containing (Association et al. 2013). That fat increase sugar level and cholesterol level in blood of human body and consequently arising diabetes. Thus, when the dietician makes different diet chart depending on body needs then it will help the people to improve physical health. Apart from that, the dietician provides weight management counselling and nutritional counselling towards heavy body weights diabetic patients (Whiting, Unwin & Roglic, 2010).
Although the care provider and the medical professionals provide service as per ethics, but the social worker also provide service for diabetes people. Being chronic disease as diabetes take lots of time to cure, and several times it is not curable so it needs lump sum amount for its treatment. In this situation, with providing psychological align the social worker will provide monetary help for the diabetic patients. As viewpoint of Hasan et al. (2009), the social worker also provide knowledge and idea related to the diabetes among indigenous people as those people possess very little amount of knowledge due to lack of education (, 2014).

Following four moral principles or commitments such as respect for autonomy, beneficence, non-maleficence and justice the medical professional as well as non medical persons used to provide service towards the diabetic patients as this cause death and increasing in lofty speed in modern time (Saleh, Amanatidis & Samman, 2002). With the help of those medical professionals and social worker, the indigenous people will get help and able to improve their health condition.

1.3 Conclusion:

This Case Study is illuminating that in developed country like Australia, indigenous people are suffering from different chronic disease and diabetes is one of the chronic diseases causing numerous deaths. Due to lack of proper knowledge of Case Study, poor-socio economic condition, access of mental stress are the main reasons of diabetes among those people because in Australia, 20% people are completely unemployed and the employed people are earning $364 per week. In this situation, the entire medical professionals, as well as the non-medical professionals, should provide service for indigenous people in order to improve cultural, social and emotional well-being along with physical well-being. In this situation, the government of Australia should provide service for indigenous people so that the unemployment rate decrease among them and they can improve their lifestyle.

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