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In Australia today, the implications of colonisation continue to influence the health and wellbeing of Aboriginal and Torres Strait Islander (ATSI) communities (Eckermann, et al., 2010, p. 170). Australian history demonstrates the attempted destruction of ATSI culture through assimilation policies, racist social concepts, and systemic disadvantage through 1788 at European settlement to present day (Eckermann, et al., 2010, p. 22-24). For these groups, the relationship between health and traditional culture is of distinct importance. Neglect to such by the Commonwealth and the Australian Government, has directly attributed to the ongoing Indigenous health crisis, which remains one of the main inequities between ATSI communities and non-Indigenous Australians (NACCHO, 2018).


ATSI peoples comprise 3% of the Australian population, however the Australian Institute of Health and Welfare (AIHW) report that Indigenous Australians over the age of 15 were 2.1 times more likely than non-Indigenous Australians to report their health as fair or poor, on a ‘fair or poor’ to ‘very good or excellent’ gradient (2015). This is reflected in life expectancy predictions, whereby Indigenous women live 9.5 years less than non-Indigenous women, and Indigenous men lives 10.6 years less than non-Indigenous men. In addition to this, statistics found ATSI are twice as likely to live with a severe or profound disability. As a population, they are at significantly increased risk of living with diabetes, with 21% of Indigenous Australians living with the disease compared to 9.4% of non-Indigenous Australians. Further, mental health complications attributed to 11% of GP consultations attended by ATSI patients; 1.3 times more than non-Indigenous members of the population. This figure is reinforced when considering suicide rates, whereby between 2008 and 2012, the rate for ATSI suicides was almost double that of non-Indigenous Australians, and alarmingly 5 times more likely for 15 to 19-year-olds. In 2012-2013 almost 31% of the ATSI population reported living with chronic respiratory disease, which accounted for 5.4% of ATSI hospitalisations within the same period; 1.2 times, and 2.4 times more likely than non-Indigenous Australians respectively. 13% of ATSI over the age of 2 reported chronic cardiovascular disease; a rate 1.2 times higher than non-Indigenous Australians (AIHW, 2015). With consideration to such figures, the inequities between Indigenous and non-Indigenous health are clear, however determining the cause is comprehensive, multisystemic, and not confined to The World Health Organisations determinants of health entirely (Eckermann, et al., 2010., p. 170).


The health of ATSI peoples does not independently adhere to western definitions, expectations and the biomedical model of health. This notion has been neglected previously in the management of ATSI health resources and services since health assimilation initiatives were introduced in 1967 (Eckermann, et al., 2010, p. 170; NACCHO, 2018). Additional determinants relevant to tradition are of higher cultural importance to such communities, and include cultural survival, affirming cultural ceremony, oral history, family support and connection, spiritual and emotional wellbeing, native title, sites recognition, self-determination, and community control. While these are all factors present in ATSI decolonisation actions within their own communities focussed on regaining control of culture and health, they are not represented within Australia’s mainstream health system and primary health care resources (Eckermann, et al., 2010., p. 170).


Primary health care (PHC) is a health system philosophy built on community participation, accountability, a holistic approach to health, and health outcomes aligned with empowerment, self-reliance, and improved health. The intention of PHC is to provide a community sustained, balanced health care system in which relationships with health professionals and community members underly. The principles of PHC align with ATSI determinants of health in highlighting the importance of community involvement and autonomy. However, in Australia, the biomedical mainstream health model lacks the structure and systems that allow community participation, ultimately reducing the efficacy, accessibility and cultural relevance of health care resources (Eckermann, et al., 2010, p 171-175). As a direct result of this, many ATSI communities have called for an increase in commitment to funding, improving and increasing self-controlled health resources in line with the foundations of PHC. This is based on research affiliated with the Close the Gap campaign, an Australian government initiative targeted towards reducing the systemic inequality between ATSI peoples and non-Indigenous Australians implemented in 2008 (Gooda & Higgins, 2016; Commonwealth of Australia, 2018). Such findings indicate specific ATSI models of health service deliverance result in improved relationships with healthcare providers, accessibility and cultural relevance. Subsequent to such, better health outcomes, disease prevention and control, chronic disease treatment and management, and maternal and child health care is incurred to the benefit of communities (Gooda & Huggins, 2016).


Despite recommendations that facilitate action to improve the lives of ATSI, the Close the Gap campaign has come under considerable scrutiny in recent years for its lack of achievement in addressing the social, environmental and economic determinants that relevantly influence the lives of ATSI peoples (Higgins, et., 2018). Following the Prime Minister’s Report in 2018, it was highlighted that a decade on, only 3 of 7 targets have been met over the majority of Australian states and territories. These include halving the gap of childhood mortality rates, achieving 95% enrolment in early childhood education, and halving the gap in attainment of year 12 or equivalent by 2020. Those not met include improved school attendance, reading and numeracy, employment, and life expectancy (Commonwealth of Australia, 2018). While systems are in place and improvement have been made in working towards meeting these goals, present failure to do so has been attributed to several causes. The most notable include the lack change to Indigenous policy allowing change, limited ATSI control and leadership within Australian parliament, and failure to recognise and integrate traditional and western determinants of health (Markham & Biddle, 2018; Reconciliation Australia, 2018).


In response to the Closing the Gap downfalls, additional recommendations have been made to the Australian government to facilitate a comprehensive enquiry into systemic and institutionalised racism in Australian health care (Gooda & Huggins, 2016). The implications of poor race relations based on stereotyping, cognitive conflict, history and prejudice, encompass dehumanisation and enforced hopelessness at the core of the discriminated populations standard of living (Eckermann, et al., 2010). Unequivocally, systemic racism in not only a healthcare setting but in a broad social setting, is detrimental to the wellbeing of ATSI peoples and maintains a direct influence on the socioeconomic gradient (Oscar & Little, 2018).


The World Health Organisation divulge that “the social conditions in which people are born, live and work is the single most important determinant of good health or ill health”, whereby high standing on the socioeconomic gradient from birth increases the chances of employment, education, housing, good health outcomes, and life expectancy (AIHW, 2016). While socioeconomic determinants of health are not the soul determinants that influence the health of ATSI communities, they are vital in understanding the health inequities between Indigenous and non-Indigenous populations, particularly in a setting focussed on the ongoing implications of colonisation (AIHW, 2018).


As reported in the 2018 Close the Gap report improvements have been made to ATSI education enrolment and participation from early childhood through to the completion of year 12 or equivalent certification (Commonwealth of Australia, 2018). In 2016 96% of ATSI peoples between ages 4 and 14 regularly attended school (ABS, 2016). These figures forecast an improvement in outcomes through future generations and as the current population ages, however the cyclical nature of poverty has an ongoing influence on current employment, housing, domestic and family violence, incarceration and health behaviour statistics require attention.


With 60% of ATSI peoples aged 15 to 64 employed, the unemployment rate for ATSI peoples is 4.2 times higher than that for non-Indigenous Australians (AIHW, 2017). 36% of ATSI live in a home they own, however ATSI families are 6 times more likely than non-Indigenous families to live in social housing (AIHW, 2017). The rate of homelessness was 14 times higher for ATSI peoples in 2011, and in 2014-15 29% of ATSI peoples reported experiencing homelessness in their lifetimes (AIHW, 2014, ABS, 2016). With consideration to such, ATSI people who were employed and residing in secure housing reported better health and life satisfaction (AIHW, 2017).

With regard to domestic and family violence ATSI women are considered one of the most vulnerable and at risk population groups in Australia. In the year 2014-15, 14% ATSI women experienced physical violence, with 1 in 4 of such encounters perpetrated by a cohabiting partner. In addition, ATSI children were 7 times more likely than non-Indigenous children to be the subject of abuse or neglect (AIHW, 2018). Such violence and abuse is attributed to the cause and effect relationship of social disadvantage and cultural, intergenerational trauma. Also causal to this, is the incidence of poor health behaviours, whereby Indigenous Australians are 4.2 times more likely to use tobacco, with pregnant mother 4 times more likely to use tobacco than non-Indigenous pregnant mothers. 54% of ATSI people aged 15 and over consumed alcohol to excess on a single occasion in a 12 month period; a rate considerably higher than non-Indigenous Australians. Further, low levels of physical activity in combination with accessibility for healthy foods for rurally living ATSI communities, 2 in 5 ATSI people over 15 are considered overweight or obese (AIHW, 2017).


Cyclical poverty, intergeneration trauma, systemic racism and cultural assimilation policies associated with colonisation have implications on the health of ATSI communities in Australia today. In order to continue to work towards effectively closing the gap, sustained culturally relevant, accessible and community involved leadership is required. In conjunction, to overcome the related health outcomes and statistics, it is imperative that a holistic ATSI primary care system be integrated into Australian health policy to enable the implementation of traditional determinants of health and wellbeing.



References

ABS. (2016). National Aboriginal and Torres Strait Islander Social Survey 2014-2015. Retrieved 14th July 2018, from: http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/4714.0~2014-15~Media%20Release~Key%20Aboriginal%20&%20Torres%20Strait%20Islander%20data%20released%20(Media%20Release)~1

Australian Institute of Health and Welfare. (2014) Australia’s Health. Retrieved 14th July 2018, from: https://www.aihw.gov.au/getmedia/d2946c3e-9b94-413c-898c-aa5219903b8c/16507.pdf.aspx?inline=true

Australian Institute of Health and Welfare. (2015). The Health and Welfare of Australia’s Aboriginal and Torres Strait Islander Peoples: 2015. Retrieved 3rd July 2018, from: https://www.aihw.gov.au/reports/indigenous-health-welfare/indigenous-health-welfare-2015/contents/table-of-contents

Australian Institute of Health and Welfare. (2016). Australia’s Health 2016. Retrieved 13th July 2018, from: https://www.aihw.gov.au/reports/australias-health/australias-health-2016/contents/population-groups

Australian Institute of Health and Welfare. (2018). Family, Domestic and Sexual Violence in Australia. Retrieved 14th July 2018, https://www.aihw.gov.au/getmedia/d1a8d479-a39a-48c1-bbe2-4b27c7a321e0/aihw-fdv-02.pdf.aspx?inline=true

Commonwealth of Australia. (2018). Closing the Gap – The Prime Ministers Report 2018. Retrieved 4 July 2018, from: https://closingthegap.pmc.gov.au/sites/default/files/ctg-report-2018.pdf

Eckermann, A., Dowd, T., Chong, E., Nixon, L., Gray, R., & Johnson, S. M. (2010). Binan Goonj : bridging cultures in aboriginal health. Retrieved 3rd July 2018, from https://ebookcentral-proquest-com.ezproxy.laureate.net.au

Gooda, M., Huggins, J. (2016). Our national shame: Closing the Gap for Indigenous Australians is More Important than Ever. Retrieved 13th July 2018, from: https://www.smh.com.au/opinion/our-national-shame-closing-the-gap-for-indigenous-australians-is-more-important-than-ever-20160316-gnkquf.html

Markham & Biddle. (2018). Three Reasons Why the Gaps Between Indigenous and non-Indigenous Australians Aren’t Closing. Retrieved 4th July 2018, from: https://theconversation.com/three-reasons-why-the-gaps-between-indigenous-and-non-indigenous-australians-arent-closing-91561

Reconciliation Australia. (2018). Failure to Close the Gap is Proof of Need for Indigenous Voice. Retrieved 14th July 2018, from: https://www.reconciliation.org.au/failure-close-gap-proof-need-indigenous-voice/

Oscar, J., Little, R. (2018). Closing the Gap on Indigenous Health: This is our National Shame, but it can be fixed. Retrieved 14th July 2018, from: http://www.abc.net.au/news/2018-02-08/closing-the-gap/9407824

  • Stephanie

Parallel to physical health, mental health is a major contributing component of overall health and wellbeing. It is considered by the World Health Organisation as “a state of wellbeing in which an individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community” (WHO, 2014). For the estimated 45% of Australians who predicted to experience mental illness in their lifetimes however, this state can be jeopardised. Highly prevalent disorders such as depression, anxiety, or substance abuse, as well as less common conditions including psychotic disorders are non-discriminatory, widespread, and have large impacts on the lives of individuals, their communities and greater society. The most recent National Survey of Mental Health and Wellbeing was undertaken in 2007, and statistics are not always accurate due to co-morbidities, diagnostic guidelines and the implications of stigma (AIHW, 2018). It is however possible to conclude that the burden of mental illness in Australia is significant.


Mental health expenditure totalled $9 billion in 2015; a figure highlighted as a 3.5% increase since 2011. Data can also be attained through the Medicare Benefits Scheme, whereby 9.8% of Australians received Medicare subsidised mental health services in 2016-17. Through the Pharmaceuticals Benefit Scheme in the same time-period, 4% of Australians received prescriptions for mental health specific pharmaceuticals. In the twelve-month period of 2015-16 an estimated 18 million GP visits were made specifically relating to mental health; an annually increasing figure since 2006-7. In the same period 410,000 Australians accessed community mental health care services (AIHW, 2018). The 2010 National Survey of People with Psychotic Illnesses indicated that an estimated 64,000 Australians living with a psychotic illness were in contact with specialised public psychotic mental health services per year. The Australian Child and Adolescent Survey of Mental Health and Wellbeing conducted in 2013-14 estimated 560,000 4 to 17-year-olds experienced mental illness in the 12 months prior to the survey (AIHW, 2018). Further to these figures, “the number of disability-adjusted life years attributed to mental disorders increased by 37% between 1990 and 2010, with depression becoming the fourth highest cause of disability in Australia” (Harvey, et al., 2017). These statistics indicate increasing trends in Australians whereby greater proportions of the population are accessing mental healthcare, and subsequently being diagnosed with mental illness. This is in part attributed to initiatives such as World Mental Health Day.


As a global health education initiative, World Mental Health Day is founded upon advocacy principals for raising awareness and overcoming stigma. In Australia, the campaign is pioneered by not-for-profit organisation Mental Health Australia and maintains a “focus on ensuring the whole community recognises the part we all play in creating a mentally healthy society”. This is done through actively promoting mental health in a positive light and providing resources and a platform for discussion to work towards discrediting misconceptions associated with mental illness and overcoming social prejudice. The key messages of World Mental Health Day are that mental illness is a part of life, people who live with mental illness are not incompetent, weak or to be feared, and that seeking help is the best way to prevent mental illness from compromising quality of life (Mental Health Australia, 2017). The success of the campaign is largely associated with its acknowledgement of the diversity present within Australia, and a variance in causal and risk factors for mental illness, and the gaps present within the current mental health care system (Mental Health Australia, 2018).


Due to the diverse nature of the Australian landscape and its population, the risk and causal factors associated with mental illness are varied. Genetics and biological factors have long been perceived as a key risk factor for psychiatric diseases, however research continues to define specifically relevant genes within DNA. Researchers believe that the challenge in defining these genes is attributed to the considerable influence environmental and social determinants of health have over the incidence of mental illness (National Institute of Health; 2013).


Majority of the Australian terrain is considered remote or very remote, however majority of the population live in urban metropolitan cities. The stressors present in urban communities differ from those in remote regions, whereby the incidence of non-communicable disease, disability, and poor health literacy and behaviour are elevated. Despite this, the rates of mental illness are relatively stable across the nation, however presentations do differ. The prevalence of self-harm or suicide increases with rurality, indicating the severity of mental illness in such communities, and reflective of limited access to essential health resources (Rural Health, 2017). Further to this, in the present instance of drought, male farm owners and managers are on average twice as likely to die by suicide or experience poor mental health than other Australian males (The University of Sydney, 2018). Associated with this, are the stressors applied by economic determinants of health often present within remote communities, whereby incomes are 20% lower than in urban areas, and unemployment is comparably higher, and education comparably lower (National Rural Health Alliance, 2011, AIHW, 2017). There is a definite relationship between unemployment, poor education and mental illness, whereby an increase in feelings of helplessness, alienation and insecurity exacerbate the prevalence of anxiety and depression. In turn, unmanaged poor mental health can result in the presence of these health determinants (Goldsmith, et al., 2012).


It is estimated that 1 in 3 Australians over the age of 10 registered with a Specialist Homelessness Service (SHS) lives with a mental illness; a rate that has increased annually since 2011. The provision of services for these individuals were predominantly related to housing crisis, domestic or family violence, and financial troubles. Alarmingly, half of all clients reported homelessness in the 12-month period prior to presenting to their SHS agency, and majority of those seeking assistance were between 10 and 24 years of age (AIHW, 2018). Research undertaken by Mission Australia in association with The Black Dog Institute, a leading organisation in generating awareness of mental illness in Australia, found that 1 in 4 young people between 15 and 19 years of age lived with mental illness, and that mental illness maintains 45% of the global burden of disease for people aged 10 to 24 years (2017).

Within the SHS registration pool, Aboriginal and Torres Strait Islander peoples were 7 times more likely to live with mental illness, as reflected in nationwide data (AIHW, 2018). 31.6% of ATSI young people met the criteria for probable serious mental illness compared to 22.2% of non-Indigenous young people in the aforementioned Youth Mental Health Report (Mission Australia, 2017). The 2015 National Aboriginal and Torres Strait Islander Social Survey revealed 29% of respondents self-reported living with depression, anxiety, behavioural or emotional problems, however respondents from non-remote areas were twice as likely to respond than those in remote communities. The major contributing factors associated with mental illness for these population groups include less than year 10 education or equivalent, participation in the work force, cultural or familial isolation, substance abuse, incarceration, financial security, housing, intergenerational trauma, and domestic or family violence (ABS, 2016).

For these marginalised and at-risk population groups, initiatives such as World Mental Health Day provide the opportunity for open discussion surrounding mental health in the greater population. It enables awareness of risk and causal factors and provides insight into accessible resources, warning signs, and the ability to campaign for improvements to accessible public health care (Mental Health Australia, 2017).

The role of government and non-government agencies in addressing mental health in Australia

In responding to and managing the incidence and prevalence of mental illness in Australia, the Australian government are responsible for subsidising the provision of primary care. This is done through the Medicare Benefits Scheme, whereby the financial cost of visits to GP’s, or mental health practitioners under the Mental Health Plan or Better Access referral system are subsidised through either bulk billing or rebate. In conjunction with such is the Pharmaceutical Benefits Scheme/Repatriation Pharmaceutical Benefits Scheme, wherein the costs of essential medicines are subsidised. In addition, the provision of “income support, social and community support, disability services, workforce participation programs, and housing assistance” are managed by the Australian federal government (AIHW, 2018). Funding for these policies are encompassed within the annual federal health budget, and with specific regard to mental health, are guided by the National Mental Health Commission (National Mental Health Commission, 2017). Specialist acute mental health care and psychiatric hospital services are funded by state and territory governments. These services include specialised community mental health services, specialised residential mental health care services, and supported accommodation and housing environments (AIHW, 2018).

Mental health oriented non-government organisations are also key in providing mental health services in Australia. The Australian Institute of Health and Welfare categorise the private services as those that “focus on providing well-being, support and assistance to people who live with a mental illness rather than the assessment, diagnostic and treatment tasks undertaken by clinically focused services” (2018). These organisations run on private or government funding, and are usually targeted to certain demographics, or focussed on a specific mental illness. One well known example is Headspace; an organisation tailored to the provision of youth mental health services.


Headspace is predominantly funded by the Australian federal government and falls into the category of Child and Youth Mental Health; a division of public healthcare which received a $110 million investment announced at the beginning of 2018. In addition, partnerships with large organisations such as K-Mart are utilised as a source of donation. The primary focus for Headspace is to undertake “a range of activities to increase the awareness of our services and how to access them among young people, their families, friends and the broader community”, and provides an additional focus on marginalised population groups including ATSI communities (Headspace, 2018). The purpose of such non-government organisations in the Australian mental healthcare system is to identify barriers, provide outreach and initiatives that streamlined government healthcare does not extend to, and provide a platform for safe, accessible resources (Mental Health Australia, 2015).


The value of engaging the community in mental health initiatives like Mental Health Week

In acknowledging the strengths and benefits of non-government mental health organisations, it is clear that community engagement is at the forefront of initiatives such as Mental Health Week. Globally, the involvement of communities in mental health awareness and education has been used as a key strategy for generating discussion, providing support and working towards overcoming stigma. The involvement of communities is also vital in ensuring initiatives are culturally relevant and accessible to their target populations, which in turn increases service utilisation and empowers populations to take control over mental health and illness within society (Peterson, et al., 2012). This is additionally reflected in organisations ability to lobby, and the policies established as an outcome of community engaged mental health initiatives. Further, engaged communities provide supportive environments for Australians struggling with mental illness, and allow the capacity for effective assistance and resource utilisation to ensure quality of life and low burden of disease (Community Mental Health Australia, 2018).


The role and impact of the media and social media in mental health promotion

In a modern society, the engagement of communities should be accessible and include online communities, through media and social media platforms. The importance of such ensures the initiatives are generating awareness, and are effective in reaching youth, older adults, communities of low socioeconomic status, and regional communities; all population groups at risk of experiencing mental illness. The use of such provides a platform for awareness and discussion and is a key tool in providing education for mental health (Welch, et al., 2016). The use of media further enables efforts to overcome misconceptions surrounding mental illness and assists in overcoming the traditional prejudice and stigma present in communities, through highlighting accuracies, working against stereotypes, and bringing the issue to the forefront of social issues (Everymind, 2014).

Conclusion

Mental health is an issue at forefront of Australian communities, whereby all members of the population are at risk due to a number of causal factors. The implications of mental illness are significant, and the expenses associated through government and non-government organisations are large, however vital in working towards overcoming the stigma and prejudice associated with mental illness, creating awareness and safe platforms for discussion, and generating awareness of disease, risk factors and warning signs.



References

Australian Institute of Health and Welfare. (2017). Australia’s Welfare 2017: In Brief. Retrieved 17/8/18, from: https://www.aihw.gov.au/reports/australias-welfare/australias-welfare-2017-in-brief/contents/education-in-australia

Australian Institute of Health and Welfare. (2018). Mental Health Services in Australia. Retrieved 18/8/18, from: https://www.aihw.gov.au/reports/mental-health-services/mental-health-services-in-australia/report-contents/specialist-homelessness-services

Australian Institute of Health and Welfare. (2018). Australia’s Health. Retrieved 16/8/18, from https://www.aihw.gov.au/getmedia/7c42913d-295f-4bc9-9c24-4e44eff4a04a/aihw-aus-221.pdf.aspx?inline=true

Community Mental Health Australia. (2018). Goals and Objectives. Retrieved 19/8/18, from: https://cmha.org.au/about-us/goals-and-objectives/

Everymind. (2014). Mental Illness in the Media. Retrieved 19/8/18, from: http://www.mindframe-media.info/for-media/reporting-mental-illness/evidence-and-research/evidence-about-mental-illness-in-the-media

Goldsmith, A., Diette, T. (2012). Exploring the link between unemployment and mental health outcomes. Retrieved 18/8/2018, from: http://www.apa.org/pi/ses/resources/indicator/2012/04/unemployment.aspx

Harvey, S., Deady, M., Wang, M., Mykletun, A., Butterworth, P., Christensen, H., & Mitchell, P. (2017). Is the prevalence of mental illness increasing in Australia? Evidence from national health surveys and administrative data, 2001-2014. The Medical Journal Of Australia, 206(11), 490-493. doi: 10.5694/mja16.00295

Headspace. (2018). Who we are. Retrieved 19/8/18, from: https://headspace.org.au/about-us/who-we-are/

Mental Health Australia. (2018). About Us. Retrieved 17/8/18, from: https://mhaustralia.org/about-us

Mental Health Australia. (2017). About. Retrieved 16/8/18, from: https://1010.org.au/about/#

Mental Health Australia. (2015). Discussion paper: Options for commissioning and funding of mental health services. Retrieved 19/8/18, from: https://mhaustralia.org/sites/default/files/docs/discussion_paper_-_options_for_commissioning_and_funding_of_mental_health_services_may_2015.pdf

Mission Australia. (2017). Youth Mental Health Report 2012-2016. Retrieved 18/8/18, from: https://blackdoginstitute.org.au/docs/default-source/research/evidence-and-policy-section/2017-youth-mental-health-report_mission-australia-and-black-dog-institute.pdf?sfvrsn=6

National Institute of Health. (2013). Common Genetic Factors Found in 5 Mental Disorders. Retrieved 16/8/18, from: https://www.nih.gov/news-events/nih-research-matters/common-genetic-factors-found-5-mental-disorders

National Mental Health Commission. (2017). 2017-18 Federal Budget: Mental Health Proves to be a Priority. Retrieved 18/8/18, from: http://www.mentalhealthcommission.gov.au/media-centre/news/2017-18-federal-budget-mental-health-proves-to-be-a-priority.aspx

National Regional Health Alliance. (2017). Mental Health in Rural and Remote Australia. Retrieved 18/8/18, from: http://ruralhealth.org.au/sites/default/files/publications/nrha-mental-health-factsheet-dec-2017.pdf

Petersen, I., Baillie, K., & Bhana, A. (2012). Understanding the benefits and challenges of community engagement in the development of community mental health services for common mental disorders: Lessons from a case study in a rural South African subdistrict site. Transcultural Psychiatry, 49(3-4), 418-437. doi: 10.1177/1363461512448375

Rural Health. (2011). The determinants of health in rural and remote Australia. Retrieved 18/8/18, from: http://ruralhealth.org.au/sites/default/files/publications/factsheet-determinants-health-rural-australia.pdf

Welch, V., Petkovic, J., Pardo Pardo, J., Rader, T., & Tugwell, P. (2016). Interactive social media interventions to promote health equity: an overview of reviews. Health Promotion And Chronic Disease Prevention In Canada, 36(4), 63-75. doi: 10.24095/hpcdp.36.4.01

University of Sydney. (2018). Mental Health and Wellbeing. Retrieved 18/8/18, from: http://sydney.edu.au/medicine/aghealth/projects/health/mentalhealth/index.php

  • Stephanie

Updated: Feb 1

Content Warning: horse racing, alcohol, violence, domestic violence.


I've been expressing my opinions against horse racing within the comfort of my familiar circles for a few years now, and these have been largely based on the premise of animal cruelty and exploitation, and the way in which the Melbourne Cup Carnival enhances consumerism and materialism. I believe the sport itself is antiquated and is run by an industry riddled with the potential for unethical treatment of horses and humans alike.


With the revelations exposed by the ABC recently into the horrendously unethical treatment of race horses within the Australian racing industry, I'm finding it difficult to remain silent publicly when discussions surrounding participation in horse racing events, or gambling on them, is the primary topic.


We know through these recent revelations that horse racing is incredibly cruel, and even contemplating writing about such themes fills me with despair. What I would like to highlight instead is the way in which participation in horse racing influences our health related behaviours; namely alcohol consumption and violence.


Alcohol consumption is one of the leading contributors to the prevalence of disease, illness or injury in Australia, particularly when we're looking at binge drinking (AIHW, 2018). It's engrained within our culture, and it's a large part of our celebrations and commiserations; the Melbourne Cup Carnival is no exception to this social norm. In fact, statistics over the years show that Melbourne Cup Day is one of the most problematic days in our calendar for alcohol consumption and related harm (VicHealth, 2014).

Exhibit A

This isn't really surprising when we look at some of the sponsors for the Melbourne Cup Carnival:

- Furphy - a major partner;

- Seppelt Wines - a major partner;

- Absolut. - an official partner;

- GH.Mumm Champagne - an official partner; and

- Jim Beam - an official partner (Flemington, 2019).


DrinkWise, a not for profit organisation whose 'primary focus is to help bring about a healthier and safer drinking culture in Australia', is also on board as an 'Event & Program Partner' (DrinkWise, 2019; Flemington, 2019). At first glance this seems really positive, however, when looking a little further into this I discovered something I've been taught to be critical of throughout my public health studies: in addition to government funding, DrinkWise relies on "voluntary industry contributions" from across the alcohol sector (DrinkWise, 2019). Receiving funds from alcohol companies who promote and profit off alcohol consumption seems a little contradictory to me. In saying this, none of the alcohol companies sponsoring the Melbourne Cup Carnival, are listed as contributors to DrinkWise on their website. Nonetheless, I'm not sold.


It's also important to recognise that advertising regulations play a part in this, as it's completely legal to advertise alcohol during televised sport Australia wide. We see it in the lead up to AFL Grand Final Day, which flows through to the Racing Carnival. This advertising has been found to directly influence the way we consume alcohol on big sporting occasions, with ongoing impacts to our attitudes towards alcohol consumption in general (Baker, 2019).


These affiliations and regulations increase the accessibility of alcohol at the events themselves, and promote the consumption of alcohol to those watching at home. We're also huge fans of watching sport at the pub, and when all of this is mixed with competition, exacerbated by financial interest where gambling is involved, is it any wonder Melbourne Cup Day is so problematic? We're practically being programmed to drink to excess.


The ramifications of this can be devastating. Excessive alcohol consumption has a direct relationship with violence and assaults, and is known to double the risk of family and domestic violence. Given the increased participation in excessive alcohol consumption during the Melbourne Cup Carnival, this rate undoubtedly spikes around this time (Miller, et al., 2016). This is particularly concerning when we know the rates of family and domestic violence are already so high in Australia, with approximately one woman per week losing her life as a result of it (Destroy the Joint, 2019).


It doesn't take a lot to see the affiliation between alcohol, violence and Melbourne Cup Day. A quick Google search will give you enough insight to determine that this is all incredibly problematic. The Melbourne Cup Carnival, and other horse racing events, are as cruel to humans as they are to animals. It is a series of events that are built from a foundation of profiting off the potential for people to cause harm to themselves, others and animals - and in 2019, I don't think that's okay.

Here's a lit of things you can do this Melbourne Cup Day that don't support such a horrible event: https://www.australianethical.com.au/news/melbourne-cup-day-if-horse-racing-isnt-your-thing/

Note: This is just my opinion, and I feel it's educated. If you don't agree, that's okay, but I ask you to consider how your participation impacts yourself, those around you, and the animals involved. Please don't come for me.

References

Australian Institute of Health and Welfare. (2018). Alcohol, tobacco & other drugs. Retrieved 21st October 2019, from: https://www.aihw.gov.au/reports/alcohol/alcohol-tobacco-other-drugs-australia/contents/drug-types/alcohol

Baker, N., (2019). Alcohol advertising in sports 'fuelling drink culture', according to study. Retrieved 21st October 2019, from: https://www.sbs.com.au/news/alcohol-advertising-in-sports-fueling-drink-culture-according-to-study

Destroy the Joint. (2019). Destroy the Joint. Retrieved 21st November 2019, from: https://www.facebook.com/pg/DestroyTheJoint/community/?ref=page_internal

DrinkWise. (2019). About. Retrieved 21st October 2019, from: https://drinkwise.org.au/about-us/about/#

Flemington. (2019). Melbourne Cup Carnival Sponsors. Retrieved 21st October 2019, from: https://www.flemington.com.au/footer-links/melbourne-cup-carnival-sponsors

Miller, P., Cox, E., Costa, B., Mayshak, R., Walker, A., & Hyder, S. et al. (2016). Alcohol/Drug-Involved Family Violence in Australia. National Drug Law Enforcement Research Fund, 68. Retrieved 21st October 2019, from https://www.ndlerf.gov.au/publications/monographs/monograph-68

VicHealth. (2014). Melbourne Cup worse event for bingeing: sports and alcohol report. Retrieved 21st October 2019, from: https://www.vichealth.vic.gov.au/media-and-resources/media-releases/melbourne-cup-number-one-day-for-bingeing

Stephanie Says acknowledges the traditional custodians of the land on which we live - the Wurundjeri people of the Kulin nation. We acknowledge their Elders past, present and emerging. Always was, always will be Aboriginal land. 

Note: Stephanie Sayss is not run by medical professionals. This platform is an educational tool only, and not intended to be used for medical advice. Always seek the assistance of a doctor - this platform is intended to be used a tool to assist you in doing so.

All references are cited on the page they are relevant to. 

©2019 by Stephanie Sayss.