The most important factor in improving Indigenous health is economic participation – getting adults into work and kids into school.
By Nyunggai Warren Mundine AO, Executive Director of the Australian Indigenous Chamber of Commerce
Years ago when I visited Alice Springs a doctor friend of mine took me to the hospital Emergency department. Outside were a dozen people. There were people in wheelchairs with amputated limbs; in casts or neck braces from accidents or assaults; with drips in their arms. Some were smoking. All were Aboriginal. It was a real life snapshot of the Indigenous health statistics. Indigenous people live shorter, less healthy lives. Some suffer illnesses other Australians haven’t heard of.
Indigenous health problems are a tapestry of interconnected health problems, risk factors and social issues. And when you step back from the tapestry what you’re really seeing is poverty. Poverty is both a cause and result of poor health. People in poverty live in environments that make them sick. Poor health, in turn, makes it harder for kids to go to school and adults to work.
People find themselves living in poverty for various reasons. But however they get there, there’s only one pathway out. Economic participation. A job. Running your own business. Going to school and getting educated so you can do that.
Recently the President of the Australian Medical Association, Dr Michael Gannon, tweeted in response to one of my articles saying there’s no question access to jobs and the economy will improve Indigenous health. He said unemployment is a huge Indigenous health issue. I interviewed him on my program “Mundine Means Business” about the economic determinants of health. He said: “Disadvantage whether it be in education or in health or in employment. They’re all linked to each other. … It’s a wicked cycle and we should try to break into it at any point we possibly can.”
Yes, it’s harder for someone in poor health to get a job but it’s even more important that they do. Yes, it’s harder for Aboriginal kids who suffer from deafness from ear infections to learn at school. But it’s even more important they go to school. You don’t fix a cyclical problem with a linear solution. You break into the cycle wherever you can.
Most Indigenous poor live in chronic inter-generational welfare dependence. Living on welfare means living in poverty. Not because welfare isn’t generous enough. Even if you doubled the payments it would still be poverty. It’s not about money. It’s about deprivation of basic needs like employment; lack of purpose and aspiration; lack of autonomy and independence.
The welfare system should be there for people who’ve fallen on hard times until they get back on their feet. I’m well aware how hard it is to do that. As a teenager I spent a year on “compo” after an accident and it was an immense struggle to get back to work. I learned people can get stuck on welfare like an animal in an iron trap. Working isn’t like breathing or walking, which your body does without thinking. It’s a habit. Habits can be broken, even forgotten. But habits can also be acquired. Anyone can develop the habit of working. It’s never too late.
A disproportionate number of Indigenous Australians are stuck in the welfare-poverty trap. Many non-Indigenous Australians are too. More than half a million Australians on Newstart have been on welfare support for over a year and around 100,000 have been on it for over a decade.
There’s one area where I agree with the critics of the welfare system. There’s no point expecting long term unemployed to find a job by applying for jobs and going to interviews. Most people on the dole for more than a year have significant barriers to employment and are unemployable if left to their own devices.
What you have to do is find a job and a willing employer (the easy part) and intensively case-manage a person to start the job and retain it for at least six months, addressing all those barriers. This approach has been demonstrated to work through the Vocational Training and Education Centre model pioneered by Fortescue Metals Group for Indigenous employment. I believe governments should apply this same model to every single person in the half a million who’ve been on the dole for over a year.
I support the welfare system and I’m proud to live in a country that looks after people who can’t look after themselves. The safety net should be there while people need it and not a day longer. I don’t say this because I think welfare recipients are bludgers or bad people. The opposite. When I see people and families stuck on welfare for generations I see people in pain.
The most effective thing we can do to improve Indigenous health is get adults into work and kids into school. Because the most important factor in improving Indigenous health is economic participation.
Versions of this article appeared in the Daily Telegraph, Herald Sun and Koori Mail.
Please follow and like us:
Posted by admin on May 5, 2018