james lamerton, caac: equitable access to health for indigenous australians
DESCRIPTION
James Lamerton, General Manager, Central Australian Aboriginal Congress delivered this presentation at the 2013 Social Determinants of Health conference. The conference brought together health, social services and public policy organisations to discuss how social determinants affect the health of the nation and to consider how policy decisions can be targeted to reduce health inequities. The agenda facilitated much needed discussion on new approaches to manage social determinants of health and bridge the gap in health between the socially disadvantaged and the broader Australian population. For more information about the event, please visit the conference website: http://www.informa.com.au/social-determinants.TRANSCRIPT
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James Lamerton
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Amoonguna (200-250)
Areyonga/Utju (200-250)
Ltyentye Apurte (600-650)
Mutitjulu (250-300)*
Ntaria &Wallace Rockhole (650-700)
*Ground zero of the „Intervention‟
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*Eastern Arrente
*Pitjantjatjara
*Luritja
*Western Arrente
*Walpiri
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*Persisting health
inequalities that would
otherwise be
preventable by
reasonable means are
health inequities
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*SDoH are the political,
economic, and social factors
that reflect “conditions in
which people are born, grow,
live, work and age” (and,
presumably, die)
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*DETERMINISM
Or
“IT IS WRITTEN”
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“Meta-causality” *(the causes of the causes)
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*Education
*Housing
*Employment
*Police
*Justice system
*The media
*Racism – institutional and social OR
„Racism in all Policy‟
*Grog
*Gambling
*THE HEALTH SYSTEM!
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*Existential angst
*“Framing”
*Governmentality
*Responsibilisation
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*The social causality of the poor health and mortality of Aboriginal
people
*The unequal social distribution of poor health and mortality (Alice
Springs!!)
*Gross exaggeration of individual volition in improved health
outcomes for Aboriginal people (see later slides!)
*Health Policies rather than policies that improve health
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The „Intervention‟ (The NT Emergency Response Act 2007)
Was a quintessentially SDoH initiative, involving as it did
agencies involved in welfare, employment, law & order,
education, family support, child and family health, housing,
land tenure and social coordination activities.
Just by the way, it also required the suspension of
Part II of the Racial Discrimination Act, 1975
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*The project of Neo-liberal governments is to wean „autonomous‟ individuals off reliance on state-provided services and shape unsuspecting punters to become self-responsible, entrepreneurial and independent. With Aboriginal people living in community, the current government has determined economic development and home ownership as the panacea for all social ills.
*The state legitimises these actions less and less by interdiction, supervision and punishment. Rather, it involves an un-coerced application of certain values rooted in the motivation for action. It is fundamentally premised on the construction of a moral agency that accepts the consequences of its actions in a self-reflexive manner – it is governance of the self. this, then, is ……..
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*Pleasure control
There is currently strong condemnation of the ease of access to pornography in central Australian Aboriginal communities – a product freely available to most adult Australian citizens in most jurisdictions.
the moral censuring of access to a form of sexual pleasure available to most other Australians, particularly (and ironically) those in Canberra, is a powerful manifestation of the concept of „governmentality‟, with the various media – but not governments - portraying Aboriginal communities as „dysfunctional‟ environments where rampant, out of control and „deviant‟ sexual transgression is the norm rather than the exception: individuals are therefore, blame-able. These are the techniques and strategies by which Aboriginal communities are rendered governable
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In Mutitjulu, ground zero of the „Intervention‟, the entire male
population had been portrayed as sexually deviant, predatory and
in need of „correction‟. In spite of the sanctimonious rhetoric
(particularly from The Australian), no charges have ever been laid
in relation to matters arising from the „Intervention‟.
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*The process (or the technology) by which subjects (us) are
shaped to see what are quintessentially social risks (poor
health status of Aboriginal people, Aboriginal poverty, poor
educational attainment etc.) not as the responsibility of the
state but as lying within the domain of the individual. In so
doing, the social risk is transformed into a problem of „the self‟
to be remedied by „the self‟. This, then, is ….........
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SELF-MANAGEMENT
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*Human reality is far too
complex to be subsumed
or conflated to simplistic
concepts of „agency‟ and
individual volition
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