Furthermore, by applying the Syndemics framework to two contrasting Indigenous ethnographic contexts; we can examine how the intergenerational embodiment of colonial biosocial forces establish differing social understandings and vast contemporary health inequalities, disease and illness between Indigenous and Western groups. Historically, the establishment of European colonisation in Australia had led to the subordination of Indigenous people; with contemporary health inequalities stemming from colonial practices persisting across multiple generations and extends to all dimensions of the holistic notion of Aboriginal wellbeing (Zubrick, Et Al, 2014).
In effect, such factors essentially shape contemporary political and social systems that inherently advantage Anglo-Saxon Australians and disadvantage Aboriginal people; and as a result, Indigenous have worse health than Western Counterparts, are over-represented amongst the poor and disadvantaged, and have 11-14 years lower life expectancy (Durey & Thompson, 2012).
Durey and Thompson’s 2012 ethnographic study of White cultural power in the delivery of health services to Indigenous-Australians discuss the historical circumstances and social and cultural characteristics in explaining patterns of health inequalities (Durey & Thompson, 2012). The authors speculate race as a core feature of health delivery, in effect reinforcing a social hierarchy founded on Anglo-Saxon privilege and Indigenous subordination. Furthermore, the alarming health disparities suffered by Indigenous-Australians are associated with socioeconomic determinants of health; which again reflects the colonial hierarchy, which associates ‘whiteness’ with higher socioeconomic status, and Indigenous with socioeconomic disadvantage.
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Correspondingly, lower levels of Indigenous collective socioeconomic status determine lower level of income, employment, education and poorer housing which ultimately determines poorer levels of health compared to European-Australians.
Additionally, the authors note institutional racism has caused social dislocation and cultural fragmentation which all negatively impact on Indigenous health (Durey & Thompson, 2012).
Intergenerational institutional racism reinforces a social structure where Indigenous knowledge, beliefs and values are subjugated to the dominant western biomedical model in policy and practice (Durey & Thompson, 2012); in effect hindering Indigenous people from adequately accessing health services; and accordingly, develop higher prevalence and incidence of disease and illness clustering than Anglo-Saxon populations. Institutional and interpersonal racism projected onto Indigenous people via white dominated healthcare policies and providers taint Indigenous social understandings of health and wellbeing, leading to poor levels of health and contribute to disease clustering and health disparities in access to treatment of most major illnesses including cancer, cardiovascular disease, kidney disease and oral health (Durey & Thompson, 2012).
Similarly, Brady’s Indigenous ethnographic study is based on, and highlights the colossal obstacles present in the distribution of health policies/services to Aboriginal people. Like Durey and Thompson, Brady notes the difference in life expectancy between Aboriginal and Western groups is determined by mass collective intergenerational social organisation and government frameworks which determine collective policies. However, brady extends on such health disparities; highlighting Aboriginal hospital admission were double non-Indigenous for accidents, poisoning, and violence; and are also experiencing an explosion of illnesses such as type 2 diabetes, end-stage renal disease, and heart disease (Brady, 2003)
Similarly, Brady associates poor Indigenous Health with lower collective socioeconomic status; however, unlike Durey and Thompson, Brady focuses more on the determinants of the physical environment for determining health inequalities. In Australia, majority of health care is clustered on the coastline; however, majority of Aboriginal demographics are concentrated in remote, rural settlements; with 1200 indigenous communities are more than 100 km from a health centre (Brady, 2003).
Correspondingly, Indigenous geographic and social dislocation again hinder Indigenous people from accessing health services. Similarly, Brady highlights in white-based dominate biomedical culture, Indigenous people are dealt with as a separate population for policy purposes (Brady, 2003); which not only creates varying social understandings of the concepts of both groups, but reinforce unequal disparities in the allocation of health resources, thus disastrously effects collective Indigenous health; thus impacting personal illness experience.
To conclude, the ideas of ‘health’ and ‘wellbeing’ are two universally broad, interrelated and intricate concepts, which acquires a range of different meanings over a range of different academic disciplines, cultures and societies. Health is a multidimensional system centred on either the Biomedical or Counter Biomedical framework; and wellbeing is concerned with the optimum multidimensional state of being for an individual, community, society and culture; and captures how people experience, understand and manifest ‘being well’. Throughout this paper I have
- Described the differences between health and wellbeing; and
- Describe and explain how the integration of multidimensional processes over thousands of years across societies has reinforced varying
Biosocial factors and inheritance (political, social and ecological, forces) which shape contrasting collective and individual and social understandings of health and wellbeing; in effect structuring and positioning one’s physiological state of being and collective social environment.
In order to demonstrate this point through this paper, I have applied two Indigenous ethnographic to the Syndemics model of health to illustrate how colonial biosocial factors and inheritance create a contemporary social hierarchy based on white privilege and Indigenous disadvantage; which not only create contrasting social understandings of health and wellbeing among both groups; but illuminate alarming health inequalities which demonstrates how disease and illness interact biologically and cluster among individuals among both sociocultural groups; thus impacting personal illness experience.
