Who cares? Aboriginal and Torres Strait Islander health care choices and access barriers in Mount Isa
McBain-Rigg, Kristin Emma (2011) Who cares? Aboriginal and Torres Strait Islander health care choices and access barriers in Mount Isa. PhD thesis, James Cook University.
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This thesis presents an illustration of the access barriers to health care as experienced by Aboriginal and Torres Strait Islander peoples in Mount Isa, Queensland, Australia. This examination is conducted via fieldwork observations and the narratives of Aboriginal and Torres Strait Islander peoples in Mount Isa, as well as the stories of the health professionals that care for them. In particular, this thesis attempts to unpack the term 'cultural barriers' as used in health and medical literature in discussions of access.
Stories are placed within the context of Australian rural health issues and considerations of global issues affecting rural, minority and Indigenous populations. The research represents a distinct blend of anthropology and health services research principles and practices. This perspective is developed utilising principles from the 'Mindful Bodies' approach within Critical Medical Anthropology, which seeks an understanding of human health issues via examination at three levels (or bodies): the individual body, the social body and the body politic (Scheper-Hughes and Lock 1987). Critical issues of concern with regards to health service provision in Mount Isa are examined using Penchansky and Thomas's (1981) taxonomy, the 5As of Access. This taxonomy allows for a nuanced discussion of access by unpacking the term and identifying the various aspects that create access: Availability, Accessibility, Affordability, Accommodation and Acceptance. Dedicated ethnographic fieldwork was undertaken in Mount Isa from October 2007 to August 2009.
An examination of the ways that Aboriginal and Torres Strait Islander peoples in Mount Isa express their understandings of the barriers to health care has two advantages. First, such discussions at a local level align with and illuminate the barriers that affect Aboriginal and Torres Strait Islander populations nationally. Second, the significance assigned to such barriers, and examination of what may constitute a cultural barrier (as discussed in health literature) highlights the ways in which cultural difference becomes constructed as problematic in health system encounters.
Culture should not be seen as a barrier to health care, but should be seen as an opportunity for increased awareness, understanding and improved personal care for patients in the health system.