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Accepted Paper:

Is poor oral health for Aboriginal Australians is a moral issue? Looking through the lens of accessing services  
Angela Durey (University of Western Australia) Linda Slack-Smith (University of Western Australia) Marlia Fatnowna (The University of Western Australia)

Paper short abstract:

Aboriginal oral health, practitioner explorations of equity and health, critical medical anthropology

Paper long abstract:

Despite dental caries being largely preventable, Aboriginal Australians have worse periodontal disease, more decayed teeth and untreated dental caries with Aboriginal children reported as having twice the rate of dental caries as non-Aboriginal children. Public health messages to reduce sugar intake, brush and floss teeth regularly and stop smoking have failed to significantly reduce disparities raising questions of where the problem lies. Qualitative research examining 35 Aboriginal Health Workers' perceptions of oral health in Aboriginal communities in Perth Western Australia revealed structural and socioeconomic barriers that were explored through the lens of 'access to services' using Harris' model of opportunity, use, equity and outcomes. Opportunities for accessing public dental services were noted as limited with long waiting lists and emergency hospital services a last resort for severe pain, often resulting in dental extraction; use of public or private dental services was constrained by cost, distance and health providers' sometimes discriminatory attitudes;. Outcomes from such constraints included self-medication for pain, fear of tooth extraction and shame about dental appearance. Most dental services are located within a neoliberal framework focusing on cost-effectiveness, profit and individual responsibility to make optimum health choices. According to Ulrich Beck, penalties for 'non-compliance' are blame and 'personal failure'. Addressing this as a moral issue requires policy makers and health providers to critically reflect on policies and practices that reproduce inequities in Aboriginal oral health, review failed service approaches and change the discourse that places Aboriginal people at the centre of the problem.

Panel Med01
(Un)healthy systems: moral terrains of health equity
  Session 1