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Indigenous Health •Fi Australia, Canada, New Zealand and The Public Health Faculty Publications School of Public Health 2010 Indigenous Health – Australia, Canada, New Zealand and the United States - Laying Claim to a Future that Embraces Health for Us All. Lisa Jackson Pulver University of New South Wales Melissa R. Haswell University of New South Wales Ian Ring University of New South Wales John Waldon Follow this and additional works at: https://digitalscholarship.unlv.edu/ University of New South Wales community_health_sciences_fac_articles Wayne Clark Part of the Community Health Commons, Demography, Population, and Ecology Commons, Inequality National Aboriginal Health Organization and Stratification Commons, and the Public Health Commons See next page for additional authors Repository Citation Pulver, L. J., Haswell, M. R., Ring, I., Waldon, J., Clark, W., Whetung, V., Kinnon, D., Graham, C., Chino, M., LaValley, J., Compher, C., Sadana, R. (2010). Indigenous Health – Australia, Canada, New Zealand and the United States - Laying Claim to a Future that Embraces Health for Us All.. World Health Report - Financing for Universal Health Coverage Background Paper, No 33 1-79. https://digitalscholarship.unlv.edu/community_health_sciences_fac_articles/207 This Article is protected by copyright and/or related rights. It has been brought to you by Digital Scholarship@UNLV with permission from the rights-holder(s). You are free to use this Article in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s) directly, unless additional rights are indicated by a Creative Commons license in the record and/ or on the work itself. This Article has been accepted for inclusion in Public Health Faculty Publications by an authorized administrator of Digital Scholarship@UNLV. For more information, please contact [email protected]. Authors Lisa Jackson Pulver, Melissa R. Haswell, Ian Ring, John Waldon, Wayne Clark, Valorie Whetung, Dianne Kinnon, Catherine Graham, Michelle Chino, Jonathon LaValley, Christina Compher, and Ritu Sadana This article is available at Digital Scholarship@UNLV: https://digitalscholarship.unlv.edu/ community_health_sciences_fac_articles/207 Indigenous Health – Australia, Canada, Aotearoa New Zealand and the United States - Laying claim to a future that embraces health for us all Lisa Jackson Pulver, Melissa R. Haswell, Ian Ring, John Waldon, Wayne Clark, Valorie Whetung, Dianne Kinnon, Catherine Graham, Michelle Chino, Jonathon LaValley, Christina Compher and Ritu Sadana World Health Report (2010) Background Paper, 33 HEALTH SYSTEMS FINANCING The path to universal coverage ADVANCED PRELIMINARY WEB VERSION 22 November 2010 © World Health Organization, 2010 All rights reserved. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers' products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. The findings, interpretations and conclusions expressed in this paper are entirely those of the author and should not be attributed in any manner whatsoever to the World Health Organization. Advanced Preliminary Web Version 22 November 2010 1 Indigenous Health – Australia, Canada, Aotearoa New Zealand and the United States - Laying claim to a future that embraces health for us all World Health Report (2010) Background Paper, No 33 Lisa Jackson Pulver1, Melissa R. Haswell1, Ian Ring1,2, John Waldon1,3, Wayne Clark4, Valorie Whetung4, Dianne Kinnon4, Catherine Graham4, Michelle Chino5, Jonathon LaValley5, Christina Compher5 and Ritu Sadana6. 1 Muru Marri Indigenous Health Unit, School of Public Health and Community Medicine, Faculty of Medicine, university of New South Wales, Australia 2 Centre for Health Service Development University of Wollongong, Australia 3 Centre for Maori Health Research and Development, Massey University, New Zealand 4 National Aboriginal Health Organization, Canada 5 School of Community Health Sciences, University of Nevada Las Vegas, USA 6 Department of Health Systems Financing Health Systems and Services Cluster, World Health Organization, Geneva Advanced Preliminary Web Version 22 November 2010 2 We pay our respects to the Indigenous Peoples of our countries, and to our Elders, past, present and future, and hope we have honoured their wishes in how this report has been compiled. As proposed by the International Group on Indigenous Health Measurement, Lisa Jackson Pulver was commissioned by the World Health Organization to coordinate the preparation of this background paper. We acknowledge each country's Ministry of Health and or national statistical agencies who shared available data in this area. The paper benefited from discussions and suggestions received during the UN Inter-Agency Support Group on Indigenous Peoples' Issues, hosted by the World Health Organization, Geneva, on 16 September 2010, as well as from peer reviewers. Advanced Preliminary Web Version 22 November 2010 3 Indigenous Health – Australia, Canada, Aotearoa New Zealand and the United States - Laying claim to a future that embraces health for us all. I. Introduction 1.1 Health for all - within and across countries. Improving the health of all peoples has been a call across the globe for many decades and unfortunately remains relevant today, particularly given the large disparities in health status of peoples found around the world. Rather than differences in health, or health inequalities, we use a different term, health inequities. This is so as mere differences in health (or "inequalities") can be common in societies and do not necessarily reflect unfair social policies or practices. For example, natural ageing implies older people are more prone to illness. Yet, when differences are systematic, socially produced and unfair, these are considered health inequities. Certainly making judgments on what is systematic, socially produced and unfair, reflects value judgements and merit open debate. We are making explicit in this paper what our judgments are, and the basis for these judgments. The World Health Assembly in 2009 (WHO 2009) passed a resolution with each of its 193 Member States endorsing, that reducing health inequities within and across countries, should be a priority for all countries and development partners, and that the task requires multiple sectors to work together, given that evidence from around the world documents that the distribution of health within and across countries reflect a broad range of social determinants, including the interaction of social determinants with biological determinants. The WHO's global health agenda clearly identifies four gaps that must be addressed. The first one is to increase social justice, followed by increasing responsibility, implementation and knowledge. Moreover, the WHO recognizes that to overcome these gaps, strong political will, integrated policies and broad participation are required. Health equity implies that everyone could attain their full health potential regardless of social position or other social circumstances. Health inequities are systematic as they are not distributed randomly. Instead they show a consistent pattern across different population groups. Many of these differences are not only due to physical health factors, but also increasingly due to social factors. In fact, the underlying causes are complex, often reflecting systematic social, political, historical, economic and environmental factors, accumulated during a lifetime and transferred across multiple generations. "Social" determinants is therefore used as shorthand for all of these factors. 1.2 Embracing Indigenous peoples. Despite a number of global achievements that have improved population health, one key marker of the impact of inequities in health status globally, is the constancy of conspicuously poor health status of Indigenous populations of their Lands and in their countries, whether we look across the globe as a whole or within the wealthiest of nations. Advanced Preliminary Web Version 22 November 2010 4 The phenomenal gains and advantage that development has thus far provided to the United States, Canada, Australia and Aotearoa New Zealand have not achieved a present that embraces equity in Indigenous health determinants, access or outcomes within their own boarders. The United Nations has estimated that there are about 370 million Indigenous people in the world today living in at least 70 countries (Canberra Report). An estimated 7 million of these people live
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