PUBH6000: Social, Behavioural and Cultural Factors in Public Health - Report Writing Assessment Answer

Social and Cultural factors in Public Health Assignment

Assignment Task

Provide a brief overview of the Closing the Gap strategy and describe what impact it has had on improving the health of Aboriginal and Torres Strait Islander Peoples.

(Hint: Briefly discuss the history of the strategy and then focus on ‘The Prime Minister’s 2017 Report to Parliament’ and his assessment of Australia’s progress on the targets. Do not list the targets)

Part 2

The report outlines a new way of engaging with Aboriginal and Torres Strait Islander Peoples.

“The Empowered Communities initiative is a new way for Indigenous communities and governments to work together to set priorities and deliver services at a regional level.” (Source: https://www.dpmc.gov.au/indigenous-affairs/empowered-communities)

Discuss this statement relating the potential impact of the initiative upon the social determinants of Aboriginal and Torres Strait Islander Peoples’ health.

(Hint: Provide a national overview of health for Aboriginal and Torres Strait Islander Peoples, then narrow focus to a brief overview of the Empowered Communities initiative, including the rationale for the initiative. You may wish to discuss the social determinants of health for Aboriginal and Torres Strait Islander Peoples by reference to the Redfern Statement or by examining the Local Solutions described in the Closing the Gap 2017 Report. See https://closingthegap.pmc.gov.au/resources)

Report - Indigenous Health InequitiesClosing the Gap strategy

Aboriginal and Torres Strait Islander population constitutes about 3 per cent of the Australian population with about 20 per cent living in remote areas. Closing the gap strategy from the prime minister aims to provide more benefits to Aboriginal and Torres Strait Islander people in terms of childhood education, educational achievement, life expectancy, employment outcomes and child mortality (Commonwealth of Australia, 2017). A formal commitment has been made by the government to offer health equality to all Aboriginal and Torres Strait Islander people within 25 years. This was agreed on a document called Indigenous health equality summit statement of intent where Australian governments and Aboriginal and Strait Islander people collaborated to work together for equality in health status and life expectancy by the year 2030 (Australian Indigenous Health Info, 2015). Every year, Prime minister brings a report on Closing the Gap strategy to the parliament that explains the progress in defined targets of this strategy (Commonwealth of Australia, 2017). One such initiative in action is the new the approach of empowered communities initiative designed by the indigenous population helping in setting the priorities, improve the already available services and align the funding efficiently at the regional level (Australian Indigenous Health Info, 2015). It defines the government backing up of the indigenous population including themselves and their children, while supporting the selected leaders for a greater positive change by establishing a trust between the community and government (Commonwealth of Australia, 2017).

Based on the latest report by the prime minister in 2017, many of the defined targets were running behind the expected outcomes, few of them were rising exponentially to meet the expected outcome eventually (Australian National Affairs, 2017). The data collected is compared with the non-indigenous population to understand the progress and balance both the communities (Australian Indigenous Health Info, 2015). Focus of the government entirely lies on offering the early childhood care and schooling for children with increasing number of indigenous specific baby and mother services (Commonwealth of Australia, 2017). The prime benefit is the commitment to increase the life expectancy of indigenous people as the rate of chronic disease is more in indigenous people when compared to non-indigenous people (Commonwealth of Australia, 2017). Stress on early childhood education has been positive and attendance in the schools remained constant when compared across two years along with employing and offering skill trainings to provide Aboriginal and Strait Islander people with sustainable employment opportunities. Community safety stays as major concern for the government as substance abuse, violence, harm and crime is still prevalent in the indigenous community especially against women and children due to high rates of domestic violence when compared to non-indigenous counterparts.

Empowered Communities initiative

The attempts of Australian government to strengthen the indigenous population over a period of time has not gained the required pace but has ensured that both the indigenous and non-indigenous population has combined their efforts to understand the problems and resolve together in harmony (Commonwealth of Australia, 2017). Government directly being involved in the targets defined affirms the scope of achieving the targets eventually (Australian Human Right Commission, 2007). Empowered communities initiative is a very strong example of the action in progress and it is designed and led by the indigenous population. It enforces ownership and adds their authority in reacting to decisions that involve or relate to them. The basic idea is to identify who can lead and bring positive changes to the Aboriginal and Strait Islander people and forwarding them to participate at front with government being the centralised body for making decisions (Commonwealth of Australia, 2017). The community leaders were funded with 5 million dollars by the government to encourage them for making a detailed design of the plan and this effort is boosted by the state government too (Australian Human Right Commission, 2007).

For better contribution to each community, the indigenous leaders were identified and placed into eight regions through Australia being Cape York, Central Coast, Inner Sydney, Goulburn Murray, East Kimberly, West Kimberly, Ngaanyatjarra Pitjantjatjara Yankunytjatjara Lands and North east Arnhem Land (Commonwealth of Australia, 2017). Every assessment and decision of this initiative is based on the social determinants of health related to Aboriginal and Strait Islander people of Australia. Socio-economic status is a major demerit for the indigenous population as the average gross household income of indigenous people is about 62 per cent of what non-indigenous people earn per week and the unemployment rate in indigenous people is about 20% which is three times higher than that the non-indigenous population (Census 2001). Also, education adds as a great factor here, where only 50 per cent of the indigenous population is likely to continue their education up till year 12 (Australia, 2004). All these factors strongly links with the poor health status as reduces the ability of the population to apply health information in their lives, income directly reflects on the availability of health care services and medication, overcrowding in the house leads to the spread of the communicable disease, poverty also contributes in poor infant diet which leads to chronic diseases in life during later years and smoking with high risk behavior is also linked with low socio-economic status (Commonwealth of Australia, 2017). All these factors associate to less knowledge and application of that knowledge in life also to the employment in future which causes financial burden on the individuals to access the available healthcare facilities adding to the burden of the unhealthy stress. Chronic stress impacts the immunity of body, circulatory system and body’s metabolic activity across a variety of hormonal pathways and leads to several problems with the circulatory systems, mental health issues, violence against women and children and overall community dysfunction (Commonwealth of Australia, 2014).

Another perspective in social determinants is the experience of control and chronic stress which indicates the associated high-risk health behavior especially substance abuse that included smokers and alcohol consumers (Australian Human Right Commission, 2017). Indigenous people were hospital twice in number as compared to non-indigenous people for behavioral or mental disorders as per the data in 2003-2004 (Commonwealth of Australia, 2017). Hospitalization based on assault and intentional self-harm can relate to the mental illness and the rate of hospitalization related to intentional self-harm was roughly twice when compared to non-indigenous people (Australian Human Right Commission, 2007). Several factors may induce chronic stress that range from poverty to racism ultimately affecting the circulatory system, immune system and metabolic functions. It is considered as the biggest cause of death in indigenous people of Australia (Commonwealth of Australia, 2017). Emotional and social health determines the degree of stress; this was observed that children living in very remote areas had better emotional and social health due to isolation when compared with people who have moved a little towards towns (Department of health, 2013).Indigenous community has also taken control of the health services to deal with the healthcare in the regions well as part of the initiative (Commonwealth of Australia, 2014). This initiated the concept of indigenous people being directly involved in the availability of services, empowering them for wide range of health benefits and helped with indigenous women greatly (Australian Institute of Health and Welfare, 2017). There has been a great reduction in psychiatric mental health admissions to a Geraldton Hospital by 58%. Antenatal services have helped a lot of mothers and babies to maintain the project by providing optimum antenatal care with a great increase in numbers for antenatal mothers coming for visits reducing prenatal deaths (Department of health, 2013). This has led to decrease in the number of low birth weight babies contributing to a healthy early age care pattern (Commonwealth of Australia, 2017). This has brought good awareness in the communities and motivated great participation over a period of time with continuous efforts (Australian Human Right Commission, 2017).Including Aboriginal and Strait Islander people in the land rights concept gave people a sense of ownership and belonging in the area (Australian Human Right Commission, 2017). This was done to support the traditional values of Aboriginal and Strait Islander People as this including with customary law and governing structures will help to improve the health status of the people living in far off or remote communities. This also ensured that Aboriginal and Strait Islander people had access to their traditional land (Commonwealth of Australia, 2017). The considered possible health impacts related to better diet, connecting indigenous people with their traditional economic stands and exercise while working on the given lands (Australian Human Right Commission, 2017). Along with the mentioned social determinants focus in empowerment initiative was also linked to reducing the prevalent racism and violence against indigenous women. Racism adds to stress and affects both physical and mental wellbeing causing increase in use of marijuana, smoking and alcohol consumption in children under age 12 (Commonwealth of Australia, 2014). Indigenous women have been reported to acquire responsibilities of the family and finished schooling at an early age with violence as an additional factor over the problem, the scenario for them becomes complex and make them vulnerable affecting their mental health (Australian Institute of Health and Welfare, 2017).As per the Redfern statement, attempts has been made and are progressive with several hundred recommendations for the Aboriginal and Strait Islander people however in spite of all the efforts and involved funding the progress is really slow on many targets and doesn’t seem to be fulfilled with the stated stipulated time (Australian National Affairs, 2017). All these initiatives and strategies emphasize the resource location and improvement of Aboriginal and Strait Islander people and their communities (National Congress of Australia’s First Peoples, 2017)