In Australia, despite the increase in mortality due to the number of total deaths, it has been continuously declining per 100,000 population. The trends associated with the decline in death rates such as improvements in the roads, decreased smoking rates, detection and treatment of diseases before the peak point and better hygiene has proved to have a better impact upon individuals. The infant mortality has dropped generally from 4.9 deaths per 1,000 live births to 3.2 in 2015. This is due to the improved medical diagnosis and improved support service for both parents and the newborn. Ischaemic heart disease including angina and heart attacks are the most commonly self-reported chronic disease however cancer is the leading cause of death in Australia. In 2014, the life expectancy for males were 78.5 years and 84.8 years for females however 50% of the deaths less than 75 years of age were preventable. The improvements since the 1970’s has resulted in lower infant mortality, decline deaths in cardiovascular disease and cancer and decreased traffic accidents.
Social justice principle allows the society the identify health issues in Australia. The equity, diversity and supportive environment are policies and actions that are acknowledged by the community to ensure that everyone has equal opportunities to seek help in health however those who are in more need than others e.g. the ATSI’s might need more health facilities as the mortality rates are higher will have more finance invested in them. This brings the equity into action where one who is in more need will have access to facilities more than someone who doesn’t. Diversity in Australia is highly increasing as migration is increasing hence Medicare services are becoming culturally sensitive by including translation services if needed and proving interpreters. Australians are ensuring that health services are at the minimal or at no cost to ensure it is being accessed in rural and remote areas along with people with disability.
Prioritising population groups in Australia is another way to ensure good health in Australia. Although the overall mortality rate is decreasing, sub-groups such as the ATSI still have a high death rate. Hence, understanding the prevalence of certain diseases such as diabetes and investing in that particular group will ensure that Australia has identifies the priority group. As a result, this will reduce the overall deaths in Australia and will close the gap amongst the Aborigines and non-indigenous people.
Keeping a track of which disease is increasing in the population is another way to prioritise health issues. The prevalence of the condition is an indication of the burden that it might have on the community. How common it is and the ability for Australia to identify the risk factors associated with it through epidemiology will ensure that it is taken into consideration as a priority. For instance, cardiovascular disease is in a decline but is the second most leading cause of death hence accounts for a large majority of deaths.
If a disease has the potential to be prevented, it is most likely that it will become a priority for the Australians. Conditions can be reduced through behavioural change and environmental modification or if it is not a life-style based then the medical advances can be a reliable source to get treatment or identify the disease before it actually occurs e.g. being in a shaded area to reduce the risk of skin cancer or going for a free medical check-up for women in every 2 years for symptoms of breast cancer.
Illnesses have both direct and indirect costs to both the individual and the community. The direct cost can include money spent on diagnosing, treating and caring and indirect cost could be the value of the output lost when people become too ill such as time. Individual costs can be associated with the hospital charges, medical practitioners’ fees and travel costs. Also, it can include the suffering experienced and the reduction in quality of life. Community based costs can be the funding, spending on medications increased by 79% and the considerable economic losses through decreased productivity when people are off work sick or injured.
Individuals who live in the rural and remote areas are more in keen to injuries, diseases and have a shorter live span. The risk of deaths increase as the remoteness of the area increases with 1.5 times than the major cities. The increased death rate may be due to the circulatory diseases, vehicle accidents and COPD while the people living there have an increased incidence to a higher rate of cancer and disability. The inequities experienced by the rural and remote individuals include higher rate of diabetes, transport accidents, suicides, burden of stroke, poor oral health and higher death rate of liver cirrhosis, perinatal and congenital conditions. They also have an increased smoking rate7% in comparison to the major cities, obesity by 10%, alcohol consumption by 5% and inactivity by 6%. The reasons for this may be linked to the poor access to health facilities, the different treatments to various health conditions and the unhygienic environment. Hence, it is important to make the rural and remote areas a priority group.
Sociocultural determinants in the rural and remote areas are families, peers, culture, media and religion. Their health is influenced upon the children who are being brought in the area. Children are exposed to a higher level of smoking, passive smoking and are more likely to become smokers later in life. Children who have overweight or obese parents are more in keen to become one themselves as similar to their parents, they will have a lower activity levels, higher drinking risks and cholesterol levels.
Socioeconomic determinants such as the level of education, income and employment have a huge influence on the living standards of the rural and remote areas. The disadvantages associated with this are, individuals are not able to complete education thus their employability levels decrease. This creates the likelihood of the people working in farms, transportation and mining fields which could be hazardous. Their average income levels a lower and their poor education levels influence them to a lower health literacy.
In rural and remote areas, the number of geographical location’s employment is rising however it is still lower than the major cities. There is very less medical specialists and technology to assist the people. Programs that are available in the major cities such as breast screening is not available in the rural areas and those who do need medical treatment must travel a long distance before having access to medical service.
Individuals’ role in addressing the nature and extent of the inequality can begin with decision making and taking care of their health along with those around them. Remaining in school or attending university online will help them gain knowledge, increase employment opportunities and make better choices. They can then inform their families and friends by encouraging them to make good choices such as not smoking and reducing alcohol consumption. As a result, it will reduce the risk factors and address health inequities.
Communities can provide health care facilities and support services with the development of Multi-Purpose Service Program to connect with the community and health centres that they offer. They can also identify their strengths and work together to increase the protective factors to support the community who may experience mental illnesses. It is an effective way because it will ensure that everyone is connected with each other.
Government financially assist many rural and remote areas to ensure that they have a good health such as the Royal Flying Doctor Service which supports them with clinics, medical evacuations and consultations. They have increased the number of GP’s and funds other services such as SARRAH which provides the same service. As a result, governments make sure that the disadvantages that are faced by the rural and remote people are taken into consideration and action is implemented.
Developing personal skills is important for the ATSI individuals to have as this will increase their educational level. ‘Close the Gap’ provides them with a learning environment that supports mothers and children into overcoming any negative influence that they society may have. It empowers them to have knowledge and skills that they can later pass onto their future generations. E.g. when a parent is aware of the healthy food choices, they can educate their children into doing the same which will help them to reduce the risk of any health-related illnesses such as diabetes. Also, knowledge about the consequences of smoking can enhance individual to not smoke from the first place. This creates a supportive environment as individuals are aware of the dangers and are less likely to influence others into doing anything like that. The continuous chain brings a positive environment to the society.
Creating supportive environment is essential for ATSI individuals as the level of support that they get is far less than non-ATSI individuals. Several initiatives have taken place such as delivering primary health care and services that they can do within the community rather than relocating them somewhere else. Most individuals are trained so that they can understand the cultural and social challenged confronted by the community. ‘Close the Gap’ has also implemented supplies/removal systems to improve housing quality while recruiting ATSI people for policing as this will increase the relationship of ATSI people with the local authorities. This is approached by the supportive environment principle as it aims to reduce the gap amongst the ATSI and non-ATSI people. The principle will help them to promote health initiatives and close the gap in terms of financial difficulties.
Implementing legislations, policies and laws, governments can work together in creating equity among individuals and communities. This will ensure the all workers are treated fairly and no discrimination is taking place in the workforce. Building healthy public policy was established in 2008 committed by the government to close the gap in health inequities amongst the ATSI people. A national indigenous representative body was employed and targets were set to improve the health equality. They were provided with funds to upskill the labourers to conquer challenges by improving the education levels and the community. The equity principle allows the ATSI group to have more facilities and services available to them to ensure that everyone is taken into consideration and that their health is increasingly improving. This has significantly decreased the gap amongst the ATSI and non-ATSI.
Strengthening community actions ensures that all health services are culturally sensitive and culturally appropriate. It involves getting the ATSI elders in planning at local and regional levels by empowering them to become active participants in the community. To promote initiatives to work, it is important to take into account of their audience as there is no point in educating the group in a language that they do not understand. Due to ATSI people being able to speak many languages, have a history of socially oppressed, racial discrimination victims and brutally mistreated have brought many concerns to the ‘Close the Gap’ campaign hence health promotion has provided them with information in their language, spoken about the racial discrimination and stigma and delivered large amounts of resources to help them overcome their hardships. The diversity has helped in many ways to conquer the adversities.
Reorienting health services seeks to prevent and promote health that is curative before the condition is diagnosed to any individual. It provides education that promotes healthy lifestyle and to prevent chronic diseases. It is identified that only partially the targeted goal has been on track. Though the death rate has decreased by 15% since 1998, there hasn’t been much of a difference since 2006. The ‘Close the Gap’ prediction that there will not be any difference in the life expectancy by 2031 seemed to not be achieved by the target year as the education, employment, housing, income, safety and health risk behaviours has not been balanced. Hence, equity is an alternative way to reduce the gap amongst the ATSI and non-ATSI people. Providing them with more funds and resources to identify illnesses will increase the life expectancy and decrease the gap.
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