Social determinants of Australian Aboriginal health

Current Health Status Of Aboriginal

Aborigines have been identified as having adverse health effects in Australia. According to Rheault et al. (2019), Aboriginal health status and health literacy are low compared to the general Australian community. The last few years have seen a huge imbalance in health. For example, there is a her 17-year age difference in life expectancy between non-Indigenous and Aboriginal peoples (Rheault et al., 2019). In addition, the mortality rate for those under 65 is higher than for the rest of the population. Furthermore, the fact that Aboriginal people are socio-economically disadvantaged does not provide equal opportunities to access health services (Rheault et al., 2017). There are two important social determinants that influence Aboriginal health status, including access to health services and socioeconomic status.

Despite various developments and advances in specific Aboriginal health interventions, large gaps still exist that contradict health benefits being implemented for the rest of the country’s population (McCalman et al., 2021). Various diseases caused by diseases such as diabetes often result in increased mortality. Such problems he has decreased dramatically by 30% since 1975 (Nolan-Isles et al., 2021). However, disease-related deaths such as diabetes have not improved for Aboriginal people (Burns, 2018). Additionally, the age structure of the Aboriginal community is young, which means that the level of problems affecting Aboriginal communities is likely to increase significantly over the next few years. A large proportion of the youth population is growing, requiring a range of advanced and improved medical services and databases to meet and keep up to date with the diverse demands of the communities selected in 1975. (Nolan-Isles et al., 2021). Efforts to maintain the status quo should also be made to achieve reductions in health disparities in selected communities (Nolan-Isles et al., 2021). Disparities in health status experienced by non-Indigenous peoples are related to systematic distinctions (Burns, 2018). Historically, Aboriginal people have not had the same opportunities to be healthy as the rest of Australia’s population. This difference is due to the unavailability of various general services and limited access to health services, such as inadequate provision of health infrastructure for target groups and inadequate primary care. This is probably the cause.

In today’s society, Aboriginal people’s burden of disease is increasing, now 2.3 times that of the rest of Australia’s population. Aspects such as chronic illness and psychological stress are prevalent in the community (Nolan-Isles et al., 2021). Furthermore, their health is considered holistic as it encompasses both community and family well-being, physical health, cultural well-being and emotions (Nolan-Isles et al., 2021). Such aspects imply the need to implement diverse programs, services and policies that consider social and cultural determinants of health.

There are two main social factors that affect Australian Aboriginal people. The first factor is socioeconomic status. Most people in society are economically disadvantaged, with significant proportions remaining unemployed or low-income (Flavvel et al., 2022). Aboriginal people have an average weekly gross household income of about US$363. However, the weekly income of non-Indigenous peoples is about 585% (Flavel et al., 2022). In addition, unemployment among Aboriginal people is high at around 20%, which is three times higher than the overall Australian population (Vallessi et al., 2018).

Various studies have shown links between an individual’s socioeconomic status and health. Poor households are often associated with poverty and poor health due to several factors. The first factor is their lack of education and literacy (Calma et al., 2017). Such aspects typically negatively affect a person’s ability to access and read various health information and resources. The second factor is inadequate income, which severely limits an individual’s ability to obtain quality health services and treatment. The final factor is infant malnutrition, which is associated with chronic disease and high mortality (Calma et al., 2017). In addition, Aboriginal people are more likely to live in overcrowded homes, which contributes to the spread of infectious diseases.

Two social determinants

A second social factor is easy access to quality medical services. These aspects can be traced back to cultural barriers that have contributed to negative attitudes towards access to health services among Aboriginal people (Delacy et al., 2020). Health disparities often exist among indigenous peoples, hindering access to universal health care and services. Aboriginal people also live in remote and rural areas, lack access to essential health care, and experience increased child and infant mortality (Pearson et al., 2020). In addition, local populations report lower birth weight and lower age-standardized mortality. Additionally, many of them are at high risk and prone to diabetes and cardiovascular disease. Differences in cultural beliefs, health identities and beliefs also reduce the willingness of indigenous communities to access their local health facilities (Delacy et al., 2020). This cultural belief is associated with significant delays in medical examinations and health checks.

Most members of indigenous communities have low incomes. They also live in overcrowded households. This aspect limits access to health services, as a small fraction of earned income is spent on food and other basic needs (Mather et al., 2018). Various studies have found that people from high-income households have longer life expectancy and better health than those from low-income households (Mather et al., 2018). In Australia, Aborigines have the lowest incomes and are the least educated. People who are unemployed in their communities are less likely to be in good health than those who are well educated (Li, 2017). In addition, low-income people are less likely to have insurance. Therefore, unless it is an emergency or a serious illness, they avoid medical examinations, which worsens their health. Most of the individuals belonging to the above population do not have access to medical services compared to the general population due to economic reasons. Such issues can raise concerns that financial assets may be more important to diverse resources and political interventions than factors such as cultural background.

Most members of indigenous communities live on low wages and spend most of their time in medical bureaucracy. They are also concerned about how they can easily access the health system and how they will survive during a medical emergency (Mather et al., 2018). Most of them believe that the health system is some kind of constant challenge that is depleting the resources of young children. Such concepts indicate that socioeconomic factors are more important for Aboriginal peoples, as they dominate sectors where systems exist that allow individuals to easily access hospitals (Li, 2017).

References

Azzopardi, P., Sawyer, S., Carlin, J., Degenhardt, L., Brown, N., Brown, A., & Patton, G. (2018). Health and wellbeing of Indigenous adolescents in Australia: a systematic synthesis of population data. The Lancet, 391(10122), 766-782. https://doi.org/10.1016/s0140-6736(17)32141-4

Burns, J. (2018). Overview of Aboriginal and Torres Strait Islander health status 2018. Healthinfonet.ecu.edu.au. Retrieved 26 April 2022, from https://healthinfonet.ecu.edu.au/healthinfonet/getContent.php?linkid=617557&title=Overview+of+Aboriginal+and+Torres+Strait+Islander+health+status+2018.

Calma, T., Dudgeon, P., & Bray, A. (2017). Aboriginal and Torres Strait Islander Social and Emotional Wellbeing and Mental Health. Australian Psychologist, 52(4), 255-260. https://doi.org/10.1111/ap.12299

DeLacy, J., Dune, T., & Macdonald, J. (2020). The social determinants of otitis media in Aboriginal children in Australia: are we addressing the primary causes? A systematic content review. BMC Public Health, 20(1). https://doi.org/10.1186/s12889-020-08570-3

Flavel, J., McKee, M., Freeman, T., Musolino, C., Eyk, H., Tesfay, F., & Baum, F. (2022). The need for improved Australian data on social determinants of health inequities. Medical Journal Of Australia. https://doi.org/10.5694/mja2.51495

Li, J. (2017). Cultural barriers lead to inequitable healthcare access for aboriginal Australians and Torres Strait Islanders. Chinese Nursing Research, 4(4), 207-210. https://doi.org/10.1016/j.cnre.2017.10.009

Mather, C., Douglas, T., & Jacques, A. (2018). Health literacy of undergraduate health profession students in Australia: A comparison of the island state of Tasmania and other Australian universities. Kontakt, 20(4), e386-e393. https://doi.org/10.1016/j.kontakt.2018.08.008

McCalman, J., Longbottom, M., Fagan, S., Fagan, R., Andrews, S., & Miller, A. (2021). Leading with local solutions to keep Yarrabah safe: a grounded theory study of an Aboriginal community-controlled health organisation’s response to COVID-19. BMC Health Services Research, 21(1). https://doi.org/10.1186/s12913-021-06761-1

Rheault, H., Bonner, A., & Coyer, F. (2017). Health literacy – “I don’t get it”. The Journal For Nurse Practitioners, 13(7), e334. https://doi.org/10.1016/j.nurpra.2017.05.042

Rheault, H., Coyer, F., Jones, L., & Bonner, A. (2019). Health literacy in Indigenous people with chronic disease living in remote Australia. BMC Health Services Research, 19(1). https://doi.org/10.1186/s12913-019-4335-3 

Pearson, O., Schwartzkopff, K., Dawson, A., Hagger, C., Karagi, A., & Davy, C. et al. (2020). Aboriginal community controlled health organisations address health equity through action on the social determinants of health of Aboriginal and Torres Strait Islander peoples in Australia. BMC Public Health, 20(1). https://doi.org/10.1186/s12889-020-09943-4

Vallesi, S., Wood, L., Dimer, L., & Zada, M. (2018). “In Their Own Voice”—Incorporating Underlying Social Determinants into Aboriginal Health Promotion Programs. International Journal Of Environmental Research And Public Health, 15(7), 1514. https://doi.org/10.3390/ijerph15071514

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