Contemporary Indigenous Health And Wellbeing

Contemporary Indigenous Health And Wellbeing

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Contemporary Indigenous Health And Wellbeing

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Contemporary Indigenous Health And Wellbeing

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Question:
Discuss about the Contemporary Indigenous Health and Wellbeing.
 
 
Answer:

The Aboriginal and Torres Islander population are known to face poor health conditions, as indicated by statistical data. Based on such information different policies have been set up to guide optimal care service delivery for this population. The present essay is based on the case study of nursing care provided to Judy, a 57yr old Aboriginal woman with type 2 Diabetes. The paper provides a brief explanation of the ‘Closing the Gap (CTG) policy together with the significance of the policy in health outcomes of Aboriginal and Torres Islander Population. Challenges and barriers affecting the changes are cited. The essay then analyses the impact of Judy’s Diabetes and how it can be addressed within CTG encompassing social and health determinants. The benefits that Judy would gain from being registered on CTG would form the next section of the essay, including the impact on her social determinants. The implication for AMS and ALO services for the patient would be highlighted next, which would include the relationship between the health systems.
Aboriginal and Torres Strait Islander population contribute to about three percent of the total population in Australia, and eighty percent of this population lives in metropolitan and regional areas. Research indicates that this section of the population has higher rates of chronic diseases as compared to the non-indigenous population. There is an immediate need of focusing on adequate prevention and management of chronic diseases so that the gap in life expectancy can be closed (Cross, Barnett and Dennis 2017) Further, Aboriginal people are expected to die 10 years earlier than non-Aboriginal Australians. On average, Aboriginal males live 67.2 years, which is 11.5 years less than their non-Aboriginal peers; women live 72.9 years, 9.7 years less than the non-Aboriginal peers (aihw.gov.au 2017). Such data, highlighting the poor health conditions of the aboriginal population drew the attention of the health care authorities and formed the basis of distinct policies.
The Closing the Gap (CTG) policy is a well known strategy put forward by the government that has the aim of reducing the disadvantage and discrimination among the Aboriginal and Torres Islander people in relation to life expectancy, early childhood education, child mortality, employment outcomes and educational achievement. This policy came into existence in the year 2008 as a response to the call of Social justice report published in 2005, and the Close the Gap social justice campaign. The government has aimed that the country would be achieving equality in life expectancy and health status between Aboriginal and non-indigenous population by the end of the year 2030. The policy had been formed with the motto of encouraging individuals of the nation to work side by side with Aboriginal and Torres Islander people on the quest of reconciliation and recognition, for building a promising future for all individuals. At the core of the policy lies the aim to have a better Australia by achieving significant milestones in the connexion between the Australian government and the Aboriginal population. The policy addresses areas of education, health and employment where progress is to be made on an immediate basis. Effective mechanisms are put in place for working in collaboration and supporting decision making at the community level (closingthegappolicyreport 2017). The importance of culture is not to be underestimated while working in collaboration with this population. It is true that the link with culture, family and land lies at the core of wellbeing of the Aboriginal people. The culture of this population is distinct and continuous. Acknowledging the impact of the past policies, the present policy focuses on addressing the gaps generated by previous initiatives. Engagement of the aboriginal population into community services has been a key issue, and therefore the policy focuses on supporting ownership and fostering a partnership of the Aboriginal people with the government (humanrights.gov.au 2017).
The policy has had a positive impact on the health outcomes of the Aboriginal and Torres Islander people. Between 2005–2007 and 2010–2012, Indigenous life expectancy at birth increased by 0.6 years for girls and by 1.6 years for boys. Over the same period, the gap between Indigenous and non-Indigenous life expectancy narrowed by 0.8 years for males and 0.1 years for females. There has been a major improvement in Indigenous mortality rate from chronic diseases, especially circulatory diseases which is the leading cause of death. This was a noteworthy achievement. Over the longer term, Indigenous child mortality rates have declined, and the gap has narrowed between 1998 and 2015. In 2016, the overall attendance rate for Indigenous students nationally was 83.4 per cent, compared with 93.1 per cent for non-Indigenous students. While considerable progress has been achieved in terms of Aboriginal health, challenges have been faced while bringing about the change. These barriers have been related to rising rate of domestic violence, substance abuse and increased crime rate (Willis, Reynolds and Keleher 2016). Moreover, there has been politics in setting up public policy goals as the present targets. Determined targets are known to be the cause of a transparent signal of commitment in the political front. The risk with targets that are overambitious is that if the targets are not achievable, then a political message is reinforced, highlighting that the government is not efficient enough (Davidson 2014).
Diabetes is a chronic disease that is the cause of multiple macro and micro complications such as diabetic retinopathy, diabetic neuropathy and extreme fatigue. Some of the well-noted complications include impaired physical functioning, increased risk of falls and deficits in postural stability. The loss of physical independence has a major negative impact on the quality of life of the patient. Foot ulcers are a serious and common complication of diabetes that requires effective management strategy implementation (Chow et al. 2014). In the present case, Judy has been diagnosed with Diabetes and has suffered leg ulcer as a major complication. The foreseeable complication that would impact her life is impaired mobility and social exclusion. Further, since her she lives alone, and is aged, it is likely that she would face difficulty in carrying out daily activities of life. Lastly, Judy is at high risk of facing social exclusion since she is living alone in her home, with minimal social support (Mondesir et al. 2015).
 
CTG, within the initiative of ‘Healthy Lives’ focuses on improvement of health and wellbeing of aboriginals since the perception is that health is more than the mere physical condition. It is emotional, social, spiritual and social wellbeing of the individual. The policy has initiatives for a healthy lifestyle and diabetes teams that educate patients on the prevention and management of diabetes. The teams focus on one-on-one interaction with patients for fostering an open discussion about diabetes management. The education emphasises on educating about the importance of healthy lifestyle and healthy diet (closingthegappolicyreport 2017).
Engaging Judy with CTG would potentially benefit her in the short term as well as long term. The registration with CTG would ensure that services are provided to empower Judy, who is being perceived as a vulnerable and disadvantaged individual. The key gain would be social support provided to the patient and her family members so that they demonstrate adequate self-management systems (Baek, Tanenbaum, and Gonzalez 2014). The social determinants of health that are relevant to the present scenario are culture, access to medical care, and social support. With the help of CTG initiatives, Judy would be provided with services that are culturally sensitive and safe in the context of respecting the dignity of the cultural beliefs and attitudes of the individual. Judy would be better placed to access healthcare services to management diabetes and leg ulcer (Gao et al. 2013).
Aboriginal Liasion Officer (ALO) is the professional responsible for ensuring that the Aboriginal and Torres Islander individuals are able to access mainstream healthcare services. The person is capable of providing emotional, cultural and social support to patients and family members when the person is suffering from poor health outcomes. This is important since Judy has been suffering from diabetes and associated health complication that is leg ulcer, and she requires social support. Her family members, that is her children, are also in the need of proper guidance regarding patient management strategies. Information about healthcare services is provided by ALO, who act as the link between hospital and other indigenous community resources. This is crucial since Judy would be in the need of additional resources for managing diabetes, which demands regular health checkups (McKenna et al. 2015).
The Aboriginal Medical Service (AMS) had been set up as the first Aboriginal community controlled health service in Australia in the year 1971. The service aims at improving the health standards in Aboriginal communities across the country. A number of diabetes service are known to provide management support to aboriginal people in the country. The diabetes service agencies work in collaboration with the AMS to provide coordinated care to diabetic patients. Through AMS, Judy would be delivered individualistic care with the support of specialists and GPS working in collaboration (Govil et al. 2014).
At the end of the essay, it is to be stated that Aboriginal and Torres Islander people’s health status is a key concern for the country as there exists a considerable gap between the outcomes of the aboriginal and non-aboriginal population. A number of initiatives have been taken up by the government that chiefly focuses on delivering adequate care to this community in collaboration with distinct agencies.  Oe such noteworthy initiative is the ‘Close The Gap (CTG)’ policy that aims at achieving significant milestones in establishing a relationship between the government and the aboriginals. Healthcare is responsible for providing culturally sensitive and safe care to patient population coming from ethnically diverse communities. Aboriginal patients, suffering from chronic conditions such as diabetes, can be better cared for by including them under the CTG. Commitment towards unbiased and discrimination-free healthcare service delivery would soon bring desired outcomes in the future. 
 
Reference
Australian Institute of Health and Welfare. (2017). Life expectancy. [online] Available at: https://www.aihw.gov.au/reports/life-expectancy-death/deaths-in-australia/contents/life-expectancy [Accessed 20 Dec. 2017].
Baek, R.N., Tanenbaum, M.L. and Gonzalez, J.S., 2014. Diabetes burden and diabetes distress: The buffering effect of social support. Annals of Behavioral Medicine, 48(2), pp.145-155.
Chow, E., Bernjak, A., Williams, S., Fawdry, R.A., Hibbert, S., Freeman, J., Sheridan, P.J. and Heller, S.R., 2014. Risk of cardiac arrhythmias during hypoglycemia in patients with type 2 diabetes and cardiovascular risk. Diabetes, 63(5), pp.1738-1747.
Closing The Gap Prime Minister’s Report 2017. (2017). Australian Government.
Cross, D.M.G., Barnett, T. and Dennis, S.L., 2017. Expanding horizons: Using virtual orientation tours to promote rural, remote and Aboriginal health. In 35th Annual CRANAplus Conference.
Davidson, H. (2014). Close the Gap and Closing the Gap – what’s the difference?. The Guardian. [online] Available at: https://www.theguardian.com/world/blog/2014/feb/12/close-the-gap-and-closing-the-gap-whats-the-differen [Accessed 20 Dec. 2017].
Gao, J., Wang, J., Zheng, P., Haardörfer, R., Kegler, M.C., Zhu, Y. and Fu, H., 2013. Effects of self-care, self-efficacy, social support on glycemic control in adults with type 2 diabetes. BMC family practice, 14(1), p.66.
Govil, D., Lin, I., Dodd, T., Cox, R., Moss, P., Thompson, S. and Maiorana, A., 2014. Identifying culturally appropriate strategies for coronary heart disease secondary prevention in a regional Aboriginal Medical Service. Australian journal of primary health, 20(3), pp.266-272.
Humanrights.gov.au. (2017). Close the Gap: Indigenous Health Campaign | Australian Human Rights Commission. [online] Available at: https://www.humanrights.gov.au/our-work/aboriginal-and-torres-strait-islander-social-justice/projects/close-gap-indigenous-health [Accessed 20 Dec. 2017].
McKenna, B., Fernbacher, S., Furness, T. and Hannon, M., 2015. “Cultural brokerage” and beyond: piloting the role of an urban Aboriginal Mental Health Liaison Officer. BMC public health, 15(1), p.881.
Mondesir, F.L., White, K., Liese, A.D. and McLain, A.C., 2015. Gender, illness-related diabetes social support, and glycemic control among middle-aged and older adults. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 71(6), pp.1081-1088.
Willis, E., Reynolds, L. and Keleher, H. eds., 2016. Understanding the Australian health care system. Elsevier Health Sciences.

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