The Impact of Social Determinants on the Health of Indigenous Peoples - Essay Example

INDIGENOUS AUSTRALIANS HEALTH AND SOCIAL DETERMINANTS {Insert student’s name} {Insert university’s name} {Insert university's name} May 12, 2013 INDIGENOUS HEALTH DETERMINANTS’ AND EXPLAIN HOW THEY CONTRIBUTE TO POOR INDIGENOUS HEALTH STATUS Social determinants have great influence on the health of indigenous people. Emotional, physical, spiritual and spiritual among the indigenous adults, youths and children are influenced by different kinds of social health determinants. These entail environments and circumstances as well as institutions and systems that not only influence the development but also the maintenance of health along a continuum ranging from excellent to poor. Health social determinants can be grouped as intermediate, proximal or distal. The distal category include factors such as economic, political, historical and social. Intermediate include capacities, resources, infrastructure, community and resources. Proximal category include social and physical environment as well as health behaviors. Housing and physical environment Consequently, physical environment plays a key functioning in determining the health of indigenous people. Among the indigenous people, physical environment that negatively impact on their health have been imposed via current settlement structures and historic traditional territories dispossession. The most pervasive outcomes of the housing structures inhibited by indigenous people include poor quality as well as inadequacy. Qu, Chen & Hillman (2012) points out that lack of affordable housing has resulted into overcrowding as well as homelessness for the indigenous people living in urban areas. For instance many are living in reserve homes which are not only crowded but also lack appropriate ventilation thus resulting into excessive mould, an aspect that has been associated with several health implications such as allergies and asthma among ingenious children. Chantelle (2007) the prevalence of diseases that could be easily treated such as diarrhea and scabies and are further linked to poor living conditions and sanitation in addition to lack of access to reliable and safe water supplies in most of the indigenous communities are strong indicators of absolute poverty (Carson, Dunbar, Chenhall, & Bailie, 2007). In addition to that poor socioeconomic conditions of the indigenous Australians is not changing. According to [AIHW] (2004), Larson, Gillies, Howard & Coffin (2007), accessing indigenous poverty from various perspectives gives an idea of not only its entrenched but also broad nature. From the income perspective, it is evident that indigenous households are disadvantage. As compared to non-indigenous Australians, the indigenous Australia live in conditions that meet the definition of the United Nations on absolute poverty to mean severe deprivation of basic needs which include sanitation facilities, shelter, food, safe drinking water, information and education (Carson, Dunbar, Chenhall, & Bailie, 2007). Carson, Dunbar, Chenhall, & Bailie (2007) in their study emphasizes that access to housing has an impact on health. Issues on the inadequate housing is mostly associated with indigenous Australians. This is due to the link between dispossession and shelter from land. Key aspects liked to inadequate housing include security of tenure, overcrowding, availability and affordability. Recent data on the Australian housing indicates that 54% indigenous Australian households live in rented dwellings. Accordingly, 9.1% of the indigenous households are classified as overcrowded compared to 3.1% of their non-indigenous counterparts ([AIHW], 2004). Additionally, Morrissey (2002) points out that indigenous people living in reserve communities and remote areas face food securities as a result of challenges in acquiring traditional foods and market. Due to the fact that cost of transporting foods to the market is high, hence nutritious and health food is not affordable to the indigenous people. Furthermore, poor waste management and sanitation, lack of community resource and safe water is a representation of physical conditions that negatively influence the health of indigenous people. Crowding and lack of clean water has been associated with various negative health outcomes among the indigenous people which include family tensions, stress, and transmission of infectious diseases, respiratory tract infections, mental health problems and even high injury rates (Carson, Dunbar, Chenhall, & Bailie, 2007). Income and employment Lower income levels as well as unemployment among the indigenous Australians is one of the key explanation for the existing gap in self assessed health between the nonindigenous and indigenous Australians. Studies have indicated that likelihood of indigenous Australians have low income as compared to their indigenous counterparts is high. According to Turrell (2001) indigenous Australians average weekly income is $395 compared to their non-indigenous counterparts who earn $666 on a weekly basis. Additionally, income level is associated with housing and education. According to Morrissey (2002) there is likelihood indigenous Australians who complete year 12 to have high income as compared to their counterparts who do not. Consequently, indigenous Australians who have their own homes have more income due to the fact that they do not spent on rent. Morrissey (2002) unemployment causes financial crisis to the indigenous Australians. Due to unemployment indigenous Australians are incapable of buying services and goods that can lead to good health and it has not only social but also psychological effects. () between 2005-2006 50% of the indigenous Australians being incapable of raising $2000 required in a week in times of emergency. The mentioned is compared to 10% of the non-indigenous Australians. Consequently Carson, Dunbar, Chenhall, & Bailie (2007) points out factors such as high rates of unemployment, low literacy, scarce socio economic opportunities and minimal attainment of educational opportunities contribute to low income and unemployment among indigenous people. Turrell (2001) in his study points out that lack of access to most important material resources like nutrient dense food may result into high rates of diabetes and obesity and resultant poor renal and cardiovascular health. Additionally, poverty is closely associated with social exclusion which prevent indigenous people from pursuing training or education. This makes them not to be in a position to save themselves from adverse poverty thus resulting into despair, anxiety, low self-esteem and insecurity. The mentioned as well as other types of psychological stress have not only been associated with additions and violence but also lack of social support and poor parenting. According to Zeunert, Cerro, Boesch, Duff, Shephard, Jureidini & Braun (2002) the accumulation of the aforementioned psychosocial stressors in most cases increased vulnerability to infections and poor mental health as well as depression, high blood pressure and diabetes. Additionally, high suicide rates among the indigenous people have been linked to substance abuse and poor mental health which are in turn associated with poverty and social exclusion. Education Education is another social determinants of health among the indigenous Australians. Marmot (2005) inadequate education in most cases results into poor literacy. Studies have indicated that indigenous people due to extreme poverty, they are unable to access formal education. The mentioned affects their ability to attain required information on healthy food preparation or proper nutrition. Additionally, inadequate education makes them to lack the necessary skills required in the labor market. Thus the ensuing social exclusion and poverty which are experienced by indigenous people and more specifically the aboriginal community causes increased risk of family instability which in most cases manifests itself in form of single parenthood or divorce. According to Carson, Dunbar, Chenhall, & Bailie (2007) it is evident that there are inequities in the distribution of opportunities and resources to the indigenous people in Australia. For example in the education sector. Despite the growth in the number of indigenous people post-secondary degrees particularly women, inadequate educational opportunities clearly manifests the adults inability to promote quality education among their children. Calma (2007) approximately 50% of the indigenous Australian youth drop out or are forced to drop out of school an aspect that contributes to diminished employment and literacy in addition to adverse poverty in the future. Carter, Hooker, & Davey (2009), poor health impacts negatively on educational attainment of the indigenous Australians. It is hence not evident whether attainment of high education results to better health and vice versa. According to Thomson (2003) mainstream education can results into detrimental influence to not only social but also emotional wellbeing of the Australians. This is because such kind of education is usually delivered to the indigenous minority and can be linguistically and culturally alienating with adverse implications on the well-being of the young indigenous Australians. Researchers have pointed out that better education results into better health status which in turn leads to high level of labor participation. Food security Carson, Dunbar, Chenhall, & Bailie (2007) poverty has an impact on health due to the fact that in part in determines the food available to the indigenous people and what they can afford to buy. Hence, individuals with low income are faced with stress food insecurity causing compromised diet that leads to various health complications such as malnourishment, ulcers, diabetes among others. Unhealthy eating is associated more with low level of income, poor education and unemployment is associated with obese or overweight, which is the second highest health risk factor among the indigenous Australians. Diet associated issues like high blood pressure, high blood cholesterol, low vegetable and fruit intake are the key contributors to indigenous health burden. According to Smith (2007) more than 56 percent of the indigenous Australians consumed took less than the recommended five serves of vegetables and 2 serves of fruits daily while high percentage do not consume vegetables and fruits at all. Thomson et al (2010) adds that a decade ago Australian indigenous people of reserve lived in households experiencing food insecurities as compared to the rest of the Australian population. Food insecurity is linked to various negative health outcomes such as depression, obesity, distress among other multiple chronic conditions (Carson, Dunbar, Chenhall, & Bailie, 2007). . Health behaviors Health behaviors is representation of proximal determinants of health that are well recognized. Among the indigenous Australians particularly the aboriginal people. The mostly witnessed health behavior among them is alcoholism which is linked to increased case of mortalities (Sanders, 2004). Additionally, there is excessive smoking which have adverse health effects and it is associated with increased rates of heart diseases and lung cancer. Consequently, poor parental care as well as drinking and smoking during pregnancy have been linked not only to poor emotional and physical development but also poor intellectual among the indigenous children (Eileen, Pearce, McCarthy, Jenkin & Ryan, 2006). [AIHW] (2004), four key preventable chronic diseases are the major causes of the life expectancy gap between the indigenous and non-indigenous Australians. These include, diabetes, cancer, mental health and cardiovascular diseases. Carson, Dunbar, Chenhall, & Bailie (2007) two thirds of the indigenous people staying in the remote areas suffer from at least one of the aforementioned chronic conditions and this is not reducing. Donato (2013) cardiovascular diseases is the leading cause of disability and death among the indigenous Australians. Between 2002 and 2005, statistics indicated that 27% of the indigenous deaths was related to cardiovascular diseases (AIHW, 2008b). The deaths among the indigenous Australians occurred before the age of 65 years as compared to 85 percent of the rest of the Australian population. The mentioned was attributed to poor housing and extreme poverty. Additionally, it has been reported that there is likelihood of indigenous Australians dying from heart diseases without seeking any form of medical attention. This is because of the high level of illiteracy because of lack of education (Paradies, 2005). The alcohol consumption pattern between non indigenous Australians and indigenous Australians is different. Reports have indicated that about 7 percent of the indigenous Australian deaths is linked to total disease burdens they experience (Mitchell, 2007). According to Carson, Dunbar, Chenhall, & Bailie (2007) among the indigenous Australians, diabetes is three times high than the non-indigenous Australians. Diabetes is reported to be the key cause of disability and death among the indigenous Australians. In the hospital, the indigenous Australians are admitted in the hospital with diabetes compared to their non-indigenous counterparts. Racism According to Paradies (2007) racism is another social determinant of health among the indigenous Australians and it is associated with not only poor self-assessed health status but also attempted suicide, psychological distress and substance use. Larson, Gilles, Howard & Coffin (2005) highlights four key pathways via which racism ill impact on health: reduces access to the most essential societal resources for instance housing, healthcare, education and employment. Furthermore, racism results into low self-worth and self-esteem leading to negative emotion reactions, stress and mental ill health as well as affecting the endocrine, cardiovascular and immune systems (Paradies, 2007). It is evident that systematic racism results to reduced opportunities to adequately access societal resources needed for better health. However, there is minimal research to quantify the health impacts on systematic racism. Paradies (2005) identifies a number of studies which proof that racism affects health care delivery. For example there is likelihood of indigenous Australians receiving kidney transplants thrice compared to the rest of Australian population (Zubrick, Lawrence et al., 2004). There is also inadequate availability and provision of health infrastructure particularly to Torres Strait islander and Aboriginal people. The royal Australasian college of physician described the aforementioned inequities as both systematic and avoidable. Therefore, there is need for the Australian government to come up with policies and strategies that will close the existing health gap. Consequently, a number of studies prove that self-reported racism is linked to various adverse health conditions. After highlighting and accounting for contributing factors, racism was linked to psychological distress, substance use, poor self-assessed health status, and smoking. Critical analysis of the study carried out by Darwin Region Urban Indigenous Diabetes (DRUID) revealed that racism is third placed as one of the factors that contribute to poor self-health status and depression prevalence among the indigenous Australians (Paradies, 2005). Accordingly, racism has been linked to increased alcohol consumption, smoking and marijuana use in a survey conducted by west Australian Aboriginal Child Health Survey (WAACHS). (Zubrick, Lawrence et al., 2004). Finally, there exist preliminary evidence from the study conducted by DRUID indicating that the effects on interpersonal racism on Australian indigenous health are mediated by chronic and acute stress as well as lack of control of an individual health. The aforementioned findings highlight the importance of the role played by chronic and acute stress in the relationship between ill health and racism among indigenous Australians. Conclusion In a nutshell social determinants influence various health capacities and vulnerabilities, health management and health behaviors. Communities, individuals and nations that experience social health determinants inequalities does not only result into additional health problems among the indigenous people, but they are usually restricted from accessing resources that may ameliorate problems. Consequently, social determinants do not only impact various dimensions of health leading to creation of health issues that often result into environments and circumstances that in turn are a representative of subsequent health determinants. For example staying in conditions associated with low income have been linked to increased disabilities and illness which is a representation of a social determinant which is closely linked to diminished opportunities which can enable gainful employment thus contributing to adverse poverty. It is evident that the health status of the Torres Strait Islander as well as those of the aboriginal people compared to the rest of the Australian population. There is a large gap inequality gap in all the Australian statistics. For instance, on the aspect of life expectation between the indigenous Australians and non-indigenous Australians, the life expectancy gap is 17 years. For people aged below 65 years however for the age-specific deaths particularly for indigenous Australians are twice of those non-indigenous Australians. Additionally, the indigenous Australian do not have the opportunity to live as healthy as their non-indigenous counterparts. The relative socioeconomic disadvantages experienced by indigenous Australians compared to the non-indigenous Australians makes them to be more risk of environmental and behavioral health risk factors. This is because they live in conditions that are not conducive for good health. References Australian Institute for Health and Welfare (AIHW) (2004). Australians Health, AIHW, Canberra. AIHW (2008b). Aboriginal and Torres Strait Islander Health Performance Framework 2008 report: detailed analyses, Australian Institute of Health and Welfare, Canberra. Chantelle, A.M. R (2007). Narratives of social support and health in aboriginal communities. Department of geography. McGill University, Montreal. Carson, B, Dunbar, R., Chenhall. D. & Bailie. R. (2007). Social Determinants of Indigenous Health. Crows Nest, NSW: Allen & Unwin. Carter, S.M, Hooker LC & Davey HM (2009). Writing social determinants into and out of Cancer control: an assessment of policy practice. Social Science & Medicine 68(8): 1448–1455. Calma, T. (2007) Close the Gap: Indigenous Health Campaign. Canberra: Australian Human Rights Commission. Donato, R. (2013). Does Australia have the appropriate health reform agenda to close the gap in indigenous health? Australian health review37, 232-238. Eileen, W. Pearce, M. McCarthy, C. Jenkin T. & Ryan. F. (2006). Utility stress as a social determinant of health: exploring the links in a remote Aboriginal Community. Health promotion journal of Australia. Mitchell J, ed. (2007). History. Social determinants of Indigenous Health, ed. Carson B, et al. Allen and Unwin: Sydney. 41. Larson, A. Gillies, M. Howard, J.P & Coffin, J. (2007). It is enough to make you sick: the impact of racism on the health of the aboriginal Australians. Australian and New Zealand journal of public health. Marmot M. (2005). Social determinants of health inequality. Lancet. ;365(9464): 1099-104. Morrissey, M. (2002), Poverty and Indigenous Health: Notes for Workshop on Social Determinants of Health, Menzies School of Health Research, Darwin, 3 June.-- 2003,'Poverty and Aboriginal health', Health Sociology Review, vol. 12, no. 1, pp. 17-29. Paradies, Y. (2005). Anti-racism and indigenous Australians. Analyses of social issues and public policy, vol. 5, No. 1. Pp 1-28. Paradies, Y. (2007). Exploring the health effects of racism for Indigenous people. Paper presented to the Rural Health Research Colloquium, Tamworth, May 2007. Sanders, W. (2004). Towards an Indigenous Order of Australian Government: Rethinking Self-Determination as Indigenous Affairs Policy. Canberra: Australian National University. Smith, J.D. (2007). Australia's rural and remote health: A social justice perspective, 2nd ed. Melbourne: Tertiary Press Thomson, N. et al (2010). Overview of Australian indigenous health status. Retrieved from www.healthinfonet.ecu.edu.ac. Thomson, N. (2003). The Health of Aboriginal and Torres Strait Islander Australians. Melbourne: Oxford University Press. Turrell, G. (2001), 'Income inequality and health: In search of fundamental causes', in The Social Origins of Health and Well-Being, eds R. Eckersley, ]. Dixon and B. Douglas, Cambridge University Press, Melbourne, pp.83-104. Qu, L, Chen, J. & Hillman, K. (2012). Have the health gaps between indigenous and non- indigenous Australians changed over time? Results from an Australian national representative longitudal study. Matern child health. 10.1007/s10995-011-0786-9. Zeunert S, Cerro N, Boesch I, Duff M, Shephard MD, Jureidini KF, Braun J. (2002). Nutrition project in a remote Australian aboriginal community. Ren Nutr. ,;12(2}:102-6. Zubrick, S., Lawrence, D. et al. (2004). The Western Australian Child Health Survey: The health of Aboriginal children and young people. Perth: Telethon Institute for Child Health Research Read More

The mentioned as well as other types of psychological stress have not only been associated with additions and violence but also lack of social support and poor parenting. According to Zeunert, Cerro, Boesch, Duff, Shephard, Jureidini & Braun (2002) the accumulation of the aforementioned psychosocial stressors in most cases increased vulnerability to infections and poor mental health as well as depression, high blood pressure and diabetes. Additionally, high suicide rates among the indigenous people have been linked to substance abuse and poor mental health which are in turn associated with poverty and social exclusion.

Education Education is another social determinants of health among the indigenous Australians. Marmot (2005) inadequate education in most cases results into poor literacy. Studies have indicated that indigenous people due to extreme poverty, they are unable to access formal education. The mentioned affects their ability to attain required information on healthy food preparation or proper nutrition. Additionally, inadequate education makes them to lack the necessary skills required in the labor market.

Thus the ensuing social exclusion and poverty which are experienced by indigenous people and more specifically the aboriginal community causes increased risk of family instability which in most cases manifests itself in form of single parenthood or divorce. According to Carson, Dunbar, Chenhall, & Bailie (2007) it is evident that there are inequities in the distribution of opportunities and resources to the indigenous people in Australia. For example in the education sector. Despite the growth in the number of indigenous people post-secondary degrees particularly women, inadequate educational opportunities clearly manifests the adults inability to promote quality education among their children.

Calma (2007) approximately 50% of the indigenous Australian youth drop out or are forced to drop out of school an aspect that contributes to diminished employment and literacy in addition to adverse poverty in the future. Carter, Hooker, & Davey (2009), poor health impacts negatively on educational attainment of the indigenous Australians. It is hence not evident whether attainment of high education results to better health and vice versa. According to Thomson (2003) mainstream education can results into detrimental influence to not only social but also emotional wellbeing of the Australians.

This is because such kind of education is usually delivered to the indigenous minority and can be linguistically and culturally alienating with adverse implications on the well-being of the young indigenous Australians. Researchers have pointed out that better education results into better health status which in turn leads to high level of labor participation. Food security Carson, Dunbar, Chenhall, & Bailie (2007) poverty has an impact on health due to the fact that in part in determines the food available to the indigenous people and what they can afford to buy.

Hence, individuals with low income are faced with stress food insecurity causing compromised diet that leads to various health complications such as malnourishment, ulcers, diabetes among others. Unhealthy eating is associated more with low level of income, poor education and unemployment is associated with obese or overweight, which is the second highest health risk factor among the indigenous Australians. Diet associated issues like high blood pressure, high blood cholesterol, low vegetable and fruit intake are the key contributors to indigenous health burden.

According to Smith (2007) more than 56 percent of the indigenous Australians consumed took less than the recommended five serves of vegetables and 2 serves of fruits daily while high percentage do not consume vegetables and fruits at all. Thomson et al (2010) adds that a decade ago Australian indigenous people of reserve lived in households experiencing food insecurities as compared to the rest of the Australian population.

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