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Groups Experiencing Inequities

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  • 1. WHAT ARE THE PRIORITY ISSUES FOR IMPROVING AUSTRALIA’S HEALTH?
    Groups Experiencing Health Inequities
    Generally speaking Australians health status is improving. However, this is not shared Australia-wide. There are fundamental differences in the level of health for particular groups. Groups within Australia experience inequities (unfair differences in levels of health status).
    Aboriginal and Torres Strait Islanders
    Socio-economically disadvantaged
    People living in rural and remote areas
    Australians born overseas
    Elderly
    People with disabilities
  • 2. Aboriginal and Torres Strait Islander Peoples
    Major inequalities exist in the health status of Aboriginal and Torres Strait Islander peoples.
    • Die younger
    • 3. Reduced quality of life
    • 4. More likely to experience disability
    The nature and extent of health inequities
    • Lower life expectancy
    • 5. Infant mortality is 3 times higher than the national average. However, the gap is closing due to better maternal and infant health care.
    • 6. Poorer mental health
    • 7. Higher hospitalisations
    • 8. Poorer sexual health
    • 9. Higher incidence of diabetes
    • 10. Higher mortality rates for cardiovascular disease, injuries, respiratory diseases, cancer, endocrine disorders and digestive disorders
  • The socio-cultural, socio-economic and environmental determinants of health
    Socio-cultural - including family, peers, media, religion, culture, social connectedness, community, legislation, policies, political stability
    Socio-economic - employment, education, income
    Environmental - geographic location, access to health care services
  • 11. The Roles of Individuals, Communities and Governments in Addressing the Health Inequities
    Modern approaches to healthcare and health promotion acknowledge the fact that Indigenous health status results from the interaction of multiple determinants.
    An “inter-sectoral” approach is required based on partnerships between people and agencies at many levels and in a variety of sectors.
    Government
    The Office of Aboriginal and Torres Strait Islander Health (OATSIH)
    www.health.gov.au/oatsih
    The National Aboriginal Community Controlled Health Organisation (NACCHO)
    www.naccho.org.au
    The Aboriginal Health and Medical Research Council of NSW (AH&MRC)
    www.ahmrc.org.au
    Government agencies aim to improve the access of Indigenous people to primary health care services.
    Communities
    Aboriginal Community Controlled Health Services (ACCHSs) and Aboriginal Medical Services (AMSs) are primary healthcare services initiated and operated by local Aboriginal communities (clinical care, health education, promotion, screening, immunisation, counselling, trasnport to medical appointments, hearing health, sexual health, substance use and mental health).
  • 12. Individuals
    There is a strong focus in many Aboriginal Health Services on providing education and support for Indigenous mothers and children, on increasing the number of Aboriginal health workers, community support workers and medically trained staff and on increasing capacity by empowering individuals.
    www.health.gov.au/internet/h4l/publishing.nsf/Content/respack-exemplarsite
  • 13. SOCIOECONOMICALLY DISADVANTAGED PEOPLE
    The Nature and Extent of the Health Inequities
    People or groups who are characterised by the following, are said to be socio-economically disadvantaged (experience financial limitations):
    • poor levels of education
    • 14. Low income
    • 15. Poor housing
    • 16. Unskilled work
    • 17. Long periods of unemployment
    People from a lower socio-economic background have significantly lower levels of health than higher socio-economic groups. Lower socio-economic groups have higher mortality and higher levels of illness.
    Socio-economically disadvantaged people:
    • Higher infant mortality
    • 18. Lower life expectancy
    • 19. More likely to die from cardiovascular disease, respiratory disease and lung cancer
    • 20. Higher levels of blood pressure
    • 21. Higher body-mass index for males and females (overweight)
    • 22. More likely to smoke
    • 23. More likely to suffer from mental health problems, diabetes and circulatory diseases
    • 24. Less likely to engage in preventative health behaviours e.g. dental checks, “pap” smears, immunisation, family planning
    • 25. Sick more often
    • 26. Less informed about health
    • 27. Sedentary behaviour
  • The socio-cultural, socio-economic and environmental determinants of health
    The Roles of Individuals, Communities and Governments in Addressing the Health Inequities
    Government
    Federal and State governmentsare committed to making improvements in funding and policies to reduce health inequities. Strategies by the government aim to improve the access of socioeconomically disadvantaged people to better health.
    Examples: Medicare, Pharmaceutical Benefit Scheme (PBS), immunisation programs funded by the government, funding oral health checks for children and adolescents (for low income families), subsidised fees for childcare (pre-schools) for low income families.
  • 28. Communities and Individuals
    Development of an increasingly community-based health workforce that focuses on prevention of disease and the management of illness.
    There many community agencies that provide:
    • community health care
    • 29. Childhood services
    • 30. Parenting and maternity services
    • 31. Community language services
    • 32. Housing assistance
    • 33. Employment training
    • 34. Home care
    • 35. Meals
    • 36. Migrant services
    • 37. Adult education
  • PEOPLE IN RURAL AND REMOTE AREAS
    The Nature and Extent of Health Inequities
    Approximately 34% of the Australian population live in rural and remote areas.
    People living in rural and remote areas:
    • more likely to smoke
    • 38. more likely to drink to hazardous levels
    • 39. More likely to be overweight
    • 40. Lower levels of education
    • 41. Engage in more sedentary behaviour
    • 42. Engage in risky occupations
    • 43. Lower life expectancy (decreasing life expectancy with remoteness)
    • 44. High death rates for coronary heart disease, other circulatory diseases and motor vehicle accidents
    • 45. Higher deaths rates for injury (motor vehicle accidents and suicide) mostly in males
    • 46. Higher levels of depression or psychological distress in males
    • 47. Females have higher levels of diabetes and arthritis
    • 48. Poorer dental health
  • The socio-cultural, socio-economic and environmental determinants of health
    The Roles of Individuals, Communities and Governments in Addressing the Health Inequities
    Governments
    Rural Health Priority Taskforce provides advice to the NSW Government about improving
    health services to people in rural and remote areas.
    Priorities:
    • Attract and retain more health professionals in rural and remote communities
    • 49. Provide sustainable quality health services
    • 50. Make health services more accessible via initiatives such as “Telehealth”, a visual
    telecommunications system for clinicians and patients.
    Examples: Medical Specialist Outreach Assistance Program and Multi Purpose Service (MPS) Program
  • 51. Communities
    Multipurpose services running in NSW rural communities. Aim to integrate services, better match services to community needs, achieve gains in productivity, reduce administration and share resources.
  • 52. OVERSEAS BORN PEOPLE
    The Australian population comprises 24% of people born overseas. Within the population of people born overseas, there is a great diversity of group characteristics and health status.
    The Nature and Extent of the Health Inequities
    In general, immigrants on arrival to Australia have better health than the Australian born population (mainly due to the government selecting people based on health, education and job skills). This is known as the “Healthy Migrant Effect”. As time goes on the new residents health declines with length of stay. This can be attributed to:
    • socio-economic status
    • 53. poor language skills
    • 54. stress associated with re-settlement
    Overseas born people:
    • Less likely to exercise
    • 55. More likely to be overweight
    • 56. Less likely to report medical conditions
    • 57. Less likely to immunise children
  • The Socio-cultural, Socio-economic and Environmental Determinants
    The Roles of Individuals, Communities and Governments in Addressing the Health Inequities
    Governments
    Government providing translation and language services within Culturally and Linguistically
    Diverse (CALD) communities. NSW Multicultural Health Communication Service (MHCS) works
    with health services to provide non-English speakers with access to important health information.
    Support is also given to health services within areas that are experiencing a growth in the
    number of new arrivals and refugees.
  • 58. Communities and Individuals
    The critical role of communities is to provide support for their members by advocating, promoting and engaging in the use and delivery of culturally appropriate health services.
    Training and education of CALD community members to support and work with health care professionals is very important.