Groups Experiencing Inequities

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Groups Experiencing Inequities

  1. 1. WHAT ARE THE PRIORITY ISSUES FOR IMPROVING AUSTRALIA’S HEALTH?<br />Groups Experiencing Health Inequities<br /> 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).<br /> Aboriginal and Torres Strait Islanders<br /> Socio-economically disadvantaged<br /> People living in rural and remote areas<br /> Australians born overseas<br /> Elderly<br /> People with disabilities<br />
  2. 2. Aboriginal and Torres Strait Islander Peoples<br />Major inequalities exist in the health status of Aboriginal and Torres Strait Islander peoples.<br /><ul><li>Die younger
  3. 3. Reduced quality of life
  4. 4. More likely to experience disability</li></ul>The nature and extent of health inequities<br /><ul><li>Lower life expectancy
  5. 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. 6. Poorer mental health
  7. 7. Higher hospitalisations
  8. 8. Poorer sexual health
  9. 9. Higher incidence of diabetes
  10. 10. Higher mortality rates for cardiovascular disease, injuries, respiratory diseases, cancer, endocrine disorders and digestive disorders</li></li></ul><li>The socio-cultural, socio-economic and environmental determinants of health<br />Socio-cultural - including family, peers, media, religion, culture, social connectedness, community, legislation, policies, political stability<br />Socio-economic - employment, education, income <br />Environmental - geographic location, access to health care services<br />
  11. 11. The Roles of Individuals, Communities and Governments in Addressing the Health Inequities<br /> Modern approaches to healthcare and health promotion acknowledge the fact that Indigenous health status results from the interaction of multiple determinants.<br /> An “inter-sectoral” approach is required based on partnerships between people and agencies at many levels and in a variety of sectors.<br />Government<br /> The Office of Aboriginal and Torres Strait Islander Health (OATSIH)<br /> www.health.gov.au/oatsih<br /> The National Aboriginal Community Controlled Health Organisation (NACCHO)<br /> www.naccho.org.au<br /> The Aboriginal Health and Medical Research Council of NSW (AH&MRC)<br /> www.ahmrc.org.au<br />Government agencies aim to improve the access of Indigenous people to primary health care services.<br />Communities<br /> 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).<br />
  12. 12. Individuals<br /> 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.<br />www.health.gov.au/internet/h4l/publishing.nsf/Content/respack-exemplarsite<br />
  13. 13. SOCIOECONOMICALLY DISADVANTAGED PEOPLE<br />The Nature and Extent of the Health Inequities<br /> People or groups who are characterised by the following, are said to be socio-economically disadvantaged (experience financial limitations):<br /><ul><li>poor levels of education
  14. 14. Low income
  15. 15. Poor housing
  16. 16. Unskilled work
  17. 17. Long periods of unemployment</li></ul> 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.<br />Socio-economically disadvantaged people:<br /><ul><li>Higher infant mortality
  18. 18. Lower life expectancy
  19. 19. More likely to die from cardiovascular disease, respiratory disease and lung cancer
  20. 20. Higher levels of blood pressure
  21. 21. Higher body-mass index for males and females (overweight)
  22. 22. More likely to smoke
  23. 23. More likely to suffer from mental health problems, diabetes and circulatory diseases
  24. 24. Less likely to engage in preventative health behaviours e.g. dental checks, “pap” smears, immunisation, family planning
  25. 25. Sick more often
  26. 26. Less informed about health
  27. 27. Sedentary behaviour</li></li></ul><li>The socio-cultural, socio-economic and environmental determinants of health<br />The Roles of Individuals, Communities and Governments in Addressing the Health Inequities<br />Government<br />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.<br />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.<br />
  28. 28. Communities and Individuals<br /> Development of an increasingly community-based health workforce that focuses on prevention of disease and the management of illness.<br /> There many community agencies that provide:<br /><ul><li>community health care
  29. 29. Childhood services
  30. 30. Parenting and maternity services
  31. 31. Community language services
  32. 32. Housing assistance
  33. 33. Employment training
  34. 34. Home care
  35. 35. Meals
  36. 36. Migrant services
  37. 37. Adult education</li></li></ul><li>PEOPLE IN RURAL AND REMOTE AREAS<br />The Nature and Extent of Health Inequities<br />Approximately 34% of the Australian population live in rural and remote areas.<br />People living in rural and remote areas:<br /><ul><li>more likely to smoke
  38. 38. more likely to drink to hazardous levels
  39. 39. More likely to be overweight
  40. 40. Lower levels of education
  41. 41. Engage in more sedentary behaviour
  42. 42. Engage in risky occupations
  43. 43. Lower life expectancy (decreasing life expectancy with remoteness)
  44. 44. High death rates for coronary heart disease, other circulatory diseases and motor vehicle accidents
  45. 45. Higher deaths rates for injury (motor vehicle accidents and suicide) mostly in males
  46. 46. Higher levels of depression or psychological distress in males
  47. 47. Females have higher levels of diabetes and arthritis
  48. 48. Poorer dental health</li></li></ul><li>The socio-cultural, socio-economic and environmental determinants of health<br />The Roles of Individuals, Communities and Governments in Addressing the Health Inequities<br />Governments<br />Rural Health Priority Taskforce provides advice to the NSW Government about improving <br />health services to people in rural and remote areas.<br />Priorities:<br /><ul><li>Attract and retain more health professionals in rural and remote communities
  49. 49. Provide sustainable quality health services
  50. 50. Make health services more accessible via initiatives such as “Telehealth”, a visual</li></ul>telecommunications system for clinicians and patients.<br />Examples: Medical Specialist Outreach Assistance Program and Multi Purpose Service (MPS) Program<br />
  51. 51. Communities<br /> 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.<br />
  52. 52. OVERSEAS BORN PEOPLE<br /> 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.<br />The Nature and Extent of the Health Inequities<br /> 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:<br /><ul><li>socio-economic status
  53. 53. poor language skills
  54. 54. stress associated with re-settlement</li></ul>Overseas born people:<br /><ul><li>Less likely to exercise
  55. 55. More likely to be overweight
  56. 56. Less likely to report medical conditions
  57. 57. Less likely to immunise children</li></li></ul><li>The Socio-cultural, Socio-economic and Environmental Determinants<br />The Roles of Individuals, Communities and Governments in Addressing the Health Inequities<br />Governments<br />Government providing translation and language services within Culturally and Linguistically<br />Diverse (CALD) communities. NSW Multicultural Health Communication Service (MHCS) works <br />with health services to provide non-English speakers with access to important health information.<br />Support is also given to health services within areas that are experiencing a growth in the<br />number of new arrivals and refugees.<br />
  58. 58. Communities and Individuals<br /> 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.<br /> Training and education of CALD community members to support and work with health care professionals is very important.<br />

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