History of Closing the Gap Policy
The health of the Aboriginal community is impacted by several factors, through the understanding of which, the service providers can acknowledge the problems that impact the Aboriginals and the Torres Strait Islanders people. Colonization had a major impact on this population that contributed to the long terms health issues that these people continue to suffer from and persists with a poor health status (Baba, Brolan and Hill 2014). This paper mainly highlights the Closing the Gap policy of Australia that was developed with the objective to reduce the deficits that prevail among the Aboriginals and the Torres Strait Islanders people, especially in terms of health. Additionally the paper identifies the impact of diabetes and how it can be addressed through this CTG policy. The paper also discusses the social determinants of health that prevail in the indigenous community and how these determinants are being addressed by the policy. In addition to this the paper also illustrates the role of AMS and ALO in the Aboriginal health and that how they are connected to each other.
The closing the gap is a strategy that is developed by the government with the objective to reduce the deficits that prevail among the Aboriginals and the Torres Strait Islanders people. These deficits are identified in terms of life expectancy, mortality rate of children, access to the education of the children along with achievement of education and outcomes of employment (Browne, Hayes and Gleeson 2014). This was established as a formal commitment that was made by the governments of Australia in order to achieve health equity of these indigenous people within a span of 25 years. This policy was developed for responding to the call of the Social justice report 2005. In the year of 2008, the government of Australia along with the Aboriginal and Torres Strait Islander people came to an agreement to work together for achieving equity in terms of status of health and increasing the life expectancy of the indigenous people along with the non-Indigenous Australians by the year of 2030 (McKenna et al. 2015).
The history of the Closing the Gap policy includes the social justice report which was called for the Australian governments to engage in achievement of quality for the indigenous people in the field of health and life expectancy within 25 years. This campaign of Closing the Gap began as the campaign of National Indigenous Health Equality in the year of 2006 by the following organizations that includes Human Rights and Equal Opportunity Commission, the National aboriginals and community controlled health organization (NACCHO), the Australian indigenous doctor’s association (AIDA), and several other government organizations (Pruett and DiFonzo 2014).
The significance of the Closing the Gap policy lies in the aim of the policy. This aimed to develop an action that is comprehensive and long-term in nature. The policy is targeted to the need and is evidence-based with the capability of addressing the inequalities that exists in the health services. This was aimed to attain equity in the health status and increase the life expectancy between Aboriginal and Torres Strait Islander peoples and non- Indigenous Australians by 2030 (Rigney and Hemming 2014). This policy also aims to ensure the full participation of the Aboriginal and Torres Strait Islander peoples along with the participation of their representative bodies in all the major aspects of addressing their needs in terms of health.
Significance of Closing the Gap Policy
The barriers or challenges that persists in the path of these changes in the policy implementation, involves the financial challenges comprising of direct cost of consultations, deficit of knowledge in practices of bulk billing and deficit of funding for the programs of indigenous health. Other barriers include the lack of cultural awareness, and reduced sensitivity of the mainstream care in addition to lack of identification of the indigenous status of the patients (Mitrou 2014). Finally there is lack of enough staffs who could take on the responsibility of closing the gap work.
The patient discussed here has been suffering from type 2 diabetes, as a result of which she has been suffering from leg ulcer. The patient can be addressed within the CTG which includes the long-terms consequences of health and the social determinants. The patient can be addressed within the CTG through the primary health care services which provides health service delivery within the Aboriginal community controlled organization (ACCO) (Kant 2013). It also delivers increased engagement of the ACCO in the regional health service in planning of health. CTG also increases the collaboration and workforce that shares services across universal and Aboriginal community-controlled organizations. In addition to this, the major focus according to the CTG is on health promotion along with the engagement with the indigenous community. This had reported improvement in the general health literacy among Aboriginal people, with a corresponding increase in changes of the health lifestyle along with better self-management. National partnership agreement on closing the gap in Indigenous health outcomes was established in order to provide long term care to the indigenous people suffering from diabetes (Greenwood et al. 2015). The community controlled primary health care services of the Aboriginal and Torres Strait Islander community, are located all over the states and the territories, which are funded by the governments at the federal, state and the territory level. These organizations aim to provide a holistic approach of health service which is also culturally significant. The activities of these organizations includes management of the chronic illness like diabetes, along with diagnoses and treatment of the disease. In addition to this, it also provides transportation for the medical appointments, immunizations, and dialysis services along with the outreach programs (Govil et al. 2014).
These aboriginals and the Torres Strait islanders experience several disadvantages in terms of economics and the social factors, which in turn has an impact on the poorer health of the indigenous people. The social determinants that are linked to the health outcomes of these individuals and in turn increases the risk factors includes the areas of education, housing and employment. The National Aboriginal and Torres Strait Islander Health Plan (Australian Government 2013) plays a role in acknowledging the importance of these determinants (Baba, Brolan and Hill 2014). It also proposes some the measures that are needed to be taken to address the social and economic determinants of health. Being involved in the CTG program, benefits Judy as these social determinants were addressed while the development of this policy. Then CTG provides a holistic approach which takes into account the full cultural, social and economic context of the lives of these indigenous people. The policy also promotes awareness of the trauma and loss that is experienced by this population a result of the process of colonization. The indigenous community is involved at every stage of the development program so that there is an assurance of development of a collaborative, genuine and sustainable partnership (Govil et al. 2014). The knowledge of the indigenous is also valued through these policies where there key social and cultural determinants are acknowledged, which ensures their social and emotional well-being. The policy development program also employs the indigenous staff in the program design by providing them with adequate training to acknowledge the key determinants.
Barriers and Challenges in Policy Implementation
AMS refers to Aboriginal medical service. This was established in order to provide a community controlled health services to the indigenous population. The AMS started the concept of Aboriginal community-controlled health care. Its broader objectives included aims to improve the health standards in Aboriginal communities across Australia. AMS was involved in referring Judy since she being a part of the indigenous community of Australia, she is entitled to the health services provided by AMS (McKenna et al. 2015). She was later referred to the ALO which is the Aboriginal Liaison Office. The role of the ALO is to ensure that the Aboriginals and the Torres Strait Islander people receive accesses to the mainstream services in terms of healthcare. The ALO is primarily is involved in providing emotion, cultural as well as social support to the patients along with their families. The liaison services is also involved in provision about the services of the hospitals and the linkage that exists between the hospitals and the indigenous Community resources (Renzaho and Oldroyd 2014). There is a collaboration between the ALO and the social workers as well for undertaking such services. A partnership exists between the AMS and the ALO in order to address the poor health status of Aboriginal people. The AMS is a community controlled health service whereas ALO is involved in providing formation and support to Aboriginal clients and their families along with practical help. The ALO liaise with the appropriate health and welfare services present within the local communities such as Aboriginal Medical Services and Community Health, of which AMS is a part.
From the above discussion it can be concluded that the Closing the Gap policy provides a significant step in addressing the problems that are shared by the Aboriginals especially in terms of health. From the paper it can be seen that these polices addresses the social determinants which in turn beneficial to the individuals of the indigenous community. Additionally it is also perceived that the community controlled health services of AMS and ALO are effective in managing the chronic patients through referrals to the hospitals and the other indigenous community services.
References
Baba, J.T., Brolan, C.E. and Hill, P.S., 2014. Aboriginal medical services cure more than illness: a qualitative study of how Indigenous services address the health impacts of discrimination in Brisbane communities. International Journal for Equity in Health, 13(1), p.56.
Browne, J., Hayes, R. and Gleeson, D., 2014. Aboriginal health policy: is nutrition the ‘gap’in ‘Closing the Gap’?. Australian and New Zealand Journal of Public Health, 38(4), pp.362-369.
Craig, S.L., Bejan, R. and Muskat, B., 2013. Making the invisible visible: Are health social workers addressing the social determinants of health?. Social Work in Health Care, 52(4), pp.311-331.
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.
Greenwood, M., De Leeuw, S., Lindsay, N.M. and Reading, C. eds., 2015. Determinants of Indigenous Peoples’ Health. Canadian Scholars’ Press.
Kant, S., Vertinsky, I., Zheng, B. and Smith, P.M., 2013. Social, cultural, and land use determinants of the health and well-being of Aboriginal peoples of Canada: a path analysis. Journal of public health policy, 34(3), pp.462-476.
Markwick, A., Ansari, Z., Sullivan, M. and McNeil, J., 2014. Social determinants and lifestyle risk factors only partially explain the higher prevalence of food insecurity among Aboriginal and Torres Strait Islanders in the Australian state of Victoria: a cross-sectional study. BMC public health, 14(1), p.598.
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.
Mitrou, F., Cooke, M., Lawrence, D., Povah, D., Mobilia, E., Guimond, E. and Zubrick, S.R., 2014. Gaps in Indigenous disadvantage not closing: a census cohort study of social determinants of health in Australia, Canada, and New Zealand from 1981–2006. BMC Public Health, 14(1), p.201.
Pruett, M.K. and DiFonzo, J.H., 2014. Closing the gap: Research, policy, practice, and shared parenting. Family Court Review, 52(2), pp.152-174.
Renzaho, A.M. and Oldroyd, J.C., 2014. Closing the gap in maternal and child health: a qualitative study examining health needs of migrant mothers in Dandenong, Victoria, Australia. Maternal and child health journal, 18(6), pp.1391-1402.
Rigney, D. and Hemming, S., 2014. Is ‘Closing the Gap’Enough? Ngarrindjeri ontologies, reconciliation and caring for country. Educational Philosophy and Theory, 46(5), pp.536-545.
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