Overview of National Aboriginal and Torres Strait Islander Health Plan
Non-communicable diseases (NCDs) are medical conditions not caused by infectious agents. They refer to chronic diseases which can progress slowly and last for long periods of time. They are not however distinguished by their duration but by their non-infectious causes (Hunter, D.J. and Reddy, 2013). Some chronic conditions, however, such as cancer, diabetes, autoimmune diseases, stroke and heart disease can lead to quick deaths.As an evidence-based policy agenda, the National Aboriginal and Torres Strait Islander Health Planis aimed at guiding programs and strategies to enhance Aboriginal and Torres Strait Islander health. This policy was established to provide a predominant framework which creates links with the principal health activities of the Commonwealth and reveals areas that need attention to guide future effort and investment relative to the healthiness of the Aboriginal and Torres Strait Islander people. The Aboriginal and Torres Strait Islander people are Australia’s first peoples who have suffered extreme hardships since colonization of the country by European settlers. These adversities not only affects their health but also leads to decline of the richness of their health (Moatti, 2013). This report describes and critically analyses one of the frameworks set aside to improve the group’s health and wellbeing. It also provides some recommendations to help progress the effectiveness of the framework and brings to light the role of health professionals in the same.
The National Aboriginal and Torres Strait Islander Health Plan was developed as part of the efforts to close the gap between the health and life expectancy of the Aboriginal and Torres Strait Islander people and other Australians. It was established through a robust partnership by the Australian government in collaboration with the Aboriginal and Torres Strait Islanders, their peak bodies and community organizations (Kimpton, 2013). This offered an opportunity to set out a plan for the direction of the group’s health collaboratively for a decade from 2013 to 2023 (ISLANDER, 2013). The National Congress of Australia’s First peoples, for instance, played a vital role through the National Health Leadership Forum in making sure of the availability of feedback as well as input during the development of the framework.
Social determinants of health arethedrivers of healthiness that lie outside the direct accountability of the health sector. The association betweenworking and living environs and an individual’s health outcomes has brought about an appreciation of how sensitive the human health is to their social surroundings. The social settings entail factors such as the conditions of employment, social support and education. A portion of the life expectancy gap between the indigenous and non-indigenous Australians can be explained by social determinants of health. These social aspects not only affects their health but also can influence how an individual interacts with their health and other amenities. For instance, the probability of the Aboriginal and Torres Strait Islander people to smoke is less if they are educated, employed and generate higher incomes (ISLANDER, 2013). Social determinants of health include:
Higherlevels of education is linked to advanced health literacy and healthier lifestyle choices which augments one’s physical wellness. Education also increases the chances of an individual obtaining a good and well-paying job which improves their living standards and wellbeing.
Social determinants of health
Commonly, people from poor economic backgrounds and social circumstances are more vulnerable to illnesses, diseases and generally poor health than the more fortunate ones. For example, rheumatic heart disease is related to environmental facets such as poor living conditions and poverty. The Aboriginal and Torres Strait Islander people therefore remain at risk of such diseases as above-mentioned. Additionally, many indigenous Australians are not capable of securing a well-paying employment opportunity due to lack of education. This limits their accessibility to quality health care which persists their ill health and the gap in life expectancy.
The fundamentals of a healthy adult are set during an individual’s childhood. The features of early childhood development such as physical, language, emotional and cognitive elements influence the child’s education, school performance as well as involvement in economic activities, health, citizenry and societal participationlater in life (CSDH, 2008). The probability of children from underprivilegedupbringings to perform poorly in school is higher than that of their advantaged peers. This interferes with their ability toget a good job later on which negatively impacts their incomes, ability to secure good health care and their health literacy. Transition of thisdetriment between subsequent generations continuously affects the health of the indigenous people.
An individual’s conditions of living has a vast impact on their health. Living in safe, clean and secure accommodations improves one’s health and their participation in the community. According to Australian standards, more indigenous Australians live in overcrowded households than non-indigenous people. In addition, less Aboriginal and Torres Strait Islander people are buying their own homes as compared to a very big percentage of non-indigenous Australians. The relationship between housing conditions and health portray that the more perilous and unsafe the conditions are the worse a person’s health gets. Indigenous people living in overcrowded houses are prone to contracting communicable diseases in addition to the chronic conditions they suffer from (O’Donnell and MacDougall, 2016). Also, more indigenous Australian are homelessdue to unaffordability of the properties in Australia.
The highest percentage of the Aboriginal and Torres Strait Islander people ail from NCDs. these chronic conditions involve complex health issues disability, trauma, mental diseases and genetic disorders(Vos et al., 2009). Tobacco, alcohol, physical inactivity, high body mass and high blood cholesterol all form small percentages of diseases which increase the health and life expectancy gap (Glantz and Gonzalez, 2012).
Principles Guiding the Approach of the Health Plan
- Aboriginal and Torres Strait Islander Control and Engagement
There is participation of the Aboriginal and Torres Strait Islanders in the making of decisions which affect their health. The most effective way of providing a solution to a community’s health issues is ensuring that those health problems are addressed at the community level. The Aboriginal and Torres Strait Islander health organizations contribute unique inputs in ensuring the provision of a comprehensive, holistic and culturally suitable health services (Browne et al., 2017).
1) Health Equality and a Human Rights Approach
A right to health defines the availability of equal opportunities to access health care by all people. Governments cannot guarantee a right to be healthy but can provide equal chances for participation of all communities in the decisions concerning their health. This is achieved by ensuring accessibility, availability and acceptability of all groups of people to obtain quality health care.
Impact of social determinants of health on indigenous Australians
2) Accountability
The framework cannot be operational if its success and implementation was not reviewed. The policy offers structures to this assessment and directs the associated organizations to be held responsible for the success or failure of their efforts.
3) Partnership
The health plan provides for a shared ownership between the government, the Aboriginal and Torres Strait Islander people and all service providers. It explains that they all should be involved in coming up with the goals and priorities relating to the health of the indigenous Australians (Parnell, Morris and Jacobs, 2017).
The health sector has a role to play in achievement of necessary progresses in education and employment of the Aboriginal and Torres Strait Islander people. This framework was developed on realization that advancements among the indigenous Australians necessitates an integrated approach embracing improvement in the social determinants of their health, reinforcing positive behavior and strengthening community participation and functioning. This Health plan especially provides the people with the ability and freedom to translate their aptitude (skills, knowledge and comprehension) into action by involving them in decision making about their health (ISLANDER, 2013).
The implementation plan for the National Aboriginal and Torres Strait Islander Health Plan states the vision of the health plan as well as the actions to be taken to improve the health of the indigenous Australians. The vision of the plan is to realize a health system free of inequality and racism and that all indigenous Australians have access to affordable, effective, appropriate and high quality health care. It identifies different domains that need action and states the objectives that should be achieved by 2023.
However, in some cases the plan does not state exactly what will be done. For instance, one objective is to reduce the percentage of Aboriginal and Torres adolescents who smoke. The plan does not explain how these teenagers will be made to stop smoking. Another aim is to reduce racism and discrimination and achieve a racism free health care system. This objective seems too ambitious because it is based on other people’s behavior. The strategies that will be taken to eliminate racism are not outlined, and even if they were, they may not be very effective since the plan is not in control of how people behave. The health plan puts too much emphasis on the results, that is, good health. Even though there is a mention of addressing the social determinants of health they are neither delineated in details nor emphasized (May, Carey and Curry, 2013). Increasing school attendance is one of the priorities in addressing social factors. This may not be achieved if the children expected in school have no means of getting there.Unfavorable infrastructure such as roads in rural and remote areas can hinder one from reaching their destination, especially in the rainy season (Otim et al., 2014).
The health plan should focus more on putting forth the specific actions that will be undertaken. Good plans would involve building infrastructure, for instance building more houses for the indigenous Australians to minimize overcrowding and homelessness as well as road construction. Availability of enough houses for the Aboriginal and Torres Strait Islander people would improve their health conditions by minimizing the transfer of infectious diseases and preventing the recurrence of chronic conditions such as otitis media. It also diminishes exposure to smoking and the likelihood of occurrence of accidents and injuries around the house.
Role of housing, education, and childhood development
The plan should indicate the specified manner in which smoking and racism are to be reduced or eliminated.
The framework should emphasize more on the strategies to address social determinants of health as these are feasible projects that can be achieved. The social aspects highly determine the health of individuals and affect their prevailing health conditions (Fisher et al., 2015).
Primary Health care
The Aboriginal Community Controlled Health Organizations (ACCHO) and the Aboriginal Medical Services (AMSs) deliver primary health care to many Aboriginal and Torres Strait Islander folks (Davy et al., 2016). There organizations employ nursing, medical practitioners and allied health practitioners who provide a range of services to the patients. The care provided by the staff of these organizations is perceived as the effective and culturally appropriate way to provide health care services to the indigenous Australians (Gomersall et al., 2015).The services provided are specific for this group of people hence leading to patient satisfaction, observance of the treatment regimen and their confidence in the services provided (Gomersall et al., 2017). These professionals thus have an important role in the health of these people.
Provision of Quality Care
The National Aboriginal and Torres Strait Islander Health Workforce Strategic Framework (2016 – 2023) was established within the National Aboriginal and Torres Strait Islander Health Plan. This framework’s aim is to contribute to the achievement of health equity in the outcomes of the health of the indigenous Australians by building a resilient and well sustained health workforce that has apposite non-clinical and clinical knowledge and skills to provide health care that is responsive and culturally appropriate(McDonald et al., 2018). This framework works towards equipping the Aboriginal and Torres Strait Islander people with the necessary skills to provide quality health care. It ensures that the indigenous Australians are represented across all disciples related to health(Topp, Edelman and Taylor, 2018). It also contributes to creation of work places that are suitable, inviting and encourage developments of talent as well as in development of best practice training. The professionals are therefore adequately trained to provide high quality health care services to the Aboriginal and Torres Strait Islander people and do this in a manner that is respecting of the group’s way of life(Thompson et al., 2014).
Conclusion
From the text, it is obvious that the Aboriginal and Torres Strait Islander people in Australia are more disadvantaged than non-indigenous Australians. They experience more health problems than other Australians due to their conditions of living, unavailability of quality health care services and lack of adequate education. Their early upbringing is more disadvantaged than that of other Australians as a result of their lower socio-economic position. Inadequate education hinders their accessibility to good employment opportunities which leads to generation of insufficient income to acquire quality health care. It also negatively affects their health literacy and lifestyle decisions they make. It is evident that the government has put efforts towards closing the health and life expectancy gap that exists between the Aboriginal and Torres Strait Islanders and other Australians. The report examines one such strategy developed for this purpose, The National Aboriginal and Torres Strait Islander Health Plan 2013-2023. This health plan’s aim is to improve the health of the indigenous Australians in an attempt to close the gap.The framework employs approaches such as minimizing the percentage of indigenous Australian teenagers who smoke and reduction of racism and discrimination towards the Aboriginal and Torres Strait Islander people. It however does not mention specific acts to achieve this. Health professionals play a vital role in the health of these people by providing quality care.
Conclusion
References
ISLANDER, T.S., 2013. Based publications.
Commission on Social Determinants of Health (CSDH), 2008. Closing the gap in a generation: health equity through action on the social determinants of health. Final report of the Commission on Social Determinants of Health. Geneva: WHO.
FISHER, M., BATTAMS, S., MCDERMOTT, D., BAUM, F. and MACDOUGALL, C., 2018. How the Social Determinants of Indigenous Health became Policy Reality for Australia’s National Aboriginal and Torres Strait Islander Health Plan. Journal of Social Policy, pp.1-21.
Vos, T., Barker, B., Begg, S., Stanley, L. and Lopez, A.D., 2009. Burden of disease and injury in Aboriginal and Torres Strait Islander Peoples: the Indigenous health gap. International journal of epidemiology, 38(2), pp.470-477.
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Fisher, M., Baum, F., MacDougall, C., Newman, L. and McDermott, D., 2015. A qualitative methodological framework to assess uptake of evidence on social determinants of health in health policy. Evidence & Policy: A Journal of Research, Debate and Practice, 11(4), pp.491-507.
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Gomersall, J.S., Aromataris, E., Brown, A., Dwyer, J., Stephenson, M., O’donnell, K., Canuto, K., Carter, D. and Gibson, O., 2015. Characteristics and value of Aboriginal Community Controlled Health Organizations’ primary health care and their financing needs: a protocol for systematic evidence reviews. JBI database of systematic reviews and implementation reports, 13(6), pp.139-167.
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Davy, C., Harfield, S., McArthur, A., Munn, Z. and Brown, A., 2016. Access to primary health care services for Indigenous peoples: A framework synthesis. International journal for equity in health, 15(1), p.163.
Parnell, D., Morris, S. and Jacobs, R., 2017. Engaging Aboriginal and Torres Strait Islander peoples in the ‘Proper Way’.
McDonald, H., Browne, J., Perruzza, J., Svarc, R., Davis, C., Adams, K. and Palermo, C., 2018. Transformative effects of Aboriginal health placements for medical, nursing, and allied health students: A systematic review. Nursing & health science
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