Question:

The “Closing the Gap” campaign aspires to achieve equality between Indigenous and other Australians. It includes seven targets on health, education and employment, and according to the “Closing the Gap Prime Minister’s Report, 2018,” there has been mixed results to date.

Does this document address the social, cultural and environmental determinants of health affecting Indigenous Australians? Discuss.

Please note: You may select on chapter of the Closing the Gap 2018 report to review in your essay.

Please use a search engine (e.g. google) to search for “Closing the Gap Prime Minister’s Report 2018”

Answer:

Introduction

Indigenous Australians tend to experience higher incidences of diseases than the non-indigenous people because of a range of social, cultural and environmental factors. Chiefly, indigenous people are predisposed to certain health issues because of both modifiable and non-modifiable risk factors. As a result, Closing the Gap was launched to address these risk factors and eventually improve health equality. Closing the Gap primarily focuses on enhancing childhood education, life expectancy and employment rates. This paper explores whether “Closing the Gap Prime Minister’s Report, 2018” addresses determinants of health impacting Indigenous Australians. The paper is divided into three sections that discuss the existing determinants of health, targets of Closing the Gap and its significance in addressing the determinants of health. Over the years, the health gaps between the aboriginals and non-indigenous Australians have been narrowing. In essence, the aim of this essay is to show that Closing the Gap is successful in addressing certain determinants of health among the indigenous people.

Social, cultural and environmental determinants of health

The social determinants of health are linked to the socioeconomic (SES) status of the people. For the indigenous Australians, occupation, employment and educational attainment are the social factors that affect their health. National Census indicates that indigenous people have lower household income and higher unemployment rate than non-indigenous Australians (Human Rights Commission, 2007). For instance, the unemployment rate of indigenous people is 17 per cent while that of the non-indigenous people is 5 per cent (Waterworth, Pescud, Braham, Dimmock, & Rosenberg, 2015). Further, indigenous people have low levels of health literacy and poor access to health care services, which increases the risk of diseases (Artuso, Cargo, Brown, & Daniel, 2013). Indigenous people are also likely to experience racism and discrimination that impacts their lives. In essence, indigenous Australians are socioeconomically disadvantaged increasing the risk of diseases.

Certain cultural factors cause aboriginal Australians not to access free health checks, follow-up hospital appointments and seek cancer screening. For instance, indigenous people might fail to access HIV treatment and instead adhere to ancient customs (Li, 2017). Language difference is another factor that causes aboriginal people to experience poor health. For instance, a substantial percentage of the population speaks Western Desert Languages, Torres Strait Island Languages and Yolngu Matha (ABS, 2017). The lack of Cultural identity also causes aboriginal Australians to experience poor health because they may fail to seek services from a person from another culture. Therefore, indigenous people may experience a high incidence of diseases due to their restraint culture.

Indigenous Australians are likely to be exposed to environmental factors that increase the risk of diseases and infections. In this regard, indigenous populations living in remote areas are susceptible to water contamination as well as inadequate clean water. These factors may promote the prevalence of vector-borne diseases, diarrhoeal and skin illnesses (Pereira et. al., 2013). Besides, research has shown that pregnant indigenous women are likely to experience pre-eclampsia because of ambient traffic air pollution (Pereira et. al., 2013). Indigenous Australians in historical asbestos mining areas have a high incidence of malignant mesothelioma due to the inhalation of asbestos particles. The effect of weather and climate on the indigenous people is not well documented (Knibbs & Sly, 2014). However, indigenous populations are likely to suffer disproportionately because of extreme climatic conditions.

Targets outlined in the Closing the Gap document

One of the most important targets is to halve child mortality by 2018. From 1998 to 2016, child mortality among the indigenous people has reduced by approximately 35% (Australian Government, 2018). Besides, the government seeks to ensure about 95 per cent of indigenous children aged four years attend childhood education by 2025 (Australian Government, 2018). As of 2016, 91 per cent of all aboriginal children were enrolled in education programs (Australian Government, 2018). Another element is to close the gaps in school attendance among the indigenous population by 2018. Current statistics indicated that the school attendant among indigenous students is 83.2% while that of the non-indigenous population is 93% (Australian Government, 2018).

Furthermore, the government seeks to halve the gaps in numeracy and reading skills by 2018. An analysis shows that indigenous students are improving based on NAPLAN standards specifically for years 3, 5, 7 and 9. By 2020, the government targets to halve gaps in Year 12 achievement (Australian Government, 2018). The achievement in Year 12 has grown from 47.4 per cent in 2006 to about 65.3 per cent in 2016 (Australian Government, 2018). As a result, the gap in Year 12 achievement between the indigenous and non-indigenous population has narrowed by about 12.6% (Australian Government, 2018). The most important target is to halve the gaps in employment by 2018 since a high number of Aboriginal Australians are unemployed. In 2012, employment rates of indigenous and non-indigenous populations were 46.6% and 71.8% respectively (Australian Government, 2018).

The last pillar is to close gaps in overall life expectancy by 2031 (Australian Government, 2018). Over the last few years, there has been a small increase in life expectancy for indigenous people meaning they still have a low life expectancy. Nevertheless, long-term indicators are promising since aboriginal death rate has reduced by 14% since 1998 (Australian Government, 2018). Therefore, Closing the Gap program has achieved significant strides in improving the lives of the indigenous people.

The relevance of Closing the Gap document

Primarily, Closing the Gap has a purpose of reducing disadvantages among the indigenous Australians in regards to educational attainment, child education, employment opportunities, child mortality and life expectancy (Australian Government, 2018). The document implies that governments at all are levels committed attain indigenous Australians health equality in a period of 25 years (Australian Indigenous HealthInfoNet). Based on the targets of closing the gap program, the indigenous people can achieve better health by addressing the determinants of health. Education yields benefits that expose beneficiaries to better health outcomes. In fact, education helps to develop a variety of traits and skills such as personal control and problem-solving abilities that result in better health outcomes (Zimmerman, Woolf, & Haley, 2015). Education can also cause people to develop and practice suitable health behaviours. Thus, Closing the Gap aims to improve education attainment, which will cause people to make appropriate health decisions.

On the other hand, Closing the Gap has an objective of increasing employment rates for the indigenous Australians, which will improve health outcomes in the long-term. The main aim of providing employment opportunities is to improve the status of the people living in low SES conditions (Zimmerman et al., 2015). In this case, the strategies of Closing the Gap will lead to better health because SES is among the major causes of diseases. The improvement of SES will help people to access resources that can be used to minimize the risks that cause diseases. This analysis shows that achieving the targets of Closing the Gap is an essential step towards health equality in Australia.

Conclusion

As evident in this paper, indigenous Australians tend to suffer disproportionately from both preventable and non-preventable diseases. However, Closing the Gap aims to enhance the health of the indigenous Australians by improving their SES status, education and life expectancy. The targets of Closing the Gap are grounded on the risks that increase the prevalence of diseases for the indigenous people such as low literacy skills, low income and poverty, and decreased life expectancy. The program of Closing the Gap is critical to enhancing the health of indigenous Australians both in the short- and long-term.

References

ABS. (2017). 2016 Census shows growing Aboriginal and Torres Strait Islander population. Retrieved 8 21, 2018, from http://www.abs.gov.au/ausstats/[email protected]/MediaRealesesByCatalogue/02D50FAA9987D6B7CA25814800087E03?OpenDocument

Artuso, S., Cargo, M., Brown, A., & Daniel, M. (2013). Factors influencing health care utilisation among Aboriginal cardiac patients in central Australia: a qualitative study. BMC Health Services Research , 13 (1), 83.

Australian Government. (2018). Closing the Gap: Prime Minister’s Report 2018. Commonwealth of Australia.

Australian Indigenous HealthInfoNet. (n.d.). Closing the Gap. Retrieved 8 21, 2018, from https://healthinfonet.ecu.edu.au/learn/health-system/closing-the-gap/

Human Rights Commission. (2007). Social determinants and the health of Indigenous peoples in Australia – a human rights based approach. International Symposium on the Social Determinants of Indigenous Health. Adelaide.

Knibbs, L. D., & Sly, P. D. (2014). Indigenous health and environmental risk factors: an Australian problem with global analogues? Global Health Action , 7(1), 23766.

Li, J.-L. (2017). Cultural barriers lead to inequitable healthcare access for aboriginal Australians and Torres Strait Islanders. Chinese Nursing Research , 4 (4), 207-210.

Pereira, G., Haggar, F., Shand, A. W., Bower, C., Cook, A., & Nassar, N. (2013). Association between pre-eclampsia and locally derived traffic-related air pollution: a retrospective cohort study. Journal of Epidemiol Community Health , 67 (2), 147-152.

Waterworth, P., Pescud, M., Braham, R., Dimmock, J., & Rosenberg, M. (2015). Factors Influencing the Health Behaviour of Indigenous Australians: Perspectives from Support People. PLoS One , 10 (11), e0142323.

Zimmerman, E. B., Woolf, S. H., & Haley, A. (2015). Population Health: Behavioral and Social Science Insights: Understanding the Relationship Between Education and Health. Retrieved 8 21, 2018, from Agency for Healthcare Research and Quality: https://www.ahrq.gov/professionals/education/curriculum-tools/population-health/zimmerman.html