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92441 Contemporary Indigenous Health and Wellbeing

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Your new patient is Judy, a 57yr old Aboriginal woman with type 2 Diabetes who has been discharged home with a leg ulcer for daily dressings. She is a widow, currently living at home by herself. Judy has two siblings, Jack and Jennifer, who live close by, and who assist when they can. One of them may be present for the first visit.

Task:

1.You are to write a brief explanation of what “Closing the Gap” (CTG) policy is including the history and data that influenced the policy’s creation. You are then to discuss the significance of this policy on Aboriginal & Torres Strait Islander People’s health outcomes using relevant literature and statistics. In this answer include any challenges and/ or barriers which may have affected the changes.

2.Analyse the impact of Judy’s Diabetes and how it is addressed within CTG including the long-term consequences to health and social determinants.

1.The discussion should be supported by relevant literature (peerreviewed) and health statistics.

2.Your essay should have an introduction and a conclusion. NO headings.

3.You are NOT to use Wikipedia to support the discussion. Essays that do not just rely on the statistics presented in the Literature will attract higher marks.

4.It is expected that presentation of the essay and referencing will be in accordance with the Faculty guidelines. Marks will be deducted for incorrect referencing, and presentation (up to 10%).


5.The reference list is to be attached and not to be included in the word count.

6.All late assessment submission to be submitted through the late assessment portal.

7.All documents must be in Microsoft word only,NO PDF format–for the reason being there may be a discrepancy in your similarity report.

8.The academic language should portray people sensitively in writing, and be culturally appropriate.

Answer:

Aboriginal health and wellbeing had been a sector that has been neglected for a long period of time after the European colonization in the late 18th century. However the revolutionary advocacy by the activists and social welfare agencies has been successful in implementing a number of key changes in the social privileges rights that the aboriginals are deserving of (Alford 2015, p. 403). The Government reforms and funding for Aboriginals and Torres Strait islanders have given rise to a number of different policies, especially in health care, in order to address the health disparities or inequities present in the health care delivery. One prime example if such a policy movement which has considerably reinvented health care service delivery for the ATSI communities in the closing the gap initiative (Bové et al. 2018, p. 106852C). This assignment will attempt to explore and evaluate aspects of this policy, its history and benefits provided with respect to a case study.

Closing the gap can be defined as the strategic action taken by the Australian government in the year of 2008 that aimed to reduce the disparities and inequalities present among the ATSI people. On a more elaborative note, the initiation of closing the gap Policy was the formal commitment made to the people to establish health equality within the coming 25 years in the nation for all members. Tom Calma, ATSI Social Justice commissioner released the Social Justice report in the year of 2005 which elaborated statistical data points indicating at the gaming inequalities and disparities present for indigenous and non-indigenous Australian (Boyle, Zhang & Chan, 2014, pp. 217-222). The start differences and disadvantages faced by the first people of Australia was sufficient for the strain in government to finally make a formal commitment to facilitate equality in all aspects of social privilege including healthcare and living conditions within the next 25 years. The next year National Indigenous Health equity campaign began, a social justice campaign which aimed to eradicate the inequalities present in healthcare within 2030 with the power of coalition of more than 40 ATSI and non-indigenous health organizations and human rights entities launched in Sydney on 2007. The cumulative efforts taken by these government and non-government bodies finally resulted in establishment of National Indigenous Reform Agreement which was later named closing the gap by Council of Australian governments in March 2008 (Chan 2014, p. 217).

In 2011 National Health leadership forum was established as a steering committee for the policy. It acted as a national representative body for ATSI organizations and working with Australian government in order to improve the ATSI health outcomes set forth in the close the gap policy. A remarkable achievement for the closing the gap policy had been in July 2013 when Australian government introduced National aboriginal and Torres strait islander health plan; a ten year health policy plan focusing on the government role in ensuring the flexibility of the health system to the different needs expressed by this minority community so that they can make healthy choices and have culturally safe and equal access to quality care. In the 10 years that closing the gap policy has been established and implemented, there have been various improvements made in the health status in life expectancy of the ATSI people. For instance, the mortality rates for the aboriginal population has decreased by 14% since the last 10 years especially for the people dying of chronic circulatory disorders. A progress has been reported in management of chronic respiratory disorders and reduction of smoking in the aboriginal population although there is still a significant gets left behind that are needed to be addressed. On a similar note a few challenges that are contributed to the inability of this revolutionary policy to achieve all of its 7 outcomes includes financial burden, lack of adequate funding, scarce resources including transport and lacking time management. Moreover the lack of cultural safety and culturally appropriate care training in the existing health workforce and lack of recruitment from the ATSI backgrounds with respect to healthcare workforce is another considerable challenge that is restricting the smooth success of this policy (McKenna et al. 2015, p.881).

With respect to the case study the patient Judy is suffering from type 2 diabetes which is one of the world's fastest growing chronic diseases and is widespread among Australian population. Exploring further as per the details research reports the socially disadvantaged and minority groups such as the search people of Australia are more prone to develop type 2 diabetes due to their lifestyle, dietary habits and lack of health promotion behaviour that can prevent the disease, which is fundamentally due to lack of health literacy among these people (Dimer et al. 2013, pp. 79-82). In order to better manage her diabetes Judy will require proper nutritional management, pharmacological management, lifestyle modifications including exercises. Exploring further as per the details research reports the socially disadvantaged and minority groups such as the search people of Australia are more prone to develop type 2 diabetes due to their lifestyle, dietary habits and lack of health promotion behaviour that can prevent the disease, which is fundamentally due to lack of health literacy among these people (Baba, Brolan & Hill 2014, p.56).

The patient has been admitted to the health care facility due to her foot ulcer which is a common manifestation of poorly managed diabetes, requiring daily dressing.  Hence, she would require a holistic diabetes management plan that was not only address a physical manifestation of the disease but will also attract emotional spiritual and psychological impact of that type 2 diabetes on her living. With respect to closing the gap strategy, an aboriginal struggling with a chronic disorder, requires holistic overall care plan that addresses her physical health needs educational needs and lifestyle modification needs as well for her to attain recovery (Harris et al. 2013, pp.S191-S196). Closing the gap initiatives have identified that certain historical social cultural and community left factors are considerable determinants of aboriginal health which also facilitates chronic conditions such as obesity and diabetes. It has two dimensions low levels of physical activity, for a healthy diet and obesity is intricately linked socio-cultural factors associated with a bottle and communities with very little awareness of these factors impacting on the health of the community members. Closing the gap as a policy attempts to address all the socio-cultural factors one by one why do fighting healthcare to the aboriginal patients so that the therapeutic measures combined with these lifestyle changes and modifications facilitating help emotional behaviour time together help the patient attain faster recovery (Adegbija, Hoy & Wang 2015, p.e0123788).

There are various benefits that Judy will be able to avail while being registered to the closing the gap scheme to manage her diabetes and its manifestation. Financial burden of managing a chronic disorder is primarily the most concerning factor for aboriginals with lower socioeconomic standard which is also one of the primary reasons for the lower health seeking behaviour and destructive care services which leads to further exercise basins and higher mortality rates. Closing the gap provides a co-payment program named as indigenous chronic disease package which provide a significant reduction of the costs that a patient is required to pay while availing care with the aid of government funding encouraging the patience to avail care services for better living (Healthinfonet.ecu.edu.au 2018). Even in case of purchasing medicines which is a very important aspect of diabetes management closing the gap policy provides concessional reliefs letting the patient pay at least 5 times lesser for the medicine. Closing the gap registration also provides the opportunity for aboriginal patients to avail remote diabetes care services from organizations such as Baker heart and diabetes Institute as a part of the outreach health service program of the closing the gap policy. This will provide Judy the opportunity to avail diabetic care services even in remote locations in case she lives territory outskirts in aboriginal communities. This policy also has attempted to incorporate 90 % of indigenous family diet to be consisting of healthy food basket for less than 25 % of the income which will help her better manage her body weight and blood sugar without a high financial risk. Lastly, closing the gap policy will also allow Judy to have culturally safe and culturally appropriate home care services by community nursing enters which will help her better manage her foot ulcer and her diabetes effectively (Abbott et al. 2012, pp.55-59).

AMS stands for aboriginal medical service which is a community controlled health care facility providing culturally safe and specialist care to the ATSI populations. ALO on the other hand is aboriginal liaison officer, acting like the mediator between healthcare providers and the aboriginal patient and their family safeguarding emotional social as well as cultural aspects of the healthcare service provided to the patient. They are the first point of contact for the indigenous patients who provide consultation reference and educational suggestions to the patients regarding how they can avail different care services and how they can manage their diseases. ALOs understand patient concerns and provide referral suggestions to facilities such as the AMS for similar community controlled primary care services for availing necessary care benefits (Baba, Brolan & Hill 2014, p.56).

On a concluding note, closing the gap has been a revolutionary change in the Healthcare sector of the ATSI populations. Closing the gap has only been able to achieve one of the seven intended outcomes till now and yet it is providing considerable benefits to these aboriginal people which has significantly improved the health status and life expectancy. It can be hope that with equal effort from the government and the society this strategy can successfully achieve all of its outcome eradicating all inequalities and establishing justice based healthcare network in Australia.

References:

Abbott, P.A., Davison, J.E., Moore, L.F. & Rubinstein, R., 2012. Effective nutrition education for Aboriginal Australians: lessons from a diabetes cooking course. Journal of nutrition education and behavior, vol. 44, no. 1, pp.55-59.

Adegbija, O., Hoy, W. & Wang, Z., 2015. ‘Predicting absolute risk of type 2 diabetes using age and waist circumference values in an aboriginal Australian community’, PloS one, vol. 10, no. 4, p.e0123788.

Alford, K.A., 2015. ‘Indigenous health expenditure deficits obscured in Closing the Gap reports’, Med J Aust, Vol. 203 no, 9, p.403.

Australian Indigenous HealthInfoNet. 2018, History of Closing the Gap - Closing the Gap - Australian Indigenous HealthInfoNet. [online] Available at: https://healthinfonet.ecu.edu.au/learn/health-system/closing-the-gap/history-of-closing-the-gap/ [Accessed 14 Aug. 2018].

Baba, J.T., Brolan, C.E. & 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, vol. 13, no. 1, p.56.

Baker.edu.au. 2018, Closing the gap in diabetes How is it going to be achieved?. [online] Available at: https://www.baker.edu.au/-/media/documents/news/ET2017-04-031-COHEN.ashx?la=en [Accessed 14 Aug. 2018].

Bové, H., Steuwe, C., Saenen, N., Rasking, L., Nawrot, T., Roeffaers, M. & Ameloot, M., 2018, May. ‘White-light from soot: closing the gap in the diagnostic market’, In Biophotonics: Photonic Solutions for Better Health Care VI (Vol. 10685, p. 106852C). International Society for Optics and Photonics.

Boyle, C., Zhang, H. & Chan, P.W.K., 2014. ‘Closing the gap’, In Equality in Education (pp. 217-222). SensePublishers, Rotterdam.

Chan, W.L., 2014. ‘Closing the gap’, Equality in Education: Fairness and Inclusion, p.217.

Dimer, L., Dowling, T., Jones, J., Cheetham, C., Thomas, T., Smith, J., McManus, A. & Maiorana, A.J., 2013. ‘Build it and they will come: outcomes from a successful cardiac rehabilitation program at an Aboriginal Medical Service’, Australian Health Review, vol. 37, no. 1, pp. 79-82.

Harris, S.B., Bhattacharyya, O., Dyck, R., Hayward, M.N. & Toth, E.L., 2013. ‘Type 2 diabetes in Aboriginal peoples’, Canadian journal of diabetes, vol. 37, pp.S191-S196.

McKenna, B., Fernbacher, S., Furness, T. & Hannon, M., 2015. ‘“Cultural brokerage” and beyond: piloting the role of an urban Aboriginal Mental Health Liaison Officer’, BMC public health, vol. 15, no. 1, p.881.

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