Health Access for Socially Disadvantaged Groups in Australian Society - Term Paper Example

Name: Course: Institution: Tutor: Health Access for Socially Disadvantaged Groups: 2.1 Health Access: Case of Australia’s Indigenous population Socially disadvantaged individuals are those that have been subjected to cultural bias or ethnic and racial prejudice within the wider society without regard to their individual identities. For these people, the social disadvantages to which they are subjected stem from circumstances beyond their control and are a reason for their poor socio-economic conditions. In Australia, numerous groups of people are socially disadvantaged. These include the elderly, the mentally health people, the homeless and the Indigenous population among others. This paper draws on past research studies and government reports to analyse the basic living standards of Australia’s Indigenous population with regard to access to health services (Australian Bureau of Statistics, 2010). As of 2009, there were about 600, 000 Indigenous people living in Australia, making 2.5% of the country’s total population (Australian Bureau of Statistics, 2009). About one sixth of these are known to live in very remote areas where access to health is very poor. Compared to other groups, the Indigenous people are not as healthy as other groups. While a significant portion of the Indigenous population lives in cities and large urban centers, they are a heterogeneous and highly mobile group with strong links to the rural communities. This group has been described as the minority in Australia and is exposed to discrimination, the result of which is poor access to health care services. Most of Australia’s Indigenous population lives in New South Wales and Queensland. They, however, make a small minority (less than 2%) of these states. The table below shows the population distribution of Indigenous population by state and territory. Distribution of Indigenous peoples – (2009) Percentage of the total Indigenous population living in a State or Territory Percentage of the State or Territory's total population that is Indigenous NSW 28.7 2.2 Vic 6.0 0.6 Qld 28.3 3.6 SA 5.0 1.7 WA 15.1 3.8 Tas 3.3 3.4 NT 12.9 31.6 ACT 0.8 1.2 Empirical researches have documented extensive evidence that health care promotion in Australia, as in any other country benefits only those groups and individuals who are already socio-economically well-off. Research studies indicate that access to health services is not favorable for Australia’s indigenous minorities, thereby adding to this group’s high level of social disadvantages. This is partly because most of the indigenous people live in remote locations and islands and that not all public health services are offered out of cities and urban areas (Taylor, 2009). Sometimes, the types of health services offered by the government are not culturally appropriate for the Indigenous population. Moreover, some members of the indigenous group may not be able to enjoy public health services because they are quite expensive (Australian Bureau of Statistics, 2010). The indigenous population has a low life expectancy than the non-indigenous population. Recent estimates by the Australian Bureau of Statistics indicate that members of the indigenous community born between 2005 and 2007are expected to live for 70.2 years compared to 82.4 for non-indigenous people. Figure 1: Expectations of life at birth for Indigenous and non-Indigenous males and females born between 2005 and 2007. 2.2-3 Geographic, Economic and Social Barriers to Access to Effective Health Care by Indigenous population A number of constraints continue to restrict the indigenous people people’s access to quality health care despite Australia having made impressive improvements in health care services. Some of these constraints are structural in terms of poor coordination and linkages across the health care system while others are related to the socio-economic conditions of the Indigenous population. However, some constraints are cultural. Cultural factors include the attitudes and practices of the health service provider, poor cultural understanding, racism and mistrust of the health care system (Menzies, Turnour, Chiu & McIntyre, 2008). Evidence presented in numerous researches suggests that Australia’s indigenous people have problems in accessing health care services. The problems of this community in accessing health care are primarily related to systematic discrimination. Historically, the Indigenous population has not had same opportunities to pursue health standards as the non-indigenous people (Thomas, 2006). The main factors that have led to the Indigenous population’s poor access to health care include: i. Unavailability of Health Care Services Generally, location barriers are associated with Indigenous population living in remote locations and islands. However, even indigenous people living in urban areas are disproportionately concentrated in low socio-economic areas where relative access to health care is poor. In addition, the socio-economically poor areas are characterised by certain factors which contribute to poor health such as availability of illicit drugs, alcohol and poker machines (Roche et al, 2008). ii. Affordability The close connection between poor access to health care and poverty is a common finding in social epidemiology. For the great majority of Indigenous population, poverty limits their access to not only health services but also health promoting information, medication services and technologies. Information released by the Australian Bureau of Statistics (2010) indicates that the mean equivalent income for an indigenous household is 55% of the income of the non-indigenous household. With the ever-increasing cost of medication, low household income has become an effective barrier to effective health care. Cunningham, Rumbold, Zhang, Condon (2008) have noted that the impact of indigenous people’s poor socio-economic conditions is not limited to the direct cost of health care. He explains that many Indigenous people especially those in remote areas do not have an active telephone connection. This has implications for emergency services when doctors and hospitals need to be contacted. iii. Acceptability While economic and location constraints to health care access are significant for Indigenous people living in urban areas, it is arguable that socio-cultural factors are also more significant. Garvey (2008) has noted that the issue of acceptability of health care services is more important than affordability or availability of these services and is a major determinant for the utilization of health care services. A survey by Garvey (2008) points out that in addition to considering access issues in terms of geographic distance and affordability, it is important for policy planners to recognize access as being about barriers to use as a result of the patient’s perceptions. Garvey has further asserted that mainstream health services in Australia are based on non-indigenous culture and this presents barriers to effective access due to the insufficient consideration of the Indigenous people’s cultural security. iv. Appropriateness One of the most notable barriers to the Indigenous people’s access to health care is poor performance of health systems in addressing the needs of multiple and complex health conditions. However, this problem is not limited to the Indigenous people only; people living with HIV and newly arrived refugees are some of the groups with complex health conditions, which present challenges for the country’s health care system. Although the Australian government has introduced free-for-service health care programs, there is substantial evidence that these free health care services do not meet the challenges of complex health care conditions which Indigenous people present (Menzies, Turnour, Chiu & McIntyre, 2008). 2.4 Existing Strategies and Initiatives for Improving the Indigenous people Access to Health Care Equitable access to improved health care is crucial for preventing ill-health and for better management of chronic and terminal diseases. To address the problem of poor access to health care by the Indigenous people, the government of Australia is committed to improving health outcomes for this group and to closing the gap between the life expectancy of the Indigenous people and other groups. An important initiative that has been undertaken by the government is the expansion of indigenous-specific primary health care services. The government has also made substantial progress in improving treatment of substance use, social and emotional welfare services and preventive health programs in remote and regional areas (Garvey, 2008). Since the year 2000, the Australian government has increased budgetary allocation on health improvement for marginalized and socially disadvantaged groups. Indigenous people living in some remote areas such as in the Northern Territory are benefiting from increased funding to build health clinics. Through the Council of Australian Governments, the government has bolstered its commitment to expand and strengthen drug and alcohol treatment, as well as, rehabilitation services for the Indigenous people (Australian Bureau of Statistics, 2009). 2.5 Recommendation The following initiatives can significantly help increase the Indigenous people’s access to public health services relative to the non-indigenous majority group: i. Training and campaigns involving Indigenous health workers in health programs. The government should increase the number of indigenous people working in the health sector as doctors, nurses, dentists and consultants. ii. Designing health promotion programs and campaigns for the indigenous people. These campaigns should take into account the unique social-cultural needs of the Indigenous people. iii. It is imperative for the government to make health services available in the remote locations and parts of the country so that members of indigenous groups do not have to travel to distant cities to look for specialized treatment. iv. It is necessary that the government increases the current level of funding for health services so that the services become more accessible to indigenous people, majority of whom are otherwise not able to afford the services. 3.5 Ways in Which Health Ideas Have Changed/Informed To improve outcomes and access to mainstream health services, the government is systematically addressing the numerous barriers that the Indigenous people face in accessing health care services. The federal government has strengthened collaboration across stakeholders in the health sector more especially between state governments. This collaboration will address the national targets of overcoming the indigenous disadvantages and decrease child mortality rates for this group of people. To this end, the government has through the National Advisory Group for Aboriginal and Torres Strait Islander Health Information and Data stepped up efforts to improve the availability and quality of information relating to the health of the indigenous people (Australian Bureau of Statistics, 2010). Moreover, the government is funding surveys aimed at determining mortality rates among the Indigenous people. These surveys will help develop guidelines for improving the identification of Indigenous people with health datasets. The government is also engaged in developing Indigenous Coordination Centers to allow for tailored, flexible and local approaches to addressing the health challenges of indigenous people. References Australian Bureau of Statistics 2009, Experimental life tables for Aboriginal and Torres Strait Islander Australians: 2005-2007, Canberra, Australian Bureau of Statistics. Australian Bureau of Statistics 2010, Population characteristics, Aboriginal and Torres Strait Islander Australians, 2006 (reissue). Canberra: Australian Bureau of Statistics. Cunningham, J., Rumbold A., Zhang, X & Condon, J 2008, Incidence, aetiology, and outcomes of cancer in Indigenous peoples in Australia. Lancet Oncology; 9(6): 585-595. Garvey, D 2008, Review of the social and emotional wellbeing of Indigenous Australian peoples. Retrieved 2012 from http://www.healthinfonet.ecu.edu.au/other-health- conditions/mental-health/reviews/our-review. Menzies, R., Turnour, C., Chiu, C & McIntyre, P 2008, Vaccine preventable diseases and vaccination coverage in Aboriginal and Torres Strait Islander people, Australia, 2003 to 2006, Canberra, Department of Health and Ageing. Roche, P et al 2008, Invasive pneumococcal disease in Australia, 2006, Communicable Diseases Intelligence, 32(1), p. 18-30 Taylor, H 2009, National Indigenous eye health survey: minum barreng (tracking eyes): full report, Melbourne, Indigenous Eye Health Unit, The University of Melbourne. Thomas, D., Condon, J., Anderson, I., Li, S., Halpin, S., Cunningham, J & Guthridge S 2006, Long-term trends in Indigenous deaths from chronic diseases in the Northern Territory: a foot on the brake, a foot on the accelerator. Medical Journal of Australia, 185(3), p. 145- 149. Read More