What Social Health Determinants Hinder the Achievement of Equitable Health Care - Research Paper Example

Clinical Nursing Practice Name of Student Student Number Institution Course Code Name of Instructor Date of Submission INDIGENOUS HEALTH This study involves description of a research question concerning access to primary health care services among the Indigenous communities and the disparities that exists in comparison to the non-Indigenous communities. Australian health and wellbeing varies between the Indigenous and non-Indigenous communities (Indigenous Health 2014). Australian Aboriginals and Torres Strait Islanders are the Indigenous communities of Australia and a number of issues affect access to quality health care services and wellbeing. Using the PICO strategy, the research contents and targets will be evaluated effectively. This will involve expounding on the research question, devising a criteria for conducting the study involving both inclusion and exclusion criteria followed by their significance. BACKGROUND INFORMATION The Australian health care systems are faced with great disparities in respect to accessibility and availability for all in an equitable manner (Macdonald 2010). Amid the great strides made in improving health care access, the Indigenous communities still lag behind the non-Indigenous communities in respect to primary health care and specialist treatment. It is evident that Indigenous people in Australia remain the most vulnerable health wise (Arabena 2013). The United States of America, Canada and New Zealand have effectively managed to improve the standards of health and well-being among their Indigenous communities from the 80’s while the Aboriginal people of Australia continue to suffer a deteriorating health crisis (Fairley and Hocking 2012). The low standards indicate massive disparities with other communities in the country and this can be attributed to neglect of looking into the determinants of health and wellbeing among the Aboriginals. In context, the social determinants of health of the Aboriginal can also be attributed to the low health standards as they are still not in a position to comprehend their predicament and champion for their improvement. Lack of employment, discrimination, poor education levels, lack of financial support and deep connection to their lands and people keep the Indigenous people in limbo (Palmer and Short 2010). Lack of these social aspects deters the individuals not having quality wellbeing. The Indigenous communities in Australia are generally worse off in comparison to the non-Indigenous people in respect to social determinants of health. Indigenous people consist of 3% of the Australian population with New South Wales having the largest Indigenous population and Northern Territory having the highest proportion living in the region (Australian Indigenous 2013). Most health services are not accessible, not user-friendly for the Aboriginals simply because they were implemented fundamentally for the non-Indigenous people (Rumbold, et al. 2010). This adds to the disadvantage of poor health care access among these vulnerable communities, and specifically those living in rural areas. Lack of health policy formulations with key tenets based upon the cultural and social beliefs of the communities seems to work ineffectively making any programmes implementation fail to achieve high standard of goals in health. Research Question: what social health determinants hinder achievement of equitable health care systems among the Indigenous communities to the levels of non-Indigenous communities? This research evaluation is based on the PICO formulation to establish the problems facing indigenous primary health access and consequently devise ways of addressing the problem. [P]: This research strategy targets primary health access among all population of Aboriginal and Torres Strait Islanders decent. This is in respect to their belief, vulnerability and what health care systems are at their disposal. [I] the increased disparities of unequitable health facilities and access to primary specialised care among the Indigenous people calls for critical analysis of the situation. This is respect to creating effective measures to address the situation and come up with effective strategies to correct the prevailing health statistics and improve indigenous health access. [C] This study is based on the real situation of Indigenous communities in Australia compared to the non-Indigenous communities. This will present the level of disparities pertaining to the [O] The major goal of the study is aimed at coming up with strategic measures for recommendations on the best ways to improve health care systems among Indigenous communities. Health care improvement involves strategic policy formulation and implementation. This calls for effective findings indicating the level of need on the ground in respect to health care systems and facilities. On the same note, funding to come up with equipment and infrastructure necessary to access health care is critical to this study. The research question will seek to evaluate effective ways to address the issue of funding health improvement and what level of funding is necessary. Significance of the Research Question Amid the prevailing disparities of health care access of Aboriginals and Torres Strait Islanders, identifying the socio-economic and cultural barriers hindering achievement of high standards is paramount. The research strategy will establish the effective strategies of enhancing accessibility of health care systems. Further, increased faith upon convectional health access among the Indigenous people is imperative. Establishing how well the indigenous health care personnel can be increased is worth noting since they know their people well and would be better placed at attending to them in ways that are convincing (Macdonald 2010). Improvement of health and wellbeing may be the prerogative of the government and the community, but individuals have the greater responsibility in ensuring health effectiveness in their lives. Thus, creating awareness and making the Indigenous people understand the benefits of quality health and wellbeing is a great stride in fighting health inequality. This awareness can only be achieved in respect to having a clear understanding of the problems facing Indigenous health as well as effective ways to address the same (Arabena 2013). Therefore, with effective and strategic understanding of the concepts behind the research question, findings will be made out which help address the prevailing situation. The poor health conditions within indigenous communities, observable social gradients, as well as marked health inequalities are attributed to unequal distribution of resources and discrimination (Rumbold, et al. 2010). The continued unfairness that has been evidenced in the Indigenous communities has led to stagnation of social life due to lacking effective social services. Through a well devised study scope, the strategy devised for this research question will ensure evaluation for effective access to health care, as well policies relevant in the prevailing situation which can exclusively deal with the negative determinants of health and wellbeing. Lack of effective social determinants of health have resulted to deteriorating lifestyles amid the fact that other communities are progressing well as per the standards of a developed nation (Palmer and Short 2010). This study is fundamentally based upon the fact that prevailing unequal distribution of health care services, infrastructure and access is not a natural occurrence, but rather a lack of policy implementation targeting the issues at hand in respect to Indigenous communities. Due to prevailing health challenges, the research question will ensure creation of effective evidence based practice that will ensure clinical and nursing decisions pertaining to Indigenous health meet the expectations of the patients. The process of evaluating evidence for quality is a crucial component of evidence based practice. However, effective interventions on primary health care among the Aboriginals and Torres Strait Islanders cannot occur without effective findings in place. METHODS This section outlines the criteria to be utilised in establishing data necessary for meeting the goals of the research question. The research question will utilise the descriptive design to establish the state of Indigenous health in Australia. The design will look at meeting the major objective of establishing socio-economic determinants of health affecting effective access to health care systems among Indigenous communities. Through effective literature review, existing findings will be outlined to evaluate the study population and establish effective steps to foster equality and equity. Through analytical and evaluative skills, data will be outsourced from the secondary sources and answer the research question under consideration. The following section outlines the inclusion and exclusion criteria to be utilised, followed by the justification of both criteria. This will bring up discreet and objective findings relevant to this study. Inclusion and Exclusion Criteria With utilisation of the inclusion and exclusion criteria, the strategy will come with a subjective scope of investigation and come up with effective findings for analysis. These will in turn create a basis for improving the structure touching on the improvement of health care systems and primary health access among the Aboriginals and Torres Strait Islanders. Inclusion refers to the traits that prospective tenets ought to possess and be included in the study to achieve target goals (Palmer and Short 2010). On the other hand, exclusion criteria are those characteristics that are not necessary in respect to the scope of the study and thus disqualified for evaluation. In respect to the research study, establishing characteristics for inclusion and exclusion are imperative for consideration to ensure effectiveness and discreetness of the research findings. The aspect under consideration involves access to primary health care services among the Aboriginal communities. Factors to be considered with respect to inclusion criteria will entail children and youths between the ages of 5-25 years coupled with women. Since health care services encompass a myriad of disorders, this research study confines itself upon the common health care services and outpatient services among the Indigenous communities. Specialised and chronic conditions will not be included in this research question analysis. On the same note male gender beyond age 25 are excluded in this study in order to critically evaluate factors affecting accessibility to primary health care among the majority groups of the Indigenous communities. This is aimed at capturing the most vulnerable groups in respect to primary health care and how they manage within the remote areas. Evaluation of women will involve assessment of access to gynaecology services, prenatal and postnatal services as well as screening for common cancers among women like breast and cervical cancers. For youths, access to health awareness on substance abuse early pregnancies and sexual behaviour will be evaluated. Aspects pertaining to availability of counselling services within their localities will be crucial for analysis and will be evaluated accordingly. Nevertheless, the analysis will adhere to high standards of confidentiality and safeguard the privacy of participants to the study. Cardiac conditions will not be included in the research strategy due to the sensitivity and nature of their occurrence which calls for specific analysis. This venture would call for detailed analysis of the study expanding the scope. Nevertheless, the recommendations would involve making comments on future studies to evaluate on this aspect to look at the extent and effects of cardiac disorders among the Indigenous communities. Justification of the Criteria The inclusion and exclusion criteria established are a based on the fact that young children, youths and mothers are the most vulnerable in any given society. Thus, conducting a research study based upon these groups of people will ensure that all aspects of social health determinants affecting Indigenous health are established. Further, the inclusion criteria ensure that both genders are covered among the children and youths. This means that health care evaluation and the social determinants of health will cover virtually every gender. Further, it will look into probable ways of ensuring a future generation that will live in standards that are equal to other non-Indigenous communities as well as access equitable services. The criteria of inclusion will ensure working with effective channel for ensuring realisation of factors geared towards success. Through incorporation the most vulnerable in the community, healthy lifestyle programs will be initiated on the basis of community management of corroboration between the national, regional and community leaders. These will be effective in enhancing physical activity levels and nutrition among the Indigenous communities. Long term partnerships between the government and Indigenous communities will ensure effective implementation of policies and strategic measures will be put in place to strengthen Indigenous platforms for health care systems. With the strategic measure of Closing the Gap existing between Australian Aboriginal and non-Aboriginal communities, it is imperative to state that government funding and indigenous communities inclusion in the programmes will ensure the real setbacks to health in the remote areas is addressed. This will be through exact identification of settings necessary for improvement and consequently required resources for improvement. SEARCH STRATEGY The search strategy involves identifying and recording two electronic databases and expound on their relevance to the research question. Further, key words from the research question will be established which will be useful in the search of the two electronic databases. A simple search strategy will be developed and recorded by use of key words from the research question. Finally, a search strategy will be implemented within the two selected databases and five relevant research articles made out crucial in answering the research question. The search strategy will yield effective data to answer the research question. In context, it presents the data collection strategy involving secondary outsourcing of data, analysis and eventual recommendation on the findings. In respect to established concepts, the strategy targets information based upon the criteria of the study earlier described. The most crucial part will entail effectiveness of the search strategy in order to ensure that the main objective of the research question is realised. Electronic Databases and their Relevance to Research Question Australian Indigenous HealthInfoNet (www.healthinfonet.ecu.edu.au/, 2013) and Health database (http://www.indigenous.gov.au/health/, 2014) have been identified as resourceful e-databases. They are out to establish facts and information pertaining to Indigenous health in Australia. Health database entails analysis of health aspects among Australian Indigenous communities as well as various social determinants of health. The fundamental concept behind this e-database search is Indigenous Health and its state among the Aboriginals and Torres Strait Islanders. They also present effective sources of information which critically delve into aspects of Indigenous health and factors hindering effective realisation of equitable and quality health care among all communities. Indigenous HealthInfoNet will establish various parameters pertaining to health care access and its state among the Aboriginals and Torres Strait Islanders. The determinants of health, facts concerning the Indigenous persons and the infrastructures state will be evaluated through this database. The second database will generally establish a basis for the health state in the Indigenous communities, policies and programs that have been put in place to ensure equitable health access. Based upon aspects surrounding physical education, health and wellbeing, the database provides crucial sources for relevant data pertaining to various aspects of Indigenous health. Resources are crucial in the development of infrastructure towards realising effective implementation of health care systems. This will devise effective measures to recommend strategies towards improving health and wellbeing of the Aboriginal and Torres Strait Islanders. Further, the move will be crucial in contributing towards the government strategy of ‘Closing the Gap’ to ensure equality and equitable health care system. Key Words for Searching the Databases This refers to crucial phrases or statement that is vital in establishing or determining relevant sources of information pertaining to the research question. On the same note, it creates a channel of acquiring data for effective findings pertaining to the subject contents behind the study. The key words in the research question involve ‘Social Health Determinants’, ‘Equitable’, ‘Systems’ and ‘Levels’ which will be crucial in the search of relevant database and articles to support the research question. These key words are useful in ensuring that accurate search of information pertaining to indigenous health in Australia. Social determinants will create a background of the state of health care systems and access among the Indigenous communities. In respect to equitable and levels, they will establish the level of disparities of health care systems of the Indigenous communities in comparison to the non-indigenous ones. Simple Search Strategy Relevant to Research Question The strategy in this study is aimed at ensuring getting effective information to meet the set objectives and answer the research question. At the onset, the first step involved coming up with a research question based upon Indigenous Health. Further, the achievement of the topic concept can only be realised with the main wording of the question which form the critical and core concepts for evaluation and analysis. The main point of study which can further be truncated to yield better search phrases in the search engines involves, “health determinants hindering equitable health care systems among Indigenous Communities in Australia.” The search process will entail: Establishing effective articles will involve assessing the journal articles with crucial information pertaining to Indigenous health. Five articles have been established to contain relevant information pertaining to Indigenous health and determinants of health in respect to primary health care access. These articles will provide the levels of disparities between Aboriginals and Torres Strait Islanders on one side and the non-Aboriginals on the other. The articles have been outlined below with a clear analysis of their crucial contents in respect to this research question. Implementation of the Search Strategy This forms the core of the research study in respect to rolling down the channel of acquiring relevant data for supporting the research question. In context, the search strategy would be conducted by use of key words identified to access relevant information on articles and journal which offer academic and standard data on Australia Indigenous health. The key aspects under consideration involve access to primary health care access, availability of health systems and their efficiency, policy formulation and implementation and finally challenges hindering effective and equitable Indigenous health. The articles will provide facts on the state of health access among the Aboriginals and Torres Strait Islanders in comparison to the non-Indigenous communities. 1. Australian Indigenous HealthInfoNet, 2013. 2. Indigenous Health, 2014. i) Arabena, K., 2013. Future Initiatives to Improve the Health and Wellbeing of Aboriginal and Torres Strait Islander Peoples. Med J Aust. Vol. 199, no. 1, pp. 22. ii) Azzopardi, P., Kennedy, E., Patton G., Power, R., Roseby, R., Sawyer, S. and Brown, A., 2013. The Quality of Health research for young Indigenous Australians: Systematic Review. Med J Austr. Vol. 199, no. 1, pp. 57-63. iii) Fairley, C. and Hocking, J., 2012. Sexual Health in Indigenous Communities. Med J Aust. Vol. 197, no. 11, pp. 597-598. iv) Macdonald, J., 2010. Health Equity and the social Determinants of Health in Australia. Social Alternatives, Vol. 29, no. 2, pp. 34-40. v) Rumbold, A., Bailie, R., Si, D., Dowden, M., Kennedy, C., Cox, R., O’Donoghue, L., Liddle, H., Kwedza, R., Thompson, S., Burke, H., Brown, A., Weeramanthri, T. and Connors, C., 2010. Assessing the Quality of Maternal Health Care in Indigenous Primary Care Services. MJA. Vol. 192, no. 10, pp. 597-598. Reference List Arabena, K., 2013. Future Initiatives to Improve the Health and Wellbeing of Aboriginal and Torres Strait Islander Peoples. Med J Aust. Vol. 199, no. 1, pp. 22. Australian Indigenous HealthInfoNet, 2013. Accessed May 31, 2014 from, . Azzopardi, P., Kennedy, E., Patton G., Power, R., Roseby, R., Sawyer, S. and Brown, A., 2013. The Quality of Health research for young Indigenous Australians: Systematic Review. Med J Austr. Vol. 199, no. 1, pp. 57-63. Fairley, C. and Hocking, J., 2012. Sexual Health in Indigenous Communities. Med J Aust. Vol. 197, no. 11, pp. 597-598. Indigenous Health, 2014. Indigenous Health, ACPE-Australian College of Physical Education. Accessed on May 31, 2014 from . Macdonald, J., 2010. Health Equity and the Social Determinants of Health in Australia. Social Alternatives, Vol. 29, no. 2, pp. 34-40. Rumbold, A., Bailie, R., Si, D., Dowden, M., Kennedy, C., Cox, R., O’Donoghue, L., Liddle, H., Kwedza, R., Thompson, S., Burke, H., Brown, A., Weeramanthri, T. and Connors, C., 2010. Assessing the Quality of Maternal Health Care in Indigenous Primary Care Services. MJA. Vol. 192, no. 10, pp. 597-598. Read More