Assignment Task
Task
Assessment 1 – Rural and Remote Elderly Indigenous people and chronic diseases:
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Introduction
Australia is one of the most urbanised countries in the world, where 69% of the population lives in urban communities (Baxter et al., 2011). Only 29% of people live in rural and remote areas (Australian Institute of Health and Welfare [AIHW], 2018a). Rural and remote encompasses all areas categorised as inner regional, outer regional, and remote or very remote areas (AIHW, 2018a). The majority of the Indigenous population lives in major cities while 19% live in remote and very remote areas (AIHW, 2019). However, a greater proportion of Indigenous people live in rural and remote areas in comparison to non-Indigenous Australians and most of them are either younger (14years and below) or elderly (65years and above) (AIHW, 2018a). Older Indigenous Australians living in rural and remote areas have poor health and a high chronic illness rate (AIHW, 2018a). This paper comprises the literature review on the health status of elderly Indigenous Australians living in rural and remote areas and the impact of social determinants like limited health service access and health literacy on their health status. Lastly, the health impact of the interaction of chosen social determinants with each other will be discussed.
Health status of Elderly Indigenous Australians
Indigenous Australians living in rural and remote places have poor health, high chronic illness and hospitalisation rate, and low life expectancy in contrast to non-Indigenous Australians (AIHW, 2019). The lower life expectancy among Indigenous Australians is due to higher rates of avoidable chronic illnesses (Sushames et al., 2017). Chronic illness accounts for 64% of the total disease burden among Indigenous Australians (AIHW, 2016). Chronic illness accounts for 95% of the mortality gap between Indigenous Australians and non-Indigenous Australians of 55-74 years aged group (AIHW, 2011).
Chronic illness resulting from risk factors (smoking, obesity, hypertension, and diabetes) is the major cause of death among the elderly Indigenous population (AIHW, 2011). The smoking rate that increases the risk of chronic diseases is the highest among the older Indigenous population living in rural areas (Sterren et al., 2020). Around 70% of additional death in rural and remote areas are due to chronic illness which includes coronary heart diseases (19%), diabetes (6%), chronic obstructive pulmonary disease (9%) and cancer (15%) (Phillips, 2009). Thus, the chronic illness among the elderly Indigenous Australians is high resulting in poor health and high mortality.
Social determinants and health impact on elderly Indigenous Australians Accessibility of services
The social determinants of health are the factors that affect health outcomes and health behaviours (AIHW, 2016). The geographical structure, housing, socioeconomic status (SES), attitude towards health, disease, and disability, and access to food, education, and health services determines the health status of Indigenous people living in remote places (AIHW, 2014). Access to services is an essential factor that impacts health and wellbeing. Older Indigenous Australians live in rural areas with limited access to health services and lower standard infrastructure compared to other Australians (Australian Human Rights Commission, 2007). They have limited access to health facilities due to geographic reasons (requires long travel and lack of transportation), financial reasons (expensive health services and poor SES), cultural reasons (no Indigenous specialist, lack of specialised doctors, and non-acceptance by other Australians) (Australian Government Department of Health, 2009). Due to these reasons, Indigenous Australians do not visit the health facilities and present in the later stages of diseases that increase hospitalisation and mortality rate.
Health literacy
Health literacy is another important health determinant that affects the health status of people. Health literacy involves information about health services available, the support system, and the use of healthcare services to maintain a good health status (Rheault et al., 2019). People with lower health literacy have poor health status as they have less knowledge about their health issues, preventive measures, screening, and are unaware of health information sources (Rheault et al., 2019). One-third of Indigenous people speak an Indigenous language as their first language which makes younger generations face problems in school that decrease the literacy rate (Australian Human Rights Commission, 2001). The lower education level leads to lower health literacy. The lower health literacy leads to an increase in health-related behaviours and minimal disease prevention and health promotional activities that ultimately results in poor health status (Australian Human Rights Commission, 2007).
Based on your Literature Review, the Minister is convinced that the social determinants you identified are significantly contributing to health inequities and require urgent attention. The Federal Budget is currently being arranged and the Minister requires support in ensuring these issues are on the agenda and that there is a strategy to address them.
The Minister has requested a Policy Brief on addressing the two social determinants you have identified in the specific population group from Assessment 1.
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