Closing The Gap Initiative: Addressing The Health Care Needs Of Aboriginals And Torres Strait Islander Peoples

Socioeconomic determinants of health for Aborigines and Torres Strait Islander peoples

The people of Australia are varied and have different cultural diversity across the country. Nursing across this region plays a crucial role maintaining the livelihood of the people around the country. Hence, there are specific needs and requirements of certain people that the nurses have understand in order to give patient centred assistance and help. Such requirements are needed by the Aborigines and Torres Strait Islander peoples. It is because these people are continuously facing inferior standards of health and facilities, when compared to non-Indigenous people of Australia (Baba, Brolan, & Hill, 2014). In the given scenario Matt’s situation and Closing the Gap has been has been discussed further in the following paragraphs.

Matt had been admitted to the hospital, and “Closing the Gap” fund enabled Matt’s mother to travel to meet her son and also get food in aboriginal hostel. There are various kinds of socio economic determinants of health, and Aboriginals and Torres Strait Islander peoples face certain diet related health issues which could lead to greater prevalence of heart attack and could also double the risk of in hospital mortality in relation to coronary heart disease (Browne et al, 2013). There persists a wide gap when it comes to the health of Aboriginal and non-Aboriginal Australians. There are complex factors which lies in this scenario for example: underemployment, inadequate education and limited access to better healthcare services and health promotion (Gracy, 2014). “Closing the Gap” Strategy has been developed by the Government of Australia in order decrease the inequities among Aboriginals and Torres Strait Islander people so that gap between the Aboriginals and non-Aboriginals is completely reduced within 25 years which is by 2030. The Closing the Gap Strategy was built in response to the Social justice report that and “Close the Gap” justice campaign also had begun. The “Closing the Gap”, initiative provides several benefits and policies related to this like availing training, funding as well as jobs. With respect to “Closing the Gap” fund Matt’s mother got the travelling allowance and also had sufficed the accommodation as well as the meal (Australian Indigenous-HealthInfoNet, 2019). However, “Close the Gap” foundation is comprised of non-governmental Organizations (NGOs), health professional bodies, and human right activists who operate the Close the Gap Campaign. Basically, “Close the Gap”, main objective is to minimise or close the gap between Aboriginals and Torres Strait Islander health gap via functioning and implementation of human rights on the basis of Commissioner’s Social Justice Report 2005. This campaign has been supported by the Government of Australia. Access to equal primary health care is a basic human right, and hence, “Close the Gap” campaign aims to avail the Aboriginals and Torres Strait Islander peoples basic human necessities and rights. 

Closing the Gap Strategy: Reducing the disparities in health care

According to the Australian Human Rights Commission Close the Gap report enlisted fifth major finding which has been referred to as ‘funding myth’ (Australian Human Rights Commission, 2019). Aboriginal and Torres Strait Islander peoples face so called The “Funding Myth” which is basically a misconception that the health expenditures and expenses are the wastage of the taxpayer’s funds. It is to be understood that Aboriginal Australians suffer from reduced and deprived overall health in comparison to the non-Indigenous Australians. In a cohort study, by Zang and Hoy (2013) life time risk of Coronary heart diseases has found to be high as one in two Aboriginal males and females and it was also observed that the Coronary heart diseases occurred in the Indigenous people under the age of 50 years. This report shows that the risk of heart disease are higher in Aboriginal and Torres Strait Islander peoples than that of non-Indigenous people of Australia. According to Atruso et al., (2013), the Aboriginal Australians utilize the health care services at much lower rates than the general population. The health care needs of the Aboriginals is not restricted to the physical health but also mental health. It is due to the reason that there is varied amalgamation of complex culture and health needs (Dudgenon et al., 2014). According to the Australian Human Rights Commission, the Aboriginal and Torres Strait Islander population have, on average, 2.3 times the disease burden of non-Indigenous people. From the fifth findings it was also mentioned that looking at the complex health needs of the Aboriginal people of Australia, the Closing the Gap strategy of the Australian Government is not sufficing the duration at which it was imposed. The Closing the gap strategy has been labelled as “market failure”.  Hence, the current Close the Gap campaign initiated by the Australian Human Rights commission reports that currently the gap related to mortality as well as life expectancy is widening, and to reduce it, more funding has to be prevailed. 

“Patient escort” is a term to define the health care professionals who are intricately involved in patient assistance when it comes to traveling as well as well as assisting patients in the nursing units. Patient escort is an amalgamation of patient education, travel as well as patient awareness. From the given discussion in the assessment it is important to acknowledge the fact that Matt lives in a remote place and his mother had to travel from the travel between Townsville and Brisbane. In these scenario the patient has to be escorted so that the he can avail all the health care needs which would cover not only the person’s specific health care assistance but also address the transportation of the patient.  According to Kelly et al., (2014), there are different and specific challenges and hardships for travelling and transport when it comes to the Aboriginal people who require hospital care. Hospital care includes planned, inpatient, outpatient, and emergency as well as diagnostic care. The Aboriginals and Torres Strait Islander peoples apart from transportation they also face varied the cross communication barriers, linguistic barriers as well as cultural barriers (Best & Fredericks, 2017). The “patient escort”, under the health care domain must serve the purpose of these transportation as well as cultural barriers when it comes to the people who need special assistance. When it comes to the severity of chronic illnesses such high cholesterol, overweight, and high diabetes, Aboriginals have higher prevalence of such diseases (Australian Bureau of Statistics, 2019). Many of the Aboriginal population lives in remote and rural area of Australia, and some might not have access to the primary health care services. The hardships not only include the health care needs but they also involve financial strains which should be understood as well as addressed by the health care professionals Therefore, patient escort services should be enhanced ad recognized by which the prevalence of preventable diseases could be reduced and primary health care could be improved. 

The ‘Funding Myth’ and the need for increased funding

Matt and his mother, are in a vulnerable condition where travelling as well as staying are difficult stand points. The duty of the Aboriginal medical officer, is to provide coordination of patient travel as well as accommodation (Queensland Government-Queensland health, 2019). In terms of closing the gap, cultural safety is one of the important aspect in reducing health inequity, and other health outcomes. There are different determinants of health socially, and culturally, and different communities need different types of health care approaches. The Indigenous or Aboriginal hospital liaison officer’s role is very important for cultural safety. It is important to acknowledge the fact that some of the communities in Australia need support and care specifically. Australia’s culture is dynamic and varied, and different cultures have specific needs, emotionally and mentally. According to de Witt et al. (2018) Indigenous or aboriginal health care professionals the patient care is associated with culturally competent services as well as follow ups. The patient centred approach is an effective way of addressing the problems and issues (Mirzaei et al., 2013). The Indigenous Liaison officer is associated with providing proper information, cultural as well as emotional support. Moreover, the Aboriginal medical liaison officer, facilitating the referral to different types of facilities and other community based services (Queensland Government-Queensland health, 2019). This would enable the Indigenous people to address their concern and also help them ensure cultural safety. The cultural safety in Aboriginals when it comes to health care revolves around Cultural sensitivity, cultural awareness as well as Cultural humility. The main objective should be to overcome the stigma, biases and provide best health consultation as a medical liaison officer. The culturally safe practice ensures the interaction and bonding in same way so that they feel safe and their cultural values are respected. This type of health care settings along with interdisciplinary approach would enhance collective empowerment and also be more effective in terms of Aboriginal self-determination (Walker, Schultz & Sonn, 2014). 

From the above discussion, it could be inferred that “Closing the Gap”, is a government initiative address the health care needs of Aboriginals and Torres Strait Islander peoples, so that the uprising differences among the Indigenous non-indigenous people decreases in health care needs. It aims at reducing the gap and all the other health inequalities among the Indigenous. However, “Close the Gap”, is a campaign which is organised by the different human right activists and Non-governmental Organizations. And by the discussion it could be concluded that the Aboriginals are in need of funding, patient as well as culturally safe support so that they can overcome the disparities of the society. 

References:

Australian Bureau of Statistics. (2019). Causes of death, Australia, 2017. Retrieved from: https://www.abs.gov.au/ausstats/[email protected]/latestProducts/3303.0Media%20Release62017

Australian Human Rights Commission. 2019. Close the Gap: Indigenous Health Campaign. Retrieved from: https://www.humanrights.gov.au/our-work/aboriginal-and-torres-strait-islander-social-justice/projects/close-gap-indigenous-health

Australian Indigenous-HealthinfoNet. 2019. Closing the Gap. Retrieved from: https://healthinfonet.ecu.edu.au/learn/health-system/closing-the-gap/

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, 13(1), 56.

Browne, J., Thorpe, S., Tunny, N., Adams, K., & Palermo, C. (2013). A qualitative evaluation of a mentoring program for Aboriginal health workers and allied health professionals. Australian and New Zealand Journal of Public Health, 37(5), 457-462.

de Witt, A., Cunningham, F. C., Bailie, R., Percival, N., Adams, J., & Valery, P. C. (2018). “It’s Just Presence,” the Contributions of Aboriginal and Torres Strait Islander Health Professionals in Cancer Care in Queensland. Frontiers in public health, 6, 344. doi:10.3389/fpubh.2018.00344

Dudgeon, W., Wright, M., Paradies, Y., Garvey, D., & Walker, I. (2014). Aboriginal social, cultural and historical contexts. In Working together: Aboriginal and Torres Strait Islander mental health and wellbeing principles and practice (pp. 3-24). Commonwealth Department of Health.

Best, O., & Fredericks, B. (2017). Yatdjuligin: Aboriginal and torres strait islander nursing and midwifery care. Cambridge University Press.

Gracey, M. (2014). Why closing the Aboriginal health gap is so elusive. Internal medicine journal, 44(11), 1141-1143.

Kelly, J., Dwyer, J., Willis, E., & Pekarsky, B. (2014). Travelling to the city for hospital care: Access factors in country A boriginal patient journeys. Australian Journal of Rural Health, 22(3), 109-113.

Mirzaei, M., Aspin, C., Essue, B., Jeon, Y. H., Dugdale, P., Usherwood, T., & Leeder, S. (2013). A patient-centred approach to health service delivery: improving health outcomes for people with chronic illness. BMC health services research, 13(1), 251.

Queensland Government-Department of health. (2019). Hosital Liaison Officers. Retrieved from: https://www.health.qld.gov.au/sunshinecoast/html/atsi-health-serv/aboriginal-and-torres-strait-islander-health-team/hospital-liaison-officers

Walker, R., Schultz, C., & Sonn, C. (2014). Cultural competence–Transforming policy, services, programs and practice. Working together: Aboriginal and Torres Strait Islander mental health and wellbeing principles and practice, 195-220.

Wang, Z., & Hoy, W. E. (2013). Lifetime risk of developing coronary heart disease in Aboriginal Australians: a cohort study. BMJ open, 3(1), e002308.