Social Determinants Of Health In Australia: A Study On End-Stage Renal Disease Among Indigenous Australians

Unique Prevalence of End-Stage Renal Disease Among Indigenous Australians

Discuss About The Social Determinants Of Health In Australia.

The rates at which the incidence and prevalence of the end-stage renal disease are rising among the indigenous Australians provides a fundamental reason for studying the situation. Statistics on health reports reveal that the end-stage renal disease is higher among the aboriginal populations than on the rest of the Australian population.  Moreover, the issue raises an important aspect of reflection due to the high mortality rates of indigenous Australians who succumb to the disease as well as other co-morbid infections. Also, a particular case among the indigenous Australian population where the individuals contract the disease ten years earlier than the non-indigenous Australians. The situation is also unique to other illnesses that characterize the infection of the end-stage renal disease among indigenous Australians. Thus, there is a need for intervention to prevent and reduce the death rate of indigenous Australians who make up 3.3% of the total Australian population as stated by the 2011 census of Australia. Therefore, this paper will discuss primary epidemiological research of the end-stage renal disease among the indigenous Australian population and the strategy that can be used to address the situation at different levels of the society.

Various epidemiological researchers conducted by scholars and healthcare professionals have revealed the significance of studying the end-stage renal disease of Australia. As far as the disease is concerned, its prevalence and incidence among the indigenous Australians are unique than in the rest of the Australians. It varies with age, gender and the methodology of treatment subjected to the affected individuals. Also, epidemiological researchers reveal that the results that take place after treatment are more inferior and fatal among the indigenous Australians than in the rest of the Australians (Luyckx et al., 2013).

Another factor of significance is that the disease has a higher comorbidity prevalence which is more complicated than in the non-indigenous population. Therefore, the rate of stabilizing the situation is slow in indigenous individuals thus explaining why the overall population of their community is still lower than other ethnic groups in Australia. Additionally, the case has rendered the health status of indigenous individuals in Australia as poor, and their life expectancy is relatively lesser than the rest of individuals in the Australian population (Yeates et al., 2009). Correspondingly, their health situation is characterized by social determinants of health such as poverty, low education levels, high cases of unemployment, high rates of drug and substance abuse, poor nutrition and an overall situation a low socioeconomic status (Mitrou et al, 2014).

Comorbid Infections and High Mortality Rates Among Indigenous Australians with End-Stage Renal Disease

Research on the incidence of end-stage renal disease conducted by the ADZDATA Registry reveal data of people receiving chronic dialysis collected in Australia. Hence, the statistical figures reveal that approximately four hundred indigenous individuals out of every one million Australians are enrolled in renal replacement therapy. Comparisons between the previous and current statistical information show that there was an increased incidence rate of the end-stage renal disease among the indigenous Australians before 2000 (Siva,2011). Since then, the data indicates stability and slow infection rates of the disease in the same population. However, the data does not offer clarity of whether the stabilization of the incidence rates has resulted from the underlying chronic kidney infections or from a propensity to treat the infection facilitated by expansion of renal services in Australian health facilities. Furthermore, an epidemiological study conducted by the Registry reveal that there was no a significant difference of people treated with the end-stage renal disease in both indigenous and non-indigenous Australians between 2003 to 2007.

Additionally, data collected in the epidemiological research reveals that the is substantial differences in the incidence of the disease concerning other aspects. The factors include age and gender. The study conducted from 2007 to 2009 did not expose a constant age at which the disease was more or less prevalent. However, it was established that the most significant incidence lied beneath individuals of middle ages of twenty-five to forty-five years. Correspondingly, the relative incident rate of the affected indigenous Australians ranged from 3.82 to 4.46 thus making an average of 4.12 (Excell, 2009). Moreover, the fixed rate was highly characterized with associations in gender. It was clear that the female gender among the indigenous population was the most affected with a relative incidence rate of 5.98. On the other hand, the affected male individuals among the indigenous Australians have a relative incidence rate of 3.01.

Moreover, another research conducted by McDonald (2013) implies that the relationship between the incidence of end-stage renal disease and age revealed a great significance. The relative incidence rate increased from 0.8 among indigenous Australians aged fifteen years old or less to 14.8 among those aged forty-five to sixty-four years. Additionally, a decrease was noted among indigenous Australians aged seventy-five years and above where the relative incidence rate fell to 2.07 (McDonald, 2013). Still, the research did not reveal a significant difference in the previous research on females. There were still lower rates of change among the infected female indigenous Australians. It indicates that in any age bracket, the end-stage renal disease was higher in females than in males. The study also proves that younger indigenous Australians are still at a higher rate of attack than the older ones.

Epidemiological Research on End-Stage Renal Disease Among Indigenous Australians

Another epidemiological research conducted by Chan et al. (2012) reveal the relationship among the incidence, treatment and the geographical location of the indigenous Australians. It implied that higher rates of infection were more prevalent among indigenous populations residing in more remote locations of Australia. Also, the study had a primary significance of determining the credibility and accuracy of the epidemiological research. This care is influenced by the distribution of the indigenous individuals in Australia. Moreover, statistics on the study report reveal that seventy-eight percent of indigenous Australians thriving in remote regions have to relocate to seek renal treatments in healthcare facilities (Chan et al., 2012). However, it is not sure that variations in the geographical areas indicate prevalence differences in chronic comorbid infections, access to treatment and progression in chronic kidney diseases. Moreover, the reported cases of death from end-stage renal infections are rarely supported by the factor of geographic variations since there is an insignificant difference of the issue between indigenous Australians and the other individuals.

In reflection to the comorbid infections that occur at the same time with the end-stage renal disorder, diabetic nephropathy is the predominant infection. The epidemiological researchers imply that sixty percent of the indigenous population of Australia who is affected by the end-stage renal disease suffer from diabetic nephropathy. The statistical were very significant compared to twenty-five percent of non-indigenous Australians diagnosed with the two comorbid infections at the same time (Tang et al., 2012). According to clinical interventions, diabetic nephropathy is a primary causal agent of the end-stage renal disorder. Thus, the diagnosis procedure carried out is similar where diabetic nephropathy symptoms indicate earlier signs of the end-stage renal disease (Reutens, 2011). Therefore, it is essential for healthcare providers to conduct further studies on the disease among the indigenous population to establish proper preventive, curative and control measures of the disorder.

As far as remoteness, age, gender, treatment procedures and comorbidity are concerned, the people are also faced with challenges of poor infrastructure and poorer socioeconomic indices as social determinants of health. Research reveals that the non-indigenous Australians are more urbanized than the indigenous Australians. Therefore, it is relevant and authentic to imply that the state of infrastructure concerning roads, schools, healthcare facilities, business institutions and others is poor (Gracey, 2009). Hence, the indigenous population of Australia are faced by a significant margin of poverty, where most of them cannot meet some basic needs such as quality education, food, and healthcare services. Their poor social, economic statuses promote some vices in the healthcare system such as healthcare disparities as much as nursing ethics are concerned. Moreover, other factors such as poor roads minimize their capabilities of accessing quality health facilities in Australia urban settings (White et al., 2010). Thus, this factor can describe why there is still a high incidence and prevalence of the end-stage renal disease among the indigenous population of Australia.

Social Determinants of Health and High Incidence of End-Stage Renal Disease Among Indigenous Australians

Correspondingly, education as a social determinant of health is another factor that can be used in predicting the health situations among the indigenous Australians. The presence of low-quality facilities that education in geographic regions dominated by indigenous populations leads to poor education performances among them. Thus, few graduates manage to acquire competitive professionals that generate quality service such as healthcare as well as income (Marmot, 2011). This situation can explain the high incidence of end-stage disorder which results from inadequate and insufficient infrastructure in healthcare facilities of Australia. The case is also reinforced by high rates of chronic and comorbid diseases such as lung and heart diseases experienced by the indigenous individuals in remote settings.

Also, highly equipped doctors with knowledge and skills concentrate more on the private sector than in the public sector. Hence, the public healthcare systems are dominated by nurses who offer other healthcare duties under the instruction of the doctor and according to hierarchy and power in healthcare institutions (Kuhlmann,2008). Moreover, limited information on proper feeding habits as well as insufficient money to meet proper and recommended diets leads to severe cases of diabetic nephropathy. Nevertheless, the condition is a primary promoter of the end-stage renal disease which is more prevalent on the indigenous population of Australia than the non-indigenous individuals.

The rate at which treatment is facilitated towards the end-stage renal disease increases globally with time. Also, the increased prevalence and incidence of the disease among the indigenous Australians establishes the need to analyze and re-examine the current treatment strategies to increase treatment outcomes of the disease. Correspondingly, there is a need for healthcare systems in Australia or different countries of the world to establish new strategies that can address the situation at workplaces, community, state level and at the federal government level (Vos et al., 2009). As revealed by epidemiological research reviews in part A, the current strategies demonstrate a certain margin of failure in facilitating quality healthcare services which are essential among most indigenous Australians, especially those residing in remote areas. There is a crucial need to improve their socioeconomic status which includes the principal determinants of health such as education, infrastructure, nutrition and others.

One of the fundamental strategies that can be applied to address the issue by organs in different levels of the society is the implementation of high-quality healthcare and education systems in regional and remote locations of the indigenous Australians (Braveman, 2011). This strategy will be essential in capacity building, collaboration, and sustainability of quality healthcare and education services among the remote regions inhabited by indigenous Australians.

Challenges Faced by Indigenous Australians in Accessing Quality Health Facilities

At the workplace, this strategy can be applied by sharing skills or educating fellow workers on proper nutrition procedures. Feeding on a healthy diet is fundamental to avoiding some nutrition-based infections such as obesity.  The latter is known to be a primary causative agent of diabetes which propels the occurrence of the end-stage renal disease. Moreover, spreading information to illiterate and affected indigenous Australians on proper health facilities which can offer adequate dialysis procedures can be crucial in prevention, treatment and controlling the high incidence and prevalence of the disease (Mathew et al, 2010). Correspondingly, it would be essential to advise fellow employees on how to collaborate non-governmental and governmental organization to offer moral education and socioeconomic support that would improve the wellbeing of indigenous Australians seeking quality education and healthcare services in their remote regions of residence.

At the community level, the strategy can be used to address the end-stage renal disease among indigenous Australians through drug and substance education procedures in association with awareness on the disease before the symptoms become critical. The epidemiological researchers conducted to reveal the indigenous Australians a highly associated with matters of drug and substance abuse. Therefore, educating them on how to alter or change the situation would save some funds used in drugs purchase for other essential uses such as teaching their young children, providing means and access to high-quality healthcare institutions and other factors (Mathew et al, 2010). Also, educating the middle-aged indigenous Australians on early symptoms of the diseases would create self-awareness thus enabling them to seek quality healthcare services once the first symptoms of the disease are experienced. Additionally, creating community committees that would address and forward issues affecting the indigenous Australians to the state and federal authorities would assist the solve some critical problems such as poor and inadequate healthcare and education systems.

Additionally, the federal and states have a critical role to play as far as matters of implementing the strategy are concerned. The state government would assist in improving the quality of healthcare and education systems in remote regions dominated by indigenous Australians. The improvement mechanism includes improved means of transport and accommodation at healthcare facilities which would enable infected indigenous Australians to access the facilities easily before the condition is too severe to heal. On the other hand, the federal government is responsible for funding, construction of quality infrastructures like roads leading to remote areas, healthcare facilities and education systems (Ayodele, 2010).

Education as a Social Determinant of Health Among Indigenous Australians

 Also, employment of skilled and enough workforce in the remote regions dominated by indigenous Australians wound be essential providing high-quality healthcare services. Also, collaborating with other non-governmental organizations would provide necessary aid to the population. They include proper diet improve medication, adequate accommodation, and others (Grol et al., 2013). Research implies that most of the indigenous Australians in remote regions reside in temporary settlements which are unconducive as far as matters pertaining to their health are concerned.

Successive application of the strategy at the mentioned levels would require social support services. This procedure would begin with identifying individuals who are needy and require the support either by relocating them to where dialysis provisions are available or availing them to the remote regions. Therefore, there is an essential aspect of the collaboration of state and federal governments, Aboriginal community controlled health organizations, NGOs, and general practice (Jha et al, 2013). Coordination among the organs would facilitate detection, management, and prevention of the end-stage renal disease among other chronic infections. A combined effort would reduce the high cases of tobacco and alcohol consumption reported among the indigenous populations (Wilson, 2010). The activity causes the occurrence of chronic conditions which are propelled by insufficient physical activities and poor nutrition.

Correspondingly, the mentioned groups can initiate local community campaigns aiming at funding the indigenous populations in towards health and education promotion projects to improve the living standards of the affected ethnic group. Also, the organs can offer to provide the required necessities for screening and detecting the disorder as well as other chronic infections to initiate new management procedures of the identified disease. It would also reduce severe disease progressions and outcomes as well as high mortality and morbidity levels among the indigenous Australians (Ludlow et al, 2011). Through collaborations, Medicare reforms can be availed to the economically challenged groups to cater for additional expenses incurred during treatment. Furthermore, the federal and state governments would ensure that the established policies of the national health are implemented to provide quality Aboriginal Health Services without charges. Also, the latter would ensure that the strategic health policy is altered to accumulate new challenges emerging among the indigenous Australians.

Another fundamental aspect to consider while addressing the health situation is the sustainability of the set strategy. Progress in healthcare and education systems would be propelled and sustained if the mechanisms employed under effective care and consideration of various factors. They include the social, environmental and economic factors in the field of operation. These factors affect how efficiently and responsibly the allocated resources are utilized and distributed among indigenous Australians to improve healthcare and education quality (Liaw et al, 2011). Moreover, the strategy becomes more sustained when the workforce promotes health effectively, prevent and control the high incidence of end-stage renal disease and offer quality education services to indigenous Australians in remote regions. Also, establishing sustainable models and projects of care would increase the credibility of the implemented strategies. In this case, sustainability is essential in ensuring equal distribution of released funds and resources by the federal and state government and other non-governmental organizations.

Impact of Healthcare Disparities and Poor Nutrition on End-Stage Renal Disease Among Indigenous Australians

Moreover, sustainability of strategies is propelled by establishing plans that reveal various challenges that are supposed to be solved. In this case, defining the health and education challenges among the indigenous Australians would be essential in setting a long-term goal. The social problems of inadequate health facilities and education system would assist in the allocation of necessary resources that would increase the quality of education and healthcare service provided to the indigenous Australians (Gruen et al., 2008). On the other hand, defining environmental challenges such as poor settlement would aid in improving the quality of settlement inhabited by the indigenous Australians. Correspondingly, identifying the financial difficulties among individuals through poor diets, inability to meet healthcare expenses and low-quality education would enable the relevant authorities to plan and meet the needs of the affected individuals.

Capacity building is another primary aspect to consider as much as strategizing in healthcare among indigenous Australians is concerned. It targets to improve sustainable health activities and strategic processes. Moreover, capacity building is characterized by empowerment and development of high cooperation levels among community individuals to yield a mutual social benefit (Baillie et al., 2009). The latter extends to international aid development, community development, education and public health. These aspects are fundamental in improving the sustainability of strategies set among the indigenous Australians in this case. It is also associated with altering the policies regulating health and education systems, provision of quality skills to the workforce, integration between organizations and community organizations. These aspects aim at improving healthcare and education services among the indigenous populations (Couzos, 2008).

In conclusion, this discussion sheds light on the significance of studying the end-stage renal disease in indigenous populations in Australia. The increasing incidence and prevalence among young and middle-aged Australians have revealed the need of taking the issue into critical consideration. Also, a higher rate of comorbid disorders and the end-stage renal disease has been observed among indigenous Australians than in the non-indigenous populations. Therefore, that issue has established the need for developing a strategy that can control, prevent and treat the condition to reduce the mortality rate and severe outcomes of treatment among the indigenous Australians. The significance of creating strategies to address the situation at different levels of the society has been revealed. Moreover, the federal and state government have a significant role to play in improving the social determinants of health among the indigenous Australians. Furthermore, the aspects of collaboration, sustainability, and capacity building have established their importance in the strategic process of addressing the health situation among the indigenous Australians.

Proposed Intervention Strategies to Address End-Stage Renal Disease Among Indigenous Australians

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