Australia is a sovereign country which comprise mainly of the Australian continent, the island of Tasmania and several other smaller islands. It is called as the largest country of Oceania. It is also stated as the world’s sixth largest country by total area (Willis, Reynolds & Keleher, 2016). In Australia, health care is largely provided by private medical practioners. It is also provided by government and private operated hospitals. It is the mixed public-private health care system and is ranked second best in the developed world (Duckett & Willcox, 2015). Both women and men are predisposed to various types of diseases. The genetic, biological and behavioral differences between both genders led to higher health risk among women in Australia. As per literature, a large number of issues have been noted among the women health which remains unreported (Dawson et al., 2017). This assignment will mainly be based on the description of the women health condition in the nation. Moreover, it will also discuss three important social determinants of women health in the nation. This would be followed by the discussion how primary health care of the nation has been addressing the women heath issues. It will also be showcasing how social and economic policies have impacted the health conditions of the women in the nation.
The national agency in Australia responsible for health and welfare information and presenting statistical data is the “Australian Institute of Health and Welfare” (AIHW). This body develops 140 reports every year on health status. The federal initiatives of Australian health care are Medicare responsible for health service subsidies. The development of healthcare sector in the country has led to increase in the life expectancy of the population. Australian government system of Medicare (Australia’s universal health care system) had helped people to cope up with their healthcare cost (Milner, Smith & LaMontagne, 2015). Medicare funds large part of the health care services. The Pharmaceutical Benefits Scheme offers subsidized medication to patients. The regulatory body of medical devices and the medicines is the Therapeutic Goods Administration (Meadows et al., 2015).
In Australia, WHA or Women Health Care Australia is the peak body for hospitals oriented towards women health. Hospitals providing maternity care and other health service to women in Australia directly work under WHA. It serves 110 maternity services across Australia.. It is the largest woman health advocacy. Some of the special interest groups of WHA includes are, “Aboriginal & Torres Strait Islander Women’s & Children’s Health”, “Maternity services” and many more (Duckett & Willcox, 2015). Despite several developments, women health is of major concern in Australia.
Most chronic and disabling disorders which are affecting women in Australia are heart diseases and stroke (Byles et al., 2015). Cardiovascular disorder is affecting considerably a larger proportion of females in this nation. Currently Australian government is considering this disorder to be the most dreaded disorder in the nation. This is reflective from the fact where 209.8/100000 deaths are occurring from heart attack, stroke as well as vascular diseases among females. This rate is considerably higher in the elder female cohorts. Ischemic as well as coronary heart diseases occur mainly due to build up of a large number of plaques in the different blood vessels (Dobson et al., 2015). This is resulting in angina and heart attacks to a large number of women per year. Increased levels of obesity are mainly considered to be the main cause behind the development of heart disorders in women. A study also suggests that the burden experienced by women from stroke is 2% higher in comparison to that of the males (Schmied et al., 2015).
Numerous types of cancer are affecting women in the nation. The burden of cancer among women of the nation is found to be dominated by breast cancer followed by lung cancers. Together these are actually resulting for about 60% of all the cancers in the nation. According to Australian Bureau of statistics, breast cancer is the 2nd most common cause of death from cancer in females (Torre et al., 2015). Australia ranks 17 in the entire world with 86% in age standardized rate per 100000 in world (Yu et al., 2015). The prevalence of new breast cancer cases among Australian women in 28.4% as per 2017 reports. There are 17586 women newly affected by breast cancer in 2017. Total number of deaths among females in 2017 due to cancers was 19453. The total number of new cases among females due to lung cancer was 18/100,000 persons in 2017 (Dasgupta et al., 2017).
Other women related issue that is also getting pronounced in the Australian context is the several disorders related to mental health. Depression related issue is one of the most common mental disorders which is affecting the women of the nation that had accounted for about 4.8% of the total diseases burden on the women (Hayman et al., 2015). Post partum depressions are found to be yet other contributors to the increasing rate of mental health disorders in Australia. It is affecting up to 15% of the childbearing women (Schmied et al., 2013). A marked difference is found in the health conditions of that of the aboriginal women (Milner, Smith & LaMonatge, 2015). It is astonishing to found that the life expectancy of such women are found to be 20 years shorter than that of the non-aboriginals. However the diseases by which they are affected are more or less similar to that of the non-Indigenous Australian women (Gausia et al., 2015). The mortality rates of the Indigenous women are 2.8 times higher than Non-Indigenous women in cardiovascular diseases. Neoplasms or cancer of such women also result in higher number of deaths with lung cancer becoming 20%, digestive organs for 20% and female genital tract for about 17% (Dawson et al., 2017).
Social determinants of health can be stated as those conditions in which individuals take birth, develop, live, learn, play and work. These factors have a high impact on their health and also on the safety and well being of the individuals. SDH includes factors such as education, employment, social support, income and others influences healthy living (Schmeid et al., 2015).
Poverty and socio-economic status is an important social determinant of health. Researchers are of the opinion that socio-economic disadvantage can be considered as the cause as well as the associated outcome of the poor condition as well as sexual and reproductive health of the women population. Socio-economic disadvantages are mainly denoted by low income as well as lower levels of education (Badland et al., 2014). In 2014-15, 20% of the Australians dwelling in the lowest socioeconomic areas were equally likely as the highest 20% to suffer from heart disease and diabetes (Newman et al., 2015). Those living in the low socioeconomic areas (bottom 20%) and in poor quality and highly crowded areas are highly susceptible to poor mental and physical health. As per AIHW, if people living in both low and high socioeconomic areas had same death rate then, then it would reduce the overall mortality rate by 13% (AIHW, 2018). The 2013 report of AIHW states that mothers, who are 30% likely to have low birth weight babies, are residents of low socioeconomic areas. As per the 2012 ABS report, the percentage of people with employment restriction due to disability from lowest socioeconomic areas constitutes 26% and 12% in highest socioeconomic areas (AIHW, 2018).
Low socioeconomic status limit the access of an individual woman to material and psychological resources at the same time affecting the ability of women to exercise decision making and autonomy. Children and unemployed women living in poverty and low socioeconomic areas are highly likely (3.6 times more than high socioeconomic counterparts) to be addicted to tobacco smoke and other addictions (1.6 times as likely to use cannabis, 1.8 times to use ecstasy and 2.4 times to use meth/amphetamines) (AIHW, 2018). Socioeconomic disadvantage affects women’s ability to access health services, contraception, abortion as well as timely screening and treatment of not only sexually and reproductive health disorders but also other mental and physical disorders (Owen et al., 2014). Researches also show that poverty influences women and their partner’s choice of welcoming a child in their life, seeing a dental professionals due to cost, and other health activities These conditions ultimately affect the physical and mental health of women in the nation (Mitchell et al., 2016).
Another social determinant of health of women is violence and discrimination which is faced by them. This determinant of health is has long lasting physical and psychological health impacts. Prevalence of violence on women is in present in Australia. This is affecting sexual and reproductive health of the victim. These conditions influence the mental and financial condition which gains impact on the mental health and physical health of the women. Studies show that one in every five women had experienced sexual assault at some point of their lifetime while one in ten women are raped by their partner (Spangaro et al., 2016). Violence and coercion can take many forms that not only include sexual assault but also contain intimate partner rape, gang rape, female genital mutilation, forced prostitution, human trafficking and many others. These factors have tremendous impact on mental development and physical health which remain associated with it (Spangaro et al., 2016). According to Hooker et al. (2017), 59% of homeless females in Australia have experienced unwanted sex. Women and girls are seen to bear the burden of ill health, injury and diseases caused by violence. Therefore heart disorders, mental health problems, sexual and reproductive issues often take place. According to Victorian police, it is seen that the women living in the western region of Melbourne who are subjected to higher rates of intimate partner violence and racial discrimination (Spangaro et al., 2016). Such victims get exposed to higher chances of unplanned pregnancy, sexually transmitted infections like HIV along with a range of gynecological issues like vaginal bleeding and infection. Fibroids, chronic pelvic pain and urinary tract infections occur in such individuals (Kelaher et al., 2014).
Australia’s gender pay gap is yet another social determinant which is affecting women health to a huge degree. Although the generation is proclaiming equal rights given to the female, statistical data is not justifying the claim. Unequal pays and pay gap statistics also shows that Australia’s full time gender pay gap is 15.3% with women earning on an average $251.20 per week less than that of the males. It has been found that when $1,387.10 is the amount received by women as full time average weekly earnings of women, $ 1638.3 is the full time average weekly earnings of men (Cassells et al., 2017). Researchers are of the opinion that a number of factors come into play and influences the gender pay gap. The first one is the discrimination and biases of the society. The corporate world is hiring more men than women and is biased in terms of pay decisions. The gender gap is also influenced by women and men working in different industries. There are female dominated industries and jobs attracting women with lower wages. Moreover lack of workplace flexibility especially in senior roles acts as a barrier for working mothers. Therefore women have to either leave their jobs or compromise with lower salaries for meeting their commitments (Cassells et al., 2017).
Often women’s greater time out of the workforce impact their career progression and opportunities to earn high salaries. It is seen that the women are given less chance in the private sector jobs to handle positions for high earning management roles such as managing directors and CEOs (Dobson et al., 2015). They are hired for lower status jobs that not only have lower pay but also poor working conditions. Women have less autonomy and control over the entire planning in an origination. They undertake work that are males dominated and are subjected to stress, anxiety and depression (Milner et al., 2015). Low job control is a well established risk factor for poor physical as well as mental health. It is seen that gender pay gap and such behaviors at workplace resulted in depression and anxiety among the working mothers. It was found that women whose income is lower than their male counterparts ha a nearly times higher risk of depression and four times higher rate of anxiety than their male counterparts. It also affects their sleep, diet, exercise and other related behaviors. It results in physical ailments and mental health disorders (Rickwood et al., 2014).
Primary care is the continuing care for the patients provided by the health care providers who are in first contact with the patient. It includes physician, nurse practioner, clinical officer, and others who give day-to-day care. Primary care is an integral component as per World Health Organization and every patient with chronic illness is entitled to it irrespective of nature of illness and socioeconomic status (Wakerman et al., 2017).
Primary care provided to Australia’s women is quite developed as they use evidence based practices and provide services appropriate for local community needs. It is reflected in National primary health care strategy. System of Medicaid had helped patients to cover up for their huge expenses but also help women to get better service delivery form the primary care providers. Both the government and the non-government sectors, the healthcare industry has been quite active in handling women health issues. They are supporting improvement in performance, quality and safety, while making best use of infrastructure. Breast cancer awareness programs have been taken by different primary and community healthcare centers so that proper screening can be conducted by the women (Dasgupta et al., 2017). Aboriginal Community Controlled Health Services is advantageous for Indigenous women in health promotion, prevention, treatment and early management. This service considers cultural and linguistic factors to maintain respect and dignity of patients. Primary health care services are targeting the specific health and lifestyle condition such as cardiovascular diseases, cancer, mental health, and obesity. Primary health care services operate differently in urban, rural and remote areas. Australian primary health care practice implements person centered care approach (Badland et al., 2014).
Community health programs and primary care services are also available which tackles different female’s sexual problems and refer to secondary care services when in need. Women are well educated by their primary care service providers with proper resources. This helps them to maintain their lifestyle in ways by which different female sexual problems can be handling with ease and can be overcome by proper lifestyles and habits. Moreover, it was also seen that proper education provided by the primary care providers have helped many violence survivors to gradually develop strength and restore their mental health. Treatments starting from hysterectomy to educating patients on incontinence leaks, menopause, and menstrual issues are also paid great attention (Tolhurst et al., 2016). Primary care services ensure community development by implementing different forms of screening programs for cancer identification in the patients. It promotes health while preventing illness. The focus is on building capacity of individual with goal of self determination (Rickweed et al., 2014).
The National Women’s Health Policy 2010 was mainly proposed with the purpose to help in improving the health and well being of all the women in Australia mainly helping those who are at a greater risk of poorer health. It helped in identifying the immediate as well as future health challenges of women at the same time of addressing the fundamental ways by which society could be structured properly. This had positive impact on the on the health and well being of the women in the nation (Rickwood et al., 2014).
The AMA’s policy (Australian medical association) focus on social model of health,, gender equity, health equity between women, upstream interventions, life course approach to health, strategic coordination and leadership and building the knowledge base to improve women’s health to highest attainable standards. This policy has been effective in addressing social determinants of health and health experiences of Aboriginal and Torres Strait Islander women. The AMA recommends gender mainstreaming in local, national, state and territory health policies (Walters et al., 2017).
There are several laws acting at federal level. The Australian Human rights commission has statutory responsibilities. The Australian Human Rights commission Act (2004), Sex Discrimination Act (1984), Racial Discrimination Act (1975), Disability Discrimination Act (1992), and Age Discrimination Act (2004) act at federal level. Together this laws has been successful in preventing discrimination against women based on sex, race, disability, identity, relationship status, social origin, political opinion, pregnancy and others. These laws and policies have been successful in improving the health status of the women to a great extent (Boer & Gruber, 2017). Despite the socioeconomic policies, there is huge disparity in women health. There is need of stringent monitoring and evaluation of the policies to ensure desired health outcomes for women. Women rights are not fully protected in Australia, the violence prevention and legal services are not available in most parts of the Australia. The family policy system and laws pertaining to it do not fully respond to the domestic violence issues. There is need to increase the indigenous women in decision making positions. The “National Plan for Violence Against Women and their Children” is a 12-year agreement and has not shown significant improvement yet (Boer & Gruber, 2017).
Conclusion
It can be concluded that Australia, although being a developed nation, also harbors many factors that affect the women health of the nation. Cardiovascular disorders, cancers, mental depressions, sexual and reproductive health issues are most prevalent health issues among Australian women. The social determinants of health are poverty, violence and discrimination, social economic status, and gender pay gap. All these affect human health both physically and mentally providing a very poor quality life. Hence, it becomes extremely important for the healthcare service of the nation to provide support and service to women in the nation. Australia’s healthcare delivery service is quite efficient and is trying their best to provide best care and compassion to them. Different policies over the years have been proposed which had helped in developing lives of the women and help them in healthy aging.
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