The Social determinants of health are the conditions, in which people are born, grow, work, and age; including the health system. These circumstances are shaped by the distribution of money, power, and resources at global, national, and local levels. The factors of social determinants of health involve the environment, housing, educations, employment, access to health care, good nutrition, access to clean water, and sanitation.
The health status of Aboriginal and Torres Strait Islander people is poor as compared to the rest of the Australian population. Social determinants that directly affect the health of Aboriginal and Torres Strait Islander People are Socio-economic status, poverty, unemployment, racial discrimination, exposure to violence, trauma, stressful events, and access to community resources.
All these factors eventually affect the health status of Aboriginal and Torres Strait Islander people as socio-economic status leads to increase in environmental health risk, due to poverty there is inadequate food and nutrition available for them and this directly affects their physical and mental health, lack of education results in unemployment and poor housing affects the well-being and health of people, racial discrimination, exposure to violence leads to trauma and stressful events which directly affects their health.
Immediate and long-term impact of this is the health-related issues faced by them such as comorbidity, disability, injury and violence which results from the cultural, environmental, and lifestyle variables, higher rate of perinatal deaths, health conditions such as hypertension and diabetes, malnutrition, Renal failure and cardiovascular diseases.
Community engagement is a way to set social determinants in place, as it aims to better the health and social outcomes by targeting the modifiable factors. Community engagement is the process of working collaboratively, developing partnerships with indigenous people and communities by engaging them on a regular or annual basis; making commitments and establishing agreements will develop the capacity of the individuals and organizations which will result in increasing the literacy and numeracy, reducing the unemployment rate and improving the housing and nutrition.
The three determinants that directly affect Mary and John are:
Responsibility of their grandchildren: In the given case study, it is mentioned that Mary has started feeling overwhelmed by her responsibilities and commitments, being old age, working for her community and fulfilling their needs as well as of her grandchildren is being hectic and is affecting both, Mary and John.
Unemployment: Inaccessibility of work at homeland leads to unemployment of their daughter and son-in-law which is affecting both of them as it is establishing financial crisis, and increasing work burden and responsibility because their daughter and son-in-law have to travel across the North-Queensland to secure their employment due to which they both have to take care of their grandchildren.
Racial discrimination: The third determinant that affected Mary and John was Racial discrimination when Mary and John went for her granddaughter’s admission the way the administrator of that school was questioning regarding Rumi, Mary’s granddaughter being Torres strait islander descent and her complexion clearly shows the cultural discrimination i.e. racism.
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