The “Closing the Gap” aims to diminish the existing gaps in the context of education, health and employment between the Indigenous and non- Indigenous people of Australia. This has been a great initiative by the Government of Australia to address the disparity issues and bring equality among all the people of the nation. These existing gaps can be resolved in the best manner by addressing the social, cultural and environmental determinants that are the underlying reason for these disparities. This essay aims to review one of the chapters of “Closing the Gap Prime Minister’s Report 2019” that is “infancy and early childhood”. This chapter will be reviewed using the social, environmental and cultural determinants health that affects the health of Indigenous people.
Healthy development is the best chance of success and it is a good start for the children at an early age. A sound foundation for life is based on the early interventions for the healthy development of the child. The positive child development is based on access to an equal share of resources and rights that helps them to retrieve the maximum amount from the opportunities accessed by them. The good start for the children opens up the opportunity of leading a healthy and successful life (Australian Government 2019). The main aim of the Australian Government for Aboriginal children is to ensure that they are safe, resilient and thriving. This chapter takes into account the different determinants of health that are addressed by the interventions proposed by the Government to ensure the healthy development of the child.
In the year 2013- 2017, the rate of infant mortality among Indigenous people was double as compared to the non- Indigenous people. Most of these deaths were recorded due to perinatal conditions like cardiovascular diseases, fetal growth disorder, respiratory disorder, complications in pregnancy and birth trauma. The rate of early childhood deaths during this time was also high and this was contributed by the external causes like drowning, accidental injury and transport accidents. The complex set of factors such as environmental factors like the use of certain medications during pregnancy, poorly controlled diabetes-like chronic conditions contributes to the congenital and chromosomal conditions that underpin higher rates of death. All these factors demand to address the social, cultural and environmental factors so that the improvement in the death rates can be recorded and the early well- being of children is ensured.
An integrated approach is used to deliver to the children at an early stage that comprises giving a structured early learning environment that addresses the environmental determinant of the health of Aboriginal children. The provision of an early learning environment is to enhance healthy early child development. The early learning environment is important to make Aboriginal people educated and well aware of their health conditions. The provision for early preschools has also been set up for the children through a series of National Partnership agreements that ensure that each child has access to quality education. The National Early Childhood Education and Care Collection (NECECC) attempted to enroll about 95% of the Aboriginal children in early preschool successfully and this had a positive impact on improving the child mortality rates (Press et al. 2015). The impact of education on health is always positive and these two variables have a direct impact on each other. The high quality of education is a universal right of all and the Government initiatives helped in establishing many schools for these children. There were higher rates of the gap in the attendance rates between Indigenous and non- Indigenous Australians when access to school was made easier for all. The five checkpoints were measured to notice the reason for gaps in attendance that are children's physical health and well- being, communication skills and general knowledge, social competence, language and cognitive skills and social competence.
The aim of the provision of culturally appropriate maternal care to reduce the significantly higher rates of death is an indicator of addressing the cultural determinant of health that affects the life of Aboriginal children and mothers. The maternal and child health interventions that are delivered to halve the rates of child morbidity are culturally appropriate for the Aboriginal people (Jongen et al. 2014). This will enhance the positive and healthy early Indigenous child development along with respecting their culture. They are given perinatal care so that the perinatal health conditions can either be avoided or cured so that it results in healthy pregnancy and delivery. The local community-based health workers who work primarily for Aboriginal and Torres Strait Islander people provide culturally appropriate care to these women at their homes. The health care workers also support pregnant women in attending appointments like in diabetes education, antenatal care and scans. This has improved the system of access because Aboriginal women have started to access such services early in their pregnancy that has led to better birth outcomes. This chapter has very well addressed the cultural determinant of health for the Aboriginal people and especially mothers and children that show high mortality rates.
The social determinants of health in relation to early child health are also discussed in this chapter. The social determinant of health discussed is the connectedness to family and culturally safe care. The connectedness to the family can be best determined with the positive parenting skills that are required to raise a healthy child. The health, safety and healthy development of the child in the first five years can be achieved with positive parenting skills and the social determinants address can only result in an active and healthy child (Sanders 2014). This will also support the alterations in the trajectories for the next generation. One such program is "The Connected Beginnings Program" which provides holistic support to get positive transition outcomes.
The second social determinant of health addressed in this chapter is access to early childhood services and education. Access to early education results in the building of social competence, cognitive skills and the development of communication skills (Jones et al. 2015). This also addresses the complex factors like low parental education. The child’s early learning ability helps the family in addressing the environmental factors also such as unstable housing, family stress and unemployment.
The environmental determinants of health like unstable housing and no access to health care services that also contribute to higher rates of early childhood morbidity and mortality are also addressed. These determinants can be best addressed by the collaborative efforts from various departments that aim to improve education access, health care access, provide opportunities for housing for all the Aboriginal people and so on. This leads to the development of healthy and stronger families thus healthy early child development.
Thus it can be concluded that this report on "Closing the Gap" addresses the social, cultural and environmental determinants of health that have led to the higher rates of morbidity and mortality among the infants. This has also affected early childhood and maternal health thus many measures have been taken to address these social, cultural and environmental determinants of health. These measures taken by the Australian government have resulted in the improvement in the death rates and have led to the successful and healthy development of the children by providing effective interventions right from the stage of early childhood.
Australian Government. 2019. Closing the Gap- report 2019. Available at https://www.niaa.gov.au/sites/default/files/reports/closing-the-gap-2019/sites/default/files/ctg-report-20193872.pdf?a=1
Jones, D.E., Greenberg, M. and Crowley, M. 2015. Early social-emotional functioning and public health: The relationship between kindergarten social competence and future wellness. American Journal of Public Health, 105(11), pp.2283-2290.
Jongen, C., McCalman, J., Bainbridge, R. and Tsey, K. 2014. Aboriginal and Torres Strait Islander maternal and child health and wellbeing: A systematic search of programs and services in Australian primary health care settings. BMC Pregnancy and Childbirth, 14(1), p.251.
Press, F., Wong, S. and Gibson, M. 2015. Understanding who cares: creating the evidence to address the long-standing policy problem of staff shortages in early childhood education and care. Journal of Family Studies, 21(1), pp.87-100.
Sanders, M.R. 2012. Development, evaluation, and multinational dissemination of the Triple P-Positive Parenting Program. Annual Review of Clinical Psychology, 8, pp.345-379.
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