Determinants of Health

Introduction to Determinants of Health

COVID-19 (more specifically, a coronavirus) also known as SARS-CoV-2 is the disease that has emerged as the cause of an epidemic of respiratory ailment (Ahmad et al., 2020). There is a drastic pandemic caused due to the spread of coronavirus, which has led to legitimatehuman concern about the risks from COVID-19 and a pandemic. As of date, their are18.4 million confirmed cases, with deaths up to 692 thousand and 11 million recovered cases. Taking a look at the Australian database, there are 19,444 confirmed cases, with deaths up to 247 and 10,935 recovered cases (Jessica & Raja 2020). This reflective essay reflects political, social, geographical and cultural factors which resulting in decline in COVID 19 cases, the social determinants of health in play during the pandemic and the efforts of the Australian governments to decrease the transmission at an early stage.

Political, Social, Geographical, and Cultural Factors

COVID-19 was first confirmed in Australia in late January 2020 (Warish & Nicola, 2020). Since then, the virus did not cause much destruction as anticipated because of rapid shutdown measures, including border sealing and the strict and mandatory home or institutional quarantine of travelers. Australia has been saluted as a global success story in surpassing the spread of Covid-19 (Stavrakakis & Katsampekis, 2020). Strict lockdown measures helped in restricting the transmission of the coronavirus in Australia and also bring down the number of influenza cases.

Political factors: Australian government effectively implemented an Australian National Disease Surveillance for COVID 19 (Australian Government, 2020). It focused on increasing the awareness of the spread of the disease and contain the virus by incorporating various public and community health measures. The Australian government was able to provide financial aid to the people who lost their jobs due to economic crisis caused by the pandemic, for people working in food industry and different businesses. As per the NEWS article published by Australian Government online on 3rd August, The government provided $33 million to the maintain childcare facilities and educational institutes, $1500 per fortnight was provided for people in Victoria who were affected by COVID19 , but could not afford a sick leave. The government has also taken a step to extend the JobKeeper Paymentand COVID 19 Supplement beyond September 2020 (Australian Government, 2020). It has also provided financial aid to various other states across Australia under “pandemic leave disaster payment” plan, contributing $2.4 billion for protecting the Australian population. (Australian Government, 2020; Department of Health, 2020). The Australian Health protection principle committee prepared a management and operational plan for the people with disability and for the aboriginal and Torres strait islanders a well-tailored customized emergency-response plan was curated to deliver culturally appropriate testing of the population including those in the rural and remote areas (Australian Government, 2020). 

Social factors: The Australian government executed a prohibition on an unimportant meeting of masses on 16 March. This moderately was levitated to a more complete lockdown on 23 March when all other major business ventures were also shut down (The Diplomat, 2020). In addition to it, very few numbers of kids have been going to school since early-March, when states and territories began propagating online classes. Australia witnessed a significant drop in COVID-19 cases since its lockdown days, with very few new cases being attended daily in early May (Australian Government, 2020). In addition to all the measures stated above, residents are downloading the government's self-explanatory coronavirus tracking app which will alert them if someone residing in their vicinity has been exposed to the virus or is asymptomatic too.

Geographical factors: Australia has a geographical advantage, being a continent surrounded by seas, which enables it to seal itself from exposure of the world, thus, preventing any new ways for entering of the virus. This has led to Australia to have a lower vulnerable position as compared to the other countries and focus mainly on the prevention of community spread of the existing cases. (The Diplomat, 2020)

Cultural factors: The government provided support to the older age group and those having comorbidities like heart disease, diabetes, chronic lung infection, and cancer are more predisposed to an aggressive form of respiratory disease by providing the prescriptions at home. Education and assistance were provided to improve the access to health care facilities in English as well as other languages for the aboriginal communities. The method to avert and slow down the spread of disease is to have a good knowledge of the causative methods of transmission, and its prevention (Australian Government, 2020).

(Source: Department of Health, States and Territories Report 07/08/2020)

Social Health Determinants

Five social health determinants are: Economic stability, education, social factors such as age, gender, sources of income; environmental and physical determinants (Gyasi & Anderson, 2020; Holt et al., 2020).All these factors have contributed in the spread of the disease, especially lack of access to proper medical facilities due to poverty, lack of education and others. However, the Australian Government has helped in protecting individuals by educating them regarding the prevention of the disease, instructions regarding washing of hands or using an alcohol-based sanitizer frequently and not touching the face and mouth frequently. These precautions have been labeled as SMS – sanitization, mask, and social distancing. The sharp decline and steady management of the number of cases are most likely because of Australia’s call to utterly seal its boundaries on 20 March and interdict all unimportant gatherings and public conferences to put a halt to the unfold of COVID-19 (The Diplomat, 2020). Also, health care officials have to go to their hospitals to care for admitted patients. Thus, understanding the factors which determine the health of an individual is the basis to have a positive impact on the wellbeing of an individual and thus in the overall betterment of the society and the country (Liebig et al., 2020). 

Young Females and Older Males Are More Affected

Various policies and measures taken by public health ministers in Australia, have not effectively addressed the gendered impact of the COVID-19 disease. According to Wenham et al, (2020), “Recognizing the extent to which disease outbreaks affect women and men differently is a fundamental step to understanding the primary and secondary effects of a health emergency on different individuals and communities, and for creating effective, equitable policies and interventions.” It has been noticed that the younger females in the age group of the early '20s and '30s are at the brunt of suffering more due to COVID 19 as compared to their male counterparts (Stefanie & Dr. Tania King 2020; Brown et al., 2020). The basis for this difference is more of a lifestyle-related issue rather than organic. Some of the known factors are, due to their social life, young women are more seen to be socially active in public places, and also the fact that mostly the women who are part of the front line workers in a health institution, which exposes them to a greater risk of contracting the disease (Smith, 2019). It's also known that young women have a higher amount of economic insecurity leading to stress and other mental health problems. Women are also seen to be engaged in industries expected to hit by the pandemic at a larger scale like the slum areas (Boniol et al., 2019). On the other hand, a significantly large number of deaths are seen in older men. So, is it genes, the immune system, or behavior that makes men more susceptible to the disease? After studying the pattern of death among elderly men, the major factor which has come up is the coexistence of long-term diseases, particularly cardiovascular problems, raised sugar levels, and cancer (Nicolette & Johannes 2020). Biologically difference in terms of the number and type of chromosomes, also contributes to a difference in the level of immunities in both the genders, making women stronger than men in terms of immunity (Cai, 2020).

Reflection on Determinants of Health

Looking at the geographical, physical, political and economic impact of the outbreak of the disease, I can perceive that a return to how life was at the start of 2020 is far from reality. Even when lockdown rules are lifted, the coronavirus will continue to have adverse effects on our daily activities and also on our thought process, completely altering the cultural framework in Australia and worldwide (Noble et al., 2020). I can feel that there is a continuous struggle to get back to how it was before, even though COVID 19 has led to a biggest setback to both small scale and large-scale business sectors for a century. Almost no nation has been granted pass as the novel coronavirus has taken the world like a fire. The lockdown, quarantine rules and unlock protocols are universal, but still, there is a great diversity in the severity and symptoms of different countries and also different demographic people (Livingston& Desai, 2020). 

The Australian government, the center for disease control and prevention (CDC) recommends airborne precautions with personal protective equipment (PPE) and N 95 masks (Edward &Angel 2020). However, the rapid or silent progression to a severe form of respiratory illness might take a few days or a few weeks to occur. The comorbid situation as discussed above plays a major role in determining the severity of the illness in a particular individual. Details regarding the physical and chemical compositions of the virus along with its implications are changing daily thus it is becoming difficult to come up with a definitive treatment in the form of a vaccine to prevent the spread of the disease at a global level (Wenham et al., 2020). All the medical fraternity at a global level; is trying their best to come up with a vaccine for the prevention of the novel coronavirus pandemic at the earliest. Many countries including Russia, UK, Indian, and Japan claim to have successfully started the clinical trials for the same for the hope of better future soon (Smith, 2019).

Conclusion on Determinants of Health

It can be concluded that Australia’s well preparedness and exceptional healthcare systems was able to efficiently fight the COVID 19 pandemic crisis. The health sectors were well-informed and put to action as soon as COVID 19 was declared an international emergency, on January 2020 by WHO. The national response was immediately put into effect. Australia’s well curated precautionary approach and response guidance for a pandemic, collaborative efforts of the state and the territorial government, were instrumental in establishing policies and procedures to minimize the spread of the disease.

References for Determinants of Health

Australian Government of Health, (2020). Australian Health Sector Emergency Response for Novel Coronavirus (COVID-19). Retrieved from https://www.health.gov.au/sites/default/files/documents/2020/02/australian-health-sector-emergency-response-plan-for-novel-coronavirus-covid-19_2.pdf

Australian Government of Health, (2020). Government’s response to COVID-19 outbreak. Retrieved from https://www.health.gov.au/news/health-alerts/novel-coronavirus-2019-ncov-health-alert/government-response-to-the-covid-19-outbreak#our-response-plan

Australian Government, (2020). August 2020 News Archive. Retrieved from https://www.australia.gov.au/news-and-updates/august-2020-news-archive

Ahmed, W., Angel, N., Edson, J., Bibby, K., Bivins, A., O'Brien, J. W., ... & Tscharke, B. (2020). First confirmed detection of SARS-CoV-2 in untreated wastewater in Australia: A proof of concept for the wastewater surveillance of COVID-19 in the community. Science of The Total Environment, 138764.

Boniol, M., McIsaac, M., Xu, L., Wuliji, T., Diallo, K., & Campbell, J. (2019). Gender equity in the health workforce: analysis of 104 countries (No. WHO/HIS/HWF/Gender/WP1/2019.1). World Health Organization.

Brown, N., te Riele, K., Shelley, B., & Woodroffe, J. (2020). Learning at home during COVID-19: Effects on vulnerable young Australians. Retrieved from https://icponline.org/wp-content/uploads/2020/05/L-at-H-rapidresponsereport-30April2020-updated.pdf

Cai, H. (2020). Sex difference and smoking predisposition in patients with COVID-19. The Lancet Respiratory Medicine, 8(4), e20.

Gyasi, R. M., & Anderson, E. A. (2020). Rethinking the Gendered Dimensions in the Impacts and Response to COVID-19 Pandemic. Public Health in Practice, 100019.

Holt, N. R., Neumann, J. T., McNeil, J. J., Cheng, A. C., Unit, H. E., & Prahan, V. (2020). Implications of COVID-19 in an ageing population. The Medical Journal of Australia, 1.

Liebig, J., Jurdak, R., El Shoghri, A., & Paini, D. (2020). The current state of COVID-19 in Australia: importation and spread. Available at SSRN 3559568.

Livingston, E., Desai, A., & Berkwits, M. (2020). Sourcing personal protective equipment during the COVID-19 pandemic. Jama, 323(19), 1912-1914.

Noble, K., Hurley, P., & Macklin, S. (2020). COVID-19, employment stress and student vulnerability in Australia. Retrieved from http://vuir.vu.edu.au/40603/1/COVID-19%20employment%20stress%20and%20child%20vulnerability.pdf

Smith, J. (2019). Overcoming the ‘tyranny of the urgent’: integrating gender into disease outbreak preparedness and response. Gender & Development, 27(2), 355-369.

Stavrakakis, Y., & Katsampekis, G. (2020). Populism and the pandemic: A collaborative report. Retrieved from https://d1wqtxts1xzle7.cloudfront.net/63633324/interventions-7-populism-pandemic-UPLOAD20200615-110465-2dceqj.pdf?1592226447=&response-content-disposition=inline%3B+filename%3DPopulism_and_the_Pandemic_A_Collaborativ.pdf

The Diplomat, (2020). How Well Has Australia Managed COVID-19 ?. Retrieved from https://thediplomat.com/2020/04/how-well-has-australia-managed-covid-19/

Wenham, C., Smith, J., & Morgan, R. (2020). COVID-19: the gendered impacts of the outbreak. The Lancet, 395(10227), 846-848.

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