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Community health focuses on the health and well being of the public belonging to a particular community. This encompasses on the social determinants of health and how it is impacting the health of the community (Clendon & Munns, 2019). However, Social determinants of health can be defined as the conditions in which an individual is born, grow, work, live, and age (World Health Organization, 2019). The community selected for this report is Aboriginal and Torres Strait Islander community. The social health determinant as per the study presented by Clendon & Munns (2019) there are ten social determinants of health that affect community health. Out of these ten, this report is going to focus on five social determinants of health relevant to the selected community i.e. Aboriginal and Torres Strait Islander community.
For improving the health status of Aboriginal and Torres Strait Islander community has always been a longstanding challenge. However, social determinants of health contribute in the community health disparities and this is why addressing social determinants of health should be the primary approach in attaining health equity (Markwick et al., 2014). The five identified social health determinants for this report are unemployment, social support, stress, addiction, and social exclusion.
Aboriginal and Torres Strait Islander community members face high unemployment issues and it has been reportedly found that unemployment and poor physical as well as psychological health are closely linked to each other (Mitrou et al., 2014). While, benefits linked with employment not only showed better income levels among the community but, has improved the health status and education levels as well. However, limited employment opportunities have been seen in secluded areas where many people live along with the lower educational qualification levels contributes to the unemployment of Aboriginal and Torres Strait Islander people.
This could be overcome by the provision of educational and employment opportunities which will help the community members in improving the self-efficacy among them. Some orientation programs such as community development programs should also be organized in remote areas to counsel the people and to increase the desire for success in obtaining employment.
Along with the physical well being; social, emotional, and cultural well being is also an important aspect that plays a crucial role in the community health of Aboriginal and Torres Strait Islander people. Social support leads to the better health outcomes while social negligence and social isolation deteriorated the health of the community (Langham et al., 2017).
Another social determinant of health that causes health-related issues is stress. Stress regarding being discriminated, isolation, unemployment, etc. leads to some health-related issues. These issues are disability, high rate of perinatal deaths, hypertension, renal failure, comorbidity, and violence (Braveman & Gottlieb, 2014). All these issues are the outcomes of cultural, lifestyle, and environmental variables.
However both of these determinants i.e., could be overcome by the provision of effective communication and community engagement. Culturally safe communication helps in achieving the desired health outcomes of the community and this could be attained by focusing on the communication style, clear language, use of medical terminology, and understanding the cross-cultural differences.
Healthcare service engaging the Aboriginal and Torres Strait Islander communities in scheming and bringing the healthcare is one of the ways to deal with the issue. Community engagement can be implemented for setting up the social determinants into places as it helps in improving the health as well as social outcomes by targeting the modifiable factors (Durey et al., 2016).
From the study by Heffernan et al. (2016) it has been reported that the prevalence of any substance use disorder is 66% among the Aboriginal and Torres Strait Islander community. Out of which alcohol dependence was considered to be one of the most frequent type of substance use disorder, next to this cannabis dependence has been seen. Intoxication with alcohol and other drugs has been seemed as high addiction. Those who are more likely to be addicted with these things significantly show higher rate of substance use disorder. These disorders include mental illness such as depression, anxiety, bipolar disorder, and psychotic disorder along with the thoughts of lifetime suicide and suicidal attempts (Malick, 2018).
This could be sorted out by organizing campaigns with the aim of anti-substance use or something else related to this to spread the awareness regarding the mental health and how addiction of any substance affects the mental health of the people. Though, there has been seen cultural incompetency between the Aborignal and non-Aboriginals and for this there should be either an interpreter or should use effective communication.
Social exlusion happens when an individual or a community suffers from a variety of interconnected problems such as poor skills, unemployment, low incomes, poor health, poor housing, and family breakdown. Aboriginal community faces social exclusion the most. Although, every individual has a fundamental necessity for positive as well as lasting relationships. Social exclusion directs many cognitive, behavioural, emotional outcomes (Walter, 2016). However, cultural safety is a way that could help in overcoming with social exclusion. Cultural safety can be described as an atmosphere that is safe and protected for people. A surrounding where people do not face any assault, rebuff their identity, regarding who they actually are and what they want. It is all about shared knowledge, shared meaning, shared respect, and experiences about learning, working, and living together with self-respect and dignity. Maintaining cultural resilience within the Aboriginal communities and cultural competency from those who are engaged with Aboriginal communities.
This report has concluded that even if the social determinants of health are potential in affecting the health of the Aboriginal and Torres Strait Islander community there are still certain ways that could be helpful in overcoming the problem of community health. The strategies that could be effective in this include provision of educational, employment opportunities, effective communication, community engagement, and organizing campaigns along with maintaining cultural safety, cultural resilience, and cultural competency.
Braveman, P., & Gottlieb, L. (2014). The social determinants of health: it's time to consider the causes of the causes. Public Health Reports,129 (Suppl 2), 19–31. https://doi.org/10.1177/00333549141291S206
Clendon, J., & Munns, A. (2019). Community health and wellness: Principles of primary health care. Elsevier. https://www.elsevier.com/books/community-health-and-wellness/clendon/978-0-7295-4274-6
Durey, A., McEvoy, S., Swift-Otero, V., Taylor, K., Katzenellenbogen, J., & Bessarab, D. (2016). Improving healthcare for Aboriginal Australians through effective engagement between community and health services. BMC Health Services Research, 16, 224. https://doi.org/10.1186/s12913-016-1497-0
Heffernan, E., Davidson, F., Andersen, K., & Kinner, S. (2016). Substance use disorders among Aboriginal and Torres Strait Islander people in custody: A public health opportunity. Health & Justice, 4, 12. https://doi.org/10.1186/s40352-016-0044-8
Langham, E., McCalman, J., Matthews, V., Bainbridge, R. G., Nattabi, B., Kinchin, I., & Bailie, R. (2017). Social and emotional wellbeing screening for aboriginal and torres strait islanders within primary health care: A series of missed opportunities? Frontiers in Public Health, 5, 159. https://doi.org/10.3389/fpubh.2017.00159
Malick R. (2018). Prevention of substance use disorders in the community and workplace. Indian Journal of Psychiatry, 60(Suppl 4), S559–S563. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_24_18
Markwick, A., Ansari, Z., Sullivan, M., Parsons, L., & McNeil, J. (2014). Inequalities in the social determinants of health of Aboriginal and Torres Strait Islander People: A cross-sectional population-based study in the Australian state of Victoria. International Journal of Equity Health, 13. https://doi.org/10.1186/s12939-014-0091-5
Mitrou, F., Cooke, M., Lawrence, D., Povah, D., Mobilia, E., Guimond, E., & Zubrick, S. R. (2014). Gaps in Indigenous disadvantage not closing: A census cohort study of social determinants of health in Australia, Canada, and New Zealand from 1981-2006. BMC Public Health, 14, 201. https://doi.org/10.1186/1471-2458-14-201
Walter, M. (2014). Social Exclusion/Inclusion for Urban Aboriginal and Torres Strait Islander People. Social Inclusion, 4(1). doi: 10.17645/si.v4i1.443
World Health Organization. (2019). Social determinants of health. Retrieved from: https://www.who.int/social_determinants/sdh_definition/en/
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