The psychosocial assessment determines the analysis of social, economic, political, cultural, and psychological factors, which are responsible for causing an impact on the health of the community. The wide parameter of these factors includes education, employment, housing, transport, income, occupations, community, and social services. In the city of Horizon, around 28,351 people reside which are in the backward class and faces social determinants. This leads to the exclusion of economic opportunities, households, employment opportunities, land ownership, and health benefits. However, this is one of the most persistent aspects of the current world with a discourse of racism in society.
These discrimination cause past colonization cultural context, denigration, poverty, trauma, inherited grief, and cultural role lacking and status (Markwick Ansari, Clinch, & McNeil, 2019). The racism faced by these people hinders their health, social support, education, and employment. It also reduces their self-esteem, self-efficacy, and cultural identity. This leads to social marginalization, normalization of pre-mature death, limited education opportunities, and entrenched trauma. With respect to the city of Horizon, people there face a challenge in livelihood; there is a need for sustainable development of health. The report illustrates the psychological assessment of the region, its populations, health issues faced by them, and the healthcare nurse's role in health promotion and development.
The City of Horizon based in South Australia near the limestone coast. It is 320 km south of Adelaide and 530 km northwest of Melbourne. It is a well-established tourist place which remains a destination place among people who visit the limestone coast. Tourist enjoys a good lifestyle with good quality accommodation, entertainment, shopping, and many facilities. The council of the city of Horizon is responsible for providing a diverging range of services and facilities. The main motive of the council is to provide a secure, healthy, prosperous, and valued lifestyle. The population has a direct relation with material availability and various indices of psychosocial exposure. The original population witnessed in the city of Horizon in 2016 was about 28, 351 which increased from 25,922 in 2011. The rate of immunization vaccine in infants of one year is about 94.4%, and the rate for the fully immunized children of 5 years of age drops to 89.8%. The decline in immunization rates is because these children grow up below the national average. These data suggest vulnerable development in terms of health and immunization.
These people are living with a typical domestic household size of 2.3. Household size and population specified as a factor for the categorical maternal age, paternal education levels, family income, and livelihood expenditure (Grinde and Tambs, 2016). The household size, family member, and economic class have a possible effect on the psychology of the individuals in the city. These variables have implications on temperament, health, behaviour problem, symptoms of anxiety, and depression (Grinde and Tambs, 2016).
The city of Horizon witnesses a higher proportion rate of a post-retirement person and a lower proportion rate of pre-schoolers in 2016. The age structure in the region requires a key insight for the demand of age-based services and facilities. These facilities are likely to change the future of the region as the wide-ranging age structure in the region demands diverse health facilities. From the data, it was found that 14.4% and 13.4% are the people under age group parents, homebuilders; and older workers, pre-retiree respectively. For the healthy living, the age group must adopt some multidimensional model of healthy aging such as self-esteem, self-achievement, social interaction, and ego integrity (Han, Lee, Gu, Oh, Han, and Kim, 2015).
Education is an utmost important contributor to the upward mobility of the region. The region relies heavily on human resources for its development and prosperity. Education is one of the important socio-economic indicators along with employment status, income, and occupation. It also helps in identifying skill gaps in the labour market, and according to education certificate, it determines the service level and income level of the person. In 2016, 8,881 people have successfully achieved a tertiary qualification such as bachelors, advanced diploma, vocational studies, or higher degree. Around 13,434 people have no qualifications. In the region, about 31% of people had completed 12th schooling as of 2016, which were aged over 15 years. The primary and secondary school completion determines the socio-economic status in lieu of English proficiency, data informs planners, decision-makers, job-oriented, and service accessible.
Socioeconomic characteristics such as education, family income, economic position, unemployment, social inequality affect the psychological thinking of the individual. In the city of Horizon, about 24,605 people are working out of which 48% is a full-time worker and 50% are part-time. The level and scale of working determine the social character of people and the strength of the economy as well. The employment type and status are connected with the various demographic factors such as age, education, family size, earning scale, and skill base of individuals. Moreover, concerning social development, the labour, workforce, earnings, have an influence on the economic well being of the region. It was stated in a paper that socioeconomic factors such as poverty, income, housing status, employment status, and education qualities ha a direct relationship with the health and wealth of individuals in the region (Macintyre, Ferris, Quinn, 2018)
One of the possible outcomes for the psychological assessment is how design and plasticity of the human brain can be moulded through environmental factors. There various strategies, which are, need to be adopted by the horizon division government to implement the best possible ways for the development of their population. They must adopt stronger and healthier communities, which take care of social and physical infrastructure within the area. The community must adopt a good and affordable living condition which is suited to each kind of person, irrespective of the lower class, middle class, and rich person. They must ensure the safe, good, and healthy eating supplements to provide good health to every individual.
Mental health in the region is one of the biggest contributors to the backwardness of the society and is one of the main reasons for social determinant (The planning and wellbeing plan, 2015-2020). Around 10.7% of males and 10.6% of females are affected with mental health in the region in 2016 (The planning and wellbeing plan, 2015-2020). It also contributes to the development of another societal effect such as behavioural disorder, suicide, depression, stress, loneliness, and mental distress (Bhatt, 2016). It is identified as one of the priority problems as it ruins one’s life along with the life of his/her family. It makes person aggressive which result in homelessness, abuse, domestic violence, and intellectual inabilities.
The underlying cause of the rising incidence of mental health in the region is due to lack of education, improper care services, lesser employment, lower wages, and other cultural belief. Other than this, the problems associated with health care also lead to the development of mental issues. The poor mental health status exacerbated by the associated stigma, lack of adequate mental health services, unhealthy eating nutrition, lack of adequate physical activity, tobacco use, high exposure to second-hand smoke, infant mortality, improper health measure during pregnancy, and childbirth.
The city of Horizon has around more than 58% of clients of child and adolescent groups in mental health services as compared to the other nonmetropolitan areas (The city of Horizon, 2015-2020). The higher rate indicates that there is a need for more services in the local community. The region witnesses above 47% non-metropolitan average of adults, which are addressing the government, funded community health service (The planning and wellbeing, 2015-2020). The percentage demands for important mental services locally.
Social determinant is one of the main reason through which the residents is facing, which further contribute to mental health. However, there is a need for the community changes that could step up from the critical and honest decision in promoting healthcare with respect to mental health. The inspirational health framework needs to be adopted, which would describe the necessary steps towards the implementation of sustainable development (Donkin, Goldbtt, Allen, Nathanson, and Marmot, 2017). There is a need for the national and local level to improve the social determinants condition in the city of Horizon, which helps to reduce the disease progression and save many lives. Social determinants trigger the stress pathway affecting mental health, and another non-communicable disease. The inequalities experienced in the region from birth and in early life showed the long-lasting effects during a lifetime (Bell and Marmont, 2019). These effects interfere with child development, adolescent growth, and adult physique. It affects cognitive, physical, emotional, intellectual, thinking, and behaviour development.
In the horizon community, the population report varied findings with respect to social, political, environmental, and economic factors on their health. The main reason for the finding is because of the aged persons, lower-income levels, lesser education, degraded health facility, limited access to recreational facilities and public transport, and lower educational achievement. Other than this, the Horizon community has reported a higher prevalence of diseases such as obesity, dental problems, mental issues, tobacco effect, and diabetes mellitus (The planning and wellbeing plan, 2015-2020). The plan identifies many health issues responsible for the development of disease are poor nutrition diet, physical inactivity, unhealthy eating, sedentary lifestyle, and massive drug usage (The planning and wellbeing plan, 2015-2020). The registered nurses could address the health issues faced by the population and implement various strategies for the good health of the population.
In Australia, the registered nurse understands the importance of history, culture, and living conditions of individuals in the community for the up-gradation of health and wellbeing of individuals. The registered nurse also reflects the understanding of the impact of colonization on the cultural, social, and spiritual lives of horizon community (NMBA, 2016). According to the Charter for health promotion, the perquisites fundamental condition for health includes peace, shelter, food, education, income, social justice, and sustainable resources. (The Charter for Health Promotion, 1986). The Charter convention of health promotion defines advocacy as the major resource for economic, personal, and social development. They state that political, behavioural, and biological factors also favour health. All the above-stated conditions can be stained through the advocacy of health, which helps in the promotion and development of health and wellbeing.
Enable is another set of Ottawa convention, which makes the person unable to achieve the full health potential. The registered nurses, healthcare practitioners, and health care providers aimed to reduce differences faced by a community with respect to health status, equal opportunities, and resource availability. These active workers also make help in reducing gender bias for health requirements as in community women were treated inferior to men for health resources.
The third pillar of the Ottawa convention is mediate. Mediate belongs to the upper organizational level for the development of health. It states that health and wellbeing promotions could be done by the active coordination within government, health sector, social sector, economic sector, NGO, voluntary organization, local authorities, industry, and media. This coordination will help in the development and pursuit of health and wellbeing in society. (The Charter for Health Promotion, 1986).
Only two-thirds of the city’s infrastructure composes of healthcare facilities, like hospitals, clinics, critical care units and specialist facilities (The planning and wellbeing plan, 2015-2020). People's access to limited healthcare services develops tremendous ill effects on health. The effect contributed due to the availability of inferior quality curative and preventive interventions that were used to manage and treat many diseases including communicable as well as non-communicable diseases in a population (AIHW 2016). This results in inferior quality of health among individuals within the region.
The registered nurse adopted optimum health care to prompt and smooth the transition which helps to provide services for everyone regardless of cultural heritage, financial circumstances, living condition, and employment category (AIHW, 2019). The registered nurses trained their juniors and other healthcare providers about timely access to health care to reduce the burden on patient and families, this also speeds up the medical treatment and provide optimum health services.
The nurse plan, prioritize, and provide the proficient age-specific nursing care to individuals without social determinants. They used through advanced, special clinical nursing knowledge and nursing care for the comfort and safety of patients. They are responsible persons, which handle care in accordance with legal, departmental policies, procedure, and health facility and implement standards of nursing care and practices as per the board of nursing (Aderman, 2018).
The nurses adopt various ways to plan safe care to the population of the city of Horizon population. These plans include a friendly relationship with a patient, Building support networks, and access to healthcare services. As a registered nurse, the implementation of health programs and preventive services should be done. The nurses spend time with the patients to build a rapport among them (Lin, Green, & Bessarab, 20116). This can be achieved through initial contact, proper communication with them; honesty, patient-centric approach, and development of trust among them. These strategies help to build as a friend relation and a sense of trustworthiness among patient, which further help to treat the patient effectively.
Moreover, clinical yarning in terms of social yarn, diagnostic yarn, and management yarn should also be implemented which build an open-ended communication with the patient (Lin, Green, & Bessarab, 2016). Building a support network with various teams allows better and in-time care for the population. The teams include health care providers, liaison officers, and family members. These teams will help the registered nurse in providing culturally appropriate care to patients (Browne, 2016). Easy access to health care services must be implemented with respect to indigenous Australian’s cultural perspectives. The services are related to the availability of system-preventive health services, primary healthcare hospitals, and specialist services (AIHW, 2019).
From the above report, it can be concluded that social detriments affect the socio-economic development of the region. The socio-economic factors associated with regional growth include demographic, education, livelihood, income, employment, and health. The population of the city of Horizon is experiencing the degraded form of facilities. Due to this, in the region, there are higher chances of disease development. However, with the involvement and proactive nature of some of the higher-end working communities such as a registered nurse, government chamber, and policymaker, the situation becomes better. These communities help to create the health and wellbeing plan in the region.
The plan considers the minute need of the population and tried to implement various strategies in the near future. Through the plan, it can be addressed that these working communities have planned various strategies for promoting health. The city of Horizon witnessed a larger number of population aged above 50 years or are in post-retirement age. The major population of these age group suffers from disease and also faces issues in health care. The registered nurses play a vital role in the healthcare system to mediate the differential outcome of illness of older people with holistic and health-promoting interventions. The nature of interventions adopted by the nurse was patient and family-centric, comprehensive, self-managed, and care coordination approach (Northwood, et al, 2017). The interventions adopted by the healthcare system is solely focused on primary care, specialist consultation, hospital transition, and patient safety.
Aderman, A. 2018. Screening for social determinants of health in clinical care:moving from the margins to mainstream. Public Health Review, 39, Pp 1-17.
Australian Institute of Health and Welfare, 2019. [Online]. Available at https://www.aihw.gov.au/news-media/media-releases/2019 [Accessed on May 13, 2020]
Bhatt, S. 2016. Effects of social media on mental health : a review. The International Journal of Indian Psychology, 4, 1-8.
Brown, A. E., Middelton, P. H., Fereday, J. A., and Pincombe, J. I. 2016. Cultural safety and midwifery care for Aboriginal women – A phenomenological study. Science Direct, 29, Pp 196-202.
Grinde, B. and Tamns, K. 2016. Effect f household size on mental problems in children: result from Norwegian mother and child cohort study. BMC Psychology, 4, Pp 1-11.
Han, K., Lee, Y, Gu J., Oh, H., Han, J., and Kim, K. 2015. Psychosocial factors for influencing healthy aging in adults in Korea. Health Quality of Life Outcomes, 13, Pp 1-10.
Lin, I., Green, C., & Bessarab, D. 2016. ‘Yarn with me’: applying clinical yarning to improve clinician-patient communication in Aborginal health care. Australian journal of Primary Health, 22, Pp 377-382.
Macinntyre, a., Ferris, D., Goncalves, B., Quinn, N. 2018. What has economic got to do with it? The impact of socioeconomic factors on mental health and the case for collective action. Palgrave Communications, 4, Pp 1-5.
Markwick, A., Ansari, Z., Clinch, D., & McNeil, J. 2019. Experiences of racism among Aboriginal and Torres Strait Islander adults living in the Australian state of Victoria: a cross-sectional population-based study. BMC Public Health, 19, Pp 1-14.
Northwood, M., Ploegg, J., Reid, M. M. , Sherifali, D. 2017. Integrative review of the social determinants of health in older adults with multimorbidity. Journal of Advanced Nursing, 74, Pp 45-60.
The Charter for Health Promotion, 1986 [Online]. Available at: https://www.who.int/healthpromotion/conferences/previous/ottawa/en/index4.html. [Accessed on: May 13, 2020]
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