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Social, Behavioural and Cultural Factors in Public Health

Introduction

Amongst the various chronic and life-threatening diseases, the contribution of coronary heart diseases in causing increased rate of morbidity and mortality is the highest in Australia. It is responsible for increased disease and healthcare burden in the country. Coronary diseases are characterized by increased accumulation of plaque in the arteries, causing thinning of arterial walls and narrowing of the lumen which in turn elevates the blood pressure levels in the individual (Dhindsa et al., 2018). Moreover, they further increase the risk of stroke or paralysis, heart attacks or cardiac arrest and aneurysms. These may include poor or unhygienic conditions of living, lack of access to the medical or healthcare services, and most commonly the nutritional deficiency and sedentary lifestyle have known to aggravate the factors (Jongen et al., 2019). This can lead to an increase in the incidence of patients suffering from coronary diseases in Australia. This paper will entail detail discussion on the impact of social factors on the cardiac health of the Aboriginal population in Australia, and how the implementation of new public health policy can be used for curbing the issue.

The Social Determinants of Health

The risk of developing coronary diseases is highest in Aboriginal people of the country, as opined by various studies which were founded in Australia. The two main aspects which impact the burden of the disease is, survival or the quality of life and the prevalence rate. According to the research, approximately, two-thirds of the Australian Population exhibits at least one co-morbidity condition and nearly one-third of the whole population presents with multiple comorbidities (Australian Government, 2016). Comorbid conditions by definition constitute the pre-existing or chronic conditions such as, high blood pressure, obesity, coronary or heart diseases, and diabetes, and lead for more than 70% of health complications in the Aboriginal community in Australia. The most important aspects contributing to this situation are the social determinants of health in the Aboriginal population living in the rural and remote areas of Australia (ABS, 2016a). The quality of life in these areas is very poor because of lack of awareness related to diet and lifestyle, which does not enable them to make well-informed choices related to their health. They are geographically restricted to have access to education and hence have lack of awareness of of how their lifestyle can increase the risk of developing coronary artery disease. (Australian Government, 2016)

Role of prevalence in increasing the disease burden is also substantial for research in the aboriginal communities. Many important links have been established between the prevalence of coronary diseases and poor socioeconomic status. This is the main cause of healthcare disparity in Australia, as a pupil with Aboriginal backgrounds are incapable of meeting their medical requirements. There is a lack of access to better health care structure and medical facilities. Thus, it is deduced that to reduce the incidence of CAD issues in these communities it is important that medical & health-related services are made accessible in these areas and also made affordable to these communities (ABS, 2018b).

Therefore, two primary factors which act as promoter of growth of the health care status in Australia are education and increased accessibility. The role of education is vital for the betterment of the health status in the Aboriginal population of Australia. Government inventiveness is required for growing the rate of literacy amongst the rural and Aboriginal population. It is important to provide awareness to them related to the change in dietary habits and lifestyle modifications. This can be done through various community health programs and local channels, which will help to provide education to the aboriginal community which will enhance their quality of life. In present times, advancement in technology has made it possible to establish communication and for reaching out to the remote areas via facilities such as internet and mobile phones. Another factor which related to the enhancement of availability of medical and health facilities can lead to better healthcare outcomes in these communities. This goal can be attained by the provision of healthcare infrastructure, and by accommodating healthcare professionals in rural and remote areas to meet the increase demand of care.

According to the Ware (2013), as well as the discoveries of “Australian National Audits for Australian nursing standards” about skilled registered nurses, it was noted that the competency of registered nurses in the primary health care setting were very general and basic in concern with the clinical knowledge as well as clinical skill. There were no particular capabilities or aptitudes for which the primary health nursing staff was trained. Furthermore, it was noted that the student nurse did not have enough exposure to the of the care system in a community set up and were not able to be abreast with the fast-paced reformatory goals which were being established in promotion of primary healthcare system by their institutes. Concepts of clinical governance along with the cultural competency must be integrated into the nursing curriculum not in theory alone but as a practical method for the development of these skills.

Implementation of Telehealth Policy

As per study of Harignton et al. (2019), there were minimum of seven federal definitions postulated that telehealth can bring revolution of healthcare which can be effective for providing care to the people in many ways, such as increasing the awareness and providing education to the community members related to dietary and life-style modification, by conducting online/real-time videos, telephonic conversations, communication via secure chat, and secure email to improvise the manner in which the care is delivered to the people (H.R. 3750, Act of 2013). The report also stresses on mandating the penalties where services do not encompass telehealth in their healthcare systems (Froehlich, 2019).

World Health Organization defined telemedicine as the means of delivering care and healing to the patients in a remote way, particularly where geographical restriction to healthcare is a primary issue. It also encompasses empowering the health care professionals with the help of technology to effectively communicate with the patients and enable them to perform their care duties from a distant (World Health Organization, 2010). It is necessary to have a financial freedom to some extent related to the medical expenditure which is to be borne by the patients. Role of community health programs in these scenarios is crucial in aiding the healthcare system of the country by incorporating technology in prescribing medication and medication monitoring via various tools (Harting et al.,2019). Telehealth can help in decrease the prevalence and hence decrease the disease burden in the aboriginal communities.

Engagement of Other Sectors/Stakeholders

Indigenous Drug and Alcohol Treatment Services receives very generous amount of funding (approximately $308.47 million from 2013/2014 to 2016/2017), which was disbursed for reducing the disparity of healthcare services in Aboriginal communities. The funding amount is decided by the Department of the Prime Minister and Cabinet, and is also focused to decrease the rate of incidence of coronary artery disease in remote and rural communities of Australia (Australian Health Ministers’ Advisory Council, 2015). In rural communities, telehealth can cause ease in maintaining “My Health Records”. Electronic health records are widely used in the healthcare industry these days due to the advancements in technology in the present times. It not only helps the patients to have a safe and secure platform for their health - related information but also eases access to the records in just a few clicks.

This advantage is also with the health facility and care professionals who are involved in the caring process of the patients. Such as the primary doctor, the rehabilitation therapist, the patient's dietician. The reason for this interoperability aspect of electronic health records is to avoid losing information or data of the patient as was in the traditional paperwork form. It provides improved access and saves the time of the healthcare professionals to retrieve relevant medical data of the patient. However, there are few points which should be considered to ensure there is no breach in accessing the medical health information in the hospital by staff which do not require to have knowledge of the patient's condition. Keeping in mind to block the information to only specific stakeholders requires collaborated team effort with the patient as well as the IT. In case of any error in the communication between the stakeholders may cause serious legal implications on the healthcare providers/facilitators.

Conclusion

Several researchers which have been conducted in Australia opined that the people in members of the Aboriginal community are at a higher risk of developed cardiac problems. it is critical for all the healthcare providers to exhibit knowledge and skill set which demonstrates cultural competency in their clinical practice. Having a knowledge of the belief system and the challenges faced by the community is a main focus of patient centred care and is embedded in the NMBA standards of nursing practice. Furthermore, it is mandatory that the government implements policies in the right direction to address the social determinants of health and provide solutions to reduce the inequality or disparity in the healthcare system, which can be done by community health programmes and implementing policies such as telehealth.

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