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Running head: NURSING
Name of the Student
Name of the University
There are many definitions of the v ...
Running head: NURSING
Name of the Student
Name of the University
There are many definitions of the vulnerable population. The word implies the
disadvantaged people of the community. It required utmost care, specific ancillary
consideration as well as well as the augmented protection. The freedom and the capability of
vulnerable individual to protect oneself from the intended or the inherent risk is abbreviated
variably, from the reduced freewill to the inability to make informed choices (Twizeyemariya
et al., 2018) .
The vulnerable group that has been chosen for this assignment are the Aboriginals and
the Torres Strait Islander people. These indigenous people all around the world have a
historical continuity with a given region before the colonisation, with a strong association
with the lands. They have discrete languages, beliefs, and culture and knowledge systems
(Shivayogi, 2013) .They are determined to maintain and develop the identity and distinct
institutions forming a non-dominant sector of the society (Chenhall & Senior, 2018) .The
indigenous people are faced with several challenges faced by the indigenous people,
including adenial of the rights for regulating or controlling their values, priorities, needs.
This paper will describe about a vulnerable population and the reason they are
vulnerable along with description of the social determinants of health, which are contributing
to the vulnerable state. Furthermore, the role of the nurses in promoting health literacy,
empowerment, and provision of primary health care for this vulnerable population and
community will also be described.
The vulnerable population and the social determinants
There is an unacceptably large difference between the health status of the indigenous
people and the non-indigenous people. The life expectancy gap between the indigenous and
the non-indigenous population is estimated to be about 19-20 years in Australia (AIHW,
2017) .Indigenous people of Australia suffer from aheavier burden of chronic illness like
cardiovascular diseases, diabetes, asthma, cancer. The prevalence of mental health disorders
and substance abuse disorders are also high among the indigenous population probably due to
the life style of the indigenous community (AIHW, 2017) .Mental health issues and substance
abuse disorder among the indigenous people can be probably linked to the intergenerational
trauma of the colonisation and the presence of lost generation obviously contributing to
psychological trauma among the indigenous people. The indigenous Australians are the most
disadvantaged and the marginalised group in Australia. They often face with the inequality in
health care access due to certain determinants of health. Poverty is one of the most important
social determinants of health which makes this population vulnerable.
On every standards and the indicators of disadvantages, the indigenous people emerge
as the socially and the economically deprived class. Although poverty is present between
almost all the ethnic groups of Australia, but it is the indigenous adults who are the most
deprived. Despite of the governmental policies directed towards achieving the economic
equality for the indigenous Australians, there had been very small improvement to the
relative socio-economic status as per the standard social indicators. Another important
determinants of indigenous health inequality in Australia includes lack of access to the
primary healthcare as well as lower standards of health infrastructure like lack of proper
housing, food and sanitation, effective sewerage system and rubbish collection services
(Davidson, 2015) .It may be due to the poverty that the indigenous people do not get access
to the equal health care. The past history of colonisation has also made them vulnerable to
racism and discrimination, due to which the aboriginals often face with racism and
discrimination (Paradies et al., 2016). Scientific literatures have informed that even small
racial bias, like being treated with less respect due to one ’srace can cause alot of health
problems such as cardiovascular problems, heart diseases clinical depression, low birth
weight of the infants, poor sleep, mortality and obesity (Paradies et al., 2016). The
association between discrimination an illness has been documented in various indigenous
groups. It is due to the racism and discrimination that indigenous people often receive
delayed care or hostile behaviour from the non-indigenous health care professionals, due to
which they sometimes tend to avoid mainstream health care services (Carson et al., 2014) .
The main reason why the aboriginal people avoid the mainstream health care services is
associated with the past histories of colonisation and the unfair government policies that has
separated them from their mother land and families. So, the indigenous people are twice as
likely to quit the mainstream care services (Carson et al., 2014) .It is evident that due to low
economic status, the indigenous people are always not being able to receive specialist
services and thus fail to receive the required care (Paradies et al., 2016).
Role of the nurses in addressing the health inequality, health promotion and health
Health literacy is strongly associated with better health outcomes and is important for
the health policy and the delivery of the services (Rheault et al., 2016) .The aboriginal people
has been found to be having poor health literacy and as per their culture and traditions, their
perceptions about health is different from the mainstream medical services, but considering
the complexities of the chronic condition, itis necessary to say that the indigenous process of
healing is not effective for all kinds of diseases (Rheault et al., 2016) .In that case, it is the
duty of the nurses to promote health promotion and health literacy to the indigenous people.
The community nurses can acts as advocates for the aboriginal people to arrange for
health promotion programs for increasing health literacy among the aboriginals (Best &
Stuart, 2014) .It is necessary that the nurses come to know about the holistic understanding of
the health and wellbeing for the indigenous Australians, which involves the well-being of the
entire community including broader social issues like social justice, rights, equalities as well
as traditional knowledge on healing (Nash & Arora, 2021). The nurses can collaborate with
the traditional healers to inform about spiritual care and treatment of the mental health illness
(Nash & Arora, 2021). Understanding of the health literacy and its relationship with the
health status of the aboriginals are an important step to work towards the promotion of the
health literacy among the aboriginal people. The community should be educated about
general health as well as the preventive health services, dietary patterns and the importance of
physical exercises and other health care practices (Nash & Arora, 2021). Nurses might
encourage the aboriginal population to put aside the stigma of mental health and as seek for
the timely treatment of the mental health disorders. In order to gain the trust of the aboriginal
population, it is also necessary to collaborate with the aboriginal health care services or
aboriginal health care workers (Best & Stuart, 2014) .
The perception of health among the aboriginals differ from that of the non-aboriginals
and hence the health promotion tools in Australian health care is abit different from that of
the normal health promotion tools, like pamphlets, posters and flipcharts (Percival et al.,
2017) .The health promotion tool in this case would be normal verbal presentations, for
example hands on techniques for hand hygiene literacy (Percival ET AL., 2017) .The health
literacy has to be given in the mode and the language they are comfortable with. Nurses can
advocate on behalf of the indigenous population to develop the primary care services for the
indigenous people, where basic health care facilities can be obtained like screening of certain
diseases and health consultations about obesity or diabetes management (Percival ET AL.,
It is necessary for the nurses to have an idea about these concepts as it will help them
in the development of the customised care plan for this population. It is also necessary to be
aware of the aboriginal terms and apply respect in all the dealings in the community. Nurses
should be self –aware of their own beliefs and the assumptions, which is critical for the
nurses to have an effective association with the community.
Apart from serving the indigenous community, the nurses can even advocate for the
health and well-being of the other vulnerable communities like health of women, children and
adults. The community nurses act as a pillar of the community development (Muntean,
Tomita & Ungureanu, 2013). They can provde the necessary care by re-establishing it.
Indirectly by the promotion of respect towards human dignity. They are responsible for
screening diseases, assessing the needs of the people, provide health literacy by setting up
health promotion programs (Muntean, Tomita & Ungureanu, 2013). The role of the nurses
are not confined to this, but have larger implication on policy making and their
AIHW, (2017). Insights into vulnerabilities of Aboriginal and Torres Strait Islander people
aged 50 and over — in brief . Access date: 15.4.21. Retrieved from:
Best, O., & Stuart, L. (2014). An Aboriginal nurse-led working model for success in
graduating Indigenous Australian nurses. Contemporary nurse , 48 (1), 59-66.
Carson, B., Dunbar, T., Chenhall, R. D., & Bailie, R. (Eds.). (2020). Social determinants of
Indigenous health .Routledge.
Chenhall, R. D., & Senior, K. (2018). Living the social determinants of health: Assemblages
in aremote Aboriginal community. Medical anthropology quarterly ,32 (2), 177-195.
Davidson, A. (2015). Social determinants of health: A comparative approach .Oxford, United
Kingdom: Oxford University Press.
Hernandez, D., & Suglia, S. (2016). Leveraging the Social Determinants to Build aCulture of
Health Housing as aSocial Determinant of Health.
Hopkins, K. D., Taylor, C. L., & Zubrick, S. R. (2018). Psychosocial resilience and
vulnerability in Western Australian Aboriginal youth. Child abuse & neglect ,78 ,85-
Muntean, A., Tomita, M., & Ungureanu, R. (2013). The Role of the Community Nurse in
Promoting Health and Human Dignity-Narrative Review Article. Iranian journal of
public health ,42 (10), 1077 –1084.
Nash, S., & Arora, A. (2021). Interventions to improve health literacy among Aboriginal and
Torres Strait Islander Peoples: asystematic review. BMC public health ,21 (1), 248.
Paradies, Y., Ben, J., Denson, N., Elias, A., Priest, N., Pieterse, A., Gupta, A., Kelaher, M., &
Gee, G. (2015). Racism as aDeterminant of Health: A Systematic Review and Meta-
Analysis. PloS one ,10 (9), e0138511. https://doi.org/10.1371/journal.pone.0138511
Percival, N. A., McCalman, J., Armit, C., O’Donoghue, L., Bainbridge, R., Rowley, K., ... &
Tsey, K. (2018). Implementing health promotion tools in Australian Indigenous
primary health care. Health promotion international , 33 (1), 92-106.
Rheault, H., Coyer, F., Jones, L., & Bonner, A. (2019). Health literacy in Indigenous people
with chronic disease living in remote Australia. BMC health services research ,19 (1),
Shivayogi P. (2013). Vulnerable population and methods for their safeguard. Perspectives in
clinical research ,4(1), 53 –57. https://doi.org/10.4103/2229-3485.106389
Twizeyemariya, A., Guy, S., Furber, G., & Segal, L. (2017). Risks for mental illness in
indigenous Australian children: a descriptive study demonstrating high levels of
vulnerability. The Milbank Quarterly , 95 (2), 319-357.
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