Australian’s initiative of Universal Health Policy has failed to bring successful results to the nation. This is because the concept of inequity of healthcare is still rooted very deeply in the society. Though the health of the Australian have improved a lot in the twentieth century due to various scientific advancement but have lagged behind in maintaining equity in healthcare. By the term equity, it means that all the citizens of Australia would get similar access to healthcare and receive benefits from them irrespective of the various socioeconomic backgrounds they belong to. However, a large number of factors have been found that had acted as barriers in maintaining equity in healthcare in Australia. Different morbidity and mortality related inequalities have been found to be associated with socioeconomic disadvantages, unequal household income, provision of education to infants and children, occupation of different adult individuals as well (Purcell, O’Rourke & Rivis, 2015). Moreover increasing cost of healthcare in the modern generation has also become a concern for the different socioeconomic classes of people for not getting access to healthcare.
I lived in Nepal in my preliminary years as my entire family had been citizens of Nepal for many years. My father and my uncle used to work in factories and we belonged to middle socio-economic classes. In those years, I have seen my family face severe issues in managing healthcare in our family. Nepal’ financial condition was not stable like any other developed countries and therefore healthcare sectors were not much well developed. However, western cultured hospitals were established in the urban regions which practiced modern medications and treatments. In the years, I have seen low and middle economic background people living in the suburban or rural areas failed miserably to accommodate funds to treat their patients in the elite westernized hospitals. We could only access the local healthcare settings where the treatment was not modernized and evidence based as travelling to urban areas were also costly. This often resulted in high rate of mortality. However the influential people could easily access those health benefits. Later government included many policies and systems to include all classes of people in healthcare. However, the initiative was not successful as the government could never negotiate with the private hospitals effectively. A similar view can also be identified with Australia where area based socioeconomic inequalities have been one of the major factors for higher mortality (Kavanagh et al., 2015). They are found to possess bad oral health, high death rates, more rates of lung cancer, lower life expectancy, high burden of stroke and many others. These areas are also found to have more rates of diabetes and different types of cancer. The presence of such a number of high rates of diseases in such areas show that these areas are less accessible to healthcare and the socioeconomic status of people of these areas are one of the contributors. As per the social model of healthcare, depict, I believe that increasing their access to healthcare through policies and plans, making healthcare cheaper for them, empowering such communities and others will have a positive impact on the development of equity in healthcare.
Being an inhabitant of Nepal, I have always seen a seen a debate among the Nepali people regarding their cultural understanding of healthcare. A greater portion of people in Nepal believes that diseases occur in people as a result of supernatural phenomena. Therefore they believe in promotion of special prayers and other spiritual interventions in order to fight for the negative forces. They believe that cultural compliance play a great role in patient recovery. They also believe that treatments involving Ayurvedic medicines, implications of proper diets and shamanic systems can cure people. However, there is also another section of people who depends on biomedical model of healthcare for treatment of patients. Therefore one can see here that cultural backgrounds often play a great role in shaping a particular individual’s perspectives in accessing to healthcare. However, Australians being a developed country believes I biomedical model of treatment. They believe that diseases occur due to physiological scientific phenomena and therefore they seek for medical advices from experts to treat themselves. However lack of education is found in the indigenous people mainly the aborigines and the Torres Strait Islander people who lack information about how to maintain a proper lifestyle that would help prevent the occurrence of harmful diseases. Their culture and religious practices also act as barriers in creating a healthy lifestyle and maintain their lives (Mitrou et al., 2014). Excessive smoking, drinking of alcohol, non maintenance of diabetes and many others often contributes to high number of health disorders among them. Moreover the importance of culture of maintenance of trust and respect were extremely significant criteria for them which were not properly understood by Australians until now. This acted as barrier to health care access.
I believe that proper education to the society about the benefits of healthcare sectors in treating diseases rather than traditional methods would decrease the rate of deaths in Nepal. Moreover properly educating citizens entirely about the importance of proper lifestyle, exercises, food habits, different diseases, their prevention can reduce the occurrence of disorders. The government should also introduce proper policies that should help in proper establishment of healthcare sectors, training of the healthcare staffs, maintenance of safe practice and others so that the issues of inequity can be dissolved in Nepal. Similarly in Australia, the socio economic sections of different strata should be properly educated about lifestyles, diseases, diet and other factors so that the rate of disorders can be reduced. Besides, increasing awareness about the benefit of healthcare in certain diseases would help people to overcome their inhibitions and help in preventing its further effects. The government should involve different policies which will allow disadvantaged people to have services of healthcare sectors. Safe practices of healthcare professionals along with maintenance of standards like practicing ethically and morally will ensure equity in healthcare sectors (Elgar et al., 2016).
Comprehensive primary health care is needed to be adopted by the nation in the present generation. This is because one needs to create awareness so the citizens at a population level taking everyone into consideration. Besides guiding individuals with specific treatment required for their disorders, comprehensive primary care also covers the underlying social, political as well as economic causes of poor health (Mithen et al., 2015). This is found to be more effective than the selective primary healthcare which focuses on particular region of patients with a fixed number of issues to be decided. Although it was found to be cost effective but it did not consider the broader aspect of maintaining equity among the all citizen of Australia.
It was found that Australians who lived in the poor socioeconomic areas in the nineteenth centuries had resulted in higher number of various health disorders. This can be described as the fact that low income resulted individuals in settling in houses with poor conditions that in turn resulted in the increase of the number of people getting ill. Again it was found that people with chronic diseases and belonging to underprivileged background could not afford to pay for their healthcare and in turn settled in less developed areas to maintain their expenditures of healthcare. If one looks over the history, epidemiology of diseases can be broken into three to four stages. the first stage was called the age of epidemics and famines during which life expectancy was low mainly within 20 years. Then another age showed rapid increase in life expectancy due to decrease in rate of epidemics and famines. The following age showed slower increase in life expectancy due to introduction of manmade diseases like heart diseases, obesity and others (Fisher et al., 2016). On clearly analyzing this it was seen that this depended highly on the socioeconomic background on the people as the low economic people was the most vulnerable of the lot. They were affected in every of the four ages due to less financial power and security of shelter. Moreover lack of education among such groups also kept them apart from practicing their right in the society.
A large number of cultural beliefs are also found to be associated with their high number of mortality in people of disadvantaged areas. Their habit of excessive smoking and improper diet create different types of cardiovascular diseases. High blood cholesterol and inactivity of body result in such diseases. Cancer is also found to be higher among them like lung cancer, liver cancer and others. Their practice of unscientific abortion mechanism also leads to uterine cancers also. However one cannot force such people to change their culture but we have the capability to educate them in such a way so that they start looking into matters in a scientific way. Diabetes was also found among the people of disadvantaged areas due to lack of proper lifestyle management, improper diet and others (Whiteford, 2014). They need to be culturally educated and financially supported so that they can overcome the consequences and achieve equity in healthcare.
Neo Marxism theory is utilized by many researchers in their work on health inequity in Australia. They have described the class struggles to be the most important aspects of modern healthcare systems. They have asked the policy makers to look into the concept of inequity by focusing their directives from bottom to up rather than from top to bottom. The influential section of the society is the ones who are privileged in every sphere and therefore it would be the duty of the government to fix the position of low socio economic people so that they get the best health benefits. Neo Marxism had helped to establish the social class concept in health and sociology and focus on the interrelationships of economic production in the society along with different processes of ownership and labor, exploitation and domination. The healthcare sectors should implement policies in such a way which would help to create strategies of establishing equity in healthcare. The SES people should be given scopes of better access to healthcare and medication. This service should ensure that no discrimination occurs in the treatment and safe practice is followed. Moreover the remote areas should be connected urban areas in a way that it becomes easier to get access. Financial support can be established by the government through insurances and subsidies for this people (Newman et al., 2015). Policies should be properly evaluated before publication in order to ensure that privileged classes do not exploit the rights and funds of the underprivileged.
A number of barriers have been identified that had made primary health care marginalized in the society of Australia. people from low socio economic background, indigenous people, asylum seekers, refugees and other have been the victims. Lack of proper awareness of healthcare services, excessive waiting times, prohibitive costs, lack of transports, stigma and embarrassment, negative experiences, poor communication have prevented such people to seek help from healthcare sectors. Similarly the primary health care mainly in elite hospitals and nursing homes and sidelined this people as they are unable to pay their high charges. This had resulted in a destruction of the values of health equity in a society that makes it subjected to criticism (Elgar et al., 2016). Therefore it had become excessively important for the government and ministers to implement policies and initiatives that will help in establishment of the social model of healthcare. Besides, providing interventions to physical development of patients, they should also portray ways that will develop their economic condition and social status. Proper education and inclusion programs in the society are also important to remove inequity in healthcare.
Thus we can come to a conclusion, that in order to remove social inequity, one must need to properly study the historical, cultural and social determinants that are acting as barriers in maintaining social equity. One must introduce reforms that will help the socio economic disadvantaged people to educate themselves and develop practices making them less subjected to disorders. Besides, initiatives should also involve the healthcare organizations to be careful enough in establishing systems that will make healthcare more accessible to such people where they will not only feel comfortable but also feel that their dignity is respected. Government should take active steps to incorporate policies which will help in addressing the inequity faced by such classes and make them more included as an important social class in the nation.
Elgar, F. J., McKinnon, B., Torsheim, T., Schnohr, C. W., Mazur, J., Cavallo, F., & Currie, C. (2016). Patterns of socioeconomic inequality in adolescent health differ according to the measure of socioeconomic position. Social Indicators Research, 127(3), 1169-1180.
Fisher, M., Baum, F. E., MacDougall, C., Newman, L., & McDermott, D. (2016). To what Extent do Australian Health Policy Documents address Social Determinants of Health and Health Equity?. Journal of Social Policy, 45(03), 545-564.
Kavanagh, A. M., Krnjacki, L., Aitken, Z., LaMontagne, A. D., Beer, A., Baker, E., & Bentley, R. (2015). Intersections between disability, type of impairment, gender and socio-economic disadvantage in a nationally representative sample of 33,101 working-aged Australians. Disability and health journal, 8(2), 191-199.
Mithen, J., Aitken, Z., Ziersch, A., & Kavanagh, A. M. (2015). Inequalities in social capital and health between people with and without disabilities. Social Science & Medicine, 126, 26-35.
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(1), 201.
Newman, L., Baum, F., Javanparast, S., O'Rourke, K., & Carlon, L. (2015). Addressing social determinants of health inequities through settings: a rapid review. Health promotion international, 30(suppl 2), ii126-ii143.
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