Social Determinants, Policies, And Safety Measures For Indigenous And Refugee Health Are Crucial Essay Topics.

Case Study 1: Pregnant Indigenous Teenager

Joanna is an Aboriginal and Torres Strait Islander 16 year old teenager who has recently found out that she is pregnant to her partner who is also an Aboriginal and Torres Strait Islander man. Joanna has left home because she found it difficult to cope with the challenge of living with seven (7) younger siblings. Her parents are not happy about her pregnancy. Since being informed of the pregnancy Joanna’s boyfriend said he felt shocked and too young to be a father.

Throughout her pregnancy Joanna has been attending the local community controlled Aboriginal health center (‘gathering place’/ medical service/ community controlled center) because she feels more comfortable and welcomed. Her friend who recently had a baby recommended this place to her. Following discussions with her friend - Joanne thought this would a good place to go for help and support while she was having her baby. While attending the center for check-ups Joanne became friendly with an older Aboriginal midwife who was kind and answered all her questions. Joanne trusted this woman and immediately felt culturally safe with her. She also thought about rebuilding connections with her own family. She missed them and hoped they could patch things up.

Experiencing a culturally safe relationship with the Aboriginal midwife Joanne thought that after the baby was born she too would like to work as a midwife. Joanna has considered returning home to her mum and feels if her mum agreed to help out with the baby, maybe she could go to the local university and become a midwife too. Joanne thought about how good it would be to help young women like herself and also help the community.

1. Comprehensively, describe the social determinants that would apply to the person in this case study. Provide reasons why such determinants would be relevant to the health and wellbeing of the person in this case study.
2. Describe a historical or current Australian social or legislative policy that has had an impact on the health of Aboriginal and Torres Strait Islanders. Describe how such policies and legislation impact this person in this case study in relation to self- determination.
3. Describe the impact of institutional racism and how this has impacted on the health and wellbeing of the person in your chosen case study.
4. Define the concept of health beliefs and describe the adverse experiences and feelings that could have negatively shaped the health beliefs of the person in your chosen case study
5. Describe the recognised historical events and occurrences in his or her social background which has led the person being hesitant to use mainstream health and social services. Identify any behaviours and or attitudes that health workers might express either overtly or covertly that would negatively impact on the person in your case study. Describe the cultural safety principles that would guide culturally safe practice for the person in your chosen case study. Include the person’s relevant cultural and social factors in your discussion.
6. Describe the cultural safety principles that would guide culturally safe practice for the person in your chosen case study. Include the person’s relevant cultural and social factors in your discussion.

Gift Kubota is 18 and has just finished high school. He arrived in Australia 4 years ago, aged 14, when his family fled the civil war in Sudan. He misses Sudan and the friends he had to leave behind and hopes to return one day. It was difficult at school not only learning a new language, a new culture and living in a world so different from his homeland. He remembers feeling the bias from his fellow students when he arrived. Gift felt they looked down on him and thought him less intelligent as he struggled to learn English. After 4 years he now feels confident in reading, comprehending and writing in English.

Gift struggled with the preconceived ideas from kids at school who he did not know very well. Over time Gift has developed a good group of friends from a variety of backgrounds and their support helps to diminish the effects of the hurtful comments. He has just finished year 12 and will be looking for work and hopes that the negative views and feelings experienced in school do not reflect his ability to get work. He hears many media reports about African gangs in some suburbs and wonders if this is true. He feels apprehensive and uneasy most of the time around people who don’t know him.

Gifts mother has been recently diagnosed with Diabetes Type 2. He has had to go with her to her medical appointments to act as an interpreter. His mother has tried to follow the guidelines but has found it difficult to adhere to the dietary guidelines as her culturally traditional diet seems to break all the rules. She does not know how to incorporate the necessary changes. Gift has tried to explain this to the health care professionals but they do not seem to understand.

1. Define the concept of health beliefs and describe the adverse experiences and feelings that could have negatively shaped the health beliefs of the person in your chosen case study.  
2. Describe the recognised historical events and occurrences in his or her social background which has led the person being hesitant to use mainstream health and social services. Identify any behaviours and or attitudes that health workers might express either overtly or covertly that would negatively impact on the person in your case study. Describe the cultural safety principles that would guide culturally safe practice for the person in your chosen case study. Include the person’s relevant cultural and social factors in your discussion.
3. Describe the cultural safety principles that would guide culturally safe practice for the person in your chosen case study. Include the person’s relevant cultural and social factors in your discussion.
4. Comprehensively, describe the social determinants that would apply to the person in this case study. Provide reasons why such determinants would be relevant to the health and wellbeing of the person in this case study.
5. Describe a historical or current Australian social or legislative policy that has had an impact on the health of Aboriginal and Torres Strait Islanders. Describe how such policies and legislation impact this person in this case study in relation to self- determination.
6. Describe the impact of institutional racism and how this has impacted on the health and wellbeing of the person in your chosen case study.

1. There are various social determinants that apply to Joanna. One of the determinant is that of education. If Joanna would be educated she would find it easier engaging in healthy behaviours rather than visiting the midwife for assistance. However, her seeking some help from Aboriginal health center is not a bad idea but if she could be educated, that could not be the next move for her. Her saying that she will join a local university so that she can become a midwife is a sign of education. The social support that she gets from Aboriginal midwife will contribute greatly towards the wellbeing of Joanna.

2. One of the policy is that of social strategy for circumstantial to indigenous health. The policy shows both the domestic and also international evidence which state that people have the right to access high quality health care which is essential towards enhancing the indigenous health status. Therefore, the policy plays a great role towards Joanna in that she has a right towards receiving a high quality medical care so as to enhance the wellbeing of her state. Despite her getting care from the midwife, she needs to get more care which is more advanced also. This will help greatly towards building her wellbeing.

3. Institutional racism causes great impacts which are negative to the society. Joanna opts to attend a local university so that she can succeed in becoming a midwife. This is as a result of her meeting the friendly midwife in the health facility. This is quite clear that that the quality of education given in the local university is not that good. Her sorting care from the midwife is also clear that institutional racism has negative impacts because the nature of care she is given there is not of high quality. Therefore, institutional racism has caused negative impacts towards Joanna leading to her wanting to join a local university (Bell, Adams, 2016).

4. Health beliefs are the personal convictions which influence the health behaviors. The boyfriend of Joanna feels is very young to be a father. On the other hand Joanna feels that she cannot bear the burden of being raised with her younger children due to her parents. This makes her to move out of the home and seek for medical care from the nearby Aboriginal center. Through her personal conviction and friendly nature of the midwife who was giving her care, she develops an urge of also going to local university so as to become a midwife. Through her personal convictions, she feels culturally save with the midwife due to the health and caring nature she was giving her (Kelder, Hoelscher, Perry, 2015).

Case Study 2: Sudanese Refugee Aiding his Mother with Diabetes Type 2

5. Joanna is hesitant towards using mainstream health due to the following. Her being Aboriginal shows that she is culturally segregated hence cannot manage to seek mainstream health services. Secondly, she comes from a humble background. She opts to move out of their home because she cannot bear the burden of being raised with her 7. One of the attitude is that of trying to make one believe that pregnancy is a disease of nine months.  If the impression was created in the mind of Joanna, she could have lost hope and even aborted the child.

6. One of the safety measure is that of local cultural conceptuality. This plays a great role towards addressing the health needs of the people within the society. Considering the background of Joanna and her culture, this safety measure can help greatly towards acquiring the needed health care and support for her wellbeing. The other safety measure is that of individual reflection. This plays a great role towards a mindful self-reflection. Joanna needs a health profession who can help her in self-reflection. However, this role has been played by the midwife but not fully. She needs a profession who is experienced to teach her more about self-reflection.(Sammer, Lykens, Singh, Mains, Lackan, 2010).

1. Health beliefs are the personal convictions which influence the health behaviors of a certain individual. Due to her strong belief in the cultural diet, the mother does not follow the guidelines which she is given in the hospital. She feels that her traditional diet is the best. Due to that, her condition has become worse hence affecting her in a negative way. She is unable to incorporate the changes which are needed by the health professions. The health care professionals do not seem to understand also. Therefore, the change of culture from their country to Australia has affected the mother adversely.

2. Moving from Sudan to Australia means there is a change of culture. Many things have changed hence making it hard for both Gift and her mother to adapt to the changes. Due to the civil wars, they had to move to Australia. However Gift misses his friends greatly. Due to him thinking much about the friends he left behind, he finds it hard to adapt to the new changes. The preconceived ideas from the school also make it hard for him to adapt to the new changes. The mother also believes in her culture. This is why it is getting harder for her to follow the guidelines that she is given in the hospital (Dudgeon, Wright, Paradies, Garvey, Walker, 2010).

Education as a Social Determinant for Indigenous Health

3. One of the principle is that of country and the community domain. This helps to reinforce the safety of culture of a particular person. Gift and his mother recognizes the culture of their country Sudan. This is what is making it hard for them to adapt to the new culture. However, they should acknowledge that they are in a different environment which has a different culture hence there is need for change. They should use the approach of culture responsiveness. They should also employ the safety of self-reflection whereby they should look behind and know where they have come from and where they are currently (Woodward, Van Staalduinen, Lemer, Greaves, Noble, Barraclough, 2010)

4. According to World Health Organization (2011) there are various social determinants that are in relation to the health and culture of an individual. One of the determinant is that of employment and economy. After the completion of high school, Gift is searching for a job. If he gets employed, life will be a bit smooth because he will get to mix with other people well. He will also be able to get the income which will help them in their day to day activities. Another social determinant is that of education. Through education, Gift will be able to get a job. Through the job, he will be able to get income that will sustain him with the mother hence promoting their wellbeing.

5. One of the policy is that of social strategy for circumstantial to indigenous health. The policy shows both the domestic and also international evidence which state that people have the right to access high quality health care which is essential towards enhancing the indigenous health status. Through that, Gift takes his mother to the hospital due to her being diagnosed with diabetes. However, the mother does not follow the guidelines because she believes in her culture. Therefore, the policy does not play any positive role towards the mother because she feels that her culture and traditional nature is the best for her.

6. Institutional racism has created a negative impact towards Gift. This is because he experiences biasness from his fellow students due to the difference in culture. Gift did not know English. The condition made him feel less intelligent and knowledgeable. He felt hopeless and at the same time isolated because he could not mix freely with the other classmates. This is because the fellow classmates could speak and write fluent English. Therefore, institution racism made Gift to work hard so that he could be in the same level with his classmates. Through that, he managed to finish his high school education.

References:

Bell, L. A., & Adams, M. (2016). Theoretical foundations for social justice education. In Teaching for diversity and social justice (pp. 21-44). Routledge.

Dudgeon, P., Wright, M., Paradies, Y., Garvey, D., & Walker, I. (2010). The social, cultural and historical context of Aboriginal and Torres Strait Islander Australians. Working together: Aboriginal and Torres Strait Islander mental health and wellbeing principles and practice, 25-42.

Kelder, S. H., Hoelscher, D., & Perry, C. L. (2015). How individuals, environments, and health behaviors interact. Health behavior: Theory, research, and practice, 159.

World Health Organization. (2011). Closing the gap: policy into practice on social determinants of health: discussion paper.

Sammer, C. E., Lykens, K., Singh, K. P., Mains, D. A., & Lackan, N. A. (2010). What is patient safety culture? A review of the literature. Journal of Nursing Scholarship, 42(2), 156-165.

Walton, M., Woodward, H., Van Staalduinen, S., Lemer, C., Greaves, F., Noble, D., ... & Barraclough, B. (2010). The WHO patient safety curriculum guide for medical schools. BMJ Quality & Safety, 19(6), 542-546.