Koolin Balit Strategy is a strategy initiated by the Victorian Government which is committed to the health system for the achievement of the longevity and quality of life improvement among the Aboriginals by the year 2022 (Jatkar, Anjou & Taylor, 2017). It is in Boonwurrung language that gives a clear idea for the achievement of measurable and significant outcomes among the Aboriginals. Among all the key priority areas, the strategy also focus on the population group of health transition to adulthood where the services provided to the vulnerable populations as in children and adolescents often end abruptly during their transition to adulthood as one of the key priority area number three (Napper et al., 2015).
The action plan for the working in the key priority area aims at reducing the smoking rate among the Aboriginal adults by the year 2022. In the year 2015, it has reduced the smoking rate among the Aboriginal adults and is aimed at further reducing the smoking rates. The strategy’s headline indicator is the reduction of uptake of smoking in the Aboriginal adolescents. The action plan is to implement the social marketing resources that targets the adolescents and focuses on the de-normalization of smoking. It is also aimed at reducing the rate of sexually transmitted diseases among the young Aboriginals. It action plan also encompasses the reduction of young Aboriginals to the emergency departments and accessibility to mental health services. The improvement of the access to mental healthcare services for the Aboriginal young people is also achieved by the year 2015 where they have developed an integrated physical and mental health liaison and the consultation model that improve the access to the mental health services. They also implemented culturally sensitive services to service provision that explore opportunities for early identification, local prevention and interventions (Davy & Lockwood, 2014).
The action plan also comprises of the continual support from the Quit’s ‘Kickstart’ camp for the young Aboriginal males while working in partnership with the Victorian Aboriginal Community Controlled Health Organization (VACCHO). VACCHO is the key body that works for the health and well-being of the Victorian Aboriginal people. The collaboration with this body would help to achieve the aim of the key priority area that is wellbeing of the Aboriginal young people (Abouzeid, Anjou & Taylor, 2015). The strategy will also link their action plans with the relevant Commonwealth funded programs that would extend their help for the achievement of the Koolin Balit Strategy. The strategic plan also highlights the importance of education that is linked to better social conditions with low rates of crime and imprisonment. Education significantly increases the life and health expectancy with positive outcomes. Victorian Aboriginal suicide prevention and response action plan 2010–15 and the Aboriginal Youth Suicide Prevention and Community Support Project is also implemented and evaluated to prevent suicide. It also implemented physical and mental health learning for the prevention and promotion of the interventions. There are also strategic plans for the reduction of sexually transmitted diseases among the Aboriginal youth. For this, they have improved the notification data received from the Aboriginal Community Controlled Health Organizations (ACCHOs) and in the conduction of tests for the screening and delivery of treatment (Chamberlain et al., 2016).
It is considered as the key priority area in the strategy as it lays the foundation for the positive Aboriginal health. The transition to adulthood is a stage where smoking habits, alcohol consumption, use of illicit drugs and the spread of sexually transmitted diseases. They are at high risk for these conditions that would contribute to the burden of disease. The addiction to alcohol and substance abuse is the major cause of illness and diseases, crime, injury, accidents, workplace problems and family disruptions. Victorian parents are concerned about their children and this stage acts as the crucial point in the life of the children when they are transiting to adulthood. For the reduction of illicit drugs, the Victorian government works in collaboration with the Telkaya network to provide support to the young Aboriginals in continuing their schooling and extend support and funding in the drug and alcohol rehabilitation services for the Aboriginals (Genat et al., 2017). To work in this priority area, Victorian government is supporting the ACCHOs capacity for the development of effective screening, testing and for the treatment of the young Aboriginal youths. It will also plan to achieve their aims by linking with the Commonwealth funded programs that are relevant to the strategic aims and objectives.
The key priorities and strategic plans are developed by taking the social determinants of health into consideration. The social, economic and cultural factors of the society contribute to the smoking, drinking and substance abuse. The poor attainment of education, unemployment and economic disadvantaged youths are highly vulnerable to addictions and substance abuse. The Aboriginal families live in remote communities and face lack of access to healthcare services and resources. Aboriginals are the most disadvantaged groups and they experience the highest level of social disadvantage in Australia. It increases the risk of the drinking, smoking and substance abuse among the Aboriginal youths as their families experience social disadvantage. The high prevalence of smoking among the disadvantaged families and communities reinforces the children to accept these addictions as normal behavior and a part of their culture and become vulnerable to these addictions (Lindquist et al., 2015).
Low socioeconomic status is linked to the inequalities of health and the addictions among the Aboriginal youths. They have poor levels of education resulting in unemployment and low levels of income. The unequal distribution of economic resources, power and prestige with low occupational status as a result of social stratification expose the youths towards addiction. Due to low levels of income, they stay in poor housing increase the risk for addiction to a greater extent. According to the data collected from the National Drug Strategy Housing Survey (NDSHS) and Australian Institute of Health and Welfare (AIHW) showed that the smokers with low levels of education and low incomes are more likely to get prone to addiction for longer periods of time. Education during early childhood is the critical time in one’s life and lays the foundation for their future where they learn the basic skills and education for the employment opportunities and income. Therefore, child development affects the risk for tobacco use, drinking and substance abuse (Myers et al., 2014).
This shows that the education attainment is a well-established social determinant of substance abuse and alcohol use. Low levels of education among the children and adolescents are linked to poor health outcomes, health behavior and the sense of empowerment and control that influences their future life chances that is income and occupation. Family and peer influences the adolescents’ addiction behavior. The young Aboriginal people are more likely to take up smoking behavior of their parents belonging to the age group of 12-15 years. Similarly, adolescent stage is also a critical period as the peer behavior influences their health behavior. They are at the transition stage towards the adulthood where they leave their parents an prepare themselves for the higher education and provide adult status. Low socio-economic status and chronic stress developed can create negative impacts on their children’s mental health and development. Adolescents raised in low-economic conditions with poor housing and less pay experience less care and supervision that can be conducive to drug and alcohol abuse (McKenna et al., 2015).
The key priorities of the Koolin Balit Strategy encompass these social determinants of health that influences and make the adolescents vulnerable to addiction and mental illness. Addiction among the adolescents result in a breakdown in the family and peer structure that have a significant effect on the spiritual and emotional wee-being of them. The priority area targets the youth justice system and child protection programs that strongly recognize the cultural identity and its connection that promotes resilience and social and emotional well-being among the young Aboriginal people (Hopkins, Zubrick & Taylor, 2014). Victorian hospitals report an increased rate of emergency cases presenting suicides and self-harm among the Aboriginals when compared to non-Aboriginal youth people. Keeping this in mind, the key priority three of the Koolin Balit strategy of healthy transition to adulthood, the action plan is aimed at reducing the high-risked behaviors among the young Aboriginal people like smoking, drug abuse or excessive alcohol consumption focusing on the education and increase of access to mental health services earlier for the young Aboriginals (Hallinan & Judd, 2016).
The aims of this key priority target and prioritize the education among the young Aboriginals that is linked to the social benefits like better nutrition, better living conditions, low levels of imprisonment and healthier life. This key priority also targets education in a way that significantly increases the life expectancy and health among the young Aboriginals that would help to achieve the key goals by 2022 (Chalmers et al., 2014).
Abouzeid, M., Anjou, M. D., & Taylor, H. R. (2015). Equity in vision in Australia is in sight. Medical Journal of Australia, 203(1), 21-23.
Chalmers, K. J., Bond, K. S., Jorm, A. F., Kelly, C. M., Kitchener, B. A., & Williams-Tchen, A. J. (2014). Providing culturally appropriate mental health first aid to an Aboriginal or Torres Strait Islander adolescent: development of expert consensus guidelines. International journal of mental health systems, 8(1), 6.
Chamberlain, C. R., MacLean, S., Bawden, G., Kelaher, M., Munro-Harrison, E., Boyle, J., & Freeman, K. (2016). An ‘equity’domain could strengthen the utility of a framework for assessing care coordination for Australian Aboriginal families. International Journal of Care Coordination, 19(1-2), 42-46.
Davy, C., & Lockwood, C. (2014). Understanding Closing the Gap strategies from the perspective of Aboriginal and Torres Strait Islander peoples and their primary healthcare providers: a systematic review protocol. JBI Database of Systematic Reviews and Implementation Reports, 12(10), 98-108.
Genat, B., Browne, J., Thorpe, S., & MacDonald, C. (2017). Sectoral system capacity development in health promotion: evaluation of an Aboriginal nutrition program. Health Promotion Journal of Australia, 27(3), 236-242.
Hallinan, C. J., & Judd, B. (Eds.). (2016). Indigenous people, race relations and Australian sport. Routledge.
Hopkins, K. D., Zubrick, S. R., & Taylor, C. L. (2014). Resilience amongst Australian Aboriginal youth: an ecological analysis of factors associated with psychosocial functioning in high and low family risk contexts. PloS one, 9(7), e102820.
Jatkar, U., Anjou, M. D., & Taylor, H. R. (2017). Grampians—Closing the Gap in Indigenous eye health. The Medical journal of Australia, 206(2), 97.
Lindquist, A. C., Kurinczuk, J. J., Wallace, E. M., Oats, J., & Knight, M. (2015). Risk factors for maternal morbidity in Victoria, Australia: a population-based study. BMJ open, 5(8), e007903.
McKenna, B., Fernbacher, S., Furness, T., & Hannon, M. (2015). “Cultural brokerage” and beyond: piloting the role of an urban Aboriginal Mental Health Liaison Officer. BMC public health, 15(1), 881.
Myers, J., Thorpe, S., Browne, J., Gibbons, K., & Brown, S. (2014). Early childhood nutrition concerns, resources and services for Aboriginal families in Victoria. Australian and New Zealand journal of public health, 38(4), 370-376.
Napper, G., Fricke, T., Anjou, M. D., & Jackson, A. J. (2015). Breaking down barriers to eye care for Indigenous people: a new scheme for delivery of eye care in Victoria. Clinical and Experimental Optometry, 98(5), 430-434.
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