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Outline plan and determinants of health

Write about the Review of Victorian Public Health and Wellbeing Plan.

Victorian Public Health and Wellbeing Plan (VPHWP) (2015-2019) is one of the path-breaking plans that is framed in order to promote health and well-being among the population residing in Australia. The following assignment will focus on the review of this health plan in doing this; the assignment will first provide an overview of the VPHWP. The assignment will then give detail of the main priority area highlighted in the plan followed by the two prone risk group of population. The following at-risk group and three determinants of health will be then critically analyzed towards the end of the assignment.

The main outline of Victorian Public Health And Wellbeing Plan (VPHWP) (2015–2019) is to make Victoria free of the avoidable burden of injury and disease so that all the residents of Victoria are enjoy optimal attainable standards of health, wellbeing along with active participation at every stage of their life (VPHWP, 2015). VPHWP is the second public health and wellbeing plan that aims to establish new standards for the population residing in Victoria. This plan is consistent with the vision and objective of Public Health and Wellbeing Act of 2008 that aims towards improving health and social outcomes in Victoria via reducing inequalities (VPHWP, 2015). The principal aim of the plan is to understand the concept of health and wellbeing of the population residing in Victoria. The plan also aims to provide strategic directions towards the overall improvement of the quality of life at every stage and thereby promoting health (VPHWP, 2015). The main achievement of these aims is to reduce inequalities in health and well-being in Australia via proper identification of the social determinants of health (VPHWP, 2015). The main risk group discussed in this plan is the aboriginals and non-aboriginal Victorians. According to Bleichet al. (2012), the main target of health inequalities in Australia, Victoria is the aboriginals, mainly the Torres Strait Islanders. These inequalities in the health outcome can be defined by the social determinants of health (VPHWP, 2015). According to Braveman and Gottlieb (2014), the main social determinants of health include economic stability, physical environment and neighbourhood, education, food, social and community context and health care system.

One of the main priority area highlighted in the VPHWP (2015) include tobacco free lining. It is a priority because nearly 12% of the adult Victorian population smokes on a daily basis (Department of Health Australia 2014). This smoking affects the disadvantaged groups of population disproportionately because smoking rate is higher among the aboriginal people. This high rate of smoking among the aboriginal people is one of the leading causes behind their high level of psychological distress and ill-birth rates (smoking among the pregnant women) (Consultative Council on Obstetric and Paediatric Mortality and Morbidity 2014; .  Moreover the incidence of tobacco smoking is also increasing the risk of cardiovascular disorder among Victorian population (Collins & Lapsley, 2011).  The actions outlined to address these issues by VPHWP (2015) include reduction in the rate of smoking via providing support at the community level (hospitals and community level services) along with special smoking cessation program for the groups who has high disproportionally high smoking rates, particularly the Aboriginals.

Priority Area and Risk Groups

Two Main risk groups identified are the aboriginal people (adults) and adolescents. According to the Australian Department of Health (2013), 12% of the young population who are 16 years old and 16% of the young population who are 17 years old and are residing in Victorian smoke cigarette. As a consequence of this they suffer from psychological distress, lower level of education. According to the Australian Bureau of Statistics (2015), 41% of Aboriginal people daily smokes cigarette. As a consequence of this they are more prone towards developing cardiovascular anomalies other psychological complication (Collins & Lapsley, 2011). This increase in the disease prevalence increases the cost to health care along with decrease in the annually productivity and increase in mortality (Collins & Lasley). All these effects cumulate into financial burden and thereby increasing health inequalities. This risk group will be targeted via legislative and non-legislative approaches towards tobacco reforms like smoking cessation support that will help to reduce the proportion of people in Victoria who smoke tobacco (VPHWP, 2015).

The social determinants of health that is responsible for the high level of smoking among the aboriginal or indigenous population on Victoria is lack of economic stability.  According to the Australian Institute of Health and Welfare (AIHW) (2015), lack of economic stability creates psychological distress. AIHW (2015) has further opined that indigenous people who are suffering from high or very high level of psychological distress are likely to smoke cigarettes. At least 30% of the indigenous people smokes cigarettes as evaluated the 2012-2013 survey of AIHW. Moreover, they also undertook a comparative study which revealed that 16% of the indigenous people who are employed smokes cigarette in comparison to 24% of unemployed people and 33% of the labour force people. This sharp difference in the percentage clearly represents that the lack of economic stability is an important social factor behind the increasing the risk of tobacco smoking among the indigenous people of Victoria.

The biological determinant of health that is responsible for the high level of smoking among the aboriginal or indigenous people in Victoria is poor health. According to VPHWP (2015), poor health is an amplifier towards increase in the rate of smoking among the disadvantaged people residing in Victoria (aboriginal and Torres Strait islanders). According to the reports published by the Australian Human Rights Commission (2017), the present health condition among the Australian’s Aboriginals and Torres Strait Islanders is extremely poor in comparison to the rest of the Australian population. The factors highlighted by Australian Human Rights Commission (2017) for this poor health backup among the Australian Aboriginals include lack of safe drinking water, lack of effective sewage system, rubbish collection and healthy housing. According to Steptoe, Deaton and Stone (2015), poor health affects the capacity of a person to work and this in turn negatively affects the health and well-being of the person and thereby affects the financial income and lack of social contact. This lack of income and social contact increases a sense of depression, anxiety and a social isolation. These negative feelings together cumulatively increase the urge of smoking. According to Leventhal and Zvolensky (2015), smoking provides a pseudo effect of decrease in depression but the actual scenario of different as smoking actually increases the level of mental health complications and thus creating health inequality. According to Steptoe, Deaton and Stone (2015), poor health thus not only cause physical pain and suffering to the individual but also increases the level of mental pain and pressure creating a huge barrier in optimal social and economic participation and health equality.

Three relevant determinants of health

The environmental determinant of health that is responsible for the high level of smoking among the aboriginal or indigenous people in Victoria is residing in remote areas. According to the data published by AIHW (2015), indigenous people who reside in remote areas are more likely to smoke cigarettes (50%) in comparison to the population, which resides in non-remote areas (39%). AIHW (2015) however, is of the opinion that the rate of tobacco smoking among the indigenous adults have decline during the year of 2012-2014 (this is a significant decrease of 8%) but still then the rate is astonishingly high in comparison to the population residing in non-remote areas. AIHW also highlighted the reason responsible for this high disparity in percentage. According to their report, indigenous people who reside in remote areas are treated unfairly by the health care professionals and thus they avoid seeking help in the domain of substance abuse or indulge in the intoxication of tobacco smoking. Moreover, tack of support from the healthcare professionals in the remote areas has lead to decrease in awareness in the domain of smoking related ill-effects and thereby further increasing the disparity among the remote and non-remote areas.

Thus from the above discussion it can be concluded that one of the main priority areas that has been highlighted by VPHWP (2015) is tobacco free living. The two main population group that is the principle target for this priority area is adult population and adolescents. Of them, the main prioritized group should be the aboriginal adults. The social, biological and environmental determinants that increase their susceptibility of this group of population from getting affected with the health threats of tobacco smoking include economic instability, poor health and living in remote areas respectively.

References

Australian Bureau of Statistics (2015), Customised report: Australian Health Survey: nutrition first results - foods and nutrients, 2011–12, Australian Bureau of Statistics, Canberra

Australian Human Rights Commission (2017). Social determinants and the health of Indigenous peoples in Australia – a human rights based approach. Access date: 10th April. Retrieved from: https://www.humanrights.gov.au/news/speeches/social-determinants-and-health-indigenous-peoples-australia-human-rights-based

Australian Institute of Health and Welfare (AIHW) (2015)., The health and welfare of Australia’s Aboriginal and Torres Strait Islander peoples: 2015. Access date: 10th April. Retrieved from: https://www.aihw.gov.au/reports/indigenous-health-welfare/indigenous-health-welfare-2015/contents/determinants-of-health-key-points

Bleich, S. N., Jarlenski, M. P., Bell, C. N., & LaVeist, T. A. (2012). Health inequalities: trends, progress, and policy. Annual review of public health, 33, 7-40.

Braveman, P., & Gottlieb, L. (2014). The social determinants of health: it's time to consider the causes of the causes. Public health reports, 129(1_suppl2), 19-31.

Collins D, Lapsley H (2011), The social costs of smoking in Victoria in 2008/09 and the social benefits of public policy measures to reduce smoking prevalence, Quit Victoria and the VicHealth Centre for Tobacco Control and Cancer Council Victoria, Melbourne.

Consultative Council on Obstetric and Paediatric Mortality and Morbidity (2014). Consultative Council on Obstetric and Paediatric Mortality and Morbidity. Access date: 10th April. Retrieved from: https://www2.health.vic.gov.au/hospitals-and-health-services/quality-safety-service/consultative-councils/council-obstetric-paediatric-mortality

Department of Health (2014), Victorian Population Health Survey 2011–12, survey findings, State Government of Victoria, Melbourne. Access date: 10th April. Retrieved from: https://www2.health.vic.gov.au/public-health/population-health-systems/health-status-of-victorians/survey-data-and-reports/victorian-population-health-survey/victorian-population-health-survey-2011-12

Leventhal, A. M., & Zvolensky, M. J. (2015). Anxiety, depression, and cigarette smoking: A transdiagnostic vulnerability framework to understanding emotion–smoking comorbidity. Psychological bulletin, 141(1), 176.

Steptoe, A., Deaton, A., & Stone, A. A. (2015). Subjective wellbeing, health, and ageing. The Lancet, 385(9968), 640-648.

Victoria State Government. (2015). Victorian public health and wellbeing plan (2015–2019). Access date: 10th April. Retrieved from: https://www2.health.vic.gov.au/about/health-strategies/public-health-wellbeing-plan

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