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Historical Factors Contributing to Health Disparities

Discuss about the Socioeconomic Groups for Health and Quality.

Inequalities of health within the Australian society are a major concern that affects the health and quality of life among the socioeconomic (SES) groups. The low socio-economic groups are at higher rates of morbidity and mortality at an earlier age. Socio-economic disadvantage is the main denominator for the health disparity among the low SES groups in Australia. Many historical, cultural, structural and critical factors have contributed to the low life expectancy among the SES groups.

The historical research shows that there is a clear link between the health disparities created by colonialism and low life expectancy among the SES groups. Colonization has greatly hampered the life of the low SES groups where traumatic events have led to the trauma that has affected the populations since years (Broom & Germov, 2014). The historic trauma as affected the physical, psychological and mental well-being of the low SES groups. Racial discrimination and social exclusion has led to the creation of barriers that has affected the quality of life and productivity. This has led to the unequitable distribution of health facilities that have led to the low life expectancy among the SES groups.  The stress of living in a racially discriminated environment has led to the negative health outcomes and has excluded them from the mainstream life within the Australian society.  These factors have led to chronic stress that has hampered the life of the low SES groups and their marginalization in the Australian community (Mitrou et al., 2014).

During the nineteenth century, the mortality change had been analysed through the eye of epidemiologic transition theory and there was a decline in the mortality rate. Due to the introduction of hygiene and sanitary reforms during the second half of the nineteenth century, there was a substantial decrease in the reduction of infectious diseases (Carson, 2015). This had markedly contributed to the gain of increase in life expectancy for the low SES groups during the nineteenth century. Belonging to a family of low SES group in Australia, I had faced health disparity and issues related to healthcare facilities. My family could not access the healthcare benefits and we only had access to local healthcare facilities. We were not able to afford the treatment in the westernized hospitals and were unable to access the healthcare facilities available there. The higher SES groups were able to avail the high quality healthcare facilities and there was a high health disparity within the Australian society. This resulted in high death rates, lower life expectancy and great burden of disease. I believe that by increasing the access to healthcare facilities, low cost of treatment and empowerment of communities can help to reduce the health disparities in Australia.

Cultural Factors Contributing to Health Disparities

Social model of health encompasses the broader determinants of health like cultural, economic, social and environmental factors rather than the physical factors and disease (Bircher & Kuruvilla, 2014). I believe that the inequalities in health among the low SES groups are due to the historical, cultural, social and critical factors that resulted in low life expectancy and poor quality of life within the Australian society. It demands social change through community approach instead of health and behaviour change. According to this model of health, I believe that there is inequality in the access of healthcare services and high cost of treatment that made the low SES groups the most disadvantaged groups in the Australian society (Kingsley et al., 2013).


Being an inhabitant of Australia, I have witnessed that there are also cultural factors that had led to the great health disparity and low life expectancy among the low SES groups. I believe that cultural understanding is also important in the aspect of healthcare. The spiritual interventions and special prayers also promote well-being and recovery. Cultural compliance also plays an important role in the fast recovery and in relieving pain associated with a disease (Artuso et al., 2013). However, in the context of Australian society, biomedical model of health is used for treatment. They believe that the disease is a manifestation of physiological factors and medical advice is required for the treatment of disease. However, the low SES groups believe that cultural beliefs also play an important role in the manifestation of diseases, as it is a supernatural phenomenon. These religious and cultural beliefs act as barriers in accessing treatment and healthcare facilities.

I believe that health literacy is important to reduce the health disparities and in the treatment of diseases in the Australian society. The citizens need to be educated about the importance of healthy lifestyle, physical activity and healthy diet that would reduce the burden of disease. The establishment of stringent laws, effective training of the healthcare professionals, proper infrastructure of healthcare centres and maintenance of safety practices can resolve the problems of health disparity and low life expectancy among the low SES groups (Davey, Holden & Smith, 2015). The disadvantaged groups need to be educated about healthy lifestyle, nutritional diet and health education that can reduce the health disparity within the Australian society. Health literacy is the key to well-being of the people and they need to be educated about the prevention of diseases to reduce the burden of disease. There is a need to create awareness among the marginalized population so that they are able to overcome their beliefs that acts as major barriers in the access to healthcare facilities (Batterham et al., 2014).

The Importance of Health Literacy


It has been found that in Australia, people who lived during the nineteenth century suffered from many health disorders as they lived in squalid conditions. The poor socioeconomic status in terms of housing resulted in illness and prevalence of diseases among them. It was also witnessed that people who belonged to marginalized groups and suffered from chronic diseases could not afford to seek treatment, as they were not able to pay for their treatment and medicines. The history in the epidemiology of diseases in Australia illustrated that there had been a period of famines contributed to low life expectancy among the SES groups (Roelfs & Bushnell, 2014). After that, there was a period of rapid increase in the life expectancy as there was a reduction in famines and epidemics. After that, there came a period when the life expectancy decreased due to the prevalence of diseases like obesity, diabetes and cardiovascular diseases. After the analysis, it was found that these chronic conditions are associated with the socio-economic status and the people who belonged to low SES groups were the most affected in terms of shelter, food and clothing.

In addition, the cultural beliefs of the people are also associated with the low life expectancy among the marginalized groups. Diabetes prevails due to the unhealthy lifestyle, smoking and high rate of heart ailments that resulted in poor health status among the disadvantaged groups. They are the most disadvantaged groups, as they have no financial support and prevalence of health illiteracy that leads to health inequality and access to healthcare facilities (Thompson, Chenhall & Brimblecombe, 2013).

Neo-Marxism theory can be applied to study the health disparity in Australia. They have witnessed clashes between the high and low classes in availing the healthcare facilities and services. The privileged sections of the society are able to avail the healthcare benefits and the low SES groups have no access to these healthcare facilities. The social class concept is explained by Neo-Marxism theory that focuses on the economic production with the concepts of domination, exploitation and labour (Aronowitz, 2016). The policy makers should develop health policies that address the health disparities and access to healthcare facilities. There should be no discrimination in the provision of healthcare services and treatment between the high and low SES groups. The remote and urban regions should be connected to the mainstream healthcare sector so that they are able to avail the healthcare services as the privileged groups. Financial assistance is also required for the marginalized groups so that they are able to afford the treatment and medicines. There is also a need for evaluation of the developed policies to ensure that there is no exploitation of the rights of the marginalized people (Sen, 2017).

Community Empowerment for Reducing Health Disparities


In Australia, primary healthcare facility is marginalized, as there are a number of barriers. The individuals from the low socio-economic background are the vulnerable groups who do not have proper access to the healthcare facilities and high cost of treatment that hinders them in enjoying the same health facilities as the privileged groups (Willis, Reynolds & Keleher, 2016). There is lack of proper awareness about diseases, lack of transport facility, excessive waiting, poor communication, stigmatization and negative experiences have hindered the disadvantaged groups to seek treatment. They are unable to bear the high cost of treatment in the primary healthcare centres in the hospitals. Moreover, there is inconsistent supply of doctors and general practitioners and the low SES groups have less access to these healthcare professionals and cut off from consultation. The health in all policies is an innovative approach where the health focus should be a part of the all the policy areas and government strategic plans. There should be shared governance for the health and well-being of all people including the low SES groups. These measures might help to achieve the desired outcomes for the low SES groups.

The health economists have come up with the alternative method of fee-for-service model where there is capitation and salary resulting in greater equity and delivery of primary healthcare services. There is evidence that the equity in healthcare is greatly enhanced by financial incentives and capitation formulas for treating the most socioeconomically disadvantaged groups in Australia (Gibson et al., 2015). There is speculation that this scheme introduced within the funding of health care services can make Australia among the most equitable groups globally. There is also urgency for the government to establish the social model of health that encompasses the wider determinants of health like social, political, cultural, historical and structural factors for the prevention of diseases rather than the disease. Measures should also be taken for developing the social and economic condition of the disadvantaged groups. Health literacy and program that include the low SES groups is also beneficial to remove the barriers and promote health equity in Australia.

There is a great health disparity prevailing in the Australian society that is hindering the low SES groups to avail the facilities in healthcare sector. There are historical, social, economical and cultural factors that act as barriers for the low SES groups to avail the mainstream healthcare facilities and services. There is an urgency to reform the existing health policies and educate people so that they are able to avail the healthcare facilities and experience health equity. Initiatives should be taken by the healthcare organizations so that they are able to have proper access to the healthcare facilities. In addition, there should be development of stringent policies that address the health disparity faced by the SES groups so that they are socially included within the Australian society.

References

Aronowitz, S. (2016). The crisis in historical materialism: Class, politics and culture in Marxist theory. Springer.

Artuso, S., Cargo, M., Brown, A., & Daniel, M. (2013). Factors influencing health care utilisation among Aboriginal cardiac patients in central Australia: a qualitative study. BMC health services research, 13(1), 83.

Batterham, R. W., Buchbinder, R., Beauchamp, A., Dodson, S., Elsworth, G. R., & Osborne, R. H. (2014). The OPtimising HEalth LIterAcy (Ophelia) process: study protocol for using health literacy profiling and community engagement to create and implement health reform. BMC public health, 14(1), 694.

Bircher, J., & Kuruvilla, S. (2014). Defining health by addressing individual, social, and environmental determinants: New opportunities for health care and public health. Journal of public health policy, 35(3), 363-386.

Broom, A., & Germov, J. (2014). Global public health.

Carson, S. A. (2015). Biology, Complexion, and Socioeconomic Status: Accounting for Nineteenth Century Body Mass Index by Race. Australian Economic History Review, 55(3), 238-255.

Davey, J., Holden, C. A., & Smith, B. J. (2015). The correlates of chronic disease-related health literacy and its components among men: a systematic review. BMC public health, 15(1), 589.

Gibson, O., Lisy, K., Davy, C., Aromataris, E., Kite, E., Lockwood, C., ... & Brown, A. (2015). Enablers and barriers to the implementation of primary health care interventions for Indigenous people with chronic diseases: a systematic review. Implementation Science, 10(1), 71.

Kingsley, J., Townsend, M., Henderson-Wilson, C., & Bolam, B. (2013). Developing an exploratory framework linking Australian Aboriginal peoples’ connection to country and concepts of wellbeing. International journal of environmental research and public health, 10(2), 678-698.

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.

Roelfs, A. P., & Bushnell, W. R. (Eds.). (2014). Diseases, Distribution, Epidemiology, and Control. Academic Press.

Sen, A. (2017). The State, Industrialization and Class Formations in India: A Neo-Marxist Perspective on Colonialism, Underdevelopment and Development (Vol. 23). Routledge.

Thompson, S. L., Chenhall, R. D., & Brimblecombe, J. K. (2013). Indigenous perspectives on active living in remote Australia: a qualitative exploration of the socio-cultural link between health, the environment and economics. BMC Public Health, 13(1), 473.

Willis, E., Reynolds, L., & Keleher, H. (Eds.). (2016). Understanding the Australian health care system. Elsevier Health Sciences.

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