Koolin Balit - Policy Analysis

This assignment analyzes the Koolin Balit policy of the Victorian government for Aboriginal health. It discusses the vision, key priorities, priority area of addressing risk factors, and relevant social determinants of health. It also covers at-risk groups like adolescents and older cohorts.

Running head: KOOLIN BALIT – POLICY ANALYSIS
KOOLIN BALIT – POLICY ANALYSIS
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KOOLIN BALIT – POLICY ANALYSIS
Introduction:
Koolin Balit: Victorian Government strategic directions for Aboriginal health 2012–2022
would be analyzed in order to understand how effective the strategies are addressing the
healthcare needs and requirements of the aboriginals of Victoria. This assignment would have an
overall discussion of the vision and key priorities of the plan (Helson et al., 2017). This would be
followed by description of the priority area of “addressing risk factors” along with the two at risk
population of “adolescents” and “older cohorts”. This would be followed three relevant social
determinants of health like “socioeconomic status”, “poor health literacy” and “culturally
incompetent care services” which when managed successfully can help in addressing the risk
factors successfully.
Overall description:
Koolin Balit meaning “healthy people” is the name given to the strategic plan developed
by the Department of Health of the Victorian government in collaboration with that of the
aboriginal communities, other parts of the government as well as with service providers. They
have committed to the improvement of aboriginal Health by developing a vision and aiming to
make significant as well as measurable impacts on the improvement of the quality and length of
lives of Aboriginal people living in Victoria (McKenna et al., 2015). These strategies were
developed for three important objectives like closing the gap in life expectancy of the
Aboriginals of Victoria, reduction in the differences in the number of infant mortality rates, low
birth weights as well as morbidity between indigenous and non-indigenous people and
improvement in access towards services and outcomes for the indigenous people of this region.
As a result, six important facts priority areas had been selected like that healthy start towards life,

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developing a healthy childhood, healthier transition to adulthood, effective care for older cohorts,
addressing of the risk factors and even managing illness with appropriate services. A wide
variety of social determinists of health like socio-economic background and many environmental
factors play major roles in determining the quality of lives of people (Jatkar et al., 2017).
Moreover, poor healthcare services which are culturally not competent to meet the needs of
aboriginal people are avoided by people (Genat et al., 2017). Therefore, developing proper
healthcare services that ensure effectiveness, coordination, responsiveness and accessibility to
aboriginals’ healthcare needs is one important motive of the Koolin Balit program as well.
Description of one priority areas and two at-risk groups:
One of the most important priority areas that is covered in the Koolin Balit policy is
effectively addressing the risk factors that are resulting in increase in the burden of the health
disorders among the aboriginals. Policy makers and researchers have well identified the main
risks factors like lifestyle factors such as tobacco smoking, poor unhealthy diets, sedentary
lifestyles, alcohol consumptions, illicit drug use, and unsafe sex as some of the main actions that
contribute to increased disease burden (Kingsley et al., 2018). This can be explained with the
help of an example. Tobacco smoking has acted as a risk factor that had contributed to about
12% of the total disorder burden and 20% of all deaths in the nation. As the data obtained in the
year 2013, it has been seen that the smoking rates of aboriginals in Victoria was 33% in
comparison to that of 19% to that of the non-indigenous people.
Another risk factor is the unhealthy lifestyles of consuming poor unhealthy diet and lack
of physical exercises. Obesity is considered to be the risk factor for various kinds of disorders

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like type-2 diabetes, cardiovascular disease, high blood pressure, osteoarthritis and certain
cancers. It was found that obesity had become the risk factors for many chronic disorders
accounting for about 11 percent among the Aboriginals in the year 2003. In Victoria in 2008, 50
percent of the Aboriginals adults were obese or overweight (Chamberlain et al., 2016).
Two of the most at risk population are the adolescents and the older cohorts of the
population. One of the at-risk populations is the young adolescents. They are highly vulnerable
to the risk factor of being addicted to smoking as this is the stage of life when smoking habits
begin. It has been seen that almost half of the aboriginal adolescents in the nation accounting for
about 4%5 of the people aging from 15 to 24 years are current smokers. Smoking disorders like
lung cancers, injuries cardio-vascular disorders and similar others as they age have been found to
be common (Fredericks et al., 2017). One of them is the older cohorts. Insufficient physical
activity, improper diets, sedentary lifestyles and many others throughout their lives exposed them
higher rates of chronic ailments like that of diabetes and stroke. Cognitive damage is also found
to be common among them with higher rates of dementia. The rate of increase of chronic
disorder burden in the native people aged over 55 years is seen to be three times higher than that
of the non-native people.
Discussion of three relevant social determinants of health:
The older cohort of the aboriginals residing in Victoria is seen to live with huge number
of co-morbid conditions thereby suffering from more than one complex disorder. Obesity is
found to be a common risk factor where many of the older individuals are found to be suffering
from diabetes, cardio-vascular disorders, strokes, cancers, fall risks, osteoarthritis.

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KOOLIN BALIT – POLICY ANALYSIS
Close analysis of the social determinants of health include low socio-economic status of
the aboriginals people. Studies have related people belonging to low socioeconomic class with
higher risks for diabetes, osteoarthritis, strokes, cardiovascular disorders and similar others.
Older aboriginals from poor socio-economic class are not able to afford quality nutritious
organic foods, fruits and vegetables that have low calories. Rather, they can only afford cheaper
calorie dense fast foods that result in weight gain. Insufficient fruit as well as vegetable
consumption have been found to account for about 3.5% of the total disorder burden for older
aboriginal people with 18% of the cardiovascular disorders cases and five percent of the health
gap (Fredericks et al., 2017). It has been found that food insecurity causes stress, lack of energy
as well as hunger. Researchers are of the opinion that in the long run, food insecurity
substantially increases the chances of obesity. It has been also found that low socio-economic
cohorts of people suffer from excessive alcohol consumption. Older people mainly lose their
physical ability and hence they cannot perform intensive work and hence they tend to spend
more time in families rearing children and others. They tend to suffer from boredom. They even
get frustrated from the sufferings of chronic ailments (Spurling et al., 2018). As a result for this,
they tend to get addicted to alcohol consumption. Many of the studies have found older cohorts
suggesting that alcohol provides them with “alternate reality” for which they tend to consume
them. Hence, they develop many disorders like cancers, cirrhosis, high blood pressure and many
others.
The second social determinant of health is the lack of education and health literacy
among the aboriginals. Strenuous childhood with impacts of colonization and stolen generation
had resulted in many of the older cohorts to go through tormenting childhood time. Moreover, at
the same time, tendency of Aboriginals dropping out from schools before attending high school

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during their adolescent years is another contributing factor for poor health literacy development
among the older people. Hence, they do not understand the importance of consuming healthy
nutrient rich fruits, vegetables and diet. Moreover, they also do not remain aware of the
importance of physical activities throughout their lives to remain fit and burn calories for staying
fit (Rowe et al., 2018). Hence, they tend to develop obesity which exposes them to different
chronic ailments. Moreover, they also do not participate in any screening sessions or in routine
yearly check-ups that help in early identification of the risk factors and prevent the occurrence of
any disorders. Hence, lack of education and improper health literacy contribute to risky
behaviors among older cohorts. Health literacy mainly helps individuals to undertake proper
healthcare decisions that help them to develop quality health. Older people with poor health
literacy cannot undertake proper healthcare choices and decisions and hence they are seen to be
subjected to more risks of developing the disorders (Farnbach et al., 2015).
Another social determinant of health is improper access to healthcare services in the
communities. The effect of colonization, torments, discrimination, racism and stolen generations
had already affected their childhood. The feelings of non-acceptance and disliking by the western
culture people towards the aboriginals are deeply ingrained in their minds. The stress, fear,
exploitation and sufferings faced by the aboriginal people during the times of colonization have
been rooted in the generations. Such children growing up to be older cohorts of the present
generations have not yet able to develop full confidence on the western culture (Askew et al.,
2018). In such arenas, discrimination and culturally incompetent care by the healthcare
professionals act as the main reasons for inaccessibility of the older cohorts to attend healthcare
services. Providing service to the older cohorts that do not align with that of the cultural
traditions, inhibitions as well as preferences of the older aboriginals affect their autonomy and

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dignity and hence may prevent them from accessing healthcare services. Hence, Koolit Balit is
trying to implement and strengthen service delivery that is not only cultural competent but also
aligns with the needs of the older people (Campbell et al., 2018).
Conclusion:
From the above discussion, it can be seen that Koolin Balit is one of the best strategic
framework developed by Victorian government to ensure holistic healthcare to the aboriginal
people. They aim in developing strategies that would cover the broad social determinants of
health that affect the life of the Aboriginals people in Victoria and thereby try to manage the
barriers ensuring quality health. The key priorities that are covered by the policy are healthy start
to life, quality teenage hood, and effective transition to adulthood, caring for old people,
assessing different risk factors and managing services to provide care to people. One of the at
risk population is the older people who are exposed to high risk factors that need to be handles
sensitively with care. Developing their financial security, health literacy level and providing
culturally competent healthcare services can help in managing the risk factors for older cohorts.

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References:
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Aboriginal and Torres Strait Islander primary healthcare service. Australian journal of
primary health.
Campbell, M. A., Hunt, J., Scrimgeour, D. J., Davey, M., & Jones, V. (2018). Contribution of
Aboriginal Community-Controlled Health Services to improving Aboriginal health: an
evidence review. Australian health review, 42(2), 218-226.
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
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KOOLIN BALIT – POLICY ANALYSIS
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