Addressing SDH in Health Policy Rationale

This essay discusses the health issue of drug addiction and substance abuse among the Indigenous population in Australia. It explores the social determinants of these issues and the health outcomes they cause. The essay also discusses the health policies implemented by the Australian government and potential stakeholders to address these social determinants.

Running head: PUBLIC HEALTH, POLICY AND SOCIETY
Assessment 2: Addressing SDH in Health Policy Rationale
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Table of Contents
Introduction................................................................................................................................2
1) Health Issues: Drug Addiction/Substance abuse...................................................................2
2) Particular Population Affected by Drug/Substance Abuse: The Indigenous Population in
Australia.....................................................................................................................................3
3) Health Outcomes of Drugs/Substance Abuse in the Aboriginal and Torres Strait Islanders 3
4) Social Determinants of Drugs/Substance Abuse among the Indigenous Australians...........7
5) Health Policies implemented by Australian Government....................................................11
6) Potential Stakeholders to address the social determinants of the health to mitigate
Drugs/Substance Abuse...........................................................................................................12
Conclusion................................................................................................................................15
Reference List..........................................................................................................................16

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Introduction
Public health referred to as the art and the science of promoting prolonging life and human
health along with preventing diseases through informed and organized efforts of the
community. The purpose of the essay is to the discussion about the health issue that largely
impacts the well-being of the nation's population. The impact of identified health issue will
be outline related to a specific population. The social determinants of the health issues will be
supported using evidence from the literature. The responsibility of the improving and
maintaining public health lies with every section of the society and for these several policies
undertaken by the government of Australia is related to the prevention of drug and substance
abuse will be the discussion. Further, potential stakeholders with the help of which social
determinants of health issues can be mitigated are also given in the essay.
1) Health Issues: Drug Addiction/Substance abuse
Among several other health issues, the concern related to substance abuse or drug addiction
has been focused here. In reference to health issues like drug addiction, the nation like
Australia cannot be escaped from the respective global issue. As per the statistics it has been
at the top in respect to drug abusers. Almost one in twenty Australian has noted to have a
hard time with health issues of drug or substance abuse (Healthdirect, 2019). Any substance
use disorder includes the use of a large amount of alcohol, other drugs or tobacco. It might be
termed as substance addiction, substance dependence or abuse.

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2) Particular Population Affected by Drug/Substance Abuse: The Indigenous
Population in Australia
The consumption of tobacco, alcohol and other drugs has been a significant cause of illness
and preventable diseases in Australia. This essay consolidates the ill impact of substance
abuse and drug addiction among the Indigenous population of Australia. The most largely
abused substance in the nation is alcohol and tobacco. On the other hand, smoking has been a
single general preventable cause of death and sickness among the peoples in the community
(AIHW, 2019).
3) Health Outcomes of Drugs/Substance Abuse in the Aboriginal and Torres Strait
Islanders
Addiction has been chronic disease featured by use and drug seeking that are hard to control,
compulsive, irrespective of harmful consequences. There are several people that enjoy
drinking now or then. Drug Addiction or Substance abuse occurs at a time when an individual
loses control of their drugs and alcohol consumption. At the time when drug or substance
starts to cause harm like medical issues, injuries, the problem at works or hampering
relationships, it might be a sign of a habit becoming a concern. The indigenous group of
Australia that noted to be high on substance abuse and drug addiction are encountering long
term health concern. With the continuous usage of drugs, the brain adapts by decreasing the
capability of cells in the reward circuit to respond to it. The long term has also led alternation
in brain circuits and chemical system affecting functions like judgement, decision-making,
learning, memory, behaviour and stress. Carswell (2019) added that Australia is inglorious
unique of gaining high proportion of recreational drugs user across globe-an embarrassing
albeit, new low from being high. Australia is a flourishing country and holiday resort to
several people across the globe. The illicit drugs are easier to find at popular clubs, streets

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and Australian beaches (Horyniak et al., 2017). Unlike other people across the globe,
Australian people also try substance and drugs out of curiosity. As people are well informed
about the dangerous impact of drugs, still they continue with such to have a new experience.
It has been found that substance abuse like tobacco consumption still remains
disproportionately high in indigenous Australian.
Figure 1: Percentage of current daily tobacco consumption among Aboriginal and
Torres Strait Islander peoples, 2014–15
(Source: van der Sterren et al., 2019)
The scope of the weight of death and diseases that tobacco imposes on individual health in
the nation is extensive. It is leading to chronic diseases among the people that appear largely
at old ages, like lung cancer and subclinical health impact (Kwan, Stratton & Bonnie, 2015).
The immediate crucial health effect involves depletion in chosen bio-available antioxidant
micro-nutrients, increase oxidative stress, inflammation, damaged immune system, self-rated
health along with altered respiratory symptoms like dyspnea, wheezing, coughing and
phlegm.

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Figure 2: Alcohol consumed used by Indigenous people in Australia
(Source: AIHW, 2019)
On the other hand, alcohol has been the most commonly used social drugs among the
indigenous group of Australia. In the community, people, such drug addiction has contributed
to increased risk of anxiety and depression as well as mental illnesses in many people. The
ethnicity, gender and existence of varying metal disorder have also influenced the risk for
addiction and drug use. As per NDSHS study in the year 2016, overall one in five indigenous
Australian, nearly about 18.8% consumes 11 or more standards drinks within a month
(Livingston & Callinan, 2015). The life of the people in the community is at great risk of
harm from alcohol, where an individual engages in operating machinery or driving. In the
short term, alcohol consumption leading health issues like memory loss deliberated harming,
vomiting and hangover, where long-term impact are high blood pressure, risk of dementia,
stroke, liver cirrhosis, liver cancer and reduced fertility.

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Figure 3: Substance used by Indigenous people in Australia
(Source: AIHW, 2019)
Similarly, in terms of illicit drugs, approximately one in three of indigenous Australian of age
15 and above found to use illicit substances at least within 12 months that has increased from
22% to 30%. The male group has noted to be higher than female in using illicit substances
(Wand et al., 2016). Cannabis as illicit drugs used by 12% males and 14% females of Torres
Strait Islander and Aboriginal people as well as non-medical substances like sedative and
analgesics are slightly common in 15% females and 11 males. Such drug consumption has
led to deteriorating well-being of the community people increase the rate of physical and
mental concerns. In case of sharing injections has also threatened the risk of dangerous
diseases like HIV and hepatitis as well as serious infection in the population of the nation. All

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this draws serious attention of the government of Australia to establish a healthy and sound
society and a better future for the future generation.
4) Social Determinants of Drugs/Substance Abuse among the Indigenous Australians
The health behaviours have originated from the complicated connection between the socio-
economic, domestic, community and environmental factors. The inequality of health needs is
created within the space in which an individual grows, lives, works, ages and deals with the
health discrepancies. The environmental, social and political factors also impact the health
needs within a community (House of Representatives, Standing Committee on Indigenous
Affairs, 2015). In the case of the indigenous people within Australia, the Aboriginals and the
Torres Strait Islanders are connected to their nature through the land, sea and culture.
Deprivation from these factors impacts their health from the perspectives of the indigenous
people. The colonisation and the impact of western cultures have depleted their culture and
the social environment to some extent. There were clear suggestions that the one-third of the
health gap among the Aboriginals and the half of the health gaps within the Torres Strait
Islanders with the non-indigenous population in Australia (Aboriginal and Torres Strait
Islander Health Performance Framework 2017 Report, 2019).
The drug and other substance abuse among the Indigenous Australian are contributed by the
variety of factors with respect to the individual as well as the individual behaviours of the
population. The issue of mitigating the associated health risks with respect to the alcohol,
tobacco and other illicit drug use is difficult to determine (House of Representatives,
Standing Committee on Indigenous Affairs, 2015). The social, cultural, economic and the
physical environment are undergoing changes which impact the health habits of the
population. In regards to the rapid changes in the western societies the changing demands of
the economy and social life with long working hours, less time for domestic life, changing

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family numbers and the pressure to meet ends impacts the societal institutions like childcare,
family life and the education.
Housing Conditions
There are also issues with the poor living conditions among the populations, with respect to
sanitary conditions, nutrition and housing services in comparison to the non-indigenous
population. The opportunities to develop healthy habits and lifestyles is lower for Aboriginals
and Torres Strait Islanders socio-economic disadvantage, which leaves them exposed to a
greater risk of behavioural and environmental risk factors (Grant et al., 2014). The natures of
the systemic discrimination being faced by the Indigenous population have pushed them into
the lower end of the development (Aboriginal and Torres Strait Islander Health Performance
Framework 2017 Report, 2019).
Access of Healthcare
One of the most important determinants of health among the Aboriginal and Torres Strait
Islanders is the lack of accessibility to primary healthcare services and poor healthcare
infrastructure in the living areas. The Indigenous Australians generally reside in remote
locations for which the healthcare providers are reluctant to visit. Poor education access and
lack of literacy among the indigenous population of Australia have affected their capacity to
be informed about the ill effects of substance abuse (Azzopardi et al., 2018). The lack of
opportunity to work and poor economic conditions deprives them of accessing the better
health needs from healthcare institutions. The living conditions of the indigenous people are
crowded and over-populated with poor living conditions and exposes them to substance
addiction more quickly. The low quality of infant and child feeding also affected the health in
later life and facilitated with poor health and medical requirements of the women. Modifiable
health factors provide detrimental health outcomes in the community and impact public

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health. This increases the disease burden among the indigenous population, where 12% was
accounted for the use of tobacco, and 8% was due to alcohol consumption. These increased
the body mass index of the population by 8%, physical inactivity by 6% and 5% increase in
the high blood pressure as good diabetes among 5% of the population (House of
Representatives, Standing Committee on Indigenous Affairs, 2015).
Educational factors
Education has been pinned one of the most significant influencing factors of the health, well-
being and the sustainability of the population in future. Education is one of the most
protective barriers against the alcohol and illicit drug abuse, which is signified by the binge
drinking among the indigenous population in the remote locations (Hing et al., 2014). The
education attainment rate is low in children from the substance abusing family. Research has
shown that the lack of concentration in school is related to the children being tired of
domestic violence as well as being unfed in their household. In general, individuals with at
least 12 years of education are considered for better employment opportunities (Aboriginal
and Torres Strait Islander Health Performance Framework 2017 Report, 2019).
Employment Inequality
It is better for physical and mental health when meaningful employment opportunity is
provided to the people. A proper employment opportunity helps the population to participate
in the societal norms and financial independence to improve the standard of living. The
individual benefit obtains from the employment benefits the overall community after the
opportunities (Dudgeon et al., 2016). In addition to this, the lack of employment
opportunities gives rise to a lack of recreational activities and boredom. This increases the
propensity to delve into the use of alcohol, tobacco and other illicit drugs. The poor education
system also decreases the capabilities of the population to get better jobs with significant

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payment. The language barrier that is seen among the indigenous population creates a
disparity in obtaining high-earning jobs where English speaking capabilities is essential
(Aboriginal and Torres Strait Islander Health Performance Framework 2017 Report, 2019).
Unemployment creates a culture of poverty, which decreases the self-respect among the
population and route towards substance abuse. The health surveys in Australia revealed that
unemployment was one of the triggering factors which induced alcohol consumption among
the youth. Only the people within this community with a regular source of income are able to
afford a better lifestyle and health outcomes.
Stress affecting mental and physical health
Stressful factors, including social discrimination and economic disparity, increase the
propensity of the population to indulge in substance abuse and lose control over their life.
The greater burden of stress to meet the requirements of the livelihood cause the prolonged
exposure of psychological demands in situations where the rewarding possibility is low
generally increases the substance use (Sarnyai, Berger & Jawan, 2016). The chronic stress
factor impacts the mental health of the population and causes behavioural changes as well as
associated physical health issues.
Racial Discrimination
Discrimination of any kind increases the propensity of the individuals to revert from the
social connections and increased their mental health disturbance. Racial discrimination also
impacted the educational opportunity, employment capability and the healthcare
inaccessibility (Goodman et al., 2017). This is one of the significant determinants of stress
within the individual, causing anxiety and depression, followed by physiological
dysregulation within the individuals. Some studies have proven the cross-connection
between the participants experiencing racial discrimination with that of the persistence of

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substance abuse among the Aboriginals and the Torres Strait Islanders (Aboriginal and Torres
Strait Islander Health Performance Framework 2017 Report, 2019).
5) Health Policies implemented by Australian Government
Policies made by the Government of a state usually operate issues taking place in the social
environment. In other words, the policy formed with the purpose of public well being of has
been universally accepted for driving change in the habits of people living life under certain
addictions (Meier, 2016). In this regard, certain policies are being enacted by the initiatives
taken by the Australian Government.
The Aboriginal and Torres Strait Islander Health Performance Framework 2017: This
particular policy has been addressing the health issues of drug addiction, alcoholism and
tobacco addictions in general. In fact, the particular policy has been actively commenced in
three different parts, which includes, Tier one, two and three in an orderly sequence. In the
First Tier of the policy, it mainly focuses on finding the existing status of human health in
the aboriginals and Torres Islanders. In addition, it looks forward to the consequences of
health disorder taken place among those aboriginals and islanders of Australia. Further, in the
second Tier, it finds the determinant of the health of those aboriginals and islanders.
Moreover, the third tier identifies the health system performances by the help of actions and
program conducted by the key stakeholders associated with the policy-making and
implementation (Wand et al., 2017). Relevant to this entire policy execution process, it
provides the primary stage of detection of chronic diseases among the public of Torres
islanders and the aboriginals to offer them with the medicinal or hospital support for the
diagnosis of their actual disease properly. This provides access to the services that need to be
given to such diseased people in this group in order to continue the regular medical checkup
through care planning for those chronic diseases already affected in the region. However, this

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would assist further to the health experts to organize training accreditations for men and
women people of the area with learning tools and techniques regarded the health issues that
have affected due to the addition of drugs as well as other types of addictions like alcohols
and tobaccos. Hence, by such means, the aboriginals and islanders are provided knowledge
about the negative of addictions and health care issues.
National Aboriginal Torres Strait Islander Peoples Drug Strategy 2014–2019: This particular
policy has been proposed by the joint effort of the Government and partnership for reducing
the harmful effects of alcohols and drugs on the families, individuals and the local
communities. In other words, the principle of this policy is to carry out a holistic approach of
detection and reduction of drug usage within the community of Aboriginals and Torres Strait
Islanders with respect and dignity without demeaning the culture (Stevens, Egger & Morgan,
2018). Relevant to this policy, it tries to maintain a systematic process of controlling this
addiction through diminishing stipulation, supply decline, and dropping down the number of
the destructions from such area. It is an effective medium, as it looks forward with the main
concerned area of improvements. Hence, such priorities are emphasizing on building
capacity, arranging a range of culturally receptive prevention programs (Fogarty et al., 2018).
Moreover, it gives the opportunity to reinforce the partnerships between the community and
the Government and provide a final evaluation.
6) Potential Stakeholders to address the social determinants of the health to mitigate
Drugs/Substance Abuse
The involvement of potential stakeholders is significant in health care programs for the social
benefit of people. In fact, stakeholders’ function empowers a plan of action formed by the
collaboration or partnership for drawing out successful results in any kind of social cause (Le
Feuvre et al., 2016). The idea understood by this context is that if potential stakeholders can

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be engaged in the participation against drug addiction programs in the communities of
Aboriginals and Torres Strait Islanders for strategic execution of the entire process. In that
case, some potential stakeholders identified are the Government of the Country, the
Community Consultants, Local Medical health experts, Policymakers and Investors. These
are the potential members can be involved actively for this entire mission.
The role of Government of the Country: The role of Government is the most valuable one
in the formation of policies in a country against any crimes. In other words, Government
plays momentous responsibility behind legalizing any kind of strategy that can restrict or
allow the public to move ahead with appropriate action against addiction of drugs (Beard et
al., 2016). Hence, following such legal framework formed by the Government, the doctors
and nurses and other health care experts are ethically enforced to accept for the well being of
the society.
The Community Consultants: Community consultants are effective players in the group
individuals living in the Torres Islands and among the Aboriginals. In other words, the
community consultants act as a medium in making a relationship between the policy makers
and the medical experts to reach the people who are affected in the region (Browne et al.,
2018). Therefore, such consultants provide assistance as a guideline in understanding the
psychology of those people in addictions in providing actual information.
Local Medical experts: The local health experts are important practitioners here playing
crucial in the life of addicted patients. Caring with an adequate supply of standard checkup
and facilities determines the quality care system (Freund et al., 2015). Such experts are
efficient in supporting the government in carrying out the policies authorized by the
government successfully at workplaces. In fact, the medical experts are also tending to offer
proper training facility to the local nurses to address the social determinants with questioning.

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Policy makers: The policymakers are another third party agents or group of the official body
part of Governments' decision-making process. In fact, policymakers have the right to put
forward any changes in the laws before they are constituted (Nowrouzi et al., 2015). In this
case, health issues relevant to the concern of drug addiction are one such social cause that is
immensely taken cared.

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Conclusion
In context to the above study, it is concluded that public health in a country is important to
improve the economic outcome. The increased public health reduces the healthcare cost
burden on the nation. The consequences of drug addiction and substances abuses are
increasing in the Indigenous Australians due to poor living conditions, lack of education, low
employment and racial discrimination. In order to control the increasing rate of substance
abuse or drug addiction in the nation, the policy like Torres Strait Islander and Aboriginal
health performance framework 2017 and related drug strategy 2019-2014 has proven to be
somewhat significant. Moreover, the strategic utilization of potential stakeholders noted to be
effective to decrease the risk of poor health effect.

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