Social Determinants of Health: Examining the Association between Natural Health Effects and Socioeconomic Disadvantage in Northern Territory of Australia

This report examines the association between the natural health effects and socioeconomic disadvantage in the Northern Territory of Australia. It highlights the impact of social determinants of health on the indigenous population and the need for addressing health inequities.

SOCIAL DETERMINANTS OF HEALTH
Determinants of Health
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SOCIAL DETERMINANTS OF HEALTH
Introduction
The Australian population has dramatically progressed during the 20th century in
regards to health and wellbeing. Comprehending inequity in health should be a priority
for the Australian government. It is essential for these issues and their health effects
including the health breach between indigenous and non-indigenous Australians to be
addressed. This report examines the association between the natural health effects and
socioeconomic disadvantage in the Northern Territory of Australia. Even though there are
several improvements, it has been characterised by severe health inequities like health
conditions and health service access and the position of socioeconomic in population
health.
In Australia, there is a broad scope in this populations, and it is the only country
in which the breach is full and extended compared with other advanced countries with the
significant indigenous population. The discrepancies and in health results between two
subpopulations in Australia has been considered by the health jurisdiction as a critical
social and public health challenge as outlined in Australian Human Rights Commission
(2005). The Australian government has shown interest in closing the life expectancy
breach within a population and have some gaps in academics and employment crisis in a
decade.
The Northern Territory is located in northern and central Australia which also has
the smallest population (231,331 in 2011) among all nations. It entails high population in
remote areas than any other state. The indigenous people live in impoverished areas
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which exposes them to continuous health inequalities and the extent to which the
socioeconomic determinants contribute to such issues (Braveman 2014, pp. 366-372).
Inequalities in health
Health inequity and Socioeconomic status
A person’s economic and social status is measured by their academics, income
and their professions. There is an expanding body of literature which outlines the
socioeconomic inequity in health in Australia. Those who belong to low socioeconomic
status do not have access to quality healthcare services because they are poor hence they
tend to die early. There is a healthy relationship between poor health, remoteness and
poverty. However, previous research in Northern Territory affirms a clear social acclivity
to the diabetes prevalence of diabetes assessed in disability-adjusted life years.
(Braveman 2003, pp. 254-258).
The old public health model has revealed that indigenous people have
experienced negative results of colonisation that has left many of them with inadequate
education, unemployment, low income, overcrowding and lack of proper health services.
The old public health model has limited success in regards to health in attempting to
modify peril behaviours like smoking, taking alcohol and obesity. The peril conditions
are often planted within the disadvantages which reinforces the risk conditions as
suggested by Culyer& Wagstaff (1993, pp. 431-457).
Health inequality has been assessed through evaluating various measures and effects between
multiple groups for similar differences in mortality rate and hospitalization rate and life
expectancy. The old public health model has also found another way of determining
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health inequality, and that is to investigate the distribution of health effects in the
population through the use of concentration index and their rectifications and
disintegration. This has helped in examining the contributions of the factors that have led
to health inequity as commented by Daniels (2008, 79-102).
Socioeconomic is considered as one of the leading causes of diagnoses of
hospitalization in Northern Territory population. The old public health model has
associated indigenous health inequity with socioeconomic inequity using the data
provided. This population has lacked access to quality healthcare services due to living in
very remote areas. They also have easy access to unhealthy meals which can lead to
obesity. The population has a high risk of suffering from infectious illnesses such as
tuberculosis and respiratory diseases due to poor sanitation and hygiene. The model tries
to highlight the usefulness of reducing the standards of living so that they can quickly
access quality healthcare services as outlined by Department of Health, Northern
Territory (2017). The northern territory population suffers a significant exposure to
unhealthy lifestyle because of overcrowding and more so low socioeconomic position in
the area.
Health inequity and Gender
Research has indicated that the men's mortality rate depends on risk-taking
behaviours that they indulge in the area. There are obvious issues that the men can
handle, and there are other things that women can control which can influence their
health outcomes. There is the presence of income inequality and violence because of the
gender identity. The biological, physiological and reproductive sex has various
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definitions and effects in different communities. Men in Northern Territory are subjected
to harsh conditions of living due to their remote areas. Therefore, they have to work
harder to support their families ( Drewnowski 2004, pp. 154-162 ). They are exposed to
cold which presents them to respiratory disease such as asthma. Thus they are unable to
get quality care because they are considered as reliable and people who can manage the
situation by themselves.
Gender criteria also allow social inequalities, for example, the difference between
male and female. This social inequity is responsible for the health effects from gender
socialization, role-related actions and gender variations in chances which give men and
women various and unmatched amenities and exposure to health perils (Leeder 2003, pp.
475-478). For example, a woman who is married contracts HIV from her partner since
the society condones her husband's lousy behaviour discouraging her from insisting on
the use of a condom.
Health inequity and Individual behavior
Personal behavior has influenced health inequity . In a male-dominated area, the
females have a difficult time some of them lack confidence in themselves since culture
depicts them as inferior beings. In the Northern Territory in Australia, the usage of
alcohol in women has increased. Research has indicated that the consumption of alcohol
among Australian women is publicly visible. Individual behavior is actually changing the
perception of women taking alcohol because they want to be at the same level as men in
the modern world (Schofield 2007, pp 105-114). The community have used alcohol for
a long time and its results as vital techniques to distinguish, represent and adjust their
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duty. Since the women in that area are considered as low income earners, they are not
able to get quality medication compared to men.
2011 Australian Bureau of Statistics health survey data (Australian Bureau of
Statistics 2013) showed that young women alcohol usage was meeting the young men’s.
This means that the number of women who suffer from cirrhosis of the liver is much
higher than men. Thus majority do not have the necessary means to get healthcare
services adequately. Most of the men take alcohol with the perception of releasing stress
and women make it boost their confidence when they lack confidence. Each individual's
action determines health inequity in Australia. Some of them indulge in drug abuse after
being lured by men and end up dying without getting necessary treatment. The old public
health explains the effects of alcohol but fails to put measures that can be used to stop
this menace. It has encouraged health inequity by providing medication for the wealthy
people as commented by Sloane et al. 2003, pp. 568-575)
Health inequity and nutrition
Lack of income has a more significant effect on the type of food people consume.
Individuals with high socioeconomic status can buy healthy nutritious foods compared to those
with low socio-economic status as outlined in ‘Australian Dietary Guidelines Appendix A:
Equity and the Determinants of Health and Nutrition Status’ (2013, pp. 31-40). They tend to
purchase less dense and unhealthy foods and hence failing to meet their daily nutrient
requirements. As a result, the latter is faced with numerous health challenges such as
malnutrition and obesity which may lead to high mortality and increased health care costs
(Drewnowski 2004 , pp. 154-162).
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Health inequity and education
Several studies have indicated that education influences the health of individuals. More
educated people have the advantage of receiving better care compared to the less educated. They
are often well informed on the benefits of good health-seeking behaviour. As a result, they do
visit the hospitals regularly for checkups and early disease detection (Berkman et al.2011, pp 97-
107). They also end up getting well-paying jobs and hence acquiring proper health insurances
which help them get improved medical care. They also have improved access to nutritious food
preventing them from preventable nutrition-related diseases. They also live in good houses that
are often free from health hazards compared to the less educated. The less educated live in
overcrowded and unhealthy environments predisposing them to diseases such as tuberculosis,
cholera and typhoid. They lack knowledge about sanitation and healthy meals which can prevent
them from the exposure to infections.
The old public health model emphasized mainly on immunization and sanitation while
the new federal health assumes that all these are well established and need only surveillance. The
former public health model tried to analyze the interventions required to restore health equity in
the Northern Territory. It encouraged the public hospitals to deliver adequate services since the
population cannot afford expensive healthcare in private hospitals. It also highlights the
importance of nutrition. The community is encouraged to practice good eating behaviours and
eat nutritious food at all times. The model emphasizes disease prevalence but does not provide
modern treatment systems that can be used to take care of people living in the rural areas. Ward
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(2009, pp. 270-284) suggested that the old public health tried to advocate a multi-causal step
that saw infectious and chronic diseases as being the result of the complicated relationship
between social and psychological elements.
New public health Model
The 6th iteration of the Andersen’s and Newman model of utilization of health care best
explains the inequalities and factors influencing the uptake of the services ( Baum 20 16 ).
The model contemplates access to and utilization of health care as a function of three features
which include predisposing factors, need factors and enabling factors.
Predisposing factors
These are the socio-cultural elements of people that exist before acquiring illnesses. They
include the social structures such as education, social networks and interactions, occupation and
ethnicity. High level of education attainment contributes to maximum utilization of health care
services. This is because well learned have a higher opportunity of getting high paying jobs
which enables them to acquire better health than others. They also know more about the
importance of going for screening services or visiting the hospitals on a regular basis.
Predisposing factors also include knowledge, values and the attitudes of people about the
health care system. These characteristics have a significant influence on the utilization of health
care services as they determine whether one will visit the hospitals or not. Lack of proper health
education on the benefits of timely treatment of diseases makes it difficult for individuals to seek
the services. Negative attitudes towards the healthcare providers and values that discourage
people from visiting the hospitals also result in reduced usage of the health care services.
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Demographics such as age and gender also influence the seeking of health care services.
Research indicates that women consume more health services compared to men. Compared to
men who tend to use the emergencies services in the hospitals, women frequently use diagnostic
and preventive services. Older individuals often fail to visit the facilities as they rely on fixed
incomes making it difficult for them to pay for the services. They also lack transport to visit the
hospitals that are distant from their houses and hence losing on essential hospital care they need.
Enabling factors to include personal or family, community and possible addictions. Some
families often lack the income to pay for the services. They also lack funds to pay for transport to
the facilities. As a result, they are unable to utilize the services and hence increasing mortality
rates. They also view visiting hospitals as a form of wasting of resources. Lack of insurance
services makes it hard for them to receive quality and timely health care. They also miss out on
the benefits that come with having an insurance such as cover for life-threatening illnesses and
increased number of checkups and diagnostics as commented by Williams et al. 2015, pp. 106-
108).
Lack of enough number of facilities and personnel influences the usage of healthcare
services. Lack of adequate professionals makes the waiting time too long and hence discouraging
the patients from visiting again. The staff also experience huge workloads, which makes them
fail to attend to all the patients and as a result, they turn them away. Lack of sufficient well-
equipped hospitals has an impact on the health-seeking behaviours of people. Some genetic and
behaviours factors affect the uptake of the services. Individuals often regard diseases as mild or
not for medical care, preventing them from acquiring the services.
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Need factors include both the perceived and evaluated needs. The perceived needs are
those that influence an individual’s understanding of the importance of adherence to medications
and care-seeking. It also involves peoples view their health as well as how they encounter
symptoms of pain, diseases and troubles concerning their health. It also includes how people
judge their illnesses to be of considerable extent and importance to seek physicians or healthcare
professionals help. Evaluated needs relate to the amount or type of treatment a patient receives
after seeing a medical care provider. It also constitutes professional decision regarding an
individual’s health status and their need for health care. The explanations of the health inequities
have changed over the years.
The old public health considered health as a uniform essential requirement and solved the
issues according to the population's health. It focused on measurements and monitoring the
inequalities that are present in health. It developed tools that can be used to measure the health of
the population. The old public health focused on service delivery and the wellbeing of the
patient. It encouraged the community to visit the nearest health facilities to get adequate
treatment. It offered limited education to the consumers concerning their eating behaviours and
hygiene practice. It showed the importance of early diagnosis but failed to provide necessary
measures after the diagnosis, and in the case of Northern Territory of Australia, people live in
very remote areas hence they are unable to get the required treatment on time (Daniels 2008, 79-
102). This increases the mortality rate of the population. The old public health majored on the
health effects of a particular illness and did not pay much attention other ailments. It was
difficult to solve health inequalities since it focused on individual behaviour.
In conclusion, the current public health model focuses on advanced health systems to
cater for various diseases. It addresses the health predicaments comprehensively and also
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considers human elements as it tries to fight health inequities. It focuses on the primary
interventions that examine the wellbeing of the patient at all times. The model helps in
evaluating the challenges that the population faces and creating awareness about healthy lifestyle
to avoid these health inequalities. It helps in understanding in solving the health inequities which
are present today.
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