Women's Health in Australia: Social Determinants and Primary Health Care

This article discusses the women's health condition in Australia, social determinants of women's health, and how primary health care is addressing women's health issues. It highlights the prevalence of heart diseases, stroke, cancer, and mental health disorders among women in the nation. It also discusses poverty, violence, and gender pay gap as social determinants of women's health. The article concludes by discussing the primary health care system in Australia and its role in providing evidence-based practices and services appropriate for local community needs.

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Introduction
Australia is a sovereign country which comprise mainly of the Australian continent, the
island of Tasmania and several other smaller islands. It is called as the largest country of
Oceania. It is also stated as the world’s sixth largest country by total area (Willis, Reynolds &
Keleher, 2016). In Australia, health care is largely provided by private medical practioners. It is
also provided by government and private operated hospitals. It is the mixed public-private health
care system and is ranked second best in the developed world (Duckett & Willcox, 2015). Both
women and men are predisposed to various types of diseases. The genetic, biological and
behavioral differences between both genders led to higher health risk among women in Australia.
As per literature, a large number of issues have been noted among the women health which
remains unreported (Dawson et al., 2017). This assignment will mainly be based on the
description of the women health condition in the nation. Moreover, it will also discuss three
important social determinants of women health in the nation. This would be followed by the
discussion how primary health care of the nation has been addressing the women heath issues. It
will also be showcasing how social and economic policies have impacted the health conditions of
the women in the nation.
Australian health care system
The national agency in Australia responsible for health and welfare information and
presenting statistical data is the “Australian Institute of Health and Welfare” (AIHW). This body
develops 140 reports every year on health status. The federal initiatives of Australian health care
are Medicare responsible for health service subsidies. The development of healthcare sector in
the country has led to increase in the life expectancy of the population. Australian government
system of Medicare (Australia’s universal health care system) had helped people to cope up with

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their healthcare cost (Milner, Smith & LaMontagne, 2015). Medicare funds large part of the
health care services. The Pharmaceutical Benefits Scheme offers subsidized medication to
patients. The regulatory body of medical devices and the medicines is the Therapeutic Goods
Administration (Meadows et al., 2015).
In Australia, WHA or Women Health Care Australia is the peak body for hospitals
oriented towards women health. Hospitals providing maternity care and other health service to
women in Australia directly work under WHA. It serves 110 maternity services across
Australia.. It is the largest woman health advocacy. Some of the special interest groups of WHA
includes are, “Aboriginal & Torres Strait Islander Women's & Children's Health”, “Maternity
services” and many more (Duckett & Willcox, 2015). Despite several developments, women
health is of major concern in Australia.
Women health issues that are important
Most chronic and disabling disorders which are affecting women in Australia are heart
diseases and stroke (Byles et al., 2015). Cardiovascular disorder is affecting considerably a larger
proportion of females in this nation. Currently Australian government is considering this disorder
to be the most dreaded disorder in the nation. This is reflective from the fact where 209.8/100000
deaths are occurring from heart attack, stroke as well as vascular diseases among females. This
rate is considerably higher in the elder female cohorts. Ischemic as well as coronary heart
diseases occur mainly due to build up of a large number of plaques in the different blood vessels
(Dobson et al., 2015). This is resulting in angina and heart attacks to a large number of women
per year. Increased levels of obesity are mainly considered to be the main cause behind the

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development of heart disorders in women. A study also suggests that the burden experienced by
women from stroke is 2% higher in comparison to that of the males (Schmied et al., 2015).
Numerous types of cancer are affecting women in the nation. The burden of cancer
among women of the nation is found to be dominated by breast cancer followed by lung cancers.
Together these are actually resulting for about 60% of all the cancers in the nation. According to
Australian Bureau of statistics, breast cancer is the 2nd most common cause of death from cancer
in females (Torre et al., 2015). Australia ranks 17 in the entire world with 86% in age
standardized rate per 100000 in world (Yu et al., 2015). The prevalence of new breast cancer
cases among Australian women in 28.4% as per 2017 reports. There are 17586 women newly
affected by breast cancer in 2017. Total number of deaths among females in 2017 due to cancers
was 19453. The total number of new cases among females due to lung cancer was 18/100,000
persons in 2017 (Dasgupta et al., 2017).
Other women related issue that is also getting pronounced in the Australian context is the
several disorders related to mental health. Depression related issue is one of the most common
mental disorders which is affecting the women of the nation that had accounted for about 4.8%
of the total diseases burden on the women (Hayman et al., 2015). Post partum depressions are
found to be yet other contributors to the increasing rate of mental health disorders in Australia. It
is affecting up to 15% of the childbearing women (Schmied et al., 2013). A marked difference is
found in the health conditions of that of the aboriginal women (Milner, Smith & LaMonatge,
2015). It is astonishing to found that the life expectancy of such women are found to be 20 years
shorter than that of the non-aboriginals. However the diseases by which they are affected are
more or less similar to that of the non-Indigenous Australian women (Gausia et al., 2015). The
mortality rates of the Indigenous women are 2.8 times higher than Non-Indigenous women in

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cardiovascular diseases. Neoplasms or cancer of such women also result in higher number of
deaths with lung cancer becoming 20%, digestive organs for 20% and female genital tract for
about 17% (Dawson et al., 2017).
Social determinates of heath (SDH)
Social determinants of health can be stated as those conditions in which individuals take
birth, develop, live, learn, play and work. These factors have a high impact on their health and
also on the safety and well being of the individuals. SDH includes factors such as education,
employment, social support, income and others influences healthy living (Schmeid et al., 2015).
Poverty and socio-economic status is an important social determinant of health.
Researchers are of the opinion that socio-economic disadvantage can be considered as the cause
as well as the associated outcome of the poor condition as well as sexual and reproductive health
of the women population. Socio-economic disadvantages are mainly denoted by low income as
well as lower levels of education (Badland et al., 2014). In 2014-15, 20% of the Australians
dwelling in the lowest socioeconomic areas were equally likely as the highest 20% to suffer from
heart disease and diabetes (Newman et al., 2015). Those living in the low socioeconomic areas
(bottom 20%) and in poor quality and highly crowded areas are highly susceptible to poor mental
and physical health. As per AIHW, if people living in both low and high socioeconomic areas
had same death rate then, then it would reduce the overall mortality rate by 13% (AIHW, 2018).
The 2013 report of AIHW states that mothers, who are 30% likely to have low birth weight
babies, are residents of low socioeconomic areas. As per the 2012 ABS report, the percentage of
people with employment restriction due to disability from lowest socioeconomic areas
constitutes 26% and 12% in highest socioeconomic areas (AIHW, 2018).

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Low socioeconomic status limit the access of an individual woman to material and
psychological resources at the same time affecting the ability of women to exercise decision
making and autonomy. Children and unemployed women living in poverty and low
socioeconomic areas are highly likely (3.6 times more than high socioeconomic counterparts) to
be addicted to tobacco smoke and other addictions (1.6 times as likely to use cannabis, 1.8 times
to use ecstasy and 2.4 times to use meth/amphetamines) (AIHW, 2018). Socioeconomic
disadvantage affects women’s ability to access health services, contraception, abortion as well as
timely screening and treatment of not only sexually and reproductive health disorders but also
other mental and physical disorders (Owen et al., 2014). Researches also show that poverty
influences women and their partner’s choice of welcoming a child in their life, seeing a dental
professionals due to cost, and other health activities These conditions ultimately affect the
physical and mental health of women in the nation (Mitchell et al., 2016).
Another social determinant of health of women is violence and discrimination which is
faced by them. This determinant of health is has long lasting physical and psychological health
impacts. Prevalence of violence on women is in present in Australia. This is affecting sexual and
reproductive health of the victim. These conditions influence the mental and financial condition
which gains impact on the mental health and physical health of the women. Studies show that
one in every five women had experienced sexual assault at some point of their lifetime while one
in ten women are raped by their partner (Spangaro et al., 2016). Violence and coercion can take
many forms that not only include sexual assault but also contain intimate partner rape, gang rape,
female genital mutilation, forced prostitution, human trafficking and many others. These factors
have tremendous impact on mental development and physical health which remain associated
with it (Spangaro et al., 2016). According to Hooker et al. (2017), 59% of homeless females in

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Australia have experienced unwanted sex. Women and girls are seen to bear the burden of ill
health, injury and diseases caused by violence. Therefore heart disorders, mental health
problems, sexual and reproductive issues often take place. According to Victorian police, it is
seen that the women living in the western region of Melbourne who are subjected to higher rates
of intimate partner violence and racial discrimination (Spangaro et al., 2016). Such victims get
exposed to higher chances of unplanned pregnancy, sexually transmitted infections like HIV
along with a range of gynecological issues like vaginal bleeding and infection. Fibroids, chronic
pelvic pain and urinary tract infections occur in such individuals (Kelaher et al., 2014).
Australia’s gender pay gap is yet another social determinant which is affecting women
health to a huge degree. Although the generation is proclaiming equal rights given to the female,
statistical data is not justifying the claim. Unequal pays and pay gap statistics also shows that
Australia’s full time gender pay gap is 15.3% with women earning on an average $251.20 per
week less than that of the males. It has been found that when $1,387.10 is the amount received
by women as full time average weekly earnings of women, $ 1638.3 is the full time average
weekly earnings of men (Cassells et al., 2017). Researchers are of the opinion that a number of
factors come into play and influences the gender pay gap. The first one is the discrimination and
biases of the society. The corporate world is hiring more men than women and is biased in terms
of pay decisions. The gender gap is also influenced by women and men working in different
industries. There are female dominated industries and jobs attracting women with lower wages.
Moreover lack of workplace flexibility especially in senior roles acts as a barrier for working
mothers. Therefore women have to either leave their jobs or compromise with lower salaries for
meeting their commitments (Cassells et al., 2017).

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Often women’s greater time out of the workforce impact their career progression and
opportunities to earn high salaries. It is seen that the women are given less chance in the private
sector jobs to handle positions for high earning management roles such as managing directors
and CEOs (Dobson et al., 2015). They are hired for lower status jobs that not only have lower
pay but also poor working conditions. Women have less autonomy and control over the entire
planning in an origination. They undertake work that are males dominated and are subjected to
stress, anxiety and depression (Milner et al., 2015). Low job control is a well established risk
factor for poor physical as well as mental health. It is seen that gender pay gap and such
behaviors at workplace resulted in depression and anxiety among the working mothers. It was
found that women whose income is lower than their male counterparts ha a nearly times higher
risk of depression and four times higher rate of anxiety than their male counterparts. It also
affects their sleep, diet, exercise and other related behaviors. It results in physical ailments and
mental health disorders (Rickwood et al., 2014).
Primary health care- Australia
Primary care is the continuing care for the patients provided by the health care providers
who are in first contact with the patient. It includes physician, nurse practioner, clinical officer,
and others who give day-to-day care. Primary care is an integral component as per World Health
Organization and every patient with chronic illness is entitled to it irrespective of nature of
illness and socioeconomic status (Wakerman et al., 2017).
Primary care provided to Australia’s women is quite developed as they use evidence
based practices and provide services appropriate for local community needs. It is reflected in
National primary health care strategy. System of Medicaid had helped patients to cover up for

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their huge expenses but also help women to get better service delivery form the primary care
providers. Both the government and the non-government sectors, the healthcare industry has
been quite active in handling women health issues. They are supporting improvement in
performance, quality and safety, while making best use of infrastructure. Breast cancer
awareness programs have been taken by different primary and community healthcare centers so
that proper screening can be conducted by the women (Dasgupta et al., 2017). Aboriginal
Community Controlled Health Services is advantageous for Indigenous women in health
promotion, prevention, treatment and early management. This service considers cultural and
linguistic factors to maintain respect and dignity of patients. Primary health care services are
targeting the specific health and lifestyle condition such as cardiovascular diseases, cancer,
mental health, and obesity. Primary health care services operate differently in urban, rural and
remote areas. Australian primary health care practice implements person centered care approach
(Badland et al., 2014).
Community health programs and primary care services are also available which tackles
different female’s sexual problems and refer to secondary care services when in need. Women
are well educated by their primary care service providers with proper resources. This helps them
to maintain their lifestyle in ways by which different female sexual problems can be handling
with ease and can be overcome by proper lifestyles and habits. Moreover, it was also seen that
proper education provided by the primary care providers have helped many violence survivors to
gradually develop strength and restore their mental health. Treatments starting from
hysterectomy to educating patients on incontinence leaks, menopause, and menstrual issues are
also paid great attention (Tolhurst et al., 2016). Primary care services ensure community
development by implementing different forms of screening programs for cancer identification in

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the patients. It promotes health while preventing illness. The focus is on building capacity of
individual with goal of self determination (Rickweed et al., 2014).
Impact of social and economic policy on women’s health
The National Women’s Health Policy 2010 was mainly proposed with the purpose to
help in improving the health and well being of all the women in Australia mainly helping those
who are at a greater risk of poorer health. It helped in identifying the immediate as well as future
health challenges of women at the same time of addressing the fundamental ways by which
society could be structured properly. This had positive impact on the on the health and well
being of the women in the nation (Rickwood et al., 2014).
The AMA’s policy (Australian medical association) focus on social model of health,,
gender equity, health equity between women, upstream interventions, life course approach to
health, strategic coordination and leadership and building the knowledge base to improve
women’s health to highest attainable standards. This policy has been effective in addressing
social determinants of health and health experiences of Aboriginal and Torres Strait Islander
women. The AMA recommends gender mainstreaming in local, national, state and territory
health policies (Walters et al., 2017).
There are several laws acting at federal level. The Australian Human rights commission
has statutory responsibilities. The Australian Human Rights commission Act (2004), Sex
Discrimination Act (1984), Racial Discrimination Act (1975), Disability Discrimination Act
(1992), and Age Discrimination Act (2004) act at federal level. Together this laws has been
successful in preventing discrimination against women based on sex, race, disability, identity,
relationship status, social origin, political opinion, pregnancy and others. These laws and policies

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have been successful in improving the health status of the women to a great extent (Boer &
Gruber, 2017). Despite the socioeconomic policies, there is huge disparity in women health.
There is need of stringent monitoring and evaluation of the policies to ensure desired health
outcomes for women. Women rights are not fully protected in Australia, the violence prevention
and legal services are not available in most parts of the Australia. The family policy system and
laws pertaining to it do not fully respond to the domestic violence issues. There is need to
increase the indigenous women in decision making positions. The “National Plan for Violence
Against Women and their Children” is a 12-year agreement and has not shown significant
improvement yet (Boer & Gruber, 2017).
Conclusion
It can be concluded that Australia, although being a developed nation, also harbors many
factors that affect the women health of the nation. Cardiovascular disorders, cancers, mental
depressions, sexual and reproductive health issues are most prevalent health issues among
Australian women. The social determinants of health are poverty, violence and discrimination,
social economic status, and gender pay gap. All these affect human health both physically and
mentally providing a very poor quality life. Hence, it becomes extremely important for the
healthcare service of the nation to provide support and service to women in the nation.
Australia’s healthcare delivery service is quite efficient and is trying their best to provide best
care and compassion to them. Different policies over the years have been proposed which had
helped in developing lives of the women and help them in healthy aging.

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References
AIHW. (2018). Chapter 4 Determinants of health. Australian Institute of Health and Welfare.
Retrieved 4 January 2018, from
https://www.aihw.gov.au/reports/australias-health/australias-health-2016/contents/
determinants
Badland, H., Whitzman, C., Lowe, M., Davern, M., Aye, L., Butterworth, I., ... & Giles-Corti, B.
(2014). Urban liveability: emerging lessons from Australia for exploring the potential for
indicators to measure the social determinants of health. Social science & medicine, 111,
64-73.
Boer, B., & Gruber, S. (2017). Legal Frameworks for World Heritage and Human Rights in
Australia.
Byles, J. E., Francis, J. L., Chojenta, C. L., & Hubbard, I. J. (2015). Long-term survival of older
Australian women with a history of stroke. Journal of Stroke and Cerebrovascular
Diseases, 24(1), 53-60.
Cassells, R., Duncan, A. S., & Ong, R. (2017). Gender equity insights 2017: Inside Australia’s gender
pay gap (No. GE02). Bankwest Curtin Economics Centre (BCEC), Curtin Business School.
Clarke, A. E., & Olesen, V. (2013). Revisioning women, health and healing: Feminist, cultural
and technoscience perspectives. Routledge.
Dasgupta, P., Baade, P. D., Youlden, D. R., Garvey, G., Aitken, J. F., Wallington, I., ... & Youl,
P. H. (2017). Variations in outcomes for Indigenous women with breast cancer in
Australia: A systematic review. European Journal of Cancer Care.

12
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Dawson, A., Hall, J. J., Black, K., Varol, N., & Turkmani, S. (2017). Evidence-based policy
responses to strengthen health, community and legislative systems that care for women in
Australia with female genital mutilation/cutting. Reproductive health, 14(1), 63.
Dobson, A. J., Hockey, R., Brown, W. J., Byles, J. E., Loxton, D. J., McLaughlin, D., ... &
Mishra, G. D. (2015). Cohort profile update: Australian longitudinal study on women’s
health. International Journal of Epidemiology, 44(5), 1547-1547f.
Duckett, S., & Willcox, S. (2015). The Australian health care system (No. Ed. 5). Oxford
University Press.
Gausia, K., Thompson, S. C., Nagel, T., Schierhout, G., Matthews, V., & Bailie, R. (2015). Risk
of antenatal psychosocial distress in indigenous women and its management at primary
health care centres in Australia. General hospital psychiatry, 37(4), 335-339.
Hayman, M., Short, C., Stanton, R., & Reaburn, P. (2015). Confusion surrounds physical activity
prescription for pregnant women. Health promotion journal of Australia: official journal
of Australian Association of Health Promotion Professionals, 26(2), 163.
Hooker, L., Theobald, J., Anderson, K., Billet, P., & Baron, P. (2017). Violence Against Young
Women in Non-urban Areas of Australia: A Scoping Review. Trauma, Violence, &
Abuse, 1524838017725752.
Kelaher, M. A., Ferdinand, A. S., & Paradies, Y. (2014). Experiencing racism in health care: the
mental health impacts for Victorian Aboriginal communities. The Medical journal of
Australia, 201(1), 44-47.

13
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Meadows, G. N., Enticott, J. C., Inder, B., Russell, G. M., & Gurr, R. (2015). Better access to
mental health care and the failure of the Medicare principle of universality. The Medical
Journal of Australia, 202(4), 190-194.
Milner, A., Smith, P., & LaMontagne, A. D. (2015). Working hours and mental health in
Australia: evidence from an Australian population-based cohort, 2001–2012. Occup
Environ Med, oemed-2014.
Mitchell, A., Leane, C., Stuart-Butler, D., Gartland, D., Weetra, D., Kit, J. A., ... & Brown, S. J.
(2016). Stressful events, social health issues and psychological distress in Aboriginal
women having a baby in South Australia: implications for antenatal care. BMC
pregnancy and childbirth, 16(1), 88.
Newman, L., Baum, F., Javanparast, S., O'Rourke, K., & Carlon, L. (2015). Addressing social
determinants of health inequities through settings: a rapid review. Health Promotion
International, 30(suppl_2), ii126-ii143.
Owen, N., Salmon, J., Koohsari, M. J., Turrell, G., & Giles-Corti, B. (2014). Sedentary
behaviour and health: mapping environmental and social contexts to underpin chronic
disease prevention. Br J Sports Med, 48(3), 174-177.
Rickwood, D. J., Telford, N. R., Parker, A. G., Tanti, C. J., & McGorry, P. D. (2014). headspace
—Australia’s innovation in youth mental health: who are the clients and why are they
presenting?. The Medical Journal of Australia, 200(2), 108-111.
Schmied, V., Homer, C., Fowler, C., Psaila, K., Barclay, L., Wilson, I., ... & Kruske, S. (2015).
Implementing a national approach to universal child and family health services in

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Australia: professionals' views of the challenges and opportunities. Health & social care
in the community, 23(2), 159-170.
Schmied, V., Johnson, M., Naidoo, N., Austin, M. P., Matthey, S., Kemp, L., ... & Yeo, A.
(2013). Maternal mental health in Australia and New Zealand: a review of longitudinal
studies. Women and Birth, 26(3), 167-178.
Spangaro, J., Herring, S., Koziol-Mclain, J., Rutherford, A., Frail, M. A., & Zwi, A. B. (2016).
‘They aren't really black fellas but they are easy to talk to’: Factors which influence
Australian Aboriginal women's decision to disclose intimate partner violence during
pregnancy. Midwifery, 41, 79-88.
Tolhurst, P., Lindberg, R., Calder, R., & de Courten, M. (2016). Australia's health tracker 2016:
A report card on preventable chronic diseases, conditions and their risk factors: Tracking
progress for a healthier Australia by 2025.
Torre, L. A., Bray, F., Siegel, R. L., Ferlay, J., Lortet‐Tieulent, J., & Jemal, A. (2015). Global
cancer statistics, 2012. CA: a cancer journal for clinicians, 65(2), 87-108.
Wakerman, J., Humphreys, J., Wells, R., Kuipers, P., Entwistle, P., & Jones, J. (2017). A
systematic review of primary health care delivery models in rural and remote Australia
1993-2006.
Walters, L. K., McGrail, M. R., Carson, D. B., O'Sullivan, B. G., Russell, D. J., Strasser, R. P., ...
& Kamien, M. (2017). Where to next for rural general practice policy and research in
Australia?. The Medical Journal of Australia, 207(2), 56-58.

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Willis, E., Reynolds, L., & Keleher, H. (Eds.). (2016). Understanding the Australian health care
system. Elsevier Health Sciences.
Yu, X. Q., Luo, Q., Kahn, C., O'Connell, D. L., & Houssami, N. (2015). Temporal trends show
improved breast cancer survival in Australia but widening urban–rural differences. The
Breast, 24(4), 524-527.