The Impact of Social Determinants on Health Outcomes in Australia

This report examines the social determinants of health, particularly focusing on the health disparities experienced by Indigenous Australians. It highlights the impact of socioeconomic factors, behavioral risks such as smoking, and access to healthcare on health outcomes. The report references various studies and surveys, including the Australian Aboriginal and Torres Strait Islander Health Survey, to illustrate the prevalence of chronic diseases, the influence of unemployment and low educational attainment, and the intersection of these factors with smoking rates. The analysis underscores the need to address social determinants to reduce health inequities and improve the life expectancy and overall health of Indigenous communities. The report also discusses the limitations of the studies and the complex interplay of factors contributing to poor health outcomes.

Running head: SOCIAL DETERMINANTS OF HEALTH
Social determinants of health
Name of the Student
Name of the University
Author Note

1SOCIAL DETERMINANTS OF HEALTH
Background
There are various vulnerable groups who are at risk of getting health diseases and
these include children, elderly, pregnant women and impoverished. The contributing factor to
these vulnerability is poverty (Who.int, 2020). The Australian health survey that included
people from Aboriginal and Torres Strait Island in remote as well as non-remote areas was
conducted to estimate the prevalence of chronic diseases and risk factors associated with the
diseases. The survey considered behavioural patterns, nutrition status, age and geographical
location. The survey revealed based on self-assessment that aboriginal people had poor or fair
health compared to the non-indegenous people and only two out five people aged 15 years or
above reported fair health. The risk factor associated with poor health included death of a
close person, health issue, umeployment and mental illness where females reported to have
more risk factors or stressors than males (Abs.gov.au, 2020). Mortality rates atyounger age is
higher in indigenous Australians due to poor health. Some chronic diseases such as heart
disease, respiratory diseases, mental illness, diabetes and kidney disease are more likely to
occur in indigenous people than the non-indegenous people. There is increasing prevalence of
certain diseases among the indigenous people that are uncertain in non-indegenous people
and that includes eye infection by bacteria and rheumatic heart disease. The continuous use of
addictive substances such as alcohol and tobacco reduces life expectancy and health of
indigenous people (Healthdirect.gov.au, 2020). In 2016, 3.3% of the Australian population
consists of ingeneous people. The burden of disease in indigenous Australians due to chronic
diseases accounts to 64%. Every one out of three indigenous young people experience
increased level of menal distress in 2014-2015 (Australian Institute of Health and Welfare,
2020). Due to lack of healthcare services for the indigenous people and low health standards,
health inequity among the Australians are rising. Life expectancy gap is high between the
indigenous and non-indegenous people accounting for approximately 17 years. There is no

2SOCIAL DETERMINANTS OF HEALTH
reduction in the death rate due to cardiovascular diseases among the ingenous people
compared to the general population (Humanrights.gov.au, 2020).
Social determinants of Indigenous health
Socioeconomic condition is one of the social determinants of health that explains the
health status of Aboriginal and Toress islanders. There is a strong association between the
socio economic condition and outcomes of health of a person. Low economic status is
observed in those who are unemployed and has low educational attainment. Another social
determinant of health that affects the socioeconomic condition is the behavioural risk such as
smoking where indigenous people who do not have a job tend to smoke frequently
(Aihw.gov.au. 2020). The indigenous people experience poor health due to below average
income and unemployment, below standard housing and overcrowding. These economically
disadvantaged families do not get proper access to healthcare services as a result suffer from
various chronic diseases. A methodological study was conducted to analyse the economic
status of the indigenous families. It was found that families have sole parent and many
children, where the adults are uneducated and unemployed. In such families, poor health and
increased adult male deaths are seen. Infant mortality has also increased along with this
severe health problems ocuur. Aboriginal aged people are younger than the non-indegenous
aged ones but the former suffer from worst health issues (Daly & Smith, 2018). A census data
analysis was performed to understand the gaps between the educational qualification of
indigenous and non-indegeneous persons. The unemployment gap was more in indigenous
Australians than ingenous people of Canada and New Zealand (Daly & Smith, 2018). To
determine another social determinant that is behavioural factor related to health status of
Aboriginal Australians, a cross sectional study of smokers using risk behaviour diagnosis
scale was done in a study. Perceived efficacy was associated with change in the behaviour.
People with high efficacy changed their smoking habit whereas low efficacy people did not

3SOCIAL DETERMINANTS OF HEALTH
bring any change in their behaviour. The study revealed that most of the participants were
aboriginal who had low intention to quit smoking. However the study was limited by small
sample number and hesitation of some participants to show their true attitude towards
smoking (Gould et al., 2015). Tobacco smoking was found to be factor affecting the health of
indigenous people and reducing their life expectancy. A study was performed to understand
the social context that gave rise to smoking among young people and it was found to be
social stress and boredom were the reasons for smoking. One limitation of their study was
they included aboriginal young people from metropolitan areas and not from remote areas
(Cosh et al., 2015).
Intersection of social determinants:
The percentage of frequent smoking was high accounting to 40.6% in indigenous
people compared to non-indegenous people from age standardised data in 2014-2015. High
smoking prevalence is seen among people who live in the remote areas with economic
disadvantage in 2017-2018 (National Cancer Control Indicators, 2020). Smoking rates were
seen higher among the Australian indigenous community in remote areas having low
socioeconomic condition. An ecological study was conducted to find out the association
between smoking rates, climatic and sociodemographic condition. data was collected from
community health centres and was dichotomised. It was found out that smoking rates have a
vast range from 25% to 96% and was high among the indigenous community of Australia.
Smoking was highly associated with low socioeconomic condition, unemployment and lower
educational qualification. Smoking was also related to stressors of the climatic condition such
as heatwaves. However the limitations they faced were small sample size consisting of only
remote Australian people and biased results due to sample loss or missing information
(Carroll et al., 2019). A peer reviewed literature revealed the social determinants of health
disparities related to smoking and health outcomes. It was found that frequent smoking

4SOCIAL DETERMINANTS OF HEALTH
prevalence among Aboriginals with unemployment is 47% and having mental illness among
66% of ow income Aboriginals. The health of children is also affected which shows that 22%
of indigenous children are likely to be exposed to tobacco smoking at home compared to 7%
of non-indgenous children. Mother with low socioeconomic condition and are indigenous
smoked above four times when compared to mothers in high socioeconomic areas (Purcell,
2015).

5SOCIAL DETERMINANTS OF HEALTH
References:
Who.int. (2020). WHO | Vulnerable groups. Who.int. Retrieved 27 March 2020, from
https://www.who.int/environmental_health_emergencies/vulnerable_groups/en/.
Healthdirect.gov.au. (2020). Indigenous health. Healthdirect.gov.au. Retrieved 27 March
2020, from https://www.healthdirect.gov.au/indigenous-health.
Australian Institute of Health and Welfare. (2020). Indigenous Australians Overview -
Australian Institute of Health and Welfare. Australian Institute of Health and Welfare.
Retrieved 27 March 2020, from https://www.aihw.gov.au/reports-data/population-
groups/indigenous-australians/overview.
Humanrights.gov.au. (2020). Social determinants and the health of Indigenous peoples in
Australia – a human rights based approach | Australian Human Rights Commission.
Humanrights.gov.au. Retrieved 27 March 2020, from
https://www.humanrights.gov.au/about/news/speeches/social-determinants-and-
health-indigenous-peoples-australia-human-rights-based.
Aihw.gov.au. (2020). Social determinants of Indigenous health. Aihw.gov.au. Retrieved 27
March 2020, from https://www.aihw.gov.au/getmedia/d115fe0f-9452-4475-b31e-
bf6e7d099693/ah16-4-2-social-determinants-indigenous-health.pdf.aspx.
Daly, A. E., & Smith, D. E. (2018). The economic status of Indigenous Australian families.
Mitrou, F., Cooke, M., Lawrence, D., Povah, D., Mobilia, E., Guimond, E. and 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), p.201.

6SOCIAL DETERMINANTS OF HEALTH
Gould, G.S., Watt, K., Cadet-James, Y. and Clough, A.R., 2015. Using the risk behaviour
diagnosis scale to understand Australian Aboriginal smoking—a cross-sectional
validation survey in regional New South Wales. Preventive Medicine Reports, 2,
pp.4-9.
Cosh, S., Hawkins, K., Skaczkowski, G., Copley, D. and Bowden, J., 2015. Tobacco use
among urban Aboriginal Australian young people: a qualitative study of reasons for
smoking, barriers to cessation and motivators for smoking cessation. Australian
Journal of Primary Health, 21(3), pp.334-341.
National Cancer Control Indicators. (2020). Smoking prevalence - adults. National Cancer
Control Indicators. Retrieved 27 March 2020, from
https://ncci.canceraustralia.gov.au/prevention/smoking-prevelance/smoking-
prevalence-adults.
Carroll, S. J., Dale, M. J., Bailie, R., & Daniel, M. (2019). Climatic and community
sociodemographic factors associated with remote Indigenous Australian smoking
rates: an ecological study of health audit data. BMJ open, 9(7).
Purcell, K. (2015). Evidence review: Addressing the social determinants of inequities in
tobacco use. Vichealth.vic.gov.au. Retrieved 27 March 2020, from
https://www.vichealth.vic.gov.au/-/media/ResourceCentre/PublicationsandResources/
Health-Inequalities/Fair-Foundations/Full-reviews/HealthEquity-Tobacco-
review.pdf?la=en&hash=E0FBC9E791F62977BE0B7C664C3FA7B8EB05D236.
Abs.gov.au. (2020). 4727.0.55.001 - Australian Aboriginal and Torres Strait Islander Health
Survey: First Results, Australia, 2012-13. Abs.gov.au. Retrieved 27 March 2020,
from https://www.abs.gov.au/ausstats/abs@.nsf/mf/4727.0.55.001.