Indigenous Health and Well-being Essay: Judy's Case and CTG

This essay examines the Closing the Gap (CTG) policy in the context of Indigenous health and well-being in Australia, focusing on a case study of an Aboriginal woman named Judy who is suffering from Type 2 diabetes and a foot ulcer. The essay begins with an overview of the CTG policy, its history, and the data that influenced its creation, highlighting the government's strategy to reduce health inequalities among Aboriginal and Torres Strait Islander people. It then analyzes the impact of Judy's diabetes on her social determinants of health, such as health literacy, healthcare access, and social support, and how the CTG policy addresses these issues. The discussion includes the potential long-term consequences of Judy's diabetes and the benefits of being registered with CTG. The essay also defines the roles of the Aboriginal Medical Service (AMS) and the Aboriginal Liaison Officer (ALO) in supporting Judy's health and well-being, emphasizing the importance of culturally safe care and community health services in managing her condition and improving health outcomes. The essay utilizes relevant literature and statistics to support its arguments and provides a comprehensive analysis of the policy's impact on Indigenous health.

Running head: INDIGENOUS HEALTH AND WELL-BEING
Indigenous Health and Well-being
Name of the Student
Name of University
Author’s note

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INDIGENOUS HEALTH AND WELL-BEING
There is a significant health equalities prevailing in Australian indigenous population. In
order to address this health inequality government of Australia has issued policy name “Closing
the Gap” (CTG) (Australian Institute of Health and Welfare 2018). The following essay is based
on the case study of a Aboriginal woman named Judy who suffering from Type 2 diabetes along
with foot ulcer. The essay will initiate with a brief over-view of the CTG policy followed by
poor social determinants of health of Judy and how CTG is addressing those issues. At the end
the essay will highlight the role of ALO and AMS and community health service in managing
the health of Judy.
“Closing the Gap” CTG policy is a government strategy that aim to decrease the
disadvantage prevailing among the Aboriginals and Torres Strait Islanders people residing in
Australia (Australian Government 2019). The main parameters of inequalities that are taken into
in CTG policy include life expectancy, childhood mortality, and access to education for the
children, improved educational achievement and employment outcomes (Australian Government
2019). The policy was implemented on 2008 under the joint collaboration of the Australian
Government and Aboriginals and Torres Strait Islander people via signing the Indigenous health
quality summit of intent, with an aim to close the gap within next 25 years (Australian
Government 2019).. The implementation of the policy is based on several reports published by
international and national organizations (Australian Government 2019). For example, the reports
published by the World Health Organization (WHO) in 2007 stated that there is a significant
disparity between health of the indigenous Australian population in comparison to the rest to the
population residing in Australia and the condition is astonishing under the context of such
affluent country (WHO 2007). The report of Australian Bureau of Statistics (2006) highlighted
that average life-expectancy of indigenous population is 17 years lower than the total population.

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The indigenous population also has high rate of infant mortality, increased substance abuse and
poor living condition with increased rate of occurrence of diabetes and heart attack. This
significant health disparity report and repeated criticism experienced in the international
conference led to the foundation of CTG policy (WHO 2007).The significance of CTG policy is
it aimed towards reducing the prevailing health inequalities among the indigenous population in
Australia and thereby helping Australia to recover from health disparity(Whitty&Littlejohns
2015).Moore et al. (2015) stated that reducing the health-inequalities will help in promoting
effective development in early childhood education and thereby helping the indigenous people to
improve the social determinants of health (REFERENCE). The report published by Australian
Parliament on behalf of Prime minister (2019) about the follow up of CTG policy, showed there
is a good process in childhood mortality and education but there is a gap in achieving targets like
life expectancy, academic achievement and employment outcome (REFERENCE). The possible
might include unequal channelization of funds, food sanitation and gap in health literacy and
educational opportunities (Australian Parliament 2019).
The long term consequence of Judy’s diabetes is include increase in the severity of
diabetes like increase tendency of heart attack, diabetic retinopathy and renal
malfunction(Lefebvre et al. 2018). The first social determinant of health (SDH) is responsible for
the present condition of Judy is lack of health literacy. Lefebvre et al. (2018) stated that
uncontrolled or unmanaged diabetes for a prolong period of time increases the tendency of
developing diabetic foot ulcer. Judy’s, diabetic foot ulcer is an outcome of her unmanaged type 2
diabetes for this she has to left her job. The gap in health literacy is managed CTG under the goal
of increase in the life-expectancy of indigenous population.Aboriginal population of Australia
suffers from poor health literacy and thus lack disease self-management skills(De Wit et al.

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2018). CTG helps to address this gap in health literacy by arranging community based health
educational campaign. Increase in health literacy will help to improve diabetes self-management
skills and preventing the chances of negative disease prognosis (Parliament of Australia 2019).
The case study also highlights that Judy has to leave her job due to mobility issue, and is a
widow. In the absence of the proper financial support, she is unable to go for a regular health
check-up in-spite of staying with 10 kilometres from the healthcare facilities. Thus the SDH that
is being affected in this case is lack of proper healthcare access. The main aim of the CTG policy
is reduce the gap in life expectancy and the government is trying of achieve the same by
increasing the provision of the healthcare access among the indigenous people residing in remote
areas(Parliament of Australia 2019). The third SDH affected in case of Judy is lack of social
support, Judy lives alone her two sons only visit her. There is no one look after her and to
manage her wound dressing. Moreover, due to her mobility issues she might experience
difficulty in conducting her activities of daily living. The CTG has no specific aim in order to
improve the social support and coping skills but unviability of ALO indicates gap in healthcare
access. Here increasing healthcare support might help to increase her coping skills (Parliament of
Australia 2019).
The potential benefits of being registered with CTG are increase in the healthcare access,
increase in financial support to manage health and increase in health literacy(Altman, Biddle &
Hunter 2018). Registering under CTG will help Judy to conduct periodic health check without
imposing a significant financial burden. Judy is unemployed and does not own and travels by
public transport. This is a reason why she is unable to go for health checkup that is 20 kilometer
away from her home. Periodic health checkup will help Judy to track her blood glucose level and
thus reducing the chances of developing micro-vascular complication of diabetes(Lefebvre et a;.

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2018). Improved healthcare access will help her to manage the wound dressing. CTG will helps
to provide financial support to the Aboriginal people and thus helping to over-come health
inequalities. Judy is unemployed and thus might be exhibiting financial constraints and difficulty
in disease management like medication management and diet management. Getting registered
under CTG will help in effective management disease. CTG also promotes health literacy by
educating the Aboriginals and Torres Strait Islanders in about self-management skills of
diabetes. Health literacy helps to promote disease awareness and helping to decrease the gap in
life expectancy and health inequalities(Altman, Biddle & Hunter 2018). Additionally registering
under closing the gap will help Judy to receive culturally safe care. CTG works closely with the
culturally competent healthcare professionals from Aboriginal origin. This help in designing
culturally competent care plan that is free from racism and helping the Aboriginals to live strong
in dignity (Medical Board of Australia 2019).
Aboriginal Medical Service (AMS) is a health service funded mainly in order to deliver
healthcare services to the Aboriginals and Torres Strait Islander population. AMS is not a
community operated service and thus all AMS are not eligible to become members of National
Aboriginal Community Controlled Health Organisation (NACCHO) and its other affiliates. Non-
community controlled AMS are run by government (state of territory government). The non-
community controlled AMS is present in Northern Territory of Australia and in northern part of
Queensland (NACCHO 2019). Aboriginal Liaison Officer (ALO) provides social, emotional and
cultural support to Aboriginal and Torres Strait Islander patients and their family members in
hospital. Staying in hospital increases the tendency of developing stress and anxiety along with
fear, sadness, isolation, and home-sickness. ALO mainly helps to overcome such complex
mental issues by the routine counselling with the use of effective communication skills. They

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also help to develop culturally safe care plan (Australian Government Department of Health
2019).
AMS will be involved in Judy’s case as currently she is unemployed. Involvement of
AMS will help Judy to meet her healthcare expenses and thus promoting effective management
of type 2 diabetes along with daily dressing of leg ulcer (Australian Government Department of
Health 2019). AMS though not eligible for attend the need to management of wound but they
funding Judy will receive through AMS will help her execute this healthcare needs. Judy also
stays alone and her sons only visit her often. Referral to ALO will help Judy will recover from
her loneliness. Moreover, losing her job due to mobility issues, developing of leg ulcer might
create a barrier in executing activities of daily living along with additional burden of hospital
visit. The counselling done by ALO will help Judy to improve her mental state of mind. ALO
and AMS will promote increased access of healthcare by referring to community health centre.
Community health centre will help to promote Judy’s health literacy, effective monitoring of
blood glucose level and disease self-management skills (Australian Government Department of
Health 2019).
Thus from the above discussion, it can be concluded that the main social determinants of
health that is affected in case of Judy is lack of health literacy, gap in healthcare access and
social support or coping skills of disease. By getting enrolled under the CTG gap policy will help
Judy to recover from her poor health status. Moreover, taking assistance from the ALO and AMS
will help Judy to avail help from community healthcare service and thus promoting effective
management of the disease(REFERENCE).

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References
Altman, J., Biddle, N. & Hunter, B., 2018. How realistic are the prospects for'closing the gaps'
in socioeconomic outcomes for Indigenous Australians?. Canberra, ACT: Centre for
Aboriginal Economic Policy Research (CAEPR), The Australian National University.
Australian Bureau of Statistics. 2006. The People of Australia Statistics from the 2006 Census.
Access date: 18th august 2019. Retrieved from:
https://www.dss.gov.au/sites/default/files/documents/01_2014/poa-2008.pdf
Australian Government Department of Health. 2019. Aboriginal Liaison Officer (ALO).Access
date: 18th august 2019. Retrieved from:
http://www.gvhealth.org.au/wp-content/uploads/Aboriginal-Liaison-Officers-
Brochure.pdf
Australian Government Department of the Prime Minister and Cabinet. 2019. Closing the Gap.
Access date: 18th august 2019. Retrieved from: https://closingthegap.pmc.gov.au/
Australian Institute of Health and Welfare. 2018. Closing the Gap targets: 2017 analysis of
progress and key drivers of change. Access date: 18th august 2019. Retrieved from:
https://www.aihw.gov.au/reports/indigenous-australians/closing-the-gap-targets-2017-
analysis-of-progress/contents/summary
De Wit, L., Fenenga, C., Giammarchi, C., Di Furia, L., Hutter, I., de Winter, A. &Meijering, L.,
2018, ‘Community-based initiatives improving critical health literacy: a systematic
review and meta-synthesis of qualitative evidence’, BMC public health, vol. 18, no. 1,
p.40.

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Lefebvre, A.L., Zullo, A.R., Dapaah‐Afriyie, R., Collins, C.M. and Elsaid, K.A., (2018),
‘Outcomes of a pharmacist‐managed clinic for underserved persons with unmanaged type
2 diabetes mellitus’, Journal of Pharmacy Practice and Research, vol. 48, no. 1, pp.65-
71.
Medical Board of Australia.2019. Closing the gap by 2031: A shared commitment. Access date:
18th august 2019. Retrieved from: https://www.medicalboard.gov.au/News/2018-07-04-
closing-the-gap-by-2031-a-shared-commitment.aspx
Moore, T.G., McDonald, M., Carlon, L. & O'Rourke, K., 2015, ‘Early childhood development
and the social determinants of health inequities’, Health promotion international, vol. 30,
no.suppl_2, pp.ii102-ii115.
National Aboriginal Community Controlled Health Organisation (NACCHO). 2019.
Aboriginality. Access date: 18th august 2019. Retrieved from:
https://www.naccho.org.au/about/aboriginal-health/definitions/
Parliament of Australia. 2019. Closing the Gap. Access date: 18th august 2019. Retrieved from:
https://www.aph.gov.au/About_Parliament/Parliamentary_Departments/
Parliamentary_Library/pubs/BriefingBook44p/ClosingGap
Whitty, J.A. &Littlejohns, P., 2015, ‘Social values and health priority setting in Australia: an
analysis applied to the context of health technology assessment’, Health Policy, vol. 119,
no. 2, pp.127-136.

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World Health Organisation [WHO].2008. Australia’s disturbing health disparities set
Aboriginals apart. Access date: 18th august 2019. Retrieved from:
https://www.who.int/bulletin/volumes/86/4/08-020408/en/