UTS 92441: Indigenous Health & the Closing the Gap Policy Essay

This essay provides a comprehensive analysis of the Closing the Gap (CTG) policy in Australia, focusing on its history, objectives, and impact on the health outcomes of Aboriginal and Torres Strait Islander people. It examines the policy's successes in reducing child mortality and chronic disease rates, as well as the challenges and barriers that hinder its effectiveness, such as financial constraints, lack of cultural awareness in healthcare services, and staffing shortages. The essay also explores the case of Judy, a 57-year-old Aboriginal woman with type 2 diabetes, to illustrate the social determinants affecting Indigenous health and the benefits of CTG registration. Furthermore, it clarifies the roles of Aboriginal Medical Services (AMS) and Aboriginal Liaison Officers (ALO) in delivering culturally sensitive healthcare. The essay concludes by emphasizing the importance of addressing both micro and macro factors to improve Indigenous health outcomes and achieve health equality.

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Health Assignment
Student’s Name
Institutional Affiliation
Professor’s Name
City
Date

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Question 1
It is a government strategy whose objective is to advance the lives of the Aboriginal
along with the Torres Strait Islander individuals by minimizing disadvantage among them with
respect to child mortality, educational accomplishment, employment outcomes, and life
expectancy together with access to early childhood education (Brown, O’shea, Mott, McBride,
Lawson and Jennings, 2015). Rudd administration instituted the National Indigenous Health
Equality Council in 2008 and COAG endorsed the National Indigenous Reform Agreement the
same year November that set out six closing the gap objectives. Moreover, it is a formal
commitment created by all Australian authorities to accomplish Aboriginal and Torres Strait
Islander health equality in 25 years.
History
Policy of closing the gap was created in retaliation to the call of the social justice
report of 2005 along with the Close the Gap social justice campaign (Brown, O’shea, Mott,
McBride, Lawson and Jennings, 2015). Australian government agreed to operate in line with
Aboriginal and Torres Strait Islander individuals around March 2008 for the purpose of
accomplishing equity in well-being status along with life expectancy amidst Aboriginal and
Torres Strait Islander people and non-indigenous Australians by 2030 when they signed the
“Indigenous health equality summit statement of intent.” Here, they spend one point six billion
dollars over four years on its Indigenous Chronic Disorder Package and the package focused on
preventive health, primary healthcare, and expansion of the Indigenous workforce (Brown,
O’shea, Mott, McBride, Lawson and Jennings, 2015).
Through the policy of closing the Gap p the health results have improved since fewer
indigenous individuals are dying from chronic diseases. The mortality rate of aboriginal children

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under five years since 1998 has reduced by 35 percent (Doran, Ling, Searles, and Hill, 2016).
From 1998 to 2016, Indigenous mortality proportions from circulatory diseases fell by around 45
percent. Also, since 2006 until 2015 death rates from kidney disease reduced by 47 percent and
since 1998 till 2015 death rates due to respiratory disease declined by 24 percent. Between 2008
and 2016 the percentage of site impairment along with blindness among Indigenous Australians
has dropped from six times to three times that of non-Indigenous Australians (Doran, Ling,
Searles, and Hill, 2016).
Moreover, the proportion of Indigenous individuals of the age of 18 years and above who
smoke has reduced significantly between 1994 and 2014-15 from 55 to 45 percent. As
Australians are on track to terminate trachoma as a public health issue by 2020, the frequency of
active trachoma in Indigenous children of five to nine years in at-risk communities reduced from
14 percent to 4.7 percent between 2009 and 2016 (Doran, Ling, Searles, and Hill, 2016).
There are several barriers or challenges which influenced the change in the health
outcomes of the Aboriginal and Torres Strait Islander individuals. The direct costs of
consultations, medication, lack of knowledge on bulk billing operations and absence of financing
for indigenous health programs was one of the challenges (Gibson et al., 2015). Furthermore,
insufficient public transport services, poor timetabling, health services not available by public
transport and the absence of cultural awareness along with responsiveness in mainstream
attention. The health services being not aware of the number of indigenous clients, because staffs
are not self-assured of querying patients on their indigenous situation and the Indigenous
Australians, are not willing to identify themselves (Gibson et al., 2015). The last challenge is
concerning staffing issues whereby there are staff shortages specifically in rural and remote

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regions and absence of indigenous staff that can take on extra closing the gap task (Gibson et al.,
2015).
Question 2
The effect of Type 2 Diabetes on Judy is microvascular complications which are the
damage of the small blood vessels causing problems in the kidneys, feet, nerves, and eyes
(Adeshara, Diwan and Tupe, 2016). Also, Judy might encounter macro vascular complications
which cause plague to build-up damaging the large blood vessels of the heart, legs, and brain.
Diabetes has been addressed within closing the Gap through the introduction of Aboriginal
Community Controlled Health Services (ACCHS) which has enhanced involvement in health at
a community level, contributed to developed health outcomes and elevated clinic consultations
(Campbell, Hunt, Scrimgeour, Davey and Jones, 2018).
The long-term consequences of diabetes on the well-being of Aboriginal and Torres Strait
Islander people consist of kidney failure, depression, nerve disease, blindness, amputation, stroke
and heart attack (Low Wang, Hess, Hiatt, and Goldfine, 2016). Some of the social determinants
which might affect Judy are unemployment, income along with social support (Cullen, Clapham,
Hunter, Porykali & Ivers, 2018). When income is high it permits for greater access to goods and
services which give health advantages like better housing along with food and extra health care
options. Judy in her condition will be affected since she does not work and her two children
although they help when they can it means that the income is low and could worsen Judy’s
condition because she might not get enough money for her check-ups and for her medications.
Moreover, unemployment has a strong effect on mental and physical well-being through
its psychological problems and the financial issues it comes with (Cullen, Clapham, Hunter,
Porykali & Ivers, 2018). In the case scenario Judy is not employed which means that her

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financial status is bad and to manage her condition will be difficult unless she gets support from
somewhere else. Finally, lack of social support leads to social exclusion which may result to
discrimination since one is not socially connected into groups which can help in improving
health outcomes. Judy lives by herself and it is not evident that she is in any social group which
affect her health.
Question 3
The benefit that Judy will get by being registered on Closing the Gap is that she will have
access to low cost or free Pharmaceutical Benefits Scheme medicines due to the Closing the Gap
(CTG) PBS (Pharmaceutical Benefits Scheme) Co-payment Program which was instituted to
lower the prices of PBS medicine for available Aboriginal and Torres Strait Islander individuals
having or being at peril of non-communicable diseases (Mellish et al., 2015). She will also be
available to register for the PBS Safety Net whereby the Closing the Gap (CTG) Pharmaceutical
Benefits Scheme (PBS) Co-payment measure do not change the amount which can be added to a
family’s Safety Net Threshold (Mellish et al., 2015). Furthermore, the policy ensures that
everybody achieves his or her full health potential and has equitable, barrier-free availability to
healthcare notwithstanding of a person’s social, demographic, geographical or economic
position.
When Judy is registered on closing the Gap policy means that she will be using little or
no income to manage her condition and therefore she can save the little money she gets to
improve her diet. Also, she will be enabled to engage in paid work since some of the diabetic
Aboriginal, and Torres Strait Islander individuals are allowed to partake in paid work which
might result to higher incomes that in turn provide resources that are positive for her health and

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well-being (Mellish et al., 2015). Therefore, her housing condition which could have worsened
her situation will be improved thus stress reduced.
Question 4
AMS stands for Aboriginal Medical Service (Dutton, Stevens and Newman, 2016) while
ALO stands for Aboriginal Liaison Officer (Katzenellenbogen, Miller, Somerford, McEvoy and
Bessarab, 2015). An Aboriginal Medical Service is a health service financed mainly to dispense
services to Aboriginal and Torres Strait Islander individuals (Glover, 2017). Aboriginal Liaison
Officer provides emotional, social, and spiritual along with cultural reinforcement to Aboriginal
and Torres Strait Islander patients and their families when they utilize the hospital at GV health.
Since Judy needs every day dressing as requested by Aboriginal Liaison Officer which is not
provided at Aboriginal Medical Service, Judy had to be discharged home so that the community
nurses could attend to her daily at home. Moreover, Aboriginal Medical Services do not do home
visits that is the reason Judy was transferred to UTS Community Health Centre which does home
visits.
Services provided at Aboriginal Medical Service include diabetes services, dental health
services, chronic disease management, alcohol, and other drugs management, community-based
programs, counseling, allied health services including Audiometry and Optometry and general
practitioner clinics (Hamilton, Mills, McRae and Thompson, 2018). Also, they provide sexual
health services and programs, postnatal services, hearing, and mental health programs, women’s
and men’s health programs, nutrition and exercise programs along with visiting specialist
services entailing respiratory, endocrinology, psychology, psychiatry together with pediatrics
(Hamilton, Mills, McRae and Thompson, 2018). Aboriginal Liaison Officer provides services

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like discharge planning, assessments, arranging transport, accommodation, and family meetings
along with support counseling (McKenna, Fernbacher, Furness and Hannon, 2015).
The association amidst Aboriginal Liaison Officer along with Aboriginal Medical Service
is that the Aboriginal Liaison Officer provides details and reinforcement to GV health team to
assist them deliver culturally delicate health services. Also, Aboriginal Liaison Officer is
required to work effectively with a team of the Aboriginal Medical Service and work with
community health centers to improve access to their services (Durey, McEvoy, Swift-Otero,
Taylor, Katzenellenbogen and Bessarab, 2016).

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