National Aboriginal and Torres Strait Islander Health Plan: A Report

This report provides a comprehensive analysis of the National Aboriginal and Torres Strait Islander Health Plan, a framework designed to improve the health and wellbeing of Indigenous Australians from 2013 to 2023. The report begins with an abstract that highlights the health disparities faced by Ab...Read More

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THE NATIONAL ABORIGINAL AND TORRES STRAIT ISLANDER HEALTH PLAN
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Abstract
This report the health of the Aboriginal and Torres Strait Islander people. These people mostly
suffer from non-communicable diseases which refer to chronic conditions. They are
disadvantaged in health and also in other aspects of the social life. A larger number of
indigenous Australians lack adequate education, appropriate housing and good jobs as compared
to non-indigenous Australians. These factors affect the functioning of the Aboriginal and Torres
Strait Islander people in the society as well as their health. These social facets not only contribute
to their ill health conditions but also worsen their prevailing healthiness. The report focuses on
The National Aboriginal and Torres Strait Islander Health Plan which was a framework that was
developed to improve the health of the indigenous Australians in the decade from 2013 to 2023.
The policy guides all other stratagems and programmes formed to contribute to enhancement of
the Aboriginal and Torres Strait Islander health and wellbeing. From the report, it is clear that
health professional practice is an important factor in accomplishment of this goal. They help
provide primary health care to the indigenous Australians in a way that is culturally appropriate.

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Table of Contents
Table of Contents
Abstract......................................................................................................................................................2
Table of Contents.......................................................................................................................................3
The National Aboriginal and Torres Strait Islander Health Plan.........................................................4
Introduction...............................................................................................................................................4
Description of the Plan..............................................................................................................................4
Social Determinants of Health among the Indigenous Australians....................................................5
Education.............................................................................................................................................5
Socio-economic position.....................................................................................................................6
Early Life.............................................................................................................................................6
Housing...............................................................................................................................................6
Burden of disease...................................................................................................................................7
Analysis of the Framework.......................................................................................................................8
Principles Guiding the Approach of the Health Plan..........................................................................8
1) Aboriginal and Torres Strait Islander Control and Engagement..................................................8
2) Health Equality and a Human Rights Approach..........................................................................8
3) Accountability.............................................................................................................................8
4) Partnership...................................................................................................................................9
Implementation of the Framework......................................................................................................9
Recommendations................................................................................................................................10
Role of Professional Practice in the Plan...............................................................................................11
Primary Health care............................................................................................................................11
Provision of Quality Care...................................................................................................................11
Conclusion................................................................................................................................................12
References................................................................................................................................................14

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The National Aboriginal and Torres Strait Islander Health Plan
Introduction
Non-communicable diseases (NCDs) are medical conditions not caused by infectious agents.
They refer to chronic diseases which can progress slowly and last for long periods of time. They
are not however distinguished by their duration but by their non-infectious causes (Hunter, D.J.
and Reddy, 2013). Some chronic conditions, however, such as cancer, diabetes, autoimmune
diseases, stroke and heart disease can lead to quick deaths.As an evidence-based policy agenda,
the National Aboriginal and Torres Strait Islander Health Planis aimed at guiding programs and
strategies to enhance Aboriginal and Torres Strait Islander health. This policy was established to
provide a predominant framework which creates links with the principal health activities of the
Commonwealth and reveals areas that need attention to guide future effort and investment
relative to the healthiness of the Aboriginal and Torres Strait Islander people. The Aboriginal
and Torres Strait Islander people are Australia’s first peoples who have suffered extreme
hardships since colonization of the country by European settlers. These adversities not only
affects their health but also leads to decline of the richness of their health (Moatti, 2013). This
report describes and critically analyses one of the frameworks set aside to improve the group’s
health and wellbeing. It also provides some recommendations to help progress the effectiveness
of the framework and brings to light the role of health professionals in the same.

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Description of the Plan
The National Aboriginal and Torres Strait Islander Health Plan was developed as part of the
efforts to close the gap between the health and life expectancy of the Aboriginal and Torres Strait
Islander people and other Australians. It was established through a robust partnership by the
Australian government in collaboration with the Aboriginal and Torres Strait Islanders, their
peak bodies and community organizations (Kimpton, 2013). This offered an opportunity to set
out a plan for the direction of the group’s health collaboratively for a decade from 2013 to 2023
(ISLANDER, 2013). The National Congress of Australia’s First peoples, for instance, played a
vital role through the National Health Leadership Forum in making sure of the availability of
feedback as well as input during the development of the framework.
Social Determinants of Health among the Indigenous Australians
Social determinants of health arethedrivers of healthiness that lie outside the direct accountability
of the health sector. The association betweenworking and living environs and an individual’s
health outcomes has brought about an appreciation of how sensitive the human health is to their
social surroundings. The social settings entail factors such as the conditions of employment,
social support and education. A portion of the life expectancy gap between the indigenous and
non-indigenous Australians can be explained by social determinants of health. These social
aspects not only affects their health but also can influence how an individual interacts with their
health and other amenities. For instance, the probability of the Aboriginal and Torres Strait
Islander people to smoke is less if they are educated, employed and generate higher incomes
(ISLANDER, 2013). Social determinants of health include:

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Education
Higherlevels of education is linked to advanced health literacy and healthier lifestyle choices
which augments one’s physical wellness. Education also increases the chances of an individual
obtaining a good and well-paying job which improves their living standards and wellbeing.
Socio-economic position
Commonly, people from poor economic backgrounds and social circumstances are more
vulnerable to illnesses, diseases and generally poor health than the more fortunate ones. For
example, rheumatic heart disease is related to environmental facets such as poor living
conditions and poverty. The Aboriginal and Torres Strait Islander people therefore remain at risk
of such diseases as above-mentioned. Additionally, many indigenous Australians are not capable
of securing a well-paying employment opportunity due to lack of education. This limits their
accessibility to quality health care which persists their ill health and the gap in life expectancy.
Early Life
The fundamentals of a healthy adult are set during an individual’s childhood. The features of
early childhood development such as physical, language, emotional and cognitive elements
influence the child’s education, school performance as well as involvement in economic
activities, health, citizenry and societal participationlater in life (CSDH, 2008). The probability
of children from underprivilegedupbringings to perform poorly in school is higher than that of
their advantaged peers. This interferes with their ability toget a good job later on which
negatively impacts their incomes, ability to secure good health care and their health literacy.

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Transition of thisdetriment between subsequent generations continuously affects the health of the
indigenous people.
Housing
An individual’s conditions of living has a vast impact on their health. Living in safe, clean and
secure accommodations improves one’s health and their participation in the community.
According to Australian standards, more indigenous Australians live in overcrowded households
than non-indigenous people. In addition, less Aboriginal and Torres Strait Islander people are
buying their own homes as compared to a very big percentage of non-indigenous Australians.
The relationship between housing conditions and health portray that the more perilous and
unsafe the conditions are the worse a person’s health gets. Indigenous people living in
overcrowded houses are prone to contracting communicable diseases in addition to the chronic
conditions they suffer from (O’Donnell and MacDougall, 2016). Also, more indigenous
Australian are homelessdue to unaffordability of the properties in Australia.
Burden of disease
The highest percentage of the Aboriginal and Torres Strait Islander people ail from NCDs. these
chronic conditions involve complex health issues disability, trauma, mental diseases and genetic
disorders(Vos et al., 2009). Tobacco, alcohol, physical inactivity, high body mass and high blood
cholesterol all form small percentages of diseases which increase the health and life expectancy
gap (Glantz and Gonzalez, 2012).
Analysis of the Framework

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Principles Guiding the Approach of the Health Plan
1) Aboriginal and Torres Strait Islander Control and Engagement
There is participation of the Aboriginal and Torres Strait Islanders in the making of decisions
which affect their health. The most effective way of providing a solution to a community’s health
issues is ensuring that those health problems are addressed at the community level. The
Aboriginal and Torres Strait Islander health organizations contribute unique inputs in ensuring
the provision of a comprehensive, holistic and culturally suitable health services (Browne et al.,
2017).
1) Health Equality and a Human Rights Approach
A right to health defines the availability of equal opportunities to access health care by all
people. Governments cannot guarantee a right to be healthy but can provide equal chances for
participation of all communities in the decisions concerning their health. This is achieved by
ensuring accessibility, availability and acceptability of all groups of people to obtain quality
health care.
2) Accountability
The framework cannot be operational if its success and implementation was not reviewed. The
policy offers structures to this assessment and directs the associated organizations to be held
responsible for the success or failure of their efforts.

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3) Partnership
The health plan provides for a shared ownership between the government, the Aboriginal and
Torres Strait Islander people and all service providers. It explains that they all should be involved
in coming up with the goals and priorities relating to the health of the indigenous Australians
(Parnell, Morris and Jacobs, 2017).
The health sector has a role to play in achievement of necessary progresses in education and
employment of the Aboriginal and Torres Strait Islander people. This framework was developed
on realization that advancements among the indigenous Australians necessitates an integrated
approach embracing improvement in the social determinants of their health, reinforcing positive
behavior and strengthening community participation and functioning. This Health plan especially
provides the people with the ability and freedom to translate their aptitude (skills, knowledge and
comprehension) into action by involving them in decision making about their health
(ISLANDER, 2013).
Implementation of the Framework
The implementation plan for the National Aboriginal and Torres Strait Islander Health Plan
states the vision of the health plan as well as the actions to be taken to improve the health of the
indigenous Australians. The vision of the plan is to realize a health system free of inequality and
racism and that all indigenous Australians have access to affordable, effective, appropriate and
high quality health care. It identifies different domains that need action and states the objectives
that should be achieved by 2023.

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However, in some cases the plan does not state exactly what will be done. For instance, one
objective is to reduce the percentage of Aboriginal and Torres adolescents who smoke. The plan
does not explain how these teenagers will be made to stop smoking. Another aim is to reduce
racism and discrimination and achieve a racism free health care system. This objective seems too
ambitious because it is based on other people’s behavior. The strategies that will be taken to
eliminate racism are not outlined, and even if they were, they may not be very effective since the
plan is not in control of how people behave. The health plan puts too much emphasis on the
results, that is, good health. Even though there is a mention of addressing the social determinants
of health they are neither delineated in details nor emphasized (May, Carey and Curry, 2013).
Increasing school attendance is one of the priorities in addressing social factors. This may not be
achieved if the children expected in school have no means of getting there.Unfavorable
infrastructure such as roads in rural and remote areas can hinder one from reaching their
destination, especially in the rainy season (Otim et al., 2014).
Recommendations
The health plan should focus more on putting forth the specific actions that will be undertaken.
Good plans would involve building infrastructure, for instance building more houses for the
indigenous Australians to minimize overcrowding and homelessness as well as road
construction. Availability of enough houses for the Aboriginal and Torres Strait Islander people
would improve their health conditions by minimizing the transfer of infectious diseases and
preventing the recurrence of chronic conditions such as otitis media. It also diminishes exposure
to smoking and the likelihood of occurrence of accidents and injuries around the house.

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The plan should indicate the specified manner in which smoking and racism are to be reduced or
eliminated.
The framework should emphasize more on the strategies to address social determinants of health
as these are feasible projects that can be achieved. The social aspects highly determine the health
of individuals and affect their prevailing health conditions (Fisher et al., 2015).
Role of Professional Practice in the Plan
Primary Health care
The Aboriginal Community Controlled Health Organizations (ACCHO) and the Aboriginal
Medical Services (AMSs) deliver primary health care to many Aboriginal and Torres Strait
Islander folks (Davy et al., 2016). There organizations employ nursing, medical practitioners and
allied health practitioners who provide a range of services to the patients. The care provided by
the staff of these organizations is perceived as the effective and culturally appropriate way to
provide health care services to the indigenous Australians (Gomersall et al., 2015).The services
provided are specific for this group of people hence leading to patient satisfaction, observance of
the treatment regimen and their confidence in the services provided (Gomersall et al., 2017).
These professionals thus have an important role in the health of these people.
Provision of Quality Care
The National Aboriginal and Torres StraitIslander Health Workforce StrategicFramework (2016 -
2023) was established within the National Aboriginal and Torres Strait Islander Health Plan. This
framework’s aim is to contribute to the achievement of health equity in the outcomes of the

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health of the indigenous Australians by building a resilient and well sustained health workforce
that has apposite non-clinical and clinical knowledge and skills to provide health care that is
responsive and culturally appropriate(McDonald et al., 2018). This framework works towards
equipping the Aboriginal and Torres Strait Islander people with the necessary skills to provide
quality health care. It ensures that the indigenous Australians are represented across all disciples
related to health(Topp, Edelman and Taylor, 2018). It also contributes to creation of work places
that are suitable, inviting and encourage developments of talent as well as in development of best
practice training. The professionals are therefore adequately trained to provide high quality
health care services to the Aboriginal and Torres Strait Islander people and do this in a manner
that is respecting of the group’s way of life(Thompson et al., 2014).
Conclusion
From the text, it is obvious that the Aboriginal and Torres Strait Islander people in Australia are
more disadvantaged than non-indigenous Australians. They experience more health problems
than other Australians due to their conditions of living, unavailability of quality health care
services and lack of adequate education. Their early upbringing is more disadvantaged than that
of other Australians as a result of their lower socio-economic position. Inadequate education
hinders their accessibility to good employment opportunities which leads to generation of
insufficient income to acquire quality health care. It also negatively affects their health literacy
and lifestyle decisions they make. It is evident that the government has put efforts towards
closing the health and life expectancy gap that exists between the Aboriginal and Torres Strait
Islanders and other Australians. The report examines one such strategy developed for this
purpose, The National Aboriginal and Torres Strait Islander Health Plan 2013-2023. This health

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plan’s aim is to improve the health of the indigenous Australians in an attempt to close the
gap.The framework employs approaches such as minimizing the percentage of indigenous
Australian teenagers who smoke and reduction of racism and discrimination towards the
Aboriginal and Torres Strait Islander people. It however does not mention specific acts to
achieve this. Health professionals play a vital role in the health of these people by providing
quality care.

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References
ISLANDER, T.S., 2013. Based publications.
Commission on Social Determinants of Health (CSDH), 2008. Closing the gap in a generation:
health equity through action on the social determinants of health. Final report of the Commission
on Social Determinants of Health. Geneva: WHO.
FISHER, M., BATTAMS, S., MCDERMOTT, D., BAUM, F. and MACDOUGALL, C., 2018.
How the Social Determinants of Indigenous Health became Policy Reality for Australia's
National Aboriginal and Torres Strait Islander Health Plan. Journal of Social Policy, pp.1-21.
Vos, T., Barker, B., Begg, S., Stanley, L. and Lopez, A.D., 2009. Burden of disease and injury in
Aboriginal and Torres Strait Islander Peoples: the Indigenous health gap. International journal of
epidemiology, 38(2), pp.470-477.
Topp, S.M., Edelman, A. and Taylor, S., 2018. “We are everything to everyone”: a systematic
review of factors influencing the accountability relationships of Aboriginal and Torres Strait
Islander health workers (AHWs) in the Australian health system. International journal for equity
in health, 17(1), p.67.
Kimpton, T.M., 2013. Partnership and leadership: key to improving health outcomes for
Aboriginal and Torres Strait Islander Australians. The Medical Journal of Australia, 199(1),
pp.11-12.

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May, J., Carey, T.A. and Curry, R., 2013. Social determinants of health: Whose
responsibility?. Australian Journal of Rural Health, 21(3), pp.139-140.
Moatti, J.P., 2013. Social determinants of health inequalities: a public health research priority.
Hunter, D.J. and Reddy, K.S., 2013. Noncommunicable diseases. New England Journal of
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Glantz, S. and Gonzalez, M., 2012. Effective tobacco control is key to rapid progress in
reduction of non-communicable diseases. The lancet, 379(9822), pp.1269-1271.
Browne, J., de Leeuw, E., Gleeson, D., Adams, K., Atkinson, P. and Hayes, R., 2017. A network
approach to policy framing: A case study of the National Aboriginal and Torres Strait Islander
Health Plan. Social Science & Medicine, 172, pp.10-18.
Fisher, M., Baum, F., MacDougall, C., Newman, L. and McDermott, D., 2015. A qualitative
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O’Donnell, K. and MacDougall, C., 2016. Social determinants of health of Australia’s First
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Gomersall, J.S., Gibson, O., Dwyer, J., O'donnell, K., Stephenson, M., Carter, D., Canuto, K.,
Munn, Z., Aromataris, E. and Brown, A., 2017. What Indigenous Australian clients value about
primary health care: a systematic review of qualitative evidence. Australian and New Zealand
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Gomersall, J.S., Aromataris, E., Brown, A., Dwyer, J., Stephenson, M., O'donnell, K., Canuto,
K., Carter, D. and Gibson, O., 2015. Characteristics and value of Aboriginal Community
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Thompson, S., Haynes, E., Shahid, S., Woods, J., Katzenellenbogen, J., Teng, T. and Davidson,
P.B.A., 2014. Effective primary health care for Aboriginal Australians. Report commissioned by
the Australian Government and prepared by the Combined Universities Centre for Rural Health
and Deeble Institute for Health Policy Research.
Otim, M.E., Kelaher, M., Anderson, I.P. and Doran, C.M., 2014. Priority setting in Indigenous
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improve Indigenous Australian health. International journal for equity in health, 13(1), p.45.
Davy, C., Harfield, S., McArthur, A., Munn, Z. and Brown, A., 2016. Access to primary health
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Parnell, D., Morris, S. and Jacobs, R., 2017. Engaging Aboriginal and Torres Strait Islander
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McDonald, H., Browne, J., Perruzza, J., Svarc, R., Davis, C., Adams, K. and Palermo, C., 2018.
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