University Nursing Report: Reflection on Social Determinants of Health

This report is a reflection by a nursing student on the social determinants of health, focusing on the experiences of Indigenous communities, particularly those affected by the Sri Lankan civil war and migration to Australia. The author discusses the impact of these events on health outcomes, including stillbirths, and highlights the importance of health literacy, socioeconomic factors, and equitable access to healthcare. The report examines three key moments in time: the civil war, graduation from university, and a personal experience with a stillbirth, linking these events to historical landmarks and the social determinants of health. The author emphasizes the need for empowerment programs, health research, and stakeholder engagement to address health disparities and improve health outcomes for Indigenous populations, advocating for policy development and health financing to support these goals. The report concludes with an action plan emphasizing the need for qualitative and quantitative research to identify vulnerable populations and implement health education programs, aiming to increase health literacy and address the social determinants of health.

Running head: REFLECTION ON SOCIAL DETERMINANTS OF HEALTH
REFLECTION ON SOCIAL DETERMINANTS OF HEALTH
Name of the Student
Name of the University
Author Note

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Introduction
I am a nursing student graduated from the University in 2001. I have encountered a
situation of a still birth baby in the year 2011. In this situation I had seen the trauma of the
mother and the grief of the family members. However, the mother has been blamed and also
the social stigma of gender discrimination. The mother was an Indigenous person and the
effects of the lifestyle impacted on the baby born and thus the still born situation took place.
The mother was an Indigenous person and the effects of the lifestyle impacted on the baby
born and thus the still born situation took place. On this context I can say that the Civil war
with the liberation tigers of Tamil Eelam (LTTE) in Sri Lanka 2000 affected the life style of
the Indigenous community and thus they seek asylum and migrated to Australia.
Approximately 4500 Indigenous people of Sri Lanka has been moved to Australia by boat in
the year 2009, 2011, 2012 and 2014 (Dss.gov.au, 2014). According to the report of Australian
Bureau of Census there were a huge surge of population and the screen of these migrated
Indigenous people were required with highest priority (Betts & Higgins, 2017). Hence, the
Australia’s Labour Government had established a policy of quick enhanced screening for the
new arrivals in the country. Hence, it can be stated that the health care improvement in the
country is impacted over the South Asian region however, the condition has not changed the
condition for the Indigenous population as the health literacy of these communities not
changed very much. Hence, the condition of the still births are prominent after the civil war
despite of the free health care providence in the country by the government (Burns et al.,
2018). In the following section I will reflect on the experience of these moments.
My three moments in time
Based on the description of the three moments of the my personal experience that are
the Sri Lankan civil war with LTTE in 2000, graduating from University in 2001 and still

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birth experience in 2011, I felt that the changes in the health care, social structure and health
education should be changed for the Indigenous people. The social structure can be changed
if the government provide the proper employment and also education to the Indigenous
people with the help of the foreign investors in this sector as the country is one of the lower
middle income country (Blencowe et al., 2016). It can also be stated that the fact of the health
equity should be provided as well. The discrimination based on the origin of the people of the
Indigenous population has been seen the Australian context as well. The health literacy is one
of the critical aspect for the Indigenous people to eliminate the health issues such as the still
births among the community. I also feel that the experience helped me in developing a clear
idea about the condition of situation. This experience would be helpful in my future
encounters of the delivery situation (Chandraratne et al., 2018).
Figure: Sri Lanka people migrating to Australia

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Link to Social determinants
The civil war impacted in a positive way that is the free health care facility in the
government hospitals and the life expectancy rate improved as well as it reached to 73 years
and lowering of mortality rate which is 6.5 per 1000 people (Abs.gov.au, 2017). Thus on this
context I can be able to state that the factor of the health care is improved in the South Asian
region and I obtained the knowledge regarding this conflictive condition in the University
graduation course. This knowledge also helped me in the proper understanding and the
effects of the social determinants of health on the delivery process of the Indigenous mother.
The still baby born on the other hand can be referred as the factors of the social determinants
of health that are socioeconomic structure, education, environmental resources, improper diet,
addictive habits and others as well (Siriwardhana, 2015). On this context I can say that it is
required to empower or educate the people of the Indigenous community in order to sustain
against the lack of resources and also the processes of health conditions. Thus I can also state
that government should focus on providing equal health care to every person of the country
(Distefano & Haan, 2018). On this context I can say that I have been able to identify the
social determinants of health with the help of this experience and also the historical
knowledge along with graduation course. It has been seen that the overpopulation due to the
immigration of the Sri Lankan Indigenous people that are the Tamils lead to the fact that is
the lack of human resource and the socio-economic issues which affected the health
conditions of the Indigenous people again and again. On this context I can say that it is
required to empower or educate the people of the Indigenous community in order to sustain
against the lack of resources and also the processes of health conditions. Thus I can also state
that government should focus on providing equal health care to every person of the country.
On this context I can also state that the aspect of the health care should be able to find the

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health problems of the community and also the social determinants of health of the
community as well.
Figure 2: Stillbirth
Link of three events to historical landmark
The civil war of Sri Lanka in 2000 was the historical landmark that affected the
condition health economy of the country as well as the Australian population and the health
condition along with the economy as well. On this civil war context the factor of the civil war
also impacted over the education system. At the period of graduation we have encountered
several difficulties as the condition of the political and social effects as the migration of the
Tamils were affecting every aspect of the government aspects as well. This factor of the civil
war affected in different perspectives of the education system as we were in the middle of the
civil war and the economic system of the country was in jeopardy at that moment. However,
our education was not affected in terms of the knowledge development. Hence, I can state
that the process of the social conflict helped us in the development of the practical knowledge
of the health care system and the process of the nursing as well. On this context it can be
stated that in 2011 when I encountered the still born situation the social conflictive situation
and the knowledge of that condition helped me in acquiring the objective of the Indigenous
health condition and also the social determinants of health affecting the condition as well. I

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helped the mother to sustain against the ill situation and also acquired the knowledge what is
the causal effects that impacted on the health condition of the Indigenous people. The
Indigenous community from the Sri Lankan origin was also affected by the health system as
well as the Australian Indigenous community as the health care system is affected by the
discriminating psychological effects. On the other hand the effects of the social determinants
that is the health literacy and the employment structure along with the lack of environmental
resources affected the situation for the Indigenous people as well. On the other hand the still
birth baby is affected by the lack of knowledge and also the socio-economic structure of these
Indigenous communities as well. The process of the care for the mother experienced the still
born baby would be would be comprising of the holistic and patient centred approach (Mohan
et al., 2019). On the other the civil war concept should be followed and also the effect of the
civil war should be implemented with better approach and economic investment. The still
baby born on the other hand can be referred as the factors of the social determinants of health
that are socioeconomic structure, education, environmental resources, improper diet,
addictive habits and others as well.
Conclusion
Based on this discussion it can be concluded that the aspect of health and health care
is related and the social determinants of health are to be prioritised. On this context it also can
be stated that the factor of the health literacy should be developed with the proper
empowerment programs. On this context I can say that it is required to empower or educate
the people of the Indigenous community in order to sustain against the lack of resources and
also the processes of health conditions. Thus I can also state that government should focus on
providing equal health care to every person of the country. On this context I can also state
that the aspect of the health care should be able to find the health problems of the community
and also the social determinants of health of the community as well. Hence, the government

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should focus on the aspects of the health literacy and also the process of the employment so
that the socio economic structure would be developed in a positive way so that the
Indigenous people would be able to access health care process along with other factors that
impact over health.
Action Plan
Based on all the discussion it can be sated that the issue should be resolved with the
help of the empowerment program. In order to provide the care and the health education the
qualitative and quantitative research would be required. Health research would be done to
find out the issues and the vulnerable population who lack the health literacy and also the
knowledge about the healthy habits. The sample population would be selected in order to find
the most rate of the mortality, morbidity and also the still born incidents along with the death
at the period of still birth as well. Then the selected population would be educated with the
factors of the health care, health care access and also the healthy habits as well. In this
process the factor of the health literacy would be developed in the country as well (Hunter et
al., 2018). Hence, the health financing or the stakeholder relationship should be prioritised.
The process of the health financing would be developed with the help of the government and
also the foreign investor should be engaged for this (Senanayake et al., 2017). On this context
it can be stated that the health literacy should be developed with the consideration of the
history and the political aspect of the civil war as well. On the context it can also be stated
that the civil war improved the sector of the health care and also provided with the
consideration of the migration of the people from Sri Lanka and also providing the improved
health care to all the people in the Indigenous community. Also the health policy
development would be helpful in the improvement of the condition (Sudasinghe, 2015).

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Figure 3: Health education program

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