NURSING 7 Report: Social Determinants of Heart Disease in Australia

This report, prepared for a nursing course, investigates the social determinants of health contributing to the high prevalence of cardiovascular diseases among rural and remote populations in Australia, with a specific focus on the Indigenous population. It highlights factors such as economic disadvantage, lack of education, limited access to healthcare, and socio-economic disparities as key drivers. The report presents statistical data from the Australian Institute of Health and Welfare, illustrating the disproportionate burden of heart disease within these communities. The study then proposes a health intervention centered on health literacy and health counseling programs to promote positive lifestyle changes and encourage higher education, also suggesting the inclusion of local government for subsidies to improve outcomes. The report concludes by emphasizing the need for comprehensive strategies to address the social determinants of health and improve the quality of life and life expectancy within the targeted population. The report references multiple studies and reports to back up the claims.

Running head: NURSING
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Name of the Student:
Name of the University:
Author Note:

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Introduction:
According to the World Health Organization (2019), the social health determinants can
be defined as the condition where community members sustain themselves. The social health
determinants or SOD are primarily responsible for existing health inequalities observed between
population groups within a country or population groups of belonging to different nations (World
Health Organization, 2019). This paper intends to analyze the social health determinants
responsible for the high prevalence of cardiovascular diseases among the rural and remote
population base of Australia and propose an intervention that can help acquire improved
outcome.
Section 1: Social determinants of Heart disease for rural/remote Australians:
Health related disorders such as cardiovascular disorders are impacted by a range of
social health disorders such as economic disadvantage, lack of education, lack of access to
healthcare facilities as well as differences in terms of socioeconomic status that include
demographic parameters such as ethnicity, race and sex. Research studies suggest that the burden
of cardiovascular or heart disorders are common within the rural and remote population base of
Australian on account of poor medical infrastructure and health inequality which is characterized
both by means of lack of education and awareness as well as socio-economic disparity (Sahle et
al., 2016; Hamilton et al., 2018). In addition to this, disparities in terms of discrimination as well
as barriers in the form of culturally inappropriate care services and linguistic differences have
also reduced access to healthcare services and have increased the disease burden pertaining to
cardiovascular or heart disorders (Sahle et al., 2016). Research studies further reveal that
additional environmental factors that impact the cardiovascular health of the people include poor

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social relationships, demerit of living within disadvantaged neighborhoods, work stress as well
as poor income status (Cockerham, Hamby & Oates, 2017). All these factors have been studied
to negatively impact the health outcome of the percentage of the Australians residing with the
rural and remote regions of Australia (Taylor et al., 2016).
Burden of heart disease in the chosen population:
As per the Australian Institute of Health and Welfare (2019), it has been mentioned that
more than 4 out of 5 hospitalizations occur on account of cardiovascular disorders Within
Australia. In addition to this, statistical reports also suggest that Indigenous Australians residing
with the rural and remote regions of Australia experienced double the time of hospitalizations
compared to non-indigenous Australians. Also, reports published in the year 2017, suggest that
1 out of 4 deaths occurred on account of cardiovascular disorders and heart disorders which
attributes to 14% of the total deaths that occur within Australia (Australian Institute of Health
and Welfare, 2019). It is worth noting in this context that between the year 2017 to 2018, the
percentage of self-reported data on stroke and associated cardiovascular disorders was higher
among the rural and remote Australian regions. Evidence reports suggests that 6.4% Australians
living within rural and remote regions of Australia were likely to present self-reported data of
cardiovascular disorders against 4.8% of Australians living with other regions of Australia
(Australian Institute of Health and Welfare, 2019). In addition to this, the prevalence of Acute
Rheumatoid Fever is higher among Indigenous Australians and 60% of the cases are diagnosed
in individuals who are aged 25 years and below (Australian Institute of Health and Welfare,
2019). It should also be noted here that Indigenous Australians were placed at 2.8 times higher
the risk of suffering from Coronary Heart Disease compared to non-indigenous Australians
(Australian Institute of Health and Welfare, 2019).

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Therefore on the basis of the available epidemiological data, it can be mentioned that the
prevalence of Cardiovascular disorders such as coronary heart disease, strokes, Rheumatic heart
disease and heart failure is higher among the Indigenous population base which is majorly
present with the rural and remote region of Australia (Australian Institute of Health and Welfare,
2019). This critically reflects the disease burden related to CVD, associated morbidity, mortality
as well as poor quality of life.
Relationship between social determinants and burden of heart disease:
The evidence base critically suggests that the population base (predominately Indigenous)
residing within the rural and remote areas of the Australian continent experience poorer health
outcome. The underlying reason attributes to a number of factors that include, poor quality of
education, poor financial income, lack of access to healthcare services as well as poor socio-
economic security. Statistical evidence suggests that only 12% of the total population residing
within the rural and remote regions of Australia possess a Bachelor’s degree in any subject of
expertise (Run.edu.au, 2019). Further, 32% of the parents within the rural and remote regions of
Australia do not expect their children to pursue higher education. The background data clearly
reveals that the status of education is poor within this area which curtails opportunities for
employment and financial security (Run.edu.au, 2019). Further, on account of poor education,
awareness in relation to healthy lifestyle choices is also insufficient within the mentioned region
of Australia (Aaby et al., 2017). This cultivates unhealthy lifestyle choices such as excessive
dependence on substance abuse, smoking as well as consumption of diet rich in fat value which
serve as risk factors that increase the probability of suffering from cardiovascular disorders in
future (Jancey etal., 2016). Therefore, it can be mentioned that that the social health determinants
of poor education and poor financial security has contributed to reduced access to care facilities

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(Fisher et al., 2016). Also, poor education has resulted in lack of awareness about healthy
lifestyle choices which as resulted in aggravation of the disease burden (Gonzalez-Chica et al.,
2016).
Section 2: Intervention to address social determinants of Heart Disease for the chosen
population:
On the basis of the identified, social health determinant, it can be mentioned that the most
appropriate intervention that can help to improve health outcome of the indigenous Australians
in combination with the population based at the rural and remote regions of Australia would
include, disseminating health literacy and awareness so as to introduce positive lifestyle changes
within the targeted population (Fisher et al., 2016). This can be achieved with the help of health
promotional programs that would focus on disseminating positive lifestyle behavior which can
reduce the risk of acquiring cardiovascular disorders and improve health outcome (Taylor et al.,
2016). In the words of Cockerham et al. (2017), the use of the health belief model can help to
introduce a positive health behavior among the individuals as the model makes use of
motivational strategies in order to encourage people to take up positive lifestyle management
strategies. Therefore, the health promotion programs would aim at disseminating education about
heart disorders through health literacy and health counseling such that rate of hospitalizations in
relation to cardiovascular disorder and associated morbidity and mortality can be reduced
significantly (Jancey et al., 2017).
Proposal of health intervention addressing a social determinant:
Health literacy and health counseling would focus on imparting education and awareness
in relation to positive lifestyle changes. Through health literacy the risk factors that trigger the

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cause of Cardiovascular disorders would be discussed and the targeted audience can be
encouraged to give up unhealthy lifestyle choices such as smoking, consumption of alcohol and
high fat value diet so as to lead a healthier life (Jancey et al., 2016). Healthier life outcome
would reduce the rate of hospitalization and people would be able to experience longer life
expectancy. In addition to this, this program would also impart counseling in relation to the
importance of pursuing higher education and how it is strongly linked to financial security in
future. It can be expected that these programs would not only help introduce a positive lifestyle
changes but would also encourage the younger generation of the targeted population base to
pursue higher education and acquire improved financial status and financial stability (Hamilton
et al., 2018).
Inclusion of other sectors in the planning of intervention:
Other sectors that could be involved within the proposed intervention process would
comprise of the local government apart from the healthcare and education sector. The rationale
for the inclusion of the local government sector can be mentioned as placing a request for
granting subsidies in learning and education both at the school as well as college level. As per
the statistical data, the literacy rate in terms of a Bachelor’s degree is only equivalent to 12%
within the rural and remote regions of Australia. Introducing subsidies or full scholarship for
school and college education would motivate Indigenous parents along with non-Indigenous
parents within the rural and remote regions of Australia to encourage their children to pursue
higher education (Aaby et al., 2017). This would subsequently improve financial stability as
higher education would make it possible to look for better employment opportunities. As a result
the living condition, quality of life, lifestyle factors in relation to chronic illness disorders such as

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Cardiovascular disorders would improve and at the same time people would lead a healthy and
experience improved life outcome (Fisher et al., 2016).
Conclusion:
Hence, in conclusion, it can be mentioned that the paper has clearly defined and
attempted to explain the meaning of the social health determinants. In addition to this, the
extensive research conducted on the population and epidemiological factors of the rural and
remote regions of Australia reveal that the major proportion of the population constitutes the
Indigenous community members and at the same time this proportion of the population is
susceptible for suffer from a number of health related disorders such as cardiovascular disorders.
Social health determinants such as poor access to healthcare, poor education level, poor financial
security and poor medical infrastructure has led to the deterioration of the overall health status.
Conduction health promotional programs and encouraging higher education can help to improve
the quality of life of the targeted audience and also fetch positive health outcome in terms of
improved life expectancy and bring about positive lifestyle changes.

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References:
Aaby, A., Friis, K., Christensen, B., Rowlands, G., & Maindal, H. T. (2017). Health literacy is
associated with health behaviour and self-reported health: A large population-based study
in individuals with cardiovascular disease. European journal of preventive
cardiology, 24(17), 1880-1888.
Australian Institute of Health and Welfare (2019). Cardiovascular disease, How many
Australians have cardiovascular disease? - Australian Institute of Health and Welfare.
[online] Australian Institute of Health and Welfare. Available at:
https://www.aihw.gov.au/reports/heart-stroke-vascular-disease/cardiovascular-health-
compendium/contents/how-many-australians-have-cardiovascular-
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%20(CHD),2017%E2%80%9318%20National%20Health%20Survey%20. [Accessed 5
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Australian Institute of Health and Welfare (2019). Rural & remote Australians Overview -
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disease.
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do Australian health policy documents address social determinants of health and health
equity?. Journal of Social Policy, 45(3), 545-564.

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Gonzalez-Chica, D. A., Mnisi, Z., Avery, J., Duszynski, K., Doust, J., Tideman, P., ... & Stocks,
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