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Australian Social Determinants of Health

Introduction

The disparity in the range of life expectancy within and between countries is a well documented issue. For instance, life expectancy in Russia stands at 58.4 years. This is a clear difference of 21 years in comparison to life expectancy in Sweden which stands at 80. On the other hand, the difference in life expectancy between people living in deprived districts of Glasgow and people living in the affluent sections of the same city stands at 12 years (Marmot and Wilkinson 2006, 6). This is a clear indication that life expectancy can vary not just between countries but even within the same country. However, what are the causes of these disparities? Is there a clearly established causal effect between poverty and health? This paper will point out that social factors, particularly education greatly affects an individual or society’s health. The indigenous Australian populations will be used as a reference point.

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In their need to understand what really causes these disparities, Marmot and Wilkinson (2006, 13) identify the social factors that determine an individual’s health. These factors are referred to as the determinants of health. The World Health Organization defines determinants of health as the circumstantial and environmental factors that combine together to determine the health of individuals and communities (World Health Organization 2010, par.5). The organization further outlines the social and economic environment, the physical environment and an individual’s specific characters. All these, together with several others determine whether an individual lives a healthy or unhealthy life. As a result, it is unreasonable to criticize an individual or give him much credit for having good health.

The World Health Organization identifies education as one of the health determinants implicating greatly on lives of individuals and societies. This notwithstanding, extensive research in the issue gives evidence that there exists a correlation between education and the health outcome of an individual or society, therefore underscoring the importance of improving education in order to alter a trend in the health of a community. The importance of education is further reiterated by Nelson Mandela and Graca Machel whose address to UNICEF read, “…each one of you deserves to have the best possible start in life, to complete a basic education of the highest quality, to be allowed to develop your full potential…” (World Health Organization 2010, par.1).

In her quest to point out the relationship between education and health, Malin (n.d, 5) purports that there is adequate research evidence to show that parental levels of schooling determines an infant’s chances of survival his general health outcome. In fact, she argues that with an estimated increase of 10% in the literacy level, infant mortality decreases at a similar percentage. It is therefore evident that with increased rate of literacy, the health of children will achieve a similar gradient. With such evidenced arguments, what implications have this on the health level of poor and marginalized societies? Does it mean that minorities and marginalized societies which are characteristically poor and with, low quality education suffer from poor health outcomes? The answer to this question is probably yes. Without a proper educational background, the minorities and marginalized societies are condemned to low life expectancy, increased infant mortality and increased deaths from preventable diseases.

The Australian Case

The indigenous populations in the Australian community suffer low socio-economic status within the country. The economic ladder points out that the indigenous Australians have found themselves in this status as a result of the historical injustices. This population has suffered exclusion and racism which eventually translates and implicates on the other aspects of their lives, health included. Based on research carried out on this demographic section, this section of the paper will elucidate on the implication of education on the health of an individual and society as a whole.

Mathews, Weeramanthri and D’abbs (1995, 50) argue that the Australian history marked by colonialism, dispossession of the aborigines and their marginalization are the root causes of poor education levels which eventually translate to poor levels of all other aspects of human life. Being evident that the aboriginals are characteristically less educated, it means that the population has increased levels of infant mortality and other forms of health complications associated with illiteracy. To be precise, the institutional capacity of the Australian community fails to highlight the real needs of the aboriginals because their planning was centered upon the requirements and literary assumptions of the dominant ethnicities. Sadly, the educational institutes which form the basis of the future lives of individuals are affected by the same institutional incapacity. The aboriginals eventually end up with poor quality of education and hence problems with their health outcomes.

Another impact of health on indigenous populations in Australia and which relates to education is social exclusion. Social exclusion is the total sum of effects of colonialism on the indigenous populations. Among them are the economic hardships experienced by these people and the marginalization imposed upon them. Both these are results of a long history of colonialism. Consequently, Shaw, Dorling and Davey-Smith (1999, 23) posit that social exclusion is a dynamic process whose implications assume a multidimensional nature. They purport that with social exclusion, a population tends to have an increased level of low income as a result of unemployment. Furthermore, this leads to poor housing, and above all, negative implications on the level of education. Consequently, the low level of education increases the rate of poor health outcome.

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Lawrie (1999, 31) identifies that indigenous populations sometimes get insufficient treatment if not none due to lack of interpreters. With this, there was until recently a pronounced communication breakdown for patients with aboriginal decent in the Northern Territory of Australia. Unfortunately, the problem was solved by use of interpreter services that have hence proved inadequate. The communication breakdown still looms large as information distortion continues. Some patients are forced into making inappropriate choices because of the inadequacy of information. What, therefore, is the relationship between interpretation services and education? It is clear that education gives a student universality, not just through the knowledge imparted but also communication tools like language. If the indigenous populations are subjected to quality education, they will have adequate comprehension of the language used in the institutions that were otherwise developed to embrace the cultural and literary needs of the dominant population.

In Australia, racism affects the access to education for the indigenous populations. As a result, Rollock and Gordon define racism as:

Belief systems concerning characteristic inferiority or superiority associated with group membership; and patterns of behavior that differentially affect the esteem, social opportunities, and life chances of members of racial groups as a function of those belief systems” (2000, p.5).

Emphasizing on the clause that indicates the deprival of access to social opportunities, it becomes clear that indigenous groups in Australia are deprived of quality education as a result of racism which marks the history of Australia.

Insufficient education leads to increased levels of stress. This consequently leads to vulnerability to certain health complications associated with it. In a study carried out on Caribbean children, it was found out that those children with increased levels of stress fell sick more often than those who were less subjected to stressing factors. The factors included domestic conflicts between parents, cases of abuse and neglect, anti social behavior and alcoholic parents. Considering the mentioned factors, it is arguably true that most of them could be cured if the parents were well educated. With quality education, the parents would stand a chance of getting better jobs that would improve their economic position and hence give them a better living. In grownups, stress leads to diseases like cancer and other cardiovascular complications. Therefore, if well educated, certain health complications would be automatically eradicated thus ameliorating the lives of individuals Lawrie (1999, 21).

For the case of the indigenous populations in Australia, it is evident that the history of colonialism, dispossession and social exclusion can be adequately stressing factors in themselves. However, one of their repercussions is the increased chances of low quality education that still leads to stress. This clearly indicates that lack of adequate education subjects the indigenous populations of Australia to stress related health complications.

Programs for Health Amelioration

Several programs have been put in place to improve on the health of the aborigines and indigenous groups. One of the groups in Australia is Kuwinyuwardu Aboriginal Resource Unit Gascoyne Healthy Lifestyle Program. Capacity building principles have been given priority within the programs of this Unit. The programs are developed in a multidimensional approach that seeks to promote effective and sustainable health practices for remote areas in the rural Australia inhabited by the aborigines (World Health Organization 2010, par.8).

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The ‘best practice’ model developed by James Howie is anchored on four basic principles which are as follows:

The principle of cultural security

The program believes that the aborigines believe that health issues are spiritual, familial and mental. Consequently, they believe that the best approach is trying to develop programs that try to embrace these believes but at the same time try to make the aboriginals have a thought pattern that is consistent with the world view. This could be achieved through merging of the Western view with the cultural view to come up with a mid point. All this is part of education. This means that by imparting appropriate means of educating, the aboriginal approach to life would be changed. Literacy designed to employ the cultural believes is the core solution (World Health Organization 2010, par.9).

Principles of Successful Community Development

This principle tends to believe that each indigenous group’s approach to life is unique and specific. The differences are as a result of traditions, structural outfit, expectations et cetera. Active participation by the community is therefore an important aspect of any program. The community must show direction throughout the implementation process while the project coordinators make use of the feedback (World Health Organization 2010, par.12).

Principles for successful health promotion

Literature points out that a successful health promotion program must give education a priority. This involves provision of adequate information plus use of peer support to increase and make the knowledgeability of the aboriginals consistent with the world.

Principles of Management and Training

This is involved with training those involved in training the aboriginals. This assists them to come up with viable approaches that put into consideration the various cultural beliefs within the education program.

Conclusion

Education is an important part of human existence. This is particularly true considering its effect on the health of an individual and the community at large. Education again leads to less economic opportunities which eventually lead to poverty and the lack of ability to attain the best quality health care. In addition, education level influences a person’s understanding of life and the mediocre approaches to life are corrected through education. Finally, communication is facilitated through education. Sadly, the indigenous Australian communities have been deprived of this precious commodity through long periods of colonialism. However, there is hope as programs like Kuwinyuwardu Aboriginal Resource Unit Gascoyne Healthy Lifestyle Program have been put in place to address the issue. Hopefully, this will improve the health of the community.

List of References

Lawrie, Daniel. Report. 1999. Inquiry into the Provision of an Interpreter Service in Aboriginal Languages by the Northern Territory Government. Darwin: Office of the NT Anti-Discrimination Commissioner.

Malin, Meshack.1994. “Make or break factors in Aboriginal students learning to read in urban classrooms.” In S.Harris and Malin (Eds.), Aboriginal Kids in Urban Schools.Wentworth Falls: Social Sciences Press.

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Marmot, Moses. & Wilkinson, Rose. 2006. Social Determinants of Health. (2nd edition) New York. Oxford University Press.

Mathews, James, Weeramanthri, Thomas., and D’Abbs, Peter. 1995. Aboriginal Health: The past is all aboutus and within. Today’s Life Science, vol. 7, no. 8, 14-20.

Rollock, David. & Gordon, Wayne. 2000. Racism and mental health into the 21st century: Perspectives and parameters. American Journal of Orthopsychiatry, 70, no 1, (2000): 5-13.

Shaw, Marlin, Dorling, Daniel. & Smith, Gary. 1999. Poverty, social exclusion and minorities. InM. Marmot & R. Wilkinson (Eds.), Social Determinants of Health. Oxford: OUP.(1999): 211-239.

World Health Organization. Health Impact Assessment: The Determinants of Health. Web.

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