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1803NRS Foundations Of Professional Nursing, Griffith University, Australia

Title: Factors influencing the Health care in Australia

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Question 1. Identify and discuss two key influences that have shaped healthcare and/or healthcare access in contemporary Australian society. (The two influences must be from 2 different influencing categories, i.e. not 2 historical issues or 2 cultural issues)

Question 2. Identify and describe how each influence has shaped contemporary healthcare and/or contemporary healthcare access

Question 3. Discuss how each influence might continue to impact the RN role.

Answer: Introduction: Australian Health care system is considered to possess best strategies and funding and delivery of health care services. The Success of the established system is evident through the increased quality of life in the population of Australian over the time. However, epidemiological studies show severe disparity in the health of Indigenous and non-indigenous populations. In the current day, there are numerous challenges faced by the Health care system in Australia such as ageing population, increasing expenses of the medical equipment, Paradigm shift in the diseases from infectious to chronic lifestyle diseases and inequalities within the populations.

Primary health care provides community-based treatment in diverse settings such as community health centres, clinics, at-home consultations with the aid local health professionals. Access to Primary health care is based on diverse factors such as spatial factors including the distance from the resources, access to transport services, socio-economic factors where the indigenous cannot afford the cost of medical services, socio-cultural factors such as the inability of the Western health care to accommodate the cultural needs of the First Australians. Establishment of an effective Health care is determined by the both healthcare provider and patient with a special emphasis on the interface (Davy, Harfield, McArthur, Munn, & Brown, 2016)

Historical influence on healthcare: The life expectancy of Aboriginal islanders is at least 10 years less than the Non-indigenous population. Research has shown the factors such as unemployment, Culture and historical roots on their perception of health care negatively influencing the healthcare system (Armstrong, Gillespie, Leeder, Rubin, & Russell, 2007). 

Indigenous populations are the first inhabitants in Australia include both Aboriginal and Torres Strait Islanders currently constitute only 3- 4% of the total Australian population and they share a similar history. They identify themselves with their hunter-gatherer lifestyle, semi-nomadic in search of food, agriculture and their spiritual connection with the environment including people. Kinship, relationship between the member of the family and others in the community are crucial aspect of their cultural values. European Colonization segregated them from practising their rituals and alleviated the ethnocentric perspective of these populations in the modern society which resulted in a severe mental trauma that perpetuated across the ages and sections of community.

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Most of the health risk behaviours observed have a direct impact on the health outcome of the Indigenous population such as smoking and tobacco. Risky health behaviours are assumed to be a result of attitude of an individual towards their self. On the contrary, the roots of these behaviours can be attributed to the past Colonial Racial behaviour exhibited towards these populations. Restrictions laid down during the Colonial rule involved the limitation in the movement of individuals to collect in social gatherings, participation of ceremonies, language liberty, Interaction with community, Conflicts associated with the liberty as individuals, communities exacerbated stress on the population leading to risky health behaviours. The effect of the atrocities is observed to be transgenerational and displayed physical implications, affected the psychological perspective towards the entire Non-indigenous population. Finally resulted in the economic disparities laid down by the disparities in the employment opportunities. The remnants of the past Colonial events is believed to cause extreme stress in the younger generations and generated an urgency to develop fast acting coping strategies further directing them away from appropriate health behaviours.

It is suggested that the avoidance of health education is also influenced by the lack of trust and gap in the interaction between the two populations (Waterworth, Pescud, Braham, Dimmock, & Rosenberg, 2015).

Socio-cultural influence on healthcare: Social factors have a broader influence on the health behaviours. Indigenous populations outlook is complex, mostly determined by their culture. Closer connection to the family and community and a significant cultural obligation on the shared resources influence the self-health behaviours. The expectation on individuals by their culture include provision for the members, support the kin despite the economically disadvantaged conditions. Following such behaviours eventually lead to stress and burden on the individual resources.

Aspects of physical well-being is believed to be related to the interconnectedness among the social circle. Emotions were influenced by the spiritual practises followed. A sense of security was established through the participation in the traditional rituals and the members learned the responsibilities and rights from the elders through these interactions.

Common health habits associated with the culture such as smoking and drinking in groups are viewed as a means of connecting with each other in other words one's cultural identity and any deviation in the lifestyle choices is regarded as culturally inappropriate and the individuals are subjected to criticism by their own community members. Stress associated with adapting new behaviours conformed them to culturally acceptable behaviours. Coping mechanisms were adapted to counter the negative psychological effects of the culture.

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Socio-economic influence of health: Indigenous population are negatively affected by their low education status a mandatory requirement to access employment opportunities led to low income status(Mitrou et al., 2014). Economic disadvantages are a major factor influencing the access of health care. These circumstances cause psychological distress in the indigenous populations. Overwhelming nature of the finances and social conditions to access the appropriate care results in the neglecting attitudes towards health. The location of residence with, number of residents is directly linked to the health behaviours adopted. Cultural obligations outweigh the risk associated with the health behaviours.

Chronic conditions are majorly responsible for the increased morbidity in the indigenous health with a highest disparity in Diabetes and End-stage Renal disease. Chronic disease such as type 2 diabetes are on the rise in the recent years with a high economic burden. Poor nutrition and lack of physical activity are the causes associated with Diabetes and 90% of the cases are preventable with timely consultations. Considering the relocation of Indigenous to reserves in the period post colonization they experienced economic loss (Conway, Tsourtos, & Lawn, 2017).

The health care funding in the recent years has seen a shift towards privatization from the public-private collaboration in Australia increasing the financial burden on the individuals negatively impacting the indigenous populations. The renewed system is a viewed as biased towards economically-advantaged populations. The health insurance cost is high and is unaffordable by the people in rural areas and especially the indigenous population. In equality in the finances result in in the disparity in the access to adequate healthcare.

Impact of socio-cultural and historical factors on nursing interventions: Health care settings display inequalities towards Aboriginal people that further hinder them from accessing the services. Alienation of these individuals by the staff and lack of flexibility in the health services provided promoted the medical mistrust in the Indigenous populations. The responsibility in closing the gap lies with the health care especially the role of health care workers is undeniable.

Council of Australian Government (COAG) as an effort towards improving the life expectancy and overall health outcome invested in partnerships between Government and local communities of Indigenous people. The key to success is based on the active participation of the local community. As a health care worker the enabling factors include respecting the cultural differences and acknowledging the historical background, building the trust (Durey et al., 2016).

This is possible through patient empowerment that helps in the identification of the health problems and a sense of control over their health outcomes through the active role in designing the health care plan. Usage of appropriate language and symbols and a simple approach towards health improved the client retention.Medical mistrust should be addressed through shared knowledge to alleviate the fear towards diagnosis.

Indigenous Health Workers (IHWs) play a crucial role as they act as means of effective communication between indigenous and non-indigenous population. However, it is often observed that the burden of responsibility on IHWs is far superior to their colleagues due to their well-informed status (Conway et al., 2017). Strategies that recruit the indigenous conceptual framework aid in the transformation of the perspective a towards the contemporary health practices. Pharmaceutical benefit scheme to reduce the burden of the medications increases the adherence to health programs.

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Conclusion: Establishment of a successful health care system requires the assertion of indigenous rights and acknowledge the cultural aspects of all the populations in the Country. In the medical institutions decolonising behaviours such as inclusion of culturally appropriate strategies should be addressed to accommodate the holistic perspective of indigenous populations. These include connection of body-mind, emotional connection with kin and community, spirituality and ancestral beliefs, symbols that represent their culture.

Diffusing the colonial power is the first step towards equality in health care. Recognition of cultural and social influences that act as determinants of health and associated behaviours. Nursing interventions healthcare policies that exhibit cultural resilience that promote trust, patient empowerment and positive influences all the while maintaining the cultural distinction in the form of activities, languages etc play a significant role in reaching the indigenous.

Improvement of hospital planning and public financing by the Health Council are key factors that improve the access to health care and retention of the clients with improved health outcomes.(Dudgeon & Walker, 2015)

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