Koolin Balit Victorian Government’s strategic directions for Aboriginal health 2012–2022
Koolin Balit Victorian Government’s strategic directions for Aboriginal health 2012–2022
Table of Contents
31. Description of the plan, determinants of health and their influence
4risk groups‐3. Description of a priority area and at
54. Relevant determinants of health
The Aboriginal community is believed to be more likely to experience poorer health outcomes than non-Indigenous in Victoria. It is based against this backdrop that the government of Victoria set to improve the health of Aboriginal people in the state through the “Koolin Balit Victorian Government’s strategic directions for Aboriginal health 2012–2022.” The strategic directions are expected to close the perceived gap (Department of Health 2012). This report focuses on the «Koolin Balit.” It first provides an overview of the Koolin Balit, before providing details on the plan, determinants of health, and how they influence the population groups. It further describes «healthy childhood» as a priority area of the plan. Finally, it discusses income, stress, and education level as the three relevant determinants of health selected.
1. Description of the plan, determinants of health and their influence
Koolin Balit delineates the strategic directions that the Victorian Government has set to promote the health of Aboriginal people in Victoria between 2012 and 2022. It outlines the roles of different health stakeholders, including the Aboriginal communities, Department of Health, as well as other relevant health service providers in ensuring improved Aboriginal health (Department of Health 2012).
The plan is focused on six priority areas. These include ensuring that the Aboriginal people experience a healthy start to life, childhood, transition to adulthood, effective care for the aged, address risk factors and manage illnesses more effectively though the available health service resources (Department of Health 2012). Koolin Balit also has three core objectives, including closing the gap in life expectancy for the Aboriginals, reducing the gap in morbidity and infant mortality rates between the Aboriginal people and non-Aboriginal people, and lastly, ensuring that Aboriginal people experienced improved access to health services and improved health outcomes (Department of Health 2012). The determinants of health that affect the Aboriginal people include education, income, stress, employment, social support, living conditions, behavioural factors and gender (World Health Organisation 2003).
3. Description of a priority area and at‐risk groups
The selected priority area is a “healthy childhood.” It has been selected because the childhood forms the basis for one positive health outcomes during one’s lifetime. It is also an important period that can be leveraged to establish positive health and social behaviours and life skills within a household unit and the general society. The key social health indicators of health during childhood include physical activity, vision, hearing, nutrition. The two at-risk groups include pregnant women, who are at risk of having preterm babies, and breastfeeding women, who are at risk of having children with poor health outcomes.
According to Wise (2013), preterm babies, who have generally been born before they have reached the 37th week of gestation, are likely to be at risk of adverse neonatal outcomes. For instance, in 2010 some 13.5 percent of the Indigenous preterm babies in comparison to 8.0 percent of non-Indigenous preterm babies had adverse neonatal outcomes.
Children who experience poor nutrition, due to poor breastfeeding, during the initial 2 years of life are likely to experience poor health outcomes than their counterparts who are well fed.
Indigenous children who experience poor nutrition are likely to visit hospitals at higher rates than non-Indigenous children of the same age (Wise 2013). To prevent these, Koolin Balit targets mothers and pregnant women. It seeks to ensure that Aboriginal mothers can access
maternal and child health services, including screening programs to identity adverse health issues to limit the chances of having preterm babies. Koolin Balit also seeks to ensure mothers are educated on the importance of good nutrition and diet in ensuring good childhood development.
4. Relevant determinants of health
This section of the report focuses on the determinants associated with pregnant women, as well as Aboriginal children experiencing poor nutrition and the associated health outcomes. The determinants discussed include employment and income, stress, and education level. The determinants are selected as they deter the capacity of the at-risk groups to participate fully in society and to experience effective health outcomes (Dick & Calma 2007).
The Aboriginal people in Victoria experience socio-economic difficulties on all the selected indicators. According to the 2001 census, it was found that Aboriginal people had an average gross household income of $364 per week or nearly 62 percent of the rate for non-Aboriginal people. The Aboriginal people also face high unemployment rates. According to the 2001 Census, Aboriginal people had a high unemployment rate of 20 percent, which was three times greater than that of non-Aboriginal Australians. In terms of education, a national study in 2004 indicated that Aboriginal people were less likely to reach year 12, compared to non-Aboriginal students (Australian Indigenous Health 2015).
Studies have indicated that there is a relationship between the income status of people and their health outcomes. According to Australian Indigenous Health (2015), poverty is linked to poor health, including in pregnant mothers. For instance, Indigenous pregnant mothers with insufficient income are less likely to access
maternal and child health services, including going for screening programs to identity adverse health issues. This increases their chances of having preterm babies. The nutritional status of Aboriginal people is associated with their socio-economic status. For instance, poor Indigenous households are likely to afford a balance diet for their children. This exposes their children to risks of health disorders, including kwashiorkor, osteoporosis, obesity, and malnutrition. They are also less likely to afford better housing. This leads them to live in run-down and overcrowded houses, which are also linked to poverty and spread of communicable disease, including influenza.
Studies have also showed that poor education attainment is associated with poor health status. As established by Australian Indigenous Health (2015), Indigenous people with poor education attainment have little capacity to use health information. For instance, Aboriginal mothers with little education attainment are likely to lack adequate knowledge on effective nutrition for young children, hence exposing their children to poor infant diet, which is linked to chronic diseases at later stages of their lives.
Stress is associated with alcohol and tobacco use. According to Australian Indigenous Health (2015), people who undergo stress have been found to be more likely to turn to alcohol and tobacco use. In turn, tobacco use contributes to increased risks of chronic disease, such as lung diseases and cancer. In relation to the at-risk groups, particularly pregnant mothers, tobacco use is a major contributor to complications during pregnancy, and is closely linked to higher chances of having preterm babies (Friel 2009). According to Australian Indigenous Health (2015), environmental tobacco smoke, specifically passive smoking exposed children to health problems, including asthma, mid-year infections, as well as sudden infant death syndrome (SIDS). According to Australian Indigenous Health (2015), in 2003, tobacco use was the major contributor to disease burdens and injuries among Aboriginal people in 2003. Additionally, excessive alcohol consumption also contributes to a variety of diseases, such as pancreatitis, coronary heart disease, and high blood pressure. In respect to the at-risk group, specifically pregnant women, alcohol consumption during pregnancy or by breast-feeding mothers affects unborn children. It also leads to foetal alcohol spectrum disorder (FASD), which is a term describing a variety of disorders like central nervous system anomaly, impaired intellectual capacity, and growth retardation.
This report has demonstrated that the Koolin Balit can effectively reduce the health determinants affecting pregnant and breast-feeding mothers, hence ensuring “healthy childhood.” Indeed, the selected priority area of the Koolin Balit is “healthy childhood.” The area has been selected because childhood forms the basis for one positive health outcomes during one’s lifetime. In particular, pregnant women are at risk of having preterm babies, who are later exposed to poorer health outcomes due to determinants of health, such as income, stress, and education level. The breastfeeding women also expose the children to poor health outcomes, which are triggered by determinants, such as income, stress, and education. To prevent these, Koolin Balit targets breastfeeding mothers and pregnant women. It seeks to ensure that Aboriginal mothers can access
maternal and child health services. It also ensures mothers are educated on the importance of good nutrition and diet in ensuring good childhood development.
Australian Indigenous Health 2015, Factors contributing to Indigenous health, viewed 30 Aug 2016, <http://www.healthinfonet.ecu.edu.au/states-territories-home/wa/reviews/our-review/health-risk-factors>
Department of Health 2012, Koolin Balit Victorian Government strategic directions for Aboriginal health 2012–2022, Department of Health, Victoria
Dick, D & Calma, T 2007, “Social determinants and the health of Indigenous peoples in Australia – a human rights based approach,» International Symposium on the Social Determinants of Indigenous Health, Adelaide, 29-30 April 2007
Friel, S 2009, Health equity in Australia: A policy framework based on action on the social determinants of obesity, alcohol and tobacco, 30 Aug 2016, <http://www.health.gov.au/internet/preventativehealth/publishing.nsf/content/0fbe203c1c547a82ca257529000231bf/$file/commpaper-hlth-equity-friel.pdf>
Wisw, S 2013, «Improving the early life outcomes of Indigenous children: implementing early childhood development at the local level,» Australia Institute of Health and Welfare, Iss no. 6 Dec 2013
World Health Organisation 2003, Social Determinants of Health: The Solid Facts, WHO, Denmark