Core 1 Health Priorities in Australia

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Syllabus Overview Slide 3

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Key Terms Slide 4

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Activity 1: Note Taking

Using the presenters slide fill in the blanks.

• Health inequities are “systematic, socially produced (and therefore .......................... ) and unfair.”

• Inequities ................................. circumstances stemming from socioeconomic status, living conditions and other social, geographical, and environmental determinants that can be improved upon by human actions.

• For example, it is an ......................... when a child born of Aboriginal or Torres Strait Islander decent is

likely to die 10 years before a non-Indigenous Australian ( .................... ).

• Health inequalities are attributable to ...................................... variations or free choice and others are attributable to the external environment and conditions mainly outside the ................................ of the individual.

Notes:

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What are Health Inequities Slide 5

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Activity 2: Watch the video clip Indigenous Health, and complete the Plus, Minus and Interesting chart.

Plus Minus Interesting

Notes:

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Overview Slide 6

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Activity 3:

A) How do life expectancy rates of Indigenous people compare with non-Indigenous people of Australia?

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B) What do you think is the leading causes of death for Aboriginal and Torres Strait Islander people and how does this compare to non-Indigenous Australians?

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Nature and Extent of Health Inequities Slide 7

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Activity 4: Read the following news article from the Australian Heart Research Institute on “Why Aboriginal and Torres Strait Islander People More Often Affected by Heart Disease?” and create a mind map on the next page to answer why they are more affected.

WHY ARE ABORIGINAL AND TORRES STRAIT ISLANDER PEOPLE MORE OFTEN AFFECTED BY HEART DISEASE? Indigenous people are more often affected by the risk factors for heart disease (such as smoking), by health conditions that can lead to heart problems (such as diabetes), and by other forms of heart disease (such as rheumatic fever).

WHAT ARE THE RISK FACTORS FOR HEART DISEASE IN ABORIGINAL AND TORRES STRAIT ISLANDER PEOPLE? While some risk factors for heart disease cannot be changed, most heart disease risk factors can be reduced by adopting a healthy lifestyle. Many risk factors for heart disease are higher for Indigenous Australians. These include:

● Smoking. Indigenous Australians rate of smoking is twice that of the non-Indigenous population. Passive smoking or being exposed to second-hand smoke also leads to a higher risk of developing heart disease and cancer. It is estimated that two in five Indigenous people smoke and one in five deaths of Indigenous people is caused by smoking. It is the single most important risk factor for heart disease in Indigenous Australians.

● High Blood Pressure. Indigenous Australians are more likely to have high blood pressure than non-

Indigenous people. This raises the risk of coronary heart disease, heart failure, and stroke and kidney disease. Many Indigenous people have high blood pressure but do not know that they have the condition.

● Diabetes. Indigenous Australians are three times more likely to have diabetes than non-Indigenous

people. Diabetes raises the risk of heart attack, angina and stroke by up to four times.

● Rheumatic Heart Disease (RHD). Acute rheumatic fever and rheumatic heart disease can lead to heart valve damage, hospitalisation and even death. Hospitalisation for rheumatic heart disease is four times higher for Indigenous men and nine times higher for Indigenous women than for non-Indigenous men and women. Aboriginal and Torres Strait Islander people have one of the highest rates of rheumatic heart disease in the world.

● Physical Activity. 62% of Indigenous people living in non-remote areas do not get enough physical activity.

● Obesity. Indigenous Australians are more likely to be above a healthy weight than non- Indigenous people. 60% of Indigenous men and 81% of Indigenous women have waist circumferences that place them at risk of developing chronic disease.

Nature and Extent of Health Inequities

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Activity 4 continued: After reading “Why Aboriginal and Torres Strait Islander People More Often Affected by Heart Disease?” Create a mind map in the box bellow to demonstrate your findings.

Mind Map Slide 9

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Nature and Extent of Health Inequities

Activity 5: The nature and extent of Health Inequities. Answer true or false to the following statement from the Aboriginal and Torres Strait Islander healthy survey results (released by the Australian Bureau of statistics 2014). Answers that are false are to be re-written as true.

Aboriginal and Torres Strait Islander people compared with non-Indigenous people were: T/F

1. Smoking more on a daily basis

2. One and a half time (1.5 x) more likely to be obese.

3. Meeting the Australian dietary guidelines for daily fruit and vegetables

4. More than two times (2x) likely to have diabetes

5. Four times as likely to have advance stages of chronic kidney disease

Notes:

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Nature and Extent of Health Inequities

Activity 5 continued:

Aboriginal and Torres Strait Islander people compared with non-Indigenous people were: T/F

6. Twice (2x) as likely to have high triglycerides

7. Higher mortality rates at all age groups

8. Infant mortality is two times (2x) higher

9. Two times (2x) more likely to die from avoidable causes

10. Higher death rates from diseases of the circulatory system, cancer, respiratory diseases, digestive diseases, and kidney disease

11. More likely to have measured higher blood pressure

Notes:

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Summary Activity, Activity 6:

What do we know about the health inequities of the Aboriginal and Torres Strait islander people? Using all the presenter information you have received today, notes from today’s video and the case study article on heart disease, use the tables below to design a user friendly, easy accessible summary table of the health inequities which exist between Aboriginal and Torres Strait Islander people and non-Indigenous Australians Complete the summary tables.

Table 1. Mortality Summary (Slide 13)

Extent of the Health Inequity Life Expectancy

Infant Mortality

CVD

Respiratory disease

Avoidable causes

All age groups

Cancer, digestive and kidney disease

Table 2. Morbidity Summary (Slide 14)

Extent of the Health Inequity

Profound disability

Diabetes

Obesity

Chronic Kidney Disease

Higher triglycerides

Nature and Extent of Health Inequities

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Activity 7:

Place the following determinants of health (bold words only) onto the following page under the correct determinant in which it belongs.

1. Lower levels of income (Aboriginal and Torres Strait Islander people were half as likely as non- Indigenous people to report an equalised weekly household income of $1,000 or more in 2016 (20% compared with 41%)].

2. Poor and overcrowded housing (Aboriginal and Torres Strait Islander people were 6 x more likely to live in social housing).

3. Poor diet and nutrition (Significantly less likely to meet the guidelines for both daily fruit and vegetable intake).

4. Higher levels of unemployment (Aboriginal and Torres Strait Islander people were 4 x more likely to be unemployed).

5. Limited access to health care services (over one-third (35%) of the Aboriginal and Torres Strait Islander population reported living in capital city areas compared with 68% for non-Indigenous people).

6. Lower levels of school completion (Aboriginal and Torres Strait Islander people aged above 20 years were half as likely to have completed Year 12 or a Certificate 3 or above).

7. Ongoing effects of colonisation (dispossession, dislocation, discrimination, loss of culture loss of identity and self worth).

8. Significant higher rates of imprisonment (was 13 times greater than the age standardised imprisonment rate for non-indigenous persons).

The Sociocultural, Socioeconomic and Environmental Determinants

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Sociocultural

Family, peers, religion, culture, family and media

Socioeconomic

Determinants of Health Education, income and employment

Environmental

Geographic location, access to health services and

access to technology

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Activity 8:

Individuals: An individuals responsibility for their own health can vary, however individuals have a role in their own and others health. An individual’s role is to reduce their risky health behaviours and increase their protective behaviours. There is a strong focus in Aboriginal health in providing education and empowering individuals.

Examples:

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Communities: Communities aim to improve the access of Indigenous people to primary healthcare services. The services vary from one community to another, however they generally will include; clinical care, health education, screening, immunisation, and specific programs such as hearing and mental health.

Examples:

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Government: The federal government is responsible for the implementation and funding of Indigenous health care on a national scale. Their services include; researching Aboriginal health, development and delivery of Aboriginal health education, health services delivery, supporting community health initiatives, collecting and evaluating Aboriginal health data and policy development.

Examples:

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The Roles of Individuals, Communities and Governments in Addressing Health Inequities

Slides 16 and 17

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Take Home Activities

The following activities can be done at home as part of your study in preparation for the HSC:

Activity 1: Summary Table Aboriginal and Torres Strait Islander People Nature and extent of the health inequities

Sociocultural, socioeconomic and environmental factors

Roles of individuals, communities and governments in addressing health inequities

Health status: Sociocultural: Individuals:

Socioeconomic:

Communities:

Environmental:

Governments:

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Activity 2: Complete the following HSC question

Explain the roles of individuals, communities and governments in addressing the health inequities experienced by Aboriginal and Torres Strait Islander peoples. (8 marks)

Criteria Marks

• Clearly demonstrates how the roles of individuals, communities and government address the health inequities experienced by the identified group

• Makes evident the relationship between the roles of individuals, communities and government

• Provides a range of relevant examples of how individuals, communities and governments address health inequities in the identified group.

8

• Demonstrates how the roles of individuals, communities and government address the health inequities experienced by the identified group.

• Provides a range of examples of how individuals, communities and governments address health inequities in the identified group.

6–7

• Demonstrates how some roles of individuals, communities and government address the

health inequities experienced by the identified group

OR

• Provides characteristics and features of the roles played by individuals, communities and government in addressing the health inequities experienced by the identified group.

4–5

• Sketches in general terms the roles of individuals, communities and government

OR

• Sketches in general terms the health inequities experienced by the identified group.

2–3

• Provides some relevant information on the roles OR the identified group’s health. 1

Complete the following past HSC question from 2010

a) Outline TWO socioeconomic determinants that contribute to health inequities experienced by

Aboriginal and Torres Strait Islander peoples. (3 marks) b) Describe the roles that individuals, communities and governments have in addressing health inequities

experienced by Aboriginal and Torres Strait Islander peoples. (5 marks)

Answers could include:

• Employment • Education • Income • SES • Access • Location

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Activity 2 Continued:

Criteria Marks

• Sketches in general terms TWO socioeconomic determinants that contribute to health inequities of ATSI people.

5

• Sketches in general terms ONE socioeconomic determinant that contributes to health inequities for ATSI

OR

• Identifies socioeconomic determinants which contribute to health inequities of ATSI people

2

• Provides some information about health inequities of ATSI people.

1

Answers could include:

● Individuals – improve ATSI people’s knowledge, accepting diversity, positive health choices, participating in ATSI community initiatives, volunteering.

● Communities – advocate for change, involve community members in ATSI initiatives, awareness

strategies, lobbying Govt, education programs for ATSI.

● Government – funding ATSI programs, increasing doctors in ATSI communities, more services for ATSI people, increasing access to services.

● Working in partnerships.

Criteria Marks

• Provides characteristics/features of the roles of individuals, communities and governments in addressing health inequities for ATSI people

5

• Sketches in general terms the roles of individuals, communities and governments in addressing health inequities for ATSI people

3–4

• Provides some relevant information on the roles of individuals, communities and governments

OR

• Provides some relevant information on health inequities for ATSI people

2

1

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Activity 3: Research questions.

1. How does life expectancy of Aboriginal and Torres Strait Islander people compare with that of non- Indigenous Australians?

2. What are the major causes of death for Indigenous people and how does

this compare to non- Indigenous Australians?

3. How does infant mortality of Aboriginal and Torres Strait Islander people compare with that of non- Indigenous Australians?

4. What affect did colonisation have on Aboriginal people?

5. What health risk factors are Aboriginal and Torres Strait Islander people

exposed to at higher levels compared with that of non-Indigenous Australians?

6. Outline the inequities that exist in the health status of Indigenous people?

7. Explain why these inequities exist

8. Describe the sociocultural, socioeconomic and environmental determinants affecting Aboriginal and Torres Strait Islander people

9. Identify the areas in which health status of Aboriginal and Torres Strait Islander people are

improving?

10. What solutions are needed to raise Aboriginal health status, and what is already being done?

Website and Resources

Australian Bureau of statistics - http://www.abs.gov.au

Australian Government Aboriginal and Torres Strait Islander Health Performance framework https://www.pmc.gov.au or https://www.aihw.gov.au

Australian Indigenous Health info net - http://www.healthinfonet.ecu.edu.au

Australian Institute of Health and Welfare - https://www.aihw.gov.au

Closing the Gap - https://closingthegap.pmc.gov.au/

Improving PDHPE - http://www.improvingpdhpe.com

PDHPE.net - https://www.pdhpe.net

The Heart Foundation - https://www.heartfoundation.org.au

World Health Organisation - http://www.who.int