PUBH6000 Indigenous Health Inequities: Closing the Gap Assessment 2 Answer
Social, Behavioural and Cultural Factors in Public Health
Overview of Closing the Gap strategy:
Brief History of the strategy:
“Closing the Gap” can be considered to be a government strategy aiming at reducing the disadvantages among the people of Torres Strait Island and Aboriginal in child mortality, educational achievement, taking education in early childhood, employment outcomes and to life expectancy. The governments of Australia have made this commitment formally and officially to achieve health equality of the people of these areas within twenty-five years (Closing the Gap - Health System, 2019).
In 2006, the campaign started focusing the inequality in national health. The organisations that formed the campaign were NACCHO, AIDA, CATSINaM, IDAA, Oxford Australia, ANTaR. There was a steering committee that was built in order to help them in the development of the campaign. In this regard, 40 or more organisations of Aboriginal and Torres Strait Island and several other non-Indigenous health organisations were united in this regard (Closing the Gap Report, 2019).
Prime Minister’s 2017 report to parliament and assessment of the targets:
Closing the Gap Strategy focused on closing the life expectancy and health gaps between Torres Strait Islander and Aboriginal and the other people of Australia which has been being created with generation to generation. In this regard, it should be mentioned that in the year 2007 COAG (Council of Australian Governments) agreed to unite to this campaign and gradually it has been being known as the Closing the Gap (Closing the Gap Report, 2019). In the NIHE summit of 2008, the targets of the campaign were mentioned. There were 6 signatories who signed the statement: the representative of the Government of Australia, NACCHO, CATSINaM, AIDA, association of the Australian dentists and the Commissioner of Social Justice of Aboriginal and Torres Strait Island. In 2008, Prime Minister Mr Rudd announced the news of NIHEC’s establishment. This incident carried a high significance as it was for the first time to Australian government to take such commitment of a high level for the substantial and significant improvement in wellbeing of the people of Torres Strait Island and Aboriginal (Closing the Gap Report, 2019).
There were several agreements made by Close the Gap that included improvement in life expectancy by the year 2031, in child mortality by the year 2018, in employment by 2018, in the attendance in school by the year 2018, in writing, reading and numeracy by the year 2018, 12 attainment by 2020 and ensuring that 95% of 4-years-olds would be enrolled in early childhood education by the year 2025. However after that another Six agreements were included in that policy: agreement of national partnership on the development of the early childhood of Indigenous people, delivery service in the remote areas, on economic participation of Indigenous people, on Indigenous housing in theremote areas, on removing the gaps in the health outcomes of Indigenous Australians, on internet access in remote areas.
In this regard, it should be mentioned that Australia’s First National Congress is the representative voice of the nation for the people of Aboriginal and Torres Strait Island. It has a great contribution in this regard as well: ensuring genuine engagement and partnership between the two places, ensuring a ‘shared journey’ between the governments and people of two places etc. In the year 2012, Australia’s National Congress suggested another new target aiming to tackle the exaggeration in representation of the people of Torres Strait Island and Aboriginal in the system of criminal justice. In June of the year 2013, the Government of Australia released NATSIHP. In April of the year 2013, then it announced to fund of $777 million to it and in July of the year 2013, an Implementation plan was released by Government for the Health Plan of Aboriginal and Torres Strait Islander in 2013–2023.
Overview of Empowered Communities Initiative:
Empowered Communities and the initiatives taken by them are highly significant to be mentioned in this regard. It can be defined in two ways. It may stand for the Indigenous people, empowering themselves by attaining the right of having all the necessary and appropriate responsibilities and powers for their own futures and lives. It may also stand for Commonwealth (Conifer, 2017).
Framework of Indigenous Empowerment
The framework of the Indigenous Empowerment has mainly based on the thought that it is the fundamental right of the indigenous Australians to develop their socio-economic culture in society. In this regard, NCP (National Competition Policy) can be mentioned that initiates in reducing the regulations and developing faith in the market. It is an undeniable fact that throughout the entire development of the policy of indigenous empowerment, the contribution of NCP is highly significant to be mentioned (Snow 2019). Empowered communities stand for determining strong and concrete agenda to influence empowerment positively. However, in this regard the lessons of domestic and global experience it should be taken seriously and the implementation of the policy should be taken seriously. Empowered Communities contributed significantly to indigenous participation and culture front and the decision making the process of government. Not only is that, in order to create concrete shape and transparency in the partnership its influence highly significant (Snow 2019). It can easily be stated that the initiative taken by Empowered Communities can be considered to be a new way for governments of the country and the Indigenous communities to perform together for setting deliver services priorities at the regional level.
Rationale for the Initiative
As per the health report of AIHW Indigenous Australians like the Aboriginals and Torres Strait Islanders experience disease burden 2-3 times more than that of non-Indigenous Australians. 64% of the health burden is because of the chronic diseases, followed by substance abuse and mental health disorder accounting for 19% of the burden. Physical injury accounts for 15% of the health burden, 12% accounts for cardiovascular disease, 9% for cancer, 8% respiratory disease and 7% of musculoskeletal diseases contributing to the health inequalities (Australian Institute of Health and Welfare, 2019). The government reported that 37% o the disease burden is preventable among the Aboriginals and Torres Strait Islanders by reducing the impact of modifiable risk factors. The identified risk factors are the use of tobacco, alcoholism, obesity, sedentary lifestyle, high blood pressure and diabetes. 51% of the health inequality between the Indigenous Australians and non-Indigenous Australians were accounted for in the report by the government. The major contributor of the health inequality was the usage of tobacco accounting for 23% of the health burden gap. The mortality gap between the Indigenous Australians and the non-Indigenous Australians is about 80% between the age group of 35 to 74 years. The cause of mortality is majorly contributed by the chronic disease manifestation like diabetes, cardiovascular diseases etc. According to the Australian Bureau of Statistics (ABS) the life expectancy of the Indigenous Australians is about 12 years for males and 10 years for females after the diagnosis of chronic diseases (Australian Institute of Health and Welfare, 2019).
Discussion on the potential impact
This 9th report of ‘Closing the Gap’ showcases the real successes that were attained at the local level across Australia—by communities, individuals, government and organisations. However, this progress should be declared at a national level. It requires a better and effective understanding of the effective solutions to the issues faced and accordingly needful changes should be ensured.
As per the child, mortality and are concerned, both have not met the target. Again, on the other hand, in the case of enrolling indigenous 4 years old children, it has shown significant success in 2015. In the year 2014, another target attendance in schools was also achieved. However, the target, planned for the progress of the Indigenous students is yet to be on track. Again, there is gradual improvement in the proportion of the natives ageing 20-24 years (45.4% in 2008 to 61.5% in 2015). Regarding employment as well, it has shown a satisfactory result.
It has already been mentioned that as per the report of 2017, there is lot improvement in order to meet the targets made in the “Closing the gap” that aims to attain equality in health for the people of Torres Strait Island and Aboriginal and by 2030.
As per Hogarth (2019), the Prime Minister of Australia, Scott Morrison, has made the statement saying that the old and unrevised framework that has been being used by the state governments and federal for "close the gap" was well-intentioned but it is undeniable that it had been "doomed to fail” as it was not sufficiently spread among the Indigenous Australians and also failed in holding the government accounts of different levels.
As per ‘The Prime Minister’s 2019 Report to Parliament’, in spite of a sheer development in meeting the targets, of closing the gap during last few decades, this year, there are only 2 ambitious targets that are on track showing that it requires much more perfections and planning in this regard. Not only that, it requires a needful change in the pattern of work. According to the Prime Minister of Australia, Scott Morrison, more deep and strong partnership between Aboriginal and Torres Strait Island should be ensured and accelerated instead of focusing on Top-down (Snow 2019). He has also mentioned that there have been remarkable shortfalls in the implementation of the agenda of the campaign in both areas. However, in this regard, it should be mentioned that, though there were several achievements of the camp, still after every year, in every report, there was definite incompleteness o the meeting the target. Several reasons are there behind this. However, in the case of the bunnies in these two areas has achieved significant and growing improvement. The people from Torres Strait Island and Aboriginal are enjoying the opportunity of meaningful jobs abs developed economic status. In addition, this progress paved the way of accessing education for the next generation children of these areas from their childhood (Snow 2019). In this regard, it should be mentioned that in order to sustain this development in education and employment, it requires embracing the need for change (Hogarth, 2019). With the help of co-designed action plans of action stronger and required accountability can be attained. Such plans include policy action, regular evaluations and funding decisions. It does not only ensure to provide proper transparency but also a concrete shape of strategy to follow. However, it should be mentioned that the government of Australia is committed to taking initiatives in order to ensure and enrich a genuine partnership between Torres Strait Islander and Aboriginal people.