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Social Determinants of Health: Heart disease in Australian women Assessment 1 Answer

Assessment 1

Social Determinants of Health. 1500 words; 25%

Tobacco, lack of physical activity, a diet high in fats and sugars, hypertension, diabetes and obesity are well-known risk factors for heart disease. Populations with lower socioeconomic status are more likely to have increased behavioural risk factors for heart disease, including smoking and lack of physical activity (Australian Institute of Health and Welfare, 2010). Although behavioural risk factors might be evident causes of diseases, public health professionals also consider social and environmental factors that contribute to the social gradient of health

To prepare for this assignment, choose a population group in Australia (e.g. men/women, low socioeconomic status, rural/remote, people with disabilities/mental illness). Then, in 1500 words, address the following, being sure to include a rationale that justifies your response:What is the pattern of heart disease in this population group? Are some sub-populations more likely to experience heart disease than others? Is it more or less prevalent than in other populations?How do social determinants of health influence heart disease prevalence, morbidity and mortality in this population group? You can compare your chosen population with different populations (i.e. men and women), or different sub-populations with one another (e.g. Indigenous women compared with Caucasian women).

Design a public health intervention that addresses a social determinant of health such as work stress, unemployment, or lack of social support, transport, housing, education, access to healthcare).How does this public health intervention address the social gradient of health? Does it increase equity of access, for example making something more affordable or accessible? Tell me how.Explain which other sectors would need to be involved aside from the health sector, e.g social welfare, housing, employment sectors.

Answer

Heart disease in Australian women

Pattern of heart disease in Australian women 

Studies revealed that Australian women are prone to develop heart disease due to consumption of inadequate amounts of nutrients, physical inactive life, and stress (Australian Institute of Health and Welfare, 2010)As per the data collected from the National Health Survey in 2004-05, suggested that cardiovascular disease was more prevalent in women compared to male. It was recognised that 20% of the women in Australia is suffering from cardiac problems. Therefore, one in five female has heart disease in Australia (Australian Institute of Health and Welfare Canberra, 2010).  

In addition, the rate of stroke in women is similar to male and approximately 8% of deaths result in 2006(Australian Institute of Health and Welfare Canberra, 2010).  

Comparison with sub- population women

Aboriginal and Torres Strait Islander people

The rate of heart disease is higher in aboriginal women compared to other Australians. Studies identified that the death rate due to cardiovascular disease is 4.3% in aboriginal female aged between 40-54 years and 3.8% for the women aged 70 or over. However, the ratio is 2.2% and 3.3% respectively for other Australian women stress (Trinh, Kerrigan, De Looper, Hurst & Bourchier, 2014).  

It can be assumed that socio-economical disadvantage, traditional beliefs, and inequality in access to healthcare facilities are responsible for a high percentage of heart disease and related deaths in indigenous women (Trinh, Kerrigan, De Looper, Hurst & Bourchier, 2014).    

Caucasian women

National Health Survey in 2004-05 indicating that only 1% of Australian women have heart disorders (Davidson et al., 2012). In addition, the death rate due to stroke is lower in whitish women in Australia compared to aboriginal women. The rate of peripheral artery disease in women ranges from 5.5% to 29% which increases with age (Davidson et al., 2012).  The overall studies on heart disease in Australia suggested that women in rural areas with poor socio-economic condition are more vulnerable in the development of heart disease due to lack of knowledge and poor food habits.  

Social determinants of heart disease 

It has been recognised that social, cultural, political conditions can create health inequalities which can enhance the chance of disease development. Therefore, analysis of social determinants can help to understand the exact reason behind the situations.

Socioeconomic condition

 People with poor economic circumstances are a greater risk for poor health outcomes along with disability and illness. It can be assumed that the lack of opportunity in female compared to male is responsible for their poor socioeconomic condition (AIHW, 2014)

 Lifestyle

It has been recognised that the disadvantaged background of the female can affect their health literacy and opportunities for wellbeing. In some cases, they are completely dependent on their family members which adversely affect their health conditions (AIHW, 2014).   

 Social exclusion

Gender discrimination and stigmatisation of the women is obstructed their health and wellbeing (AIHW, 2014). In addition, sexual harassment and racism can cause social exclusion and psychological distress in women which is increasing the stress-related factors.    

Employment 

Employment can bring wealth and opportunities for the individual. However, social inequalities and discrimination are responsible for unemployment in women which increases their psychological stress and has a strong impact on their health (AIHW, 2014).   

Housing

Safe and secure housing can be associated with better health in individuals. A poor socioeconomic condition in native Australian women can deprive them form proper housing facilities which increase the incidence of illness (AIHW, 2014).     

Income

Poor socioeconomic condition of Australian women can obstruct the accessibility of proper food, housing, and health care facilities (AIHW, 2014). However, loss of income can adversely affect the socioeconomic position of the individuals. In addition, poor income is directly related to poor health outcomes in women.   

Comparison between the men and women about disease pattern  

The main types of cardiovascular heart disease (CVD) in Australia are a stroke, coronary heart disease and heart failure. In 2017, CVD is responsible for 27% of deaths in Australia among them 26% for male whereas 28% for female (Sahle, Owen, Mutowo, Krum & Reid, 2016). It has been isolated that one in six Australian is affected by the CVD in Australia among them 66% are male and aged 75 and over (Sahle, Owen, Mutowo, Krum & Reid, 2016)

The poor socioeconomic condition in men is also elevating their risk factors for CVD compared to women. In addition, the faulty lifestyles of Australian men in terms of drinking and smoking habits are increasing their risk factors. It has been observed those males are prone to develop high blood sugar, cholesterol and obesity due to work and social pressure along with food habits and lifestyle patterns. Therefore, they are more vulnerable compared to female.  In Australia, the death rate of men aged 55 is 29.6% due to CVD with two major risk factors (The Heart Foundation, 2014). The morbidity risk is also high in men compared to women. It has been recognized that men aged 45 with two or more risk factors have 49.5% risk for development of CVD whereas women have 30.7% chances (Sahle, Owen, Mutowo, Krum & Reid, 2016).  

Design a public health intervention that addresses a social determinant of health

Adopt a consumer focused approach to prevention and settings 

Implementation of social marketing intervention can improve consumer awareness and skill about the CVD and healthy lifestyle to reduce the risk factors. It is essential to adopt the culturally appropriate strategies for the selected population. Therefore, the adoption of flexible and innovative approaches can be beneficial in the elimination of risk (Heart Foundation, 2011).   

 Improve health workforce and training 

The proper education of healthcare professionals can eliminate the chances of social discrimination and negligence in healthcare sectors (Greenlund, Keenan, Clayton, Pandey & Hong, 2012). It can also help in understanding the gender issues and identification of specific risk factors in the population. Therefore, the development of the multidisciplinary team in health sectors can assure the patients about the facilities and services. 

Early Identification and health promotion

Early screening process in the community can eliminate the chances of mortality and morbidity due to CVD. Therefore, the government should take initiative in implementing a proper screening process to identify and control the vulnerable group (Greenlund, Keenan, Clayton, Pandey & Hong, 2012).  Controlling the risk factors for disease management and risk reduction can achieve in medical and community setting. Therefore, the government should introduce risk control measures and require promotion of the health programs within the vulnerable community which can improve their physical condition. 

Develop an integrated cross-sector approach to chronic conditions 

Application of gender-based approach in the prevention of chronic diseases can be beneficial. Therefore, adoption of a multifaceted approach to developing the women health and wellbeing can eliminate the chance of social negligence and ignorance (Heart Foundation, 2011). The special consideration in aboriginal people is essential for improving the whole scenario. 


Public health intervention address the social gradient of health

Considering the social determinants 

Social determinate plays an important role in the development of chronic disease an illness. It has been observed that psychological burden in lower socioeconomic classes can instigate the chronic disease. Therefore, improvement in social determinates by improving health literacy and effective engagement can eliminate the risk factors (Coffey, Ralph & Krause, 2018).     

Focused on gender bias

Improve the biasness in the health care sector is an important aspect in the elimination of social discrimination. Healthcare professionals should respect the identity of the individual in order to provide better service and care in rehabilitation (Greenlund, Keenan, Clayton, Pandey & Hong, 2012)

Social support 

It is a vast domain helps in socialisation and education. It can help to diminish the health of individual and communities. It can create a burden in CVD either directly or indirectly. It has been observed that social isolation is considering increasing the risk of death from CVD. Therefore, the rate of death from CVD is high among the countries with no social support (Friel, Hattersley and Ford, 2015).    

Environmental Determinant

Geographical location can restrict access to healthcare services and resources. The household environment can control the behaviour of the individual which increase the chance of cardiac risk. Studies indicating that exposure to chemical or pollutants can increase the CVD by changing the physiological mechanism inhuman (Coffey, Ralph & Krause, 2018). Therefore, the unsuitable build environment with unhealthy food and exposure to toxins can contribute a role in the development of CVD. It can be concluded that the environment is an import consideration for preventing and controlling CVD. 


Health care services

Improvement in healthcare facilities can provide better care and services to the women and deprived section of society. In the case of aboriginal people, the inclusion of new policy and programme in health can improve their condition (AIHW, 2014).   

The social gradient in Australian mortality

Figure 1: The social gradient in Australian mortality, 2009–2011 (AIHW, 2014)


Other sectors need to incorporate in the elimination of heart disease

Improve Employment and working conditions

Women need opportunities in every aspect of their life. The employment opportunities can reduce the inequalities in society which triggers social determinates. Employment can help women to reduce their mental stress and lead an active life (Williams, Costa, Odunlami & Mohammed, 2008). Therefore, a positive work environment can motivate the women to lead a healthy lifestyle which can reduce the chances of cardiovascular disease.     

Educational advancement

The social discrimination can be eliminated with the help of education. Therefore, the government should motivate female children to participate in school to enhance their knowledge and skills (Friel, Hattersley and Ford, 2015). It would help them to achieve employment and social recognition. Therefore, the positivity in their personal life can reduce their tension and anxiety. 

Social participation 

Promotion of civic engagement, participation in the decision making process, and social acceptance of the individual can eliminate the risk factors in women (Williams, Costa, Odunlami & Mohammed, 2008). Thus, the development of a positive relationship with society can reduce their stress and stress-related health problems.   

Daily living conditions

Physical active life with appropriate food intake can help the women to maintain their normal body functioning which is essential for avoiding heart related disorders. Moreover, stress-free life with the consumption of appropriate diet and mild physical activity can reduce the risk factors in women (Williams, Costa, Odunlami & Mohammed, 2008). In aboriginal people, improving the living standards with safety and security can be beneficial for them.  

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