NAME: Natasha Tegelaar

STUDENT NUMBER: 220197803

UNIT CODE: HSNS246

ASSIGNMENT: Assessment 1 – Reflective piece on Social Determinants of Health

UNIT COORDINATORS NAME: Sally Bristow

DUE DATE: 23 March 2020

WORD COUNT: 1,000

WEIGHT: 20%
HSNS246 Primary and Community Health Assignment 1

The social determinants of health (SDOH) are the situations in which individuals are born, grow,

live, work, and age (Fisher, Baum, MacDougall & Newman, 2016). These circumstances are

shaped by the distribution of money, power, and resources all at global, national, and local levels.

This creates health inequality among different groups of people based on social and economic

class, gender, and ethnicity, which all affect a wide range of health, functioning, and quality of life

outcomes and risks (World Health Organization, 2020). The SDOH consists of general socio-

economic, cultural and environmental conditions, social and community networks, in addition to

individual lifestyle factors. This essay will, therefore, discuss the importance of having access to

health services as a SDOH among the Indigenous community.

Early research defined access in terms of how effectively available services can meet the health

needs of the populations they serve (Richard et al, 2016). According to Adelson (2005), access to

health care has been a challenge for Indigenous Australians. This is because it is difficult for them

to access health services due to the barriers and inequalities they face. Clearly, very little has been

discovered about the distinct effect of SDOH in the lives of Indigenous people. Still, the

dimensions of holistic health among them are distinctly affected by several social determinants.

Therefore, because the Indigenous people have limited or no access to healthcare, this can impact

on their quality of life and generally lead to poor health outcomes (Davy, Harfield, McArthur,

Munn & Brown, 2016).

The Australian Human Rights Commission (2007) claims that a large inequality gap remains

between Indigenous and non-Indigenous Australian citizens as they have not been given the same

opportunities to remain healthy. Evidence, therefore, suggests that the colonial policy has

progressively influenced the health of Aboriginals, hence creating another health gap for the

population (Prum, Deschamps & Barbier, 2012). Consequently, the period of colonisation has

1
HSNS246 Primary and Community Health Assignment 1

inflicted health problems on the Indigenous as it marginalised them economically, socially, and

politically, which has led to their health and wellbeing being affected drastically.

Ensuring equal accessibility to healthcare services will significantly improve the health outcomes

of populations. However, inequalities faced by the Indigenous limits their access to health services.

These inequalities could not only result in them developing far more health issues but also reduce

their access to assets that may improve their issues (Peiris et al., 2012). Indigenous Australians do

not benefit from the same accessibility to health services, such as healthcare infrastructure and

primary health care, in comparison with other non-Indigenous Australians (Sherwood & Geia,

2014). They do not have access to services, such as safe supplies of drinking water, healthy food,

healthy housing, effective sewage systems, etc. Access to health services is even more crucial

when these Indigenous populations are living with a high chronic disease rate. The number of

Indigenous individuals who die from chronic diseases in Australia is estimated at 1.5% greater

than that of other Australians (Australian Institute of Health and Welfare, 2020b). Despite this rate,

Indigenous people have reduced access to healthcare services due to discrimination, racism and

the high costs of healthcare.

The life expectancy of Indigenous people is approximately nine years less than non-Indigenous

populations (Peiris et al., 2012). This is one of the health outcome impacts of reduced healthcare

services on indigenous populations. Reduced access to healthcare services also leads to high levels

of morbidity rates among these populations. This is because they have significantly lower levels

of access to Medicare benefits. This then lowers their immune system and increases their chances

of acquiring a disease, while also diminishing their resilience to diseases. Reduced healthcare

services among the Indigenous also increases their stress levels since they lack control over the

2
HSNS246 Primary and Community Health Assignment 1

issue, thus contributing to mental illness and making it more difficult to address bad health

(Australian Institute of Health and Welfare, 2020a).

Nurses have the ability to take action and improve healthcare services for indigenous populations.

However, to do this, they must be informed on what changes need to be made, and they must also

desire to make these changes. Nurses should be taught about the colonial history of Australia and

the issues that Indigenous populations faced during this time, which affects the way they access

healthcare today (Fredericks, 2006). As a nurse, joining hands and partnering with Aboriginal

communities is one way to take action. This will help to increase coordination between nurses and

thereby enhance access to healthcare services for the indigenous community.

Nurses could also participate on relevant research to improve nursing practices. Moreover, a nurse

could develop a friendlier approach when handling patients from Indigenous populations. Suffice

to say, the nurse should try to be humane and treat these individuals by the same way themselves

would like to be treated.

Reflective practice is a technique used in analysing one’s self experiences in order to improve as

a practitioner (Bolton, 2010). Due to the multiple services that nurses provide, they require

introspection in order to improve their communication skills and their practices. It also helps in

improving the nurse’s knowledge and skills to ensure they are able to offer the services expected

of them by the institution. Nursing comes with a certain emotional cost, which is the key to

reflective practice. Therefore, in response to their job, nurses may have distressing emotions and

thoughts due to dealing with tough conditions (Nursing and Midwifery Board of Australia, 2017).

This is the main reason why the Nursing and Midwifery Board of Australia includes reflective

practice within their standards of practice.

3
HSNS246 Primary and Community Health Assignment 1

Reflective practice enables nurses to tolerate uncertainty and the anxiety associated with it. This

allows them to think critically and improve self awareness. It also enables them to become fully

involved in their work and develop better ways to respond to situations. An example of reflective

practice includes a scenario where the nurse must provide answers that are devastating to the

patient, even though it will hurt the patient.

In conclusion, SDOH are crucial components with a significant impact on the health outcomes of

populations. Indigenous populations face great difficulty in accessing health services, due to

discrimination, racism, and the colonial legacy they faced. However, being a nurse, it is possible

for me to take action and contribute to change through partnering with Indigenous communities

and engaging myself in research relevant to improving nursing practice. I can also ensure that I

treat Indigenous patients with dignity and humanity just as I would like to be treated.

4
HSNS246 Primary and Community Health Assignment 1

References

Adelson, N. (2005). The embodiment of inequity: Health disparities in Aboriginal Canada. Canadian

Journal of Public health, 96(2), S45–S61. https://doi.org/10.1007/BF03403702

Australian Human Rights Commission. (2007). Social determinants and the health of Indigenous peoples

in Australia – a human rights based approach.

https://www.humanrights.gov.au/about/news/speeches/social-determinants-and-health-

indigenous-peoples-australia-human-rights-based#endnote2

Australian Institute of Health and Welfare. (2020a). Australia’s health.

https://www.aihw.gov.au/getmedia/9844cefb-7745-4dd8-9ee2-f4d1c3d6a727/19787-

AH16.pdf.aspx?inline=true

Australian Institute of Health and Welfare. (2020b). Australia’s health.

https://www.aihw.gov.au/getmedia/11ada76c-0572-4d01-93f4-d96ac6008a95/ah16-4-1-social-

determinants-health.pdf.aspx

Bolton, G. (2010). Reflective practice: Writing and professional development. Sage publications.

Davy, C., Harfield, S., McArthur, A., Munn, Z., & Brown, A. (2016). Access to primary health care

services for Indigenous peoples: A framework synthesis. International journal for equity in

health, 15(1), 163. Doi: 10.1186/s12939-016-0450-5

Fisher, M., Baum, F.E., MacDougall, C., & Newman, L. (2016). To What Extent do Australian Health

Policy Documents address Social Determinants of Health and Health Equity? Journal of Social

Policy, 45(3), 545–564. https://doi.org/10.1017/S00472794150000756

Fredericks, B. (2006). Which way? Educating for nursing Aboriginal and Torres Strait Islander peoples. A

Contemporary Nurse: A journal for the Australian nursing profession, 23(1), 87–99.

https://doi.org/10.5172/conu.2006.23.1.87

5
HSNS246 Primary and Community Health Assignment 1

Kieft, R.A., De Brouwer, B.B., Francke, A.L., & Delnoji, D.M. (2014). How nurses and their work

environment affect patient experiences of the quality of care: a qualitative study. BMC Health

Services Research, 14(249). https://doi.org/10.1186/1472-6963-14-249

Marmot, M., & Wilkinson, R. (Eds.). (2019). Social determinants of health. OUP Oxford.

Nursing and Midwifery Board of Australia. (2017). Registered nurse standards for practice.

https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-

standards/registered-nurse-standards-for-practice.aspx

Peiris, D., Brown, A., Howard, M., Rickards, B. A., Tonkin, A., Ring, I., Hayman, N., & Cass,

A. (2012). Building better systems of care for Aboriginal and Torres Strait Islander

people: findings from the Kanyini health systems assessment. BMC Health Services

Research, 12(1), 369. https://doi.org/10.1186/1472-6963-12-369

Prum, M., Deschamps, B., & Barbier, M. (2012). Racial, Ethnic, and Homophobic Violence.

Taylor & Francs.

Richard, L., Furler, J., Densley, K., Haggerty, J., Russell, G., Levesque, J.F. & Gunn, J.

(2016). Equity of access to primary healthcare for vulnerable populations: the IMPACT

international online survey of innovations. International Journal for Equity in Health,

https://doi.org/10.1186/s12939-016-0351-7

Sherwood, J., & Geia, L. K. (2014). Yatdjuligin: Aboriginal and Torres Strait Islander nursing

and midwifery care. Cambridge Press

World Health Organization. (2020). Social determinants of health.

https://www.who.int/social_determinants/sdh_definition/en/