Aboriginal and Torres Strait Islander Health

Contemporary Issue Essay

Unit Code and Title: NUM1102 Application of key concepts to a Case Study: Aboriginal Pregnant Lady

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Even in the most affluent countries, a person is less well off has substantially a shorter life expectancy with more illness as compared to the rich. These differences in health facilities are not only a significant social injustice however it has also gained scientific attention towards some of the most powerful determinants regarding health standards in this modern society. This specific context is to be explored in this essay, where a case of a teenage pregnant girl is to be focused on. Exploring this context is to be carried out to present a clear picture of the differences in healthcare facilities, which a city hospital offers and a local community-controlled healthcare offers. Thus, structuring this essay follows a key difference and similarity based on the services offered by both the healthcare service-provider, then major concepts such as stereotyping, social-determinants of health, and a few more are to be incorporated with the given case study and then offering key strategies to manage such health issues. Lastly, the entire essay is to be summed up with concluding statements indulging the key findings obtained in the above sections.

Similarities and differences between health services provided by local staffs and a city hospital_400

Discrepancies in the PHC (Primary Health Care) services between a city hospital and a community-controlled setting exist. PHC carries a history of fragmented delivery, usually with insufficient support to general practices (1, p.112). These two healthcare service providers are similar in terms of the number of inpatients, for instance, the number of patients admitted to a city hospital seems to be equal to the no. of patients admitted to a community-controlled healthcare provider. In terms of ancillary charges, both types of service providers share some similarities, for instance, if city hospital charges around 59% then community-controlled service providers charge around 58% for ancillary services. The total number of discharges in both the service-providers that is city-hospital and community-controlled is also similar. In terms of ALOS (Average Length of Stay), both types are similar to each other, for instance, if a city hospitals ALOS is 13.9 days then a community-controlled nursing homes ALOS is found to be 13.8 days. In Australia, from the viewpoint of the spatial distribution of healthcare resources, it is identified that spatial accessibility to every single public hospital in remote areas is similar to major cities (2, p. 1). Hot-spot LGAs (Local Government Authorities) are located not only in major cities but also in rural or community-controlled health-service areas.

Comparing the differences between these two reflect that accessibility to such hospitals providing surgery and emergency services seems to be higher in city hospitals as compared to community-controlled. Hot-spot regions having high accessibility to the hospitals supporting surgery and emergency services have primarily been clustered in city hospitals however cold-spot clusters are majorly located in community-controlled areas. Accessibility in terms of traveling time also makes a huge difference in both the types such as 30 minutes to a city hospital and 60 minutes to another one. Community-controlled providers matter little in terms of delivering healthcare at the national level, however, city hospitals offer the dominant share of tertiary and secondary care (3, p.38). Differences can easily be seen in terms of costs, for instance, a city hospital is able for achieving economies of scale, and is more competitive in systems, wherein payment is funded by the outcomes. In terms of quality, there again seems to be a huge difference between these two, for instance, the quality of care in a community-controlled hospital seems to substantially be less as compared to the services provided in a city hospital. Furthermore, community-controlled hospitals are challenged worldwide by the issues with a workforce, they have not only the difficulties while attracting suitably qualified professionals, however, retention is also a problem to them as compared to a city hospital. In addition, there seems to be a natural assumption based on the part of decision and policy-makers that the promise of offering better care in a city hospital, overrides any dismay, which the communities may feel about the closure of a community-controlled hospital. As compared to a patient admitted in city hospitals, a community-controlled healthcare service is beneficial to the patients in an isolated community and remote regions through enabling them for receiving care from specialists or doctors far away without any trouble of traveling to visit them. Remote healthcare systems in the field of telemedicine have been gaining considerable attention because of their significant role in people’s lives (4, p. 1).

Relationship between concepts and case study


A lack of confidence is seen in accessing healthcare early in the period of illness or at all because of indirect or direct racism by the healthcare providers (Textbook, p.34). Since there are different forms of racism thus; in this case, cultural racism is applicable to establish a relationship between this concept and the case study. Since, the ideals, values, and beliefs of the cultural group, to which Tanika belongs, are found to be inferior to the other Australian cultural groups, thus Tanikas decision of getting treated in her local hospital sounds better in terms of her mental wellbeing. Stereotypes involve a belief about the behavior, characteristics, and attributes of a member of a specific group (6, p.135). Thus, Tanika applies this belief regarding a city hospital only to reduce her inherent complexity, which she might face as per her belief in that environment. Tanikas belief about a city hospital is based on the threat of being judged negatively by the city hospital’s doctor as per her social status, ethnicity, and culture. This as a result might report Tanikas experiences of adverse health effects on her delivery. Stereotype threat is considered to contribute to complicating the patient-physician interactions and might evoke disengagement, avoidance, and distrust that could affect follow through with the provider’s recommendations (7, p.140).

Social-Determinants of Health

The health’s social determinants shape aboriginal and Torres Strait Islander’s access to healthcare services and creating a healthcare system, which seems to be responsive enough to their needs. In the case of Tanika, social-determinant could shape her access to those services, which her delivery period seeks, and the community-controlled hospital needs to create such a healthcare system that could meet her needs. Universal access to medical care seems to be one of the social determinants of health, which directs that Tanika can have universal access to the medical care, her current period needs. RLS (Racialized Legal Status) is found to be operating as a social determinant of health including health disparities (8, p. 19). For the community, Tanika belongs to the social determinants of health include a few factors such as participation in various cultural activities, cultural identity, family, and access to traditional lands (9, para. 3). As per the key determinants of Tanikas health inequality in Australia, a few factors that lead her to experience include a lower standard of health infrastructure in her community-controlled hospital and lack of equal access to primary health care. For instance, indigenous people across Australia always experience a socio-economic gap or disadvantage on every single major indicator (9, para. 26).

Culture Safety

Cultural safety aims at reducing the tendency for the healthcare practices, which cause the patients for feeling powerless and unsafe (10, p. 7). Concerning Tanika, cultural safety refers to the experience that Tanika being the recipient of care gains while getting the delivery and healthcare services. This measure of care is clinical safety, which would allow Tanika to feel safe in the healthcare interactions that she might conduct while availing services of a city hospital. While accessing and using the healthcare services, along with treatment by a city healthcare professional, Tanika gets a positive feeling of being culturally safe and fairly treated. Several consistent factors associated with self-discharge in the respective community such as lack of cultural safety including culturally suitable care, racism, loneliness, isolation, miscommunication, and many others (evidence, para. 34). Hence, self-discharge could be a major concern concerning Tanikas case.

Health Literacy

As per WHO (World Health Organization), health literacy or HL refers to the social and cognitive skills that determine the ability and motivation of an individual for gaining access to, understanding, and using information with ways promoting and maintaining good health (11, p. 3). Relating this with Tanikas case, the degree to which Tanika has the capacity for obtaining, processing, and understanding basic healthcare information with services seems to comparatively be less to make suitable health decisions. Lack of HL skills restricts Tanika from taking control of her well-being as she is unable to make smart healthcare choices, as a result, she might suffer real consequences.

Access to healthcare services

Access to these services seems to be a key contributor to wellbeing and health, as it is significantly an influence on the health status of the respective community, provided their overall poor health with a greater need for healthcare as compared to the non-indigenous community (12, para. 1). Concerning Tanika, a few factors come as obstructions to her access to the medical facilities offered by a city hospital, for instance, distance or travelling time (availability), finance (affordability), and her cultural aspects (acceptability) restrict her to access those healthcare services.

Strategies for managing health issues in a culturally safe manner_400

There could be various strategies, which could apply to manage health issues in a culturally safe way, however, among all one effective strategy could be providing cultural safety education to the nurses. This Training or Education promotes culturally safe with respectful practice, which makes the nurses understand that only a single person or/and her/his family could determine whether or not care seems to culturally be respectful and safe. These trained and educated nurses would respect diverse beliefs, cultures, gender-identities, peoples experience, and sexualities, with among team members. Another key strategy to manage the above concern is to create positive, productive, and culturally safe working environment. This strategy could be achieved by role modelling along with supporting the dignity, safety, and rights of every single employee in the work environment along with colleagues and other people. Next strategy is creating a culturally safe medical home. In this home, providers could acknowledge and seem to be sensitive towards the racism, which families and children experience by integrating a family and patient-centred communication strategies and screening tools based on evidence, which could incorporate valid measures of experienced and perceived racism into their clinical practices (13, p. 6). A conventional concept such as CSC (Culturally Safe Care) could also work. It moves beyond approach being culturally-sensitive for explicitly addressing the inequitable power-relations, ongoing effects of current and historical inequities, and discrimination within the healthcare encounters. This strategy seeks the community-controlled centre building self-awareness of the effects of stereotyping, discrimination, and stigma over a patients health and their access to healthcare services (14, p. 641).

Another efficient strategy to achieve the same would be encouraging policies for fostering an interactive learning community, which could further promote cultural humility, for instance, lifelong commitment towards self-evaluation, self-awareness, and commitment towards management of power imbalances. It is also important for providing simulation opportunities for ensuring the new paediatricians are competent enough to delivery culturally suitable with family and patient-centred care. Another strategy is based on developing a welcoming space for the indigenous patients, which could be achieved through displaying art-pieces or acknowledging with participating in National Aboriginal Day. Next strategy is to integrate culturally-driven or appropriate food in menus and providing care, which respects spiritual practices in the absence of culturally-centric spiritual care-services.


After analysing the overall scenario, it can be concluded that Aboriginal and Torres Strait Islander lacks effective delivery of healthcare services, however the above findings reflect that how these services could be improved and easily accessible to this specific community. Apart from it, Tanikas case after analysing from every single concept, it is identified that Tanika needs to access the medical and healthcare services with facilities that a city hospital offers instead of being remained admitted in a community-controlled healthcare service providers.

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