4: Health Flashcards
(11 cards)
The importance of health
The World Health Organisation defines health as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity” (World Health Organisation [WHO], 1948, p.100). Most countries in the world take health very seriously and as a result, health is primary welfare provision. This means that it is a priority for every country. Even in the poorest countries in the world, governments spend money on health. We all need and use health services across our entire life cycle, from birth to death. Health is also considered to be a fundamental right
The medical model of health
Health in most modern Western democracies is dominated by the medical profession/model and has always been the domain of the ‘specialised expert’. Within the medical model the physician focuses primarily on the defect/illness of the patient and addresses using a problem-solving approach. The model is focused on the physical and biological of certain diseases/illnesses/conditions
The biopsychosocial model and social determinants of health
Health is also linked to social aspects and there is much research that demonstrates that health is linked to ‘social determinants’. This refers to the conditions that people are born into, live, grow, work and age. These circumstances are influenced by the conditions that we live in, including the distribution of money, power and resources. Health outcomes are therefore related to:
Levels of education – people with education are more likely to access better health care
Unemployment – lack of job means we are likely to have worse health
Types of work – some occupations, such as mining, carry higher health risks
Religious affiliation – certain religious groups have better health outcomes
Social networks – people with strong connections to others have better health outcomes
Childhood experiences of adversity
Reading: Social Determinants of Health: The Solid Facts by Wilkinson and Marmot (2003)
This influential WHO publication outlines the key social and economic factors that influence health outcomes. Wilkinson and Marmot argue that good health is not only a matter of medical care or personal choices, but largely shaped by social conditions in which people are born, grow, live, work, and age.
Key Social Determinants of Health Identified:
The Social Gradient
Health follows a social gradient: the lower a person’s socioeconomic status, the worse their health.
Reducing inequality improves overall health.
Stress
Chronic stress from difficult life circumstances affects the body’s systems, increasing risk for disease.
Prolonged exposure to stress can lead to physical and mental health issues.
Early Life
A child’s start in life profoundly influences future health, learning, and behavior.
Poor early development due to disadvantage can have lifelong impacts.
Social Exclusion
Poverty, discrimination, and lack of access to services lead to social exclusion, which harms health.
It can result in low self-esteem, isolation, and mental illness.
Work
Safe, secure, and fair employment promotes health.
Job insecurity, poor working conditions, and unemployment are harmful to physical and mental health.
Unemployment
Being unemployed increases the risk of illness, mental health issues, and premature death.
The longer the unemployment, the greater the risk.
Social Support
Strong social networks improve health and buffer against disease.
Support from family, friends, and community is protective.
Addiction
While addiction directly harms health, it often stems from social disadvantage and worsens inequalities.
Tackling root causes is more effective than blaming individuals.
Food
Access to healthy, affordable food is essential.
Poor nutrition is linked to poverty and causes chronic diseases.
Transport
Health is improved by transport systems that promote walking, cycling, and public transit, and reduce car dependency.
Transport design influences access to work, education, and health services.
Overall Message:
Health is shaped by much more than healthcare. The conditions in which people live and work have a greater impact. Policies that reduce social and economic inequality can significantly improve population health.
National Disability Insurance Scheme
Through the National Disability Insurance Scheme Act 2013, the National Disability Insurance Agency was established to fund for universal scheme to provide appropriate levels of lifetime care and support on a no-fault basis for people who have significant and permanent disabilities. The NDIS is jointly governed and funded by the Commonwealth and State and Territory governments. Where the previous models of service provision by States was based on block-funding, that is, funding delivered to service providers to provide a certain quantity of services, the NDIS works with disabled persons to identify the services required and supports them to access services from service providers. In theory, this provides service users with more choice and flexibility, being able to make decisions about where to access services. In reality, choice can still be highly limited and restricted based on the availability of service providers.
Different people have different preferences in terms of language.
The concept of ‘person first’ language would suggest that the phrase “person with a disability” is more humanising, as you put the person before the disability. However, many advocates believe this misses a fundamental truth, that disability is socially constructed. A disability is not something inherent to a person, but a function of societies dis-abling people, i.e. taking away their ability. Advocates propose “disabled person” makes it apparent that the person is being disabled by society. For instance, if a person in a wheelchair faces a set of stairs, is the person disabled by not being able to walk, or by stairs being placed in their way?
A study by Artuso, Cargo, Brown and Daniel (2013) revealed disparity in our health system. The study found that Aboriginal and Torres Strait Islanders do not benefit from mainstream health services to the same extent as other Australians because:
Health services are limited, particularly in remote Aboriginal communities (a lack of transport to receive treatment is problematic)
Poor communication has led to misinterpretation or a lack of understanding
Negative past experiences have led to perceived racism and a general mistrust in the health system
Long wait times deterred patients decisions to use health services
Mainstream health services often lack cultural sensitivity and remain unwelcoming places for many Indigenous peoples (Artuso, Cargo, Brown & Daniel, 2013).
It fails to address other root causes. More than 200 years of dispossession, racism and discrimination have left Indigenous Australians with some of the lowest levels of education, highest levels of unemployment, poorest health and most appalling housing conditions (Australian Medical Association [AMA], 2007).
A 2008 National Aboriginal and Torres Strait Islander Social Survey found that little more than 60% of Aboriginal and Torres Strait Islander persons felt hospitals could be trusted (Central Australian Aboriginal Congress, 2015).
SEIFA (the Socio-Economic Indexes For Areas
A tool widely used in the health policy sector is SEIFA (the Socio-Economic Indexes For Areas), which allows researchers, policy makers and decision makers to understand how relatively ‘disadvantaged’ an area in Australia is compared with other areas in Australia. What is clear from SEIFA data is that there are significant variations between regions (e.g. between Logan and Brisbane).
Australian Health Care System
The Australian health system is a sophisticated public-private and federal-state blend. It’s highly complex and knowing who funds what is not always easy to fathom. We have a mixed model of service provision and accountabilities. Like some other areas of funding, responsibility for health is shared across federal and State governments. The Federal government provides policy framework and the financial basis (the money), and the State governments do the implementing, by running hospitals, community health and other health services.
NDIS - purpose
- 2013, Julia Gillard
- The National Disability Insurance Scheme
Act 2013 (NDIS) - Purpose:
- Universal
- Entitlement
- Appropriate levels of lifetime care
and support - No-fault basis
- People who have significant and
permanent disabilities
NDIS - current
- Current Issues
- Fragment and
underdeveloped markets - Complexity to navigate
- Delays and lack of
transparency about decision
making - Interface between disability and
health
