Different social determinants on health in the Australian context

The health of a person is dependent on a number of factors and many different attributes come together to determine the health conditions of the elderly people all over the planet. A broad range of economic, social, cultural and environmental factors dictate the health conditions that may be experienced by some people and why may they be different from the health conditions of other groups (Mitchell et al., 2017). Biological factors such as genetics also have important roles to play in this aspect. Throughout the life of any person, health is largely affected by the social context within which an individual grows up. Social standards are what that determines inequalities, exposure and decides vulnerability of the individual in different times and conditions. Even though these social contexts are highly influential and interfere with the general well-being of individuals, functional independence and overall quality of life for the elderly, they are most overlooked by interventions and policies that are supposed to help the old aged people to have a better life through social care and support (Mitchell et al., 2017). Older people tend to be more neglected in health policies and other social support facilities more than other people in other different stages of life. This paper takes the case study from the previous assignment on the case study of Tony Watson and discusses how do these social parameters of health and ageing may impact the current situation of the person as well as talk about relevant policies that may help to alter the situation for the betterment of the health conditions of the elderly people (Australia, Winwood & Dollard, 2016).

The holistic term “ageing well” is an umbrella term that is used by researchers and scholars of social conditions and the society in general to encompass positive and constructive views of ageing, health and wellbeing of the older population in the world. Every country has different and specific policies that are aimed towards trying to help the elderly people to have a better life where their dependency on the others can be minimised and they can be helped to live a life as independently as possible (Britton et al., 2016). This term does not only consider people who are “old” per se, rather looks at ageing as a lifelong process for everyone which is absolutely normal for everyone and which cannot be evaded at any cost. Widespread studies and researches have been conducted to understand how do the social parameters affect the different ageing groups and how do different social statures come into play while deciding the magnitude of impact these social parameters have on people from different economic as well as age groups.

The case

Australia is one of the largest countries in the world, with relatively smaller population size of a mere twenty-two million. The majority of the population is concentrated in the bigger cities and the eastern states of the country. The country has a high per capita income and is the twelfth largest economy on the planet (Stasinopoulos et al., 2017). Moreover, the populace of the country enjoys a good life expectancy for both the males and the females. However, depending upon the socio-economic groups stark health inequalities also exist throughout the country. Rural and urban groups, different ethnic groups as well as even within the aboriginal peoples, contrasts relating to the health conditions vary significantly. For example, life expectancy at birth for the aboriginals and the STSI peoples has been measured to be at almost ten years lower than the national rates which have been mentioned above. The health services are provided to the population by the regional governments of the six states and the two territories (Kate-ellen et al., 2015). The provincial governments are responsible for delivering the health benefits to the people with the Commonwealth Government only acting as the exerciser of the terms of the Constitution.

Tony Watson is a seventy-nine-year-old man who is living in a local old age care giving home with his friends and family all living nearby. Tony is utterly upset about the fact that he has to live in such a care giving home and his friends and family not taking care of him in his own home. Despite them visiting him regularly, he is thoroughly convinced about the fact that his own family and friends are neglecting him. Further facts that are making his stay a disturbed one is the fact that he is barred from smoking. All of the conditions are making it increasingly difficult for him to have a peaceful mental condition and he is gradually getting depressed (Barrie, 2017). He is reluctant to cooperate with his care givers and this is increasingly making it difficult to keep him in a good condition (Barrie, 2017).

Even though Tony is otherwise normal and his cognitive activities are in perfect working order, his motor activities are incapacitated because of various health issues and their effects. He is suffering from different chronic diseases, diabetes, obesity, arthritis and emphysema. All of these physical problems have caused him to lose some of his activities and skills and have made further problems out of his already existing issues (Jefferson et al., 2016).

The social determinants of health

This case study is going to form the basis for the current paper which looks into the different problems that are faced by the old age people in the country and the different government policies that pertain into the issue as well as the services and privileges that are given to the elderly.

The social determinants of health are the different social and environmental conditions within which people live and work (Hugo et al., 2016). These include the different parameters as follows:

Social gradient: Throughout the life of any individual, the person’s social an economic conditions affect their health the most. Across the entire society a gradient of health runs encompassing every socio-economic group (Duckett & Willcox, 2015). A visible and profound difference in health can be seen between the most and least disadvantaged of the society. Even within a single social or economic group, differences can be seen in the health of the people: the upper middle populace of the least disadvantaged people are more likely to get better health services than the people who belong to the lower middle class of the least disadvantaged. Disadvantage of a person can come in many forms: it can be both absolute or relative. Absolute disadvantage refers to having no access to education or health benefits whatsoever, whereas, relative disadvantage may occur when a person is given these services but are in relatively poorer standards than what others are getting. At every critical juncture of life, the decisions and the outcomes of the situations may put a person in a more advantageous or disadvantageous condition, that may affect the entire health conditions that the person is liable to receive. The people who are in a more disadvantaged condition in the past have a higher risk in every subsequent transition (Perrin, 2013). The cumulative effects of these decisions and the outcomes tend to be passed down from generation to generation and can long lasting impacts on the person, as well as their families and the society as a whole. In the current paper, the case study goes on to show that the social gradient is a very important factor and Tony is being influenced heavily by the same. The social status of his family may be either an obstacle in providing him with the services at his own home or his family may be reluctant or unable to do so. Whatever is the case, his mental health is highly impacting his physical health and this may be related to his and his family’s social stature.

Stress: One of the most important and significant impactors on a person’s health is the mental condition of the person. This mental condition can be severely affected by the stress level that the person is experiencing at that particular point of time. By this logic the health conditions of a person may change and go through alternative phases, despite no change in the social or economic class of the same person (Keshavarz Moahmmadi, 2017). Too much of stress can become the cause of premature death of a person as well. Stressors can be of different nature and may include various aspects such as continuous anxiety issues, social isolation, a sense of no control over professional or personal life of the person, insecurities and many other similar natured issues. These stressors do not only affect the mental condition of people, but also significantly contributes to the deterioration of the physical health of a person. Even though in the short run, these may not become much of a problem, in the short run these can create long lasting and deep impacts. Infections, obesity and diabetes are only some of the problems that may be caused by these mental stressors in the long run. Depression is another serious matter that can constitute immense problems for a person (Perrin, 2013). While these problems are more apparent in the industrialised countries, the groups that are more prone to these issues are the people who live in the lower levels of the social hierarchy. Tony is incredibly stressed about the fact that he has to live alone in the old age care home and not his own house. His mental stress is clearly reflecting on his physical health: the mental pressure that he is going through is causing his health to deteriorate further.

Early life: It is a common knowledge that a person’s early life and childhood almost always form the paths that they will be taking later in their lives and these early conditions are the prime determinants of the health care that they are liable to receive. During the phase of physical development, acute health services are absolutely necessary and the failure to receive this may result in poorer health conditions throughout their entire lives. This may also result in poorer cognitive health and emotional functioning as well and also poses a serious threat to the emotional health of a person (Braveman & Gottlieb, 2014). Even poorer health services received by a mother during the critical stage of pregnancy may severely affect the health conditions of the child and can very well give birth to a baby with permanent health or mental conditions or, in many cases, both. Foetal development itself is hindered if the mother does not live a healthy lifestyle during pregnancy.

Social inclusion or exclusion: Health and other mental conditions are often most seriously affected by poverty and the economic status of a person. The social perception on a person almost always is associated with the financial conditions of a person and despite these being mutually exclusive in many cases, sometimes they are correlated beyond simplistic terms. Poverty often denies a person to avail the full privileges of the society and also restricts the person from full participation in the community. Homeless people have the highest possibilities of premature death around the planet. Racism, sexism, stereotyping, discrimination based on cast, creed, religion, stigmatisation and other issues stemming from such inhibitions can give birth to high rates of social exclusion (Badland et al., 2014). Social exclusion can also cause both economic, physical and mental stress and may result in widespread poverty among specific groups of people. The more time that a person spends in a disadvantageous position, the higher the risks of being economically downtrodden in the society and in turn, even more socially secluded compared to others who have had a better life. This also means poorer health conditions and a worse off social status for most. Even though people move in and out of poverty throughout their lives, or at least faces economic hardships from time to time, the people who have gone through more prolonged periods of social exclusion before are observed to be more affected by the same in the current situation and context (Badland et al., 2014). Tony feels that he is excluded by his own family members and also perhaps the society as well. This feeling is creating a problem for Tony to have mental peace.

Education: Education is the parameter that is perhaps the most significant in term of providing a person with the capabilities to alter the conditions within which she or he was born in. Poorer education is much less effective when it comes to providing the person with the necessary tools to alter their current conditions.

Social support: The social support a person receives from the community can act as a saviour in many cases. The community is an inter-laced web that is made up with every entity within the society. Every person within the society is liable for some basic support from the society and these supports are essential for the survival of the people. These support provide for the necessary health and mental benefits of a person. Societies that have higher rates of economic disparity tend to have more social crimes and poorer social cohesion (Marmot & Allen, 2014). The social support that Tony is receiving is provided to him by the care givers and the staff at the care centre. However, he feels that his own family is not supporting him and is making him stay alone. This may well be one of the major factors for the degradation in Tony’s health.

Income: Having enough money in hand can significantly impact the ageing process as well as the quality of life during old age. Almost all the other determinants of health are determinant on this aspect and not having enough disposable income in hand can cause severe problems. However, after a certain point, there are no significant correlation between increased income and increased health of a person. Even so, with higher socio-economic status, the possibilities of a better health also increase.

Transport: Mode of transport can be a very important determinant of a person’s health. Traveling by using cycles, walking and higher use of public transportation helps a person to be in a better shape and health than those who are mostly reliant on private cars and rarely go about using any other mode of transport.

Housing: Having a secured place to live has a huge mental significance and contributes massively on the well-being of a person. If a person does not have a proper place to live. It can lead to serious anxiety, depression and other mental problems that may also adversely affect the physical health of the person.

The response of the health system to the people in need: The health services that are provided by the government is vital to make sure that every person within the society are getting the health benefits that they are liable to get. Every health practitioner has the social responsibility to look after the people who are in need of physical and mental health problems (World Health Organization, 2014). The Australian Medical Association can make the greatest impacts in terms of providing health support to the people who are subjected to receive them.

Along with these factors, physical and mental disabilities, disposable income, food and nutrition are also important factors that all have significant roles to play in the health services that are given by the government or various private health service providers.

The global population is getting older and it is happening when the environment is being most affected by the actions of the humans. This impact on the environment is currently happening at a scale that has never been experienced by the planet ever before in the history of the planet. Critical ecological limits are almost met5 and exceeding further. The elderly people are the most vulnerable to these changes as their physical immunity systems are on a downward trend and this makes them more susceptible to different diseases that can be fatal in nature (Braveman & Gottlieb, 2014). The agenda of sustainable development is the only thing that can make sure that the old aged people are not harmed so much by this change in the environment and this has to be made sure by the government that the different policies are amended in such a way that does not have negative impacts on the people living in the societies. Some groups are more vulnerable to these changes more than others.

In order to properly understand the case of Tony Watson, several of aforementioned points can be related to his case and help to fathom the case that he is suffering from.

Tony is obviously much stressed about the fact that he has to live a care giving home rather than with his own family at his own home. This can be a serious factor that can have much impact on the mental health of Tony. The long standing mental issues that he is facing can in turn make his physical well-being problem and it is of fair knowledge by now that mental health and physical well-being are deeply connected to each other (McLachlan, 2013). His mental pressure is gradually becoming more severe and this is affecting his already problematic motor skills. The fact that he is dependent on others for even the most normal daily chores may also have adverse effects on his mentality and make it an issue for his poor conditions. Even if he is being given all the care that is possible to provide him by the care givers, his own mental blockade can be a hindrance and not yield any significant positive outcomes (Nakanishi & Nakashima, 2014).

The gender of the patients can also play a dubious role in the recovery process of a person. Historically, males have been viewed as the providers of the family and the sole earning members of the society. Coming down from that status and being dependent on others may also be a very significant point that can have long lasting effects on Tony’s psyche. A lot of social support is provided to the males based on their roles in the family and by this theory it may be speculated that Tony’s family may have lower respect for him than previously. This may be potentially destructive for the self-respect a person has and in turn also affect their physical well-being (Gao et al., 2014). Being physically inactive also has importance for the current mental condition on Tony. Addiction to so0mething in many cases act as the only possible way out of the depression for a person, and in this case the fact that he is barred from smoking may be one of the biggest obstacles for Tony to get out of the depressive state of being where he is now (Britton et al., 2016).

The Australian government has various policies that are aimed at solely trying to make sure that the old age people are not subjected to any so9rt of traumatising experiences and are ensured the mental and physical health that they are supposed to have. These policies are formulated based on careful research and analysis of the socio-economic structure of the Australian society so that no one is left and the governmental support is the most vital input in this attempts to ensure public health across all the groups, irrespective of any background of the person.

CDRC program: The National Respite for Carers Program funds the Consumer Directed Respite Care (CDRC). These are packaged care giving programs which are aimed to provide the elderly with all-round and inclusive care that are likely to provide them with any sort of requirements they may have, both physical and emotional. The Australian government funds a few selected Commonwealth Respite and Carelink Centres which provide the CDRC packages across the country, and this is among the many initiatives by the Australian government that are designed to provide assistance to the family and relatives of the patients so that they can be cared for by their own family at the shelter of their own homes. Technically this is one of the best possible initiatives by the government and the case of Tony Watson can be greatly benefited by this policy. Residential respite care, emergency respite services are all provided by these centres that enables patients to be treated in the comfort if their own home and not in any foreign environment. where they may feel alienated

ACSA: The ACSA (Aged and Community Services Australia) is another government policy that is aimed to give the aged population of the country the best possible healthcare services possible. The ACSA also provides home care services and other amnesties that can be of great help for both the patients as well as their friends and family. Most of the organisations that provide these services are not-for-profit in nature and are supposed to be a method to make sure that the aged people are not excluded from the society. Rather, these services are focused to make sure that the maximum social inclusion is achieved and the old people are not left alone in a state of severe and acute depression.

Commonwealth Continuity of Support (CoS): This program of the Australian government ensures that the aged people with disabilities, who are currently receiving state and regional disability services keep receiving these services. However, it must be remembered that a person is liable for this program only if the patients is not eligible for National Disability Insurance Scheme (NDIS).

Information resources: When purchasing any product or services, it is vital to possess every bit of knowledge about the commodity (Nichols, Horner & Fyfe, 2015). With this in mind, the Australian government tries to formulate policies that can give the patients and their families the best information about the country’s healthcare facilities that are given by the government (Wakerman et al., 2017). With this knowledge, the best possible actions can be taken by the families of the patients that is the most beneficial for both the patient as well as their families.

Conclusion

From the above discussion, it can be concluded that the Australian government’s health service policies are well aware about the social exclusion that the elderly people face every day and are also active in making sure that these issues are dealt with in the best possible manner. The case of Tony Watson goes on to show that it is not only physical conditions of the patient that need to be kept under check, but the mental well-being is just as important. However good attention may be given to the patients, if they are not in a good mental condition, it can be immensely problematic to make them recover from their current state, rather it may well be the case that the mental issues can heighten the physical problems. Tony’s family members can also look into these care programs and government policies to understand what can the best option to make him feel good and yet ensuring his health is in good condition. His family members should put some effort into ensuring the mental well-being of Tony along with trying to help his physical health.

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