Cultural Safety and Quality

Descriptor 1: Population Health

Introduction

You will cover the following as part of the Safety and Quality cultural capability:

• Population Health
• Social and cultural determinants

This topic aims to develop students’ knowledge of the current demographic and contemporary health status for Australia’s First Peoples.

Learning Outcomes

Upon the completion of this topic you should be able to identify current demographic, health indicators and statistical trends for Australia’s First Peoples.

Content

What is population health?

Population health refers to all organised measures to prevent disease, promote health and prolong life among the population as a whole (WHO, 2016a). The aim of a population health approach is to provide conditions in which people can be healthy, and focus on entire populations, not individual disease (WHO, 2016a).

Change in health outcomes must involve actions directed at strengthening the skills and capabilities of individuals as well as action directed towards social, environmental and economic conditions, known as determinants of health discussed in topic 2.2 (WHO, 1986).

Descriptor 2: Social and Cultural Determinants

Introduction

This topic introduces students to the concepts of the social and cultural determinants of health.

Learning Outcome

Upon the completion of this topic you should be able to identify, differentiate and compare the strengths and challenges in delivering healthcare with respect to the social and cultural determinants of health.

Content

The social determinants of health are the conditions in which people are born, grow, work, live and age. They are the wider set of forces and systems shaping the conditions of life. These include economic, policies, systems, development agendas, social norms, social policies and political systems (WHO, 2016).

Promoting a Social and Cultural Determinants Approach to Aboriginal and Torres Strait Islander Affairs states that cultural determinants of health "originate from and promote a strength based perspective, acknowledging that stronger connections to culture and country build stronger individual and collective identities, a sense of self-esteem, resilience, and improved outcomes across the social determinants of health including education, economic stability and community safety" (Promoting a Social and Cultural Determinants Approach to Aboriginal and Torres Strait Islander Affairs, Lowitja Institute, 2014, n.p).

The National Aboriginal and Torres Strait Islander Health Plan 2013-2023 was developed by the Council of Australian Governments (COAG). The Plan identifies as crucial, an Australian health system that is free of racism and inequality and all Aboriginal and Torres Strait Islander people have access to health services that are effective, high quality, appropriate and affordable. Together with strategies to address social inequalities and determinants of health, this provides the necessary platform to realise health equality by 2031 (Australian Government. (2013). National Aboriginal and Torres Strait Islander Health Plan 2013-2023 (Canberra: Department of Health).

(Figure Reference: Australian Government. (2013). National Aboriginal and Torres Strait Islander Health Plan 2013-2023. (Canberra: Department of Health).

This image further highlights the importance of the central positioning of culture for First Peoples wellbeing and healthcare practice, linking it to practical applications within service provision. Consider how you may apply these strategies within your own professional practice.

To understand these health disparities requires understanding of the factors and processes outside traditional domains of health. These are the structures of society and social conditions in which people grow, live, work and age (Zubrick et al., 2014).

Descriptor 4: Healthcare Models

Introduction

This descriptor introduces students to the dominant western cultural paradigm of the Australian healthcare system. It develops the students’ ability to understand the characteristics of the mainstream health care system.

Learning Outcome

Upon the completion of this topic you should be able to define Australia's dominant western cultural paradigm and discuss how this influences the contemporary health system.

Content

How we make sense of our values and beliefs about health care comes from various different frameworks of health. Different models of health have informed the way in which medicine and healthcare has evolved.

What is health? Health is defined in several ways. Consider the following definitions of health:

The World Health Organisations’ Model of Health (WHO, 1946): A state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.

First Peoples Model of Health:

“Aboriginal health” means not just the physical well-being of an individual but refers to the social, emotional and cultural well-being of the whole Community in which each individual is able to achieve their full potential as a human being, thereby bringing about the total well-being of their Community. It is a whole-of-life view and includes the cyclical concept of life-death-life (National Aboriginal Health Strategy, 1989).

Social & Emotional Wellbeing:

Social and emotional wellbeing is a multidimensional concept that encapsulates mental health, in addition to connection to country, culture, spirituality, ancestry, family and community. Culture is placed at the centre of this definition of health, and recognises the impact that social, cultural, historical and political determinants of health (Dudgeon et al., 2014).

The Biomedical Model of Health:

This is a narrow view of health concerned only with physical changes to the body. In this view, Western medicine aims to restore balance for the body to function (Taylor & Guerin, 2014).

Health care services that make up the healthcare system in Australia are dominated by tertiary hospitals that largely treat patients at the end stages of disease using principles of Western medicine. What may be the implications of treating patients who share different views of health than the dominant biomedical model?