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Social Justice and the Social Determinants of Health

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Shima Adroub

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Transcript of Social Justice and the Social Determinants of Health

by Laura, Helena, Katie,
Alexandra, Shima ~ ... The Effectiveness of
fundamental Services The Social determinants of Health Indigenous people have not had equal opportunities to be as healthy as non-indigenous people.

Lack of mainstream servicesand lower access to health services and primary health care.

This is barrier to the full enjoyment of the right to health for indigenous people.

Poverty is clearly associated with poor health.

Systemic Discrimination Close the Gap References
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Caldwell, J. C. 1993, ‘Health transition: The cultural, social and behavioural determinants of health in the Third
World’, Social Science and Medicine, vol. 36, no. 2, pp. 125–35.

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pp. 29–32.
Social Justice and the Social Determinants of Health Overview:

Introduction, Social Determinants.

Indigenous Health Policy and Practice

Provision of Effective Health Services

The Effectiveness of fundamental Services

Indigenous people and the future 2005 - The Social Justice Report 2005 was released by HREOC in February. This report examined the implementation of the new whole-of-government approach Indigenous administration, noting that some developments had emerged but there were some under-addressed gaps in policy, co-ordination and representation.

2006 - COAG met in mid-July and discussed many Indigenous issues, agreeing to establish a working group to develop a detailed plan for practical reform reflecting the diversity of circumstances in Indigenous communities across Australia.

2007 - In April, Oxfam released its report, Close the gap: solutions to the Indigenous health crisis facing Australia, that outlined the disparities of life expectancies between Indigenous and non-Indigenous people in Australia, and also compared health of Indigenous people in Australia, New Zealand, Canada, and the United States of America. The Close The Gap campaign, comprised 40 of Australia’s leading Indigenous and non-Indigenous health organisations, was launched on 4 April

2008 - At COAG’s December meeting, the members committed to closing the difference in life expectancy within a generation, and reducing the mortality gap of children under five, as well as the gap in reading, writing, and numeracy, by half within a decade.

2008 - The Close the Gap coalition presented the Federal Government and Opposition with a set of National Indigenous Health Equality Targets in July. The targets aimed to address the 17-year gap in life expectancy between Indigenous and non-Indigenous Australians.

Indigenous people
and the future Social Justice and the Social
Determinants of Health By: Zaliana, Shima, Neville,
Hue, Ruby References

The Miscommunication Gap, between health professionals and indegenous australians. This could result in bad diagnostic accuracy and basic quality of care. Aboriginal people could have troubles describing their signs and symptoms effectively, asking questions and talking about fear and anxieties lead to further distress

Access to medical services and education.

The Social Determinants of health that prevent provision of affecive heath care to indegenous people are the age of an individual can sometimes determin wherther that individual can be treated or not, where grow up, live, work and age, including the health system. What needs to
be done to Improve health outsomes:? Cannon, R. (2008). The Social determinants of health.

Anderson, P., & Wild, R. (2007). The “Little children are Sacred” report, 83-164.

Swerissen, H. (2007). Understanding the sustainability of health, 7-9.

Fogarty, G., & White, C. (1994). Differences between values of Aboriginal and non-Aboriginal students. Journal of cross cultural psychology, 25(3), 394-408.

Coorey, L. (2001). Child sexual abuse in rural and remote Australian Indigenous communities.

Kenway, P., Palmer, G., & Rahman, M. (2002). Monitoring poverty and social exclusion.

New South Wales interagency plan to tackle child sexual abuse in Aboriginal Communities. (2006).

Yingiya, G. (2008). Retrieved from: http://www.creativespirits.info/aboriginal

Marmot, M., & Wilkinson, R. (2003). The Solid Fact.

Australian Indigenous HealthInfoNet (2008). Major developments in national Indigenous health policy since 1967. Retrieved 27 August 2010 from http://www.healthinfonet.ecu.edu.au/html/html_programs/programs_policy/programs_policies_timelines.htm

Lloyd J (2008) How is Aboriginal health policy implemented? Doctor of Philosophy in Medicine thesis, Menzies School of Health Research, Darwin, University of Sydney, Sydney, New South Wales.

Council of Australian Govt http://www.coag.gov.au/coag_meeting_outcomes/2009-07 02/docs/NIS closing thegap.pdf - 334k - [ pdf ]

Australian Human Rights Commission (2006) Retrieved 31 August, 2010 from http://www.hreoc.gov.au/about/media/speeches/social_justice/2007/social_determinants_n_the_health_of_indig_peoples.html

Australia's Indigenous Population (2001) Retrieved 1 September, 2010 from

Close the Gap (2008) Retrieved 31 August, 2010 from

Carson, B, Dunbar, T., Chenhall, R.D and Bailie,R.(Eds.)(2007) Social Determinants of Indigenous Health. Crows Nest, NSW: Allen & Unwin

The social determinants of health range from the macrosocial to the individual, and impact upon population differently throughout the life course.

Racism occurs through a social system in which are divided into "races" with power unevenly distributed occordingly to these racial classifications.

The concept of social class and its relationship to population health outcomes is also a questionable one in explaining Indigenous health outcomes.

Education is a main role to change Indigenous people's health outcome.

Indigenous welfare has direct and broader dimensions that intersect with Indigenous people's health. All dimension have a place in understanding the social determinants of Indigenous health.

Human rights discourse has been suggested as a framework for arguing that the Australian Government has a legal obligation to take steps to improve health outcomes for Indigenous Australia. True Or False What are the Social
Determinants of health? Aboriginal Health Policy at a Federal, State and Local Level 1967 - Constitutional Amendment gave power for the Commonwealth to legislate for Aboriginals and include them in the census.

1971 - The first Aboriginal Medical Service (AMS) was initiated on a voluntary basis in Redfern, Sydney

1973 - The Commonwealth Government made a formal offer to the State Ministers to assume from them full responsibility for Indigenous affairs policy and planning.

1976 - The Commonwealth asked the House of Representatives Standing Committee on Aboriginal Affairs (HRSCAA) to conduct a review of Aboriginal health.

Federal Timelines 1992 - The National Commitment to Improved Outcomes for Aboriginal and Torres Strait Islander People was endorsed, providing a framework for bilateral agreements between the Commonwealth and State/Territory governments to improve programs and services for Indigenous people.

1994 - A high-level Evaluation Committee appointed by the Commonwealth Ministers for Health and Aboriginal Affairs noted that the National Aboriginal Health Strategy had never been effectively implemented and that all governments had grossly under-funded initiatives in remote and rural areas.

1995 -Health Ministers agreed to a process for the development of multilateral framework agreements with States and Territories. The Framework Agreements provided for the establishment of consultative national and State/Territory forums to provide policy and planning advice on Indigenous health issues

1997 - A set of National Aboriginal and Torres Strait Islander Health Performance Indicators and Targets were endorsed by all Health Ministers.

2001 - The National Aboriginal and Torres Strait Islander Health Council released for discussion the draft National Aboriginal and Torres Strait Islander Health Strategy
Federal Timelines Federal Timelines 2002 - In April, the Council of Australian Governments (COAG) agreed to commission the Steering Committee for the Review of Commonwealth/State Service Provision (SCRCSSP) to produce a regular report to COAG against key indicators of Indigenous disadvantage.

2004 - In early 2004, the Australian Government announced the introduction of significant changes to the way policies, programs and services were developed and delivered to Indigenous people and communities. Responsibility for the delivery of all Indigenous-specific programs was transferred to mainstream agencies and a ‘whole-of-government’ approach adopted.

2004 - The Aboriginal and Torres Strait Islander Commission (ATSIC) and its service delivery arm, the Aboriginal and Torres Strait Islander Services (ATSIS), were subsequently abolished.

2004 - 1 July 2004, the new governmental changes regarding the “whole-of-government” approach to Indigenous affairs at a Federal level began being implemented.The Australian Medial Association (AMA) released the Indigenous health workforce needs report in July, outlining the need to expand the Indigenous health workforce and improve the provision of health services to Indigenous people.

Federal Timelines COAG Targets

To close the gap in life expectancy within a generation

To halve mortality rates for Indigenous children under 5 within a decade

To ensure all Indigenous 4 year olds in remote communities have access to early childhood education within 5 years

To halve the gap in reading, writing and numeracy achievements for Indigenous children within a decade

To halve the gap in Indigenous students in year 12 equivalent attainment by 2020

To halve the gap in employment outcomes between Indigenous and non- Indigenous Australians within a decade.
Closing The Gap COAG Building Blocks

Early childhood



Economic participation

Healthy homes

Safe communities

Governance and leadership
Closing The Gap Closing The Gap
•Recent government statistics counted approximately 400,000 aboriginal people

•2% of Australia's total population.
Population of Aboriginals people in Australia
The health status of Aboriginals people is poor in comparison to the rest of the Australian population.

Aboriginal peoples do not have an equal opportunity to be as healthy as non-Aboriginal Australians.

There has been very little progress in reducing this inequality gap between Aboriginal and non-Aboriginal s Australians over the past decade.
Aboriginal health in Australia
Life of opportunity and dignity

Free from discrimination and disadvantage

A basic human right,one that we all share in common.
What is Social Justice? Recognising the distinctive rights that Indigenous Australians hold as the original peoples of this land, including:

The right to a distinct status and culture
The right to self-determination
The right to land

Self determination is an ‘on going process of choice’ to ensure that Indigenous communities are able to meet their social, cultural and economic needs.

Simple acknowledgment that Indigenous peoples are Australia’s first people

Have that right respected by others

What is self determinant?

The link between health status and socio-economic status/poverty

Relation between perceptions of control and chronic stress

Evidence of the health impact of Indigenous community control of health services

Traditional ownership of land and health status

Social determinants as a contemporary reflection of historical treatment

Recognising social determinants as a contemporary reflection of the impact of colonisation – international developments
Social determinants of Indigenous health in Australia Close the Gap

What is Close the Gap?

It is a campaign calls on federal, state and territory governments to commit to closing the life expectancy gap between Indigenous and non-Indigenous Australians within a generation. Education



Land right
The current situation of
indigenous people Education High rate school leaver

New South Wales education policy 1982

Have improvement, but compared with non-aboriginal it is still low
Employment CDEP employment policy

Low indigenous employment
Housing Most of aboriginal people still live in poor housing condition

The reason that result in housing failure

The government’s policy to improve housing standard
Australian government land right program

the positive effect on aboriginal land right ownership
Land rights The factors that lead to social
determinants of health The lack of education leads to unemployment in Aboriginal communities.

Low income which leads to poor nutrition and cause lot of diseases such as diabetes, obese, high blood pressure.

Smoking tobacco leads to heart diseases, lung cancer, strokes.
Reduced or unequal access to employment, adequate housing, education, medical care, social support and social participation.

Negative emotional reactions that contribute to stress and mental ill health. This also adversely impacts upon the endocrine and cardiovascular systems.

Use of substances such as tobacco, alcohol and other drugs

Physical manifestations of racism such as physical assault, intimidation
Racism, Discrimination and Culture Attempt to close the life expectancy gap of indigenous and non-indigenous australians.

On average aboriginal people have a life expectancy that is 17 years less than that of non-Indigenous Australians.

Request to Australian government to make sure that Indigenous citizens have equal access to health services.

Deal with the other social determinants of health such as housing, education and social justice.

The campaign is a combination of more than 40 non-government development, community and health organisations and is supported by tens of thousands of Australians

Health Services There are a wide range of health services dedicated to the health problems and issues of Indigenous Australians over 50, which can be accessed through a number of programs and organisations including:

•Primary Health Care Access Program

•Sharing Health Care Initiative

•Aboriginal Community Controlled Health Services

•Australian Indigenous Health Info Net

•Indigenous Portal

While there have been improvements on some measures of Aboriginal health status, they have not matched the rapid health gains made in the general population in Australia.

The young age structure of the Aboriginal population means that the scope of the issues currently being faced is expected to increase in the coming decades.

The inequality in health status experienced by Aboriginals peoples is linked to systemic discrimination. 1980 - The Aboriginal Development Commission was established. One of its primary functions was to provide advice to the Minister for Aboriginal Affairs on matters pertaining to Indigenous social and economic development.

1987 - A meeting of Commonwealth, State and Territory Health and Aboriginal Affairs Ministers led to the formation of a Joint Ministerial Forum on Indigenous health and the appointment of a National Aboriginal Health Strategy Working Party (NAHSWP).

1990 - The Aboriginal and Torres Strait Islander Commission (ATSIC) was established, replacing the DAA and the Aboriginal Development Commission, and assumed national responsibility for Indigenous health Provision of Effective Health
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