NUM3511 Community Health Care in Nursing and Midwifery Practice Assessment Answer

1. Introduction

A crucial instrument for comprehending the social needs and health status of a particular population is the community health needs assessment (CHNA) (Center for Rural Health, 2023). A key function of the registered nurse in this activity is the process of performing assessments to guide practice (Nursing and Midwifery Board of Australia [NMBA], 2016). In this essay, a rehabilitation/disability support nurse (RDSN) who works with persons with disabilities in Western Australia intends to provide an overview of the assessment's principles and procedures. In order to provide primary healthcare through community partnerships, interdisciplinary practice, health promotion, and cultural safety, the CHNA is essential (Evans‐Agnew et al., 2017). Understanding the current health requirements and concerns in the area is made possible by data collection and analysis (World Health Organization, 2020). These findings are utilised as the foundation for health promotion initiatives, resource distribution, and planning to develop and support a healthy community in cooperation with the community.

2. Health Assessment

In community nursing and midwifery, it is crucial to do a thorough health needs assessment. The foundation for adjusting healthcare services to this population's particular and special demands is this assessment (Potter et al., 2021). A sizeable component of the populace in Western Australia is made up of the target population of individuals with disabilities. Around 18% of Australians are expected to have a handicap, according to data from the Australian Institute of Health and Welfare (AIHW) (AIHW, 2022). This high percentage emphasises how crucial it is to meet this group's healthcare needs in its entirety. In Western Australia, 1,464,421 people (or 5.8% of the population) reported needing assistance with daily activities because of a handicap in 2021 (Id community, 2023). This population group includes people of all ages, including young people with birth defects, individuals with developed disabilities, and elderly with age-related disabilities.

 According to AIHW (2022), approximately 380,000 children with impairments between the ages of 5 and 18 attend primary or secondary school, while 187,000 disabled adults between the ages of 15 and 64 are pursuing non-schooling credentials. Due to Australia's multicultural society, people with disabilities come from a variety of ethnic backgrounds and have their own distinctive cultural beliefs and traditions. Language diversity is another notable feature of the population comprising individuals with disabilities (Kymlica et al., 2020). For instance, according to the Australian Human Rights Commission (AHRC), from 2023, approximately 20% of Australians are multilingual. In addition, Mandarin was the most common language spoken at home in Western Australia, followed by English, with 51,751 speakers, or 1.9% of the total population (Id community, 2023).

3. Social Determinants of Health

3.1 Social and Economic Factors

For many people who have disabilities in Western Australia, income disparity is a stark reality. The depth of this problem is highlighted by the Australian Bureau of Statistics (ABS) statistics from 2018, which shows that the median gross income for Australians with disabilities was much lower at $505 per week compared to $800 per week for individuals without impairments (ABS, 2019). Disability-related economic inequality places people at an economic disadvantage and significantly restricts their ability to pay for critical assistive devices, support services, and healthcare (Cortese et al., 2021).

Additionally, the economic difficulties this community faces are made worse by education inequality. Their capacity to find permanent employment may be hampered by limited access to chances for skills development and high-quality education (Olney et al., 2022). According to the AIHW (2022), around 1 in 10 (or 380,000) Australian school pupils have a disability, and nearly 1 in 18 (5.4% or 206,000) have an extreme or profound handicap. Reduced career options due to lower education levels can keep people insecure about their financial situation (Wilson et al., 2020). This is especially clear from statistics on job rates, which continuously show a low employment rate for people with impairments. In 2018, 53.4% of individuals with disabilities and 84.1% of people with no disabilities were employed, according to ABS (2020).

3.2 Discrimination

Another important social factor that negatively impacts the health of people with disabilities is discrimination. Discrimination can take many different forms, such as discrepancies in healthcare, social exclusion, and employment (Cocks et al., 2020). According to an AIHW survey, 1 in 5 (22%) of people aged 15 and over with disabilities had experienced discrimination of some kind, including disability discrimination, as opposed to 1 in 7 (15%) of people without disabilities (AIHW, 2022). Such discrimination may discourage people from getting essential medical attention, putting off diagnoses and treatments and ultimately negatively impacting their health (Bates et al., 2021).

3.3 Accessibility to Healthcare Services

People with disabilities who live in distant or rural parts of Australia, in particular, experience additional healthcare issues as a result of geographic limitations (Dassah et al., 2018). Furthermore, it is 15 times harder for people with impairments to find unaffordable and inaccessible transportation than it is for people without disabilities. These people may have limited access to specialised medical treatment, rehabilitation services, and assistive technology (WHO, 2023). People with disabilities are almost three times more probable to be denied healthcare, nearly four times more likely to experience poor treatment from healthcare professionals, and over two times as inclined to view the facilities and competence of healthcare providers to be deficient (GWA, 2016).

4. Health Issues

Two prevalent health issues that have a substantial impact on the population of people living with disabilities in Western Australia are chronic health conditions and mental health challenges. Epidemiological data underscores the significance of these health issues within this community, highlighting the need for targeted interventions and support.

4.1 Chronic Health Conditions

When contrasted with the general population, individuals who have disabilities in Western Australia have a higher burden of chronic medical conditions (Walker et al., 2017). Specific chronic illnesses such as diabetes, asthma, angina, hypertension, and congestive heart failure account for 54% of all hospitalisations in Western Australia that could have been avoided (Government of Western Australia [GWA], n.d). Comparative data help to further highlight how serious this problem is. Based on underlying or related causes of mortality, eight prevalent chronic illnesses in Australia are responsible for 61% of disease burden, 37% of hospitalisations, and 87% of fatalities (Australian Government, 2023). According to the WHO, people with disabilities have a twofold increased risk of getting diseases like obesity, diabetes, asthma, depression, and poor dental health (WHO, 2023). These differences highlight the need for focused prevention and management initiatives by showing that the population with disabilities is more likely to develop chronic diseases.

4.2 Mental Health Challenges

Another significant challenge for people with disabilities in Western Australia is mental health issues. Compared to the overall population, this group frequently has a higher prevalence of mental health problems (Glasson et al., 2020). According to AIHW, 71.8% of NDIS members who resided in metropolitan areas in 2020 had a primary psychosocial disability, underscoring the high prevalence of mental health conditions in this population (AIHW, 2023). Social exclusion, stigma, prejudice, and the psychological strain of living with a disability are all factors that contribute to these difficulties (Glasson et al., 2020). Comparative figures from the AIHW highlight how serious the problem is. Compared to persons without disabilities (8.0%), adults with disabilities are significantly more likely (32%) to report high or extremely high degrees of psychological anguish. They are also more likely to report mood and anxiety issues (AIHW, 2022). These figures highlight the critical need for better mental health services and assistance that are specifically targeted to the needs of people with disabilities.

Conclusion

In summary, the community health needs assessment (CHNA) is a critical tool for understanding and meeting the varied healthcare requirements of people with disabilities in Western Australia. The high prevalence of disabilities across age ranges, ethnic origins, and communication skills emphasises the urgent need to customise healthcare treatments for this diverse community. The well-being of people with disabilities in the area is significantly impacted by social determinants of health, such as economic inequality, discrimination, and inadequate access to healthcare. This population has a high prevalence of chronic illnesses and mental health issues, emphasising the importance of support networks and specialised therapies. The use of CHNA data by rehabilitation/disability support nurses (RDSNs) is essential for creating health promotion programs, effectively allocating resources, and engaging in transdisciplinary activities while maintaining cultural safety. We can fight to ensure that people with disabilities in Western Australia have a healthier, more inclusive, and fair future by tackling these issues and developing community partnerships.

References

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