PUBH6000: Public Health Program - Assessment Answer

Key Social Determinants and Health Inequalities

Housing: Housing plays an important role in affecting the health and well-being of the elderly in Australia. It acts as a contributing factor with respect to the security associated with mental and emotional well-being. Poor conditions of housing such as dampness, and overcrowding can result in allergies and respiratory problems in the elderly. For instance, 18,600 elderly people who were 55 and older were homeless, according to the 2016 census. 13,600 elderly individuals who were in substandard alternatives for accommodations (such as trailer parks and congested or unfinished buildings) were also at risk of becoming homeless.(Australian Institute of Health and Welfare, 2022).

Family Relationship: Due to the aging Australian population, families are facing an increased number of issues related to elderly relatives such as care, medical facilities and other life decisions. This can lead to conflict which can result in abuse or violence faced by the elderly. In addition to this, disabilities or illnesses related to ageing can be the cause of physical, financial and mental burdens coupled with other chronic health issues. According to a study, 24% of elderly clients reported family violence to be a presenting issue followed by mental health issues (22%) and loss and grief caused due to the death of loved ones.(8%) (Australian Institute of Family Studies, 2019).

Access to health services: It has been discovered that older persons from lower socioeconomic origins, including those who reside in rural and isolated places, have less access to healthcare.This can lead to stress and anxiety among the elderly. In addition, this can also lead to delayed diagnosis and treatment and a lack of access to medications which can result in worsened health outcomes (van Gaans & Dent, 2018). For instance, the lowest rates (25%) were recorded by those in the lowest income quintile, according to the Australian Bureau of Statistics (ABS), which found that in 2017–18, almost 15% of Australians 65 and older reported delaying or forgoing a necessary visit to a GP owing to cost (Australian Bureau of Statistics, 2018).

Recommendation for Public Health Intervention

Firstly, to improve housing conditions, there should be improvements with respect to the quality of housing for the elderly. This can consist of an increase in access to housing that is affordable, in addition to home modifications suiting the specific needs and concerns of elderly individuals, especially the ones with any kind of disabilities. in addition to this, providing resources associated with the maintenance and repair of homes is also necessary. Elderly people who are homeless should be provided with access to emergency shelters and assistance related to subsequent housing for the long term (Ige et al., 2019). For instance, the Commonwealth Home Support Program (CHSP) implemented by the Australian government aims at providing support services to the elderly which can enable them to lead an independent life in their homes. The CHSP encompasses a wide range of services such as transport, personal care, domestic assistance and social support. Additionally, this programme addresses social determinants of health and assists seniors in maintaining housing and social ties in addition to providing additional support for accessing healthcare services (Department of Health and Aged Care, 2023).

In order to address the health disparities linked to family connections, it is crucial to promote family interactions. For this, efforts should be made for establishing connections and maintain social support networks for the elderly. This can consist of providing support from caregivers, promoting living arrangements with an intergenerational approach, and increasing access to volunteer programs and senior centres (Ten Bruggencate et al., 2018). One such program is the Brotherhood of St Laurence's Elder Care Program (BSLECP) which works towards the improvement of family relationships for the maintenance of the health and well-being of the elderly in Australia.This program provides elderly people with a variety of services that deal with counselling, building social connections and providing home support and help to make sure that elderly individuals remain independent for the longest time possible. The BSLECP also takes into consideration the role family members play in the care given to the elderly. The concerned families are provided with resources and assistance which enable them to comprehend the complexities related to the care of the elderly care (Brotherhood of St Laurence, 2023).

Last but not least, comes the issue of access to healthcare services, which requires efforts towards increasing access to services associated with healthcare that are culturally competent and affordable, for elderly people. this could consist increase in funding related to healthcare infrastructure, an expansion in coverage of insurance, and making investments in telehealth and other innovative models of delivery. In addition to this, services related to transportation should also be expanded to ensure increased accessibility of the elderly to healthcare services (White et., 2019). An example of such a program in Australia is the Hospital in the Home (HITH) program. It is a program that provides care similar to that of a hospital and involves nursing and medical care to elderly people in their homes, instead of a hospital setting. The HITH program aims at acting as an alternative to hospitalisation for those elderly individuals who cannot afford it or might have issues related to accessibility. It provides services such as review and assessment, management of medication, nursing care and services involved in rehabilitation. Moreover, trained healthcare professionals are available for patients who ensure that the patients get the care and support tailored to specific needs and concerns, in their homes (Department of Health, 2023).

Potential Stakeholders

Firstly, local governments and government agencies play an important role with respect to health interventions as far as the development of policies and their implementation are concerned. They can assist with the arrangement of funds and allocation of resources that can be used to

support health interventions. In addition to this, they can also collaborate with other stakeholders for the development of strategies and provide different community-based interventions and support in the form of health centres or outreach programs (Trezona et al., 2018).

In Australia, the Department of Social Services (DSS), the Department of Veterans' Affairs (DVA), the Departments of Health and Industry, as well as state and territorial governments, are the primary funders of aged care. Making sure older persons are healthy and have access to their needs for daily living is their top priority (Burgess et al., 2018).

Secondly, public agencies also function as important stakeholders as they help in the identification of local health issues, along with providing feedback and supporting the delivery of interventions which can be crucial while designing and implementing the interventions. The primary objectives of these organisations are to track, assess, and report on the efficacy of reform implementation in the elderly care sector. The goal of their design is to increase standards of care while reducing complaints.

For instance, in Australia, the organisations are the Aged Care Commissioner, the Aged Care Reform Implementation Council, the Aged Care Financing Authority, the Aged Care Pricing Commissioner, the Aged Care Gateway, and the Australian Aged Care Quality Agency (AGQA). For instance, the ACPC's main responsibility is to approve proposed payments for housing and additional service fees that exceed the amounts specified by the Minister, as well as any other pricing-related functions that the Minister may issue (Burgess et al., 2018).

The third important stakeholders are not-for-profit organisations which are essential with respect to the education and advocacy associated with interventions related to healthcare. They also play a salient role in funding and providing resources that can support health interventions and provide information and education to the elderly (Lavoie et al., 2018). Usually, non-profit organisations, offer services to the entire market. advocacy organisations including the Council on the Ageing (COTA), the National Aged Care Organisations that advocate for consumers, providers, unions, etc other service providers, like Baptistcare and Anglicare, all work to maintain the highest quality of Australia's ageing population practises.

There are more entities involved in the elderly care sector, such as Health Workforce Australia (HWA), a Commonwealth body that implements a national strategy for reforming the health workforce (HWA, 2015). HWA regularly publishes data and information about the welfare of the Australian elderly community. Finally, age discrimination equity problems are addressed by the Age Discrimination Commissioner at the Human Rights and Equal Opportunity Commission (Burgess et al., 2018).

Conclusion

To conclude, the following report shed light on the association between the identified social determinants of health and health inequalities existing among the elderly population in Australia. This was followed by recommendations regarding approaches and strategies which can be followed and implemented for addressing the determinants and the associated healthcare inequality. Current programs and initiatives such as HITH and CHSP programs were also explored which are currently functional in Australia to deal with healthcare and housing-associated problems in the elderly. The last segment discussed the role of different stakeholders in addressing issues related to healthcare inequalities and how they can play an effective role in providing quality care with respect to the physical, mental and emotional health of the elderly in Australia.

References

(At least 10 references, APA 7th)

Australian Bureau of Statistics. (2018). Patient experiences in Australia: summary of findings. https://www.abs.gov.au/statistics/health/health-conditions-and-risks/patient-experiences-australia-summary-findings/latest-release

Australian Institute of Family Studies. (2019). Assisting families with ageing-related relationship issues. https://aifs.gov.au/resources/short-articles/assisting-families-ageing-related-relationship-issues

Australian Institute of Health and Welfare. (2022). Older Australians. https://www.aihw.gov.au/reports/older-people/older-australians/contents/housing-and-living-arrangements

Brotherhood of St Laurence. (2023). Aged care services. https://www.bsl.org.au/services/aged-care/

Burgess, J., Connell, J., Nankervis, A., Dhakal, S., & Fitzgerald, S. (2018). Developing sustainable career pathways for aged care workers: a WA case study (No. BCEC Research Report No. 13/18). Bankwest Curtin Economics Centre. https://espace.curtin.edu.au/bitstream/handle/20.500.11937/75210/75452.pdf?sequence=2

Department of Health. (2023). Hospital in the home. https://www.health.vic.gov.au/patient-care/hospital-in-the-home

Department of Health and Aged Care. (2023). Commonwealth home support programme (CHSP). https://www.health.gov.au/our-work/commonwealth-home-support-programme-chsp

Feo, R., Urry, K., Conroy, T., & Kitson, A. L. (2023). Why reducing avoidable hospital readmissions is a ‘wicked’problem for leaders: A qualitative exploration of nursing and allied health perceptions. Journal of Advanced Nursing, 79(3), 1031-1043. https://doi.org/10.1111/jan.15220

Ige, J., Pilkington, P., Orme, J., Williams, B., Prestwood, E., Black, D., & Scally, G. (2019). The relationship between buildings and health: A systematic review. Journal of Public Health, 41(2), e121-e132. https://doi.org/10.1093/pubmed/fdy138

Lavoie, J. G., Varcoe, C., Wathen, C. N., Ford-Gilboe, M., & Browne, A. J. (2018). Sentinels of inequity: Examining policy requirements for equity-oriented primary healthcare. BMC Health Services Research, 18(1), 1-12. https://doi.org/10.1186/s12913-018-3501-3

Ten Bruggencate, T. I. N. A., Luijkx, K. G., & Sturm, J. (2018). Social needs of older people: A systematic literature review. Ageing & Society, 38(9), 1745-1770. https://doi.org/10.1017/S0144686X17000150

Trezona, A., Rowlands, G., & Nutbeam, D. (2018). Progress in implementing national policies and strategies for health literacy—what have we learned so far?. International Journal of Environmental Research and Public Health, 15(7), 1554. https://doi.org/10.3390/ijerph15071554

van Gaans, D., & Dent, E. (2018). Issues of accessibility to health services by older Australians: A review. Public Health Reviews, 39(1), 1-16. https://doi.org/10.1186/s40985-018-0097-4

White, J., Plompen, T., Tao, L., Micallef, E., & Haines, T. (2019). What is needed in culturally competent healthcare systems? A qualitative exploration of culturally diverse patients and professional interpreters in an Australian healthcare setting. BMC Public Health, 19, 1-8. https://doi.org/10.1186/s12889-019-7378-9

World Health Organisation. (2023). Social determinants of health. https://www.who.int/health-topics/social-determinants-of-health#tab=tab_

Learning Journal: Compulsory Task of This Assessment

Use the table below to present key information/data/ideas of at least 4 references from your reference list. Present what you have learnt from developing this assessment, please present in a succinct form (see example below).

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