INTERVENTIONS ESSAY

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INTERVENTIONS ESSAY

DIABETES TYPE II AMONG ABORIGINAL COMMUNITY

SUMMARY

Diabetes type II is a health issues that have been considered to present most risks to the Aboriginal community. The probability of risks is determined by the social factors as well as the genetic factors. However, the genetic factor in most studies is not emphasized on, therefore implicating the risks towards the social determinants. The social determinants are the issues related to individual behaviors prompting more risks with regards to chronic diseases. Aboriginal community has been linked to lifestyles that contribute to more risks with reference to eating habits changes. This is further compared to the earlier traditions of maintaining health diets coupled with customary activities such as food gathering in hunting expeditions.

Various factors have been aligned to maintenance of preventive and promotion initiatives among the aboriginal community. This is specifically aligned to the strategies used to reach out to diabetic patients and those at risk especially the Aboriginal group. However, the Aborigine community has been alienated from adequate health initiatives implicating on the effectiveness of the health actions utilized in Australia. Furthermore the activities implemented to enhance individual awareness are probable liabilities in health programs effectiveness. Though there are derivative measures applied, the effectiveness is however questionable in respect to resources to facilitate accessibility, knowledge accessibility and continuous assessment of the issue.

INTRODUCTION

Health issue

Diabetes type 2 is a health issue that has been rampant in Australia. It is however a public health concern towards the aboriginal community living in Australia. Aboriginal community is one of the indigenous communities in Australia who have been alienated in terms of health acquisition as identified by [1]. Furthermore, notes that the risks that have been assessed comparing aboriginal Health risk in reference to diabetes are high as opposed to non indigenous groups in Australia. The risks are more focused on the women as opposed to their male counterparts [1].

The number of people affected by type II diabetes among the aboriginal group is considered to be four times of the non-Aboriginal group. This shows the severity of the health issues to wards the Aboriginal group in Australia [2]. Consequently, the disease affects individuals according to the lifestyles adopted as well as genetic factors. Davis et al [2] theorizes that, genetic factors are not primarily considered to be the initial cause among the Aboriginal group as the issues connected to social and economic factors. The severity of this issue is related to the health issues that emanate from it, such as heart attacks, and blood pressure [3]. More so, on the critical note, individuals with questionable lifestyles concerning health have high risks. Therefore, the correlation of Aboriginal group risk to Type II diabetes is facilitated by the behavior adopted as related to the past traditional norms.

On the other hand, the healthy system has to consider the economic status of the Aboriginal group [2]. On the contrary the cost of health system for aboriginal Australians have presented questionable gap in relation to the affordability of living up to the standards advocated for by policy makers, to curb the severity or rather minimize the probability of the disease.

Determinants

According to [1], diabetes type II is determined by the lifestyle adopted by individuals as well as factors related to genes. Diabetes type II among the aboriginal community has been subject of public health concern as experts have alerted on the risks connected to it as opposed to non-Aboriginal groups. There are factors that have facilitated the consideration of this issue to become a public health concern in Australia. These factors are:

  • Social economic factors- the aboriginal Australians have been aligned to the risk of diabetes due to the unhealthy nature of their lifestyles. Davis et al. [2] notes the significant contribution of lifestyles to the elevate diabetes type II risks Concerns are raised in accordance to the past norms in reference to lifestyles having been eroded by the Westernization factor. The Westernization factor is associated with the eating habits that were observed in the past being replaced with modern habits. Foods composed of high fats are more welcome among the aboriginal community with a very small percentage of individuals observing the traditional methods [2].
  • Simmons [4] notes that the aboriginal Australians adopting Westernized culture are in high risks of contracting diseases related to weight issues due to their genetic composition, which can lead to diabetes once individuals starts consuming unhealthy foods.
  • Access to health programs is another determinant among the aboriginal community due to the nature of health systems within the country in respect to the construed marginalization as compared to the non-indigenous Australians. Cunningham [5] acknowledges that the issue of diabetes is a major concern in reference to inequality levels between the Aboriginal Australians and the non aboriginal group. Therefore, this leads to varied accessibility levels of health care systems as well as the standards of care required for individuals with diabetes.
  • Behavior associated to unhealthy conduct of the Aboriginal group has been identified by [6] in terms of large number of smokers with comparison to the non aboriginal groups. This however, determines the vulnerability of this community in respect to type II diabetes. More so, such behaviors impact negatively on their health resulting to high cases of complications as well as mortality level probability very high. This can further be attributed to concerns of the quality health accessibility.
  • Income is also considered as a determinant of the disease among the Aborigine –Australians in education, ability to obtain and maintain quality living standards, employment and food availability. The income factor affects Aboriginal community in accessing quality living standards on the grounds that financial security facilitates health acquisition and maintenance [7].

Health promotion program for the diabetes issue is a concern for the Australian healthy policy makers as they have to consider the gap between the Aboriginal community and the non- Aboriginal community. Therefore the significant gap results to significant issues related to the marginalization of the community coupled with accessibility of essential needs aligned with it. In Australia, the impact of health promotion is focused on assisting individuals’ access control to the determinants that are associated with health issues. This is further facilitated by the Ottawa Charter with determination of mitigating factors that elevate health issues to individuals, as well as group(s).

This paper aims at assessing the type 2 diabetes among the aboriginal community in Australia. The focus is centered on examining the health issues with reference to facts from varied research findings. The programs implemented by health organizations to facilitate the well being of this group are subject to be focused on. In addition, varied aspects related to health need to be scrutinized in reference to promotion of health, preventive measures adopted and actions taken to deal with the health issue.

DISCUSSION

Health programs implemented-Controlling Type 2 diabetes determinants

Research studies concerned with the issue have implemented approaches to determine the way forward in dealing with diabetes type II. The studies are facilitated organizations, health institutions as well as the government. In Australia, the program implemented to deal with promoting health of diabetic patients and those at risk, holistically focuses on the control of diabetes related determinants. Mostly, these determinants are associated with weight issues as well as the lifestyles adopted by individuals [2]. Other factors related to control of diabetes type II are exercise, diet management and treatment. In addition, this is further facilitated by the consideration of the population affected hence initializing research work based on demographics [8]. In reference to Aboriginal community factors such as treatment, and maintenance of health diet are challenges due to alienation of the group as compared to other groups in Australia [7].

 

 

Assessment of health action through Ottawa Charter of Health Action

Formulating public health policy

In accordance to the Ottawa Charter which advocates for health promotion, strategies implemented by the Australian health policy makers can be assessed in relation to the Charter’s action areas. Initially, the intervention program for type II diabetes on holistic perspective in Australia focuses on dealing with the causes related to Diabetes type II.

WHO [9] states that one of the action areas to promote health, focuses on developing policies for the public health issues. These policies act as the advocating factors related to health issues under major concern. For instance, policies incorporate the legislation, determining economic empowerment, taxation and also changes within policy formulation. This is however achievable through considering the health statistics within a given society with high rates of risks. More so, in Australia varied studies have been conducted to determine the patterns of people affected by diabetes type II, hence the conclusion that the Aboriginal group is highly prone to Diabetes risk factors [10]. Consequently, evaluating the strategies towards policy formulation, [7] indicates that the legislation is still devoid of holistic implementation towards the Aboriginal community health. This is also inclusive of the economic empowerment that facilitates accessibility to standard health maintenance.

Population strategies are considered to determine the number of people affected by any health issue. Further, this is attained through conducting research based on potential risks and prone individuals for deriving ways minimizing harms [10]. This can attributed as one factor adhered to by the initiative implemented towards mitigating diabetes type II. However, in mitigating the diabetes determinants, the effectiveness towards the aboriginal group is evident in terms of inequality in resources distribution [11] [12].

The need for cultural based strategies in reference to curbing the problem is significant with concerns focused on sustainability too. This will further contribute to management of diabetes among the Aboriginal community especially those who have already adopted the Western culture and those living in urban areas. Urban areas have significant contribution to the lifestyles adopted by Aboriginal – Australians due to the availability of resources to facilitate behavioral change  and adoption as opposed to the rural aboriginal who partially or wholly maintain traditional practices [2] [13].

Supportive environments

Secondly, the Ottawa Charter stipulates that by facilitating supportive factors for the individuals in the high risk bracket, risk – resultant factor are mitigated. However, the pubic policy implemented towards diabetes type II have questionable significance towards the Aboriginal –Australian community [12]. Further, [14] [15] ascertains that support for the Aboriginal community in relation to health matters have been under scrutiny in numerous studies, indicating that these individuals do not receive quality and quantity support.

Strengthening actions within a particular community

Community initiatives have to be considered as mandated by the Ottawa Charter [9]. The focus of this action is to enhance the support to community posing high risks in reference to any health issue. The public program initiative dealing with diabetes has approach focuses on controlling the behavior as well as advocate for change in terms of determinants [17]. Also, strengthening actions within the community entails the empowerment directed to communities in terms controlling own initiatives.  In reference to diabetes type II and the Australian policies implemented, initiatives with consideration of the aboriginal community have minimum evidence [12]. However, Victoria State has taken the initiative of promoting awareness among the aboriginal community living within the state [16]. Therefore, the question derived from the outcomes reflects on how effective the initiatives towards Aborigines living in urban settings in Queensland and other states are. The populations of Aborigines in the urban areas are at greater risk due to westernization factors. More so they are disadvantaged in terms of community based initiatives due to scattered inhabitation leading to inadequate health assessment [12]. This is further compared to Aborigines living in remote areas, within an aggregate community, hence easily located for empowerment programs.

Personal development and empowerment

On personal perspective, the Ottawa Charter identifies the need for individual development in terms of skills. These initiatives achieved through educating on health issues and personal care as well as enabling personal understanding in life skills. However, [18] identifies that Aboriginal groups especially those living in urban setting are prone to dealing with deficits more as opposed to those living within the remote areas. More so, both groups are highly prone to risks of diabetes due to limited access to preventive initiative as well as promotional programs from the policy makers [19]. Therefore, the intervention program can be construed to have considered the Aboriginal group in terms of advocating for healthy lifestyles. On the contrary, gaps are presented when one considers the Aborigines living in remote areas with limited access to information that can assist in improving lifestyles [20]. Further, even if the information available, there is no guarantee that these individuals can maintain their lifestyle according to the intervention strategies. Harris [11] notes that majority of individuals in Aboriginal community are curbed with poverty hence income generated cannot sustain the need in quality personal maintenance such as dietary changes as well as medical prescriptions to individuals with Diabetes [21].

Health issues prevention and health promotion initiatives

Finally, the Charter maintains that prevention has key significance as opposed to treatment and cure approaches [9]. This is further emphasized in respect to shared responsibilities among individuals, the community, institution and organization offering health related services and the government [21]. In Australia prevention is approached on a general point with states such as Victoria implementing state -geared approaches to diabetes [16].

  • Promotion -Controlling the lifestyle of individual as one of the methods utilized to curb diabetes type II occurrences is significant [8]. Health promotion focuses on issues that will facilitate the improvement form current scenario to more adequate initiatives.

Promoting change of lifestyles and behavior presents a challenge to the individuals’ altogether. Consequently, it also implicates on the program implemented as differences in social groups vary. This is because the Aboriginal group has been construed to be marginalized with reference to the non- Aborigines [7].

  • Prevention-Controlling the lifestyle of individual as one of the methods utilized to curb diabetes type 2 occurrences is significant [8] [20] [22].  Diabetes Australia [16] identifies that the preventive tactics are prominently utilized in Australia as a long-term strategy to varied individuals. This is because type 2 diabetes create burden for policy makers in terms of intervention tactics especially in respect to the Aboriginal group.

Consequently, these preventive approaches contrast with the lifestyles of the Aboriginal community. The challenges related to the advocating for healthy lifestyles among the Aboriginal community especially those living in urban setting presents a hurdle for policy makers. More so, the challenges are also presented to the authorities in reference to the interventions delivered as well as consistency in supporting affected groups towards changing behavior [22][23]. On the other hand all the intervention tactics are facilitated at a price, such that the effectiveness in terms of costs [14] is questionable, concerning the aboriginal community. Policies have to be laid down for intervention swell as the prevention of type 2 diabetes requiring assimilation of factors connected to the vulnerability of Aboriginal group, differently from other groups [25]

CONCLUSION

Diabetes type II is an issue requiring major concerns from all governments especially if the risks are ascertained. More so, the diffusion of services is a factor that has emerged from assessing type II diabetes among the Aboriginal community. This can be attributed to factors connected to their lifestyles in facilitating health deficits as well as factors aligned to accessibility of health services in reference to the programs of interventions. The actions implemented are appropriately focused on the well being of diabetes type II patients and those at risks. However, based on this issue affecting the Aboriginal community, it probes questions as to the effectiveness of the actions of interventions. This is due to varied studies identifying the gap between Aboriginal community and the non- aboriginal community in terms of accessing quality health care. Therefore, it is agreeable that for appropriateness of these actions to impact positively towards Aboriginal community, policies need to formulate with reference to this group alone.

Factor that present hurdles for the efforts laid down are connected to diabetes type II determinants. Determinants that are associated to the Aboriginal group are related to lifestyles adopted. This is further identified in categories such as diet, activities and behavior. In managing the health issue effectively hindering factors could generate from changing health lifestyles among the Aboriginal community based on income levels as compared to non-indigenous Australians.

Lastly, the best approach is to integrate is in reference to state managed health actions as evident in Victoria state management of diabetes. Furthermore initiatives to support individual with concerns on low income factors through extensive education programs facilitated by quality assessments on health matters among Aboriginal Australians.

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