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Social, Behavioral and Cultural Factors in Public Health

Introduction

It is unfortunate that despite the extensive measures implemented to ensure that people are protected from diseases, they continue suffering from chronic health conditions (Lin, Smith & Fawkes, 2014). Numerous factors including social and economic ones as pointed out by Vukovic (2016) contribute significantly to the increased risk and prevalence of diseases. In Australia, for instance, heart diseases, whose risks include genetics factors and social as well as economic factors, have been identified as major causes of death (Vukovic, 2016). Health reports, as highlighted by The Heart Foundation (2018) indicate that a large number of people present with varying complications of heart disease. Heart disease results in hospitalization, disability, and increased burden of care among the people (Lin, Smith & Fawkes, 2014). This disease results in the death of one Australian in every twelve minutes (The Heart Foundation 2018). Regardless of the improvements in the Australian health care system, heart diseases have persisted as the nation’s biggest health problem. Limited access to care is a significant factor that contributes to the increased prevalence of diseases among disadvantaged populations in society (Lin, Smith & Fawkes, 2014). This paper focuses on heart disease among women in Australia. Women constitute a vulnerable that suffers disproportionately from diseases including heart conditions.  A description of the pattern of heart diseases in this population will be provided together with an explanation of the social determinants of health associated with these diseases. A practical public health intervention for heart diseases will also be highlighted as the role of stakeholders in addressing this problem.

Heart disease among women in Australia

Heart disease is a leading cause of death among women in Australia. Statistics have revealed that these disorders kill four times more women in Australia than breast cancer (The Heart Foundation 2018). Reports have revealed that over 24 female deaths recorded daily emanate from cardiovascular conditions Australian Institute of Health and Welfare, 2015). Some reports also indicate that one in every nine premature deaths in this population is related to heart diseases. Many deaths related to cardiovascular diseases in women occur since they usually develop symptoms at an advanced stage than men (Australian Institute of Health and Welfare 2017). The symptoms are mostly vague and therefore hard to connect with heart conditions. Whereas the main symptoms of heart disease in men are chest pain, shortness of breath and nausea, women experience numerous symptoms including lightheadedness, neck and jaw pain, chest discomfort, vomiting, nausea, fatigue, tightness, sweating, and back pain among others (Healey 2012). Most women do not seek care for heart diseases since they associate the symptoms with other diseases. The Heart Foundation (2018) estimate that in Australia over 48000 women are provided with cardiovascular care services every year. This implies that the number of women who do not seek care is extremely high. It is irrefutable that heart disease is a major health problem which should be addressed practically to improve population health.

A ‘Social Determinants of Health’ Approach

A ‘social determinants of health’ approach can be used to elucidate the patterns of morbidity and mortality for cardiovascular conditions in women when compared with other groups. This approach provides a multi-dimensional and multi-level platform to assess the factors that might have contributed to the increased prevalence of heart diseases among women in the country (Harper, Lynch & Smith, 2011). Healthcare professionals have made it clear that the risk of heart diseases among women is aggravated by the fact many women are not aware of the social factors related to these conditions (Vukovic, 2016). Some factors such as access to health care are out of the control of women hence take a huge toll on their health. Statistics indicate that over 31% of women have three or more risk factors, which include high cholesterol level, age, obesity, tobacco smoking, hypertension and inactivity (Vukovic, 2016). The lifestyle adopted by most of the women in the country neither promotes health nor protects them from diseases. It is estimated that over 1 million women have extremely high cholesterol levels (Harper, Lynch & Smith, 2011). Most of these women are not aware of the impact of high cholesterol in their bodies. In addition, approximately half the population of women is obese and overweight besides living an inactive life (The Heart Foundation, 2018).  Moreover, the high mortality rate is attributed to the fact that diagnosis is usually done after the disease has progressed to critical stages. Harper, Lynch and Smith (2011) noted that the lower likelihood of women seeking help quickly due to heart conditions than men aggravates this problem. Since heart diseases are conventionally believed to affect more men than women, health care providers are less likely to check for these conditions (Vukovic, 2016). This implies that there is a need to develop a practical intervention strategy to address this health problem

Public health intervention to address access to healthcare

Access to healthcare is a major problem for women in Australia. The Department of Health (2016) asserted that limited access to care has significant effects on the quality of life and can result in poorer health outcomes especially for groups with specific needs. People with chronic conditions require unlimited access to care for their health to improve. Women experience numerous barriers in their search for quality care regardless of whether it is in the rural or urban areas. These barriers include remoteness, indigenous status, socioeconomic status and age. To improve access to care, all these factors must be addressed (Australian Institute of Health and Welfare, 2017). However, no single program is capable of addressing all of these issues. The Australian Institute of Health and Welfare (2017) also reported that over 5% of women presenting with symptoms of chronic conditions did not seek care from a general practitioners’ office in 2015. It was also reported that 21% of women waited longer to seek care or get an appointment with the GP.

The development of Health Call Centers is one of the practical ways through which the limited access to care for women in Australia can be addressed. The Health Direct Australia (2017) made it clear that health call centers provide an effective way for increasing access to healthcare information for women. The centers also have the potential to address the time and geographical restrictions associated with limited access to care. Every region will have a call centre, and its contact information will be communicated to the people through mainstream media. An online platform will also be developed to augment the services provided by the call centers. The establishment of patient access and call centre services will establish a platform for improving patient engagement and patient satisfaction. The health call centers are manned by experienced nurses who can provide accurate health information to women seeking assistance on cardiovascular-related issues (The Department of Health 2016). The nurses will educate women on the risk factors of cardiovascular disorders and the most effective ways of preventing these diseases. Women, at risk of heart diseases, across the geographical divide will be provided with an opportunity to contact care providers in real time without having to travel long distances, book appointments and wait in the long queues at the hospital.

Describe how you would address the social gradient of health through this public health intervention.

Reports have revealed that inactivity, tobacco, hypertension, obesity and diabetes are the key risk factors for heart disease. Socioeconomically disadvantaged populations are believed to exhibit behavioral aspects that predispose them to these risks (Vukovic, 2016). However, even though behavioral risk factors are evident contributors to the disease, health care professionals assert that social and environmental factors aggravate the social gradient of health (Harper, Lynch & Smith, 2011). The establishment of health call centers has the potential to address the challenges women experience in the search for healthcare thereby resolving the social gradient. Most women suffer in silence from symptoms indicating the possibility of cardiovascular disease since the nearest healthcare facilities are many miles away. Moreover, many women do not have the financial capacity to seek preventive care services.  Women also fear being subjected to discrimination in healthcare facilities. The health call centers will enable the delivery of information which can be sued to prevent diseases among women. It is anticipated that the call centers will increase the number of women seeking health care information and services while reducing the number of those suffering from preventable conditions. Even though the call centers will not improve the socioeconomic status of women, they will ensure that all women regardless of status are treated equally and provided with information that can help them overcome the heart disease problem (The Department of Health 2016).

Explain what other sectors would need to be involved aside from the health sector.

The health sector is the main stakeholder in the proposed initiative. The department of health will allocate nurses to the call centers to ensure they are manned all the time. The telecommunication sector will also be involved in this initiative. The communication sector will establish the necessary infrastructure to facilitate communication between the care providers in the call centers and the patients in different geographical regions. The mass media will also be involved in this initiative. The media will broadcast the contact information of the call centers in different regions to the people. The local and the national government will also be involved in the public health initiative. The government has a responsibility to oversee and support initiatives aimed at improving the health of the people regardless of their gender and potentially discriminating backgrounds. The local and national government will provide the finances necessary to run the call centers. The finances required to advertise the contact

Conclusion  

Socioeconomic factors contribute significantly to the increased risk and prevalence of heart disease among women in Australia. Heart disease results in hospitalization, disability, and increased burden of care for this population. Limited access is a social determinant of health that increases the risk of heart disease. The establishment of health call centers can address the issue of access to care thus ensure that women are informed of the ways to protect themselves from heart disease.

 

 

References:

Australian Institute of Health and Welfare 2017, The health of Australia’s females. viewed on March 12, 2018 from <https://www.aihw.gov.au/reports/men-women/female-health/contents/access-health-care>

Australian Institute of Health and Welfare. 2015, What are cardiovascular diseases? Viewed on March 15, 2018 <http://www.aihw.gov.au/cardiovascular-health/about/>

Chang, E & Johnson, A 2014, Chronic Illness and Disability: Principles for Nursing Practice. Churchill Livingstone, Australia

Harper, S., Lynch, J., & Smith, G. 2011, Social Determinants and the Decline of Cardiovascular Diseases: Understanding the Links. Viewed on March 15, 2018 http://search.ror.unisa.edu.au/record/UNISA_ALMA51108428620001831/media/digital/open/9915909355501831/12143970230001831/13143997160001831/pdf

Healey J 2012, Cardiovascular Health, Spinney Press, Sydney.

Lin, V., Smith, J., & Fawkes, S 2014, Public health practice in Australia: The organized effort (2nd ed.). NSW: Allen & Unwin.

The Department of Health 2016, national health call center network, viewed on march 12, 2018 <http://www.health.gov.au/internet/main/publishing.nsf/content/national-health-call-centre-network-team-overview>

The Health Direct Australia 2017, Equity of access for all Australians, viewed on march 12, 2018 <https://about.healthdirect.gov.au/equity-of-access-for-all-australians>

The Heart Foundation 2018, Heart disease in Australia. Retrieved from <https://www.heartfoundation.org.au/about-us/what-we-do/heart-disease-in-australia

Vukovic, D., (2016). Heart disease ‘number one killer’ of Australian women, causing more deaths than most cancers. Viewed on March 12, 2018 <http://www.abc.net.au/news/2016-10-11/heart-disease-kills-more-women-than-most-cancers-study-finds/7920880>

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