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Health Promotion Essay: Awareness Of Diabetes Among Indigenous Australians

Question

Task:
Prepare a health promotion essay critically discussing the health promotion need including current influences on the problem, and responses to this in current policy and practice alongside potential innovations for future practice.

Write an evidence based rationale for an area of need in health promotion. Your main purpose is to argue why this area may need a health promotion intervention or programme, and to identify current policy and practice in this area and why it might not be working.

Answer

Introduction
Health promotion plays an important role in awaking people related to certain major occurring health issues. Health promotion allow individual to enhance control over their health. Health promotion includes a broader range of social and environmental interventions that are constructed to get the advantages and secure the individual's health and quality of the life. It is done by addressing and detecting the prevention measures for the fundamental cause to ill health, not only focusing on the treatment and cure. Such a need for health promotion is seen for metabolic disorder diabetes among the poor indigenous Australians. Diabetes is a disease that is occurring at a higher frequency, leading to reduce the life expectancy of the people worldwide. According to the global diabetes prevalence in 2019, it was estimated that more than 463 million people are affected by this metabolic disorder. The increasing frequency of diabetes in the world is estimated by the end of the year 2045 is to be more than 700 million people (World Health Organization, 2019). Again from the same study, it was estimated, that the impaired glucose tolerance (IGT) is estimated to be 374 million in the year 2019 (Saeedi et al., 2019). Hence, it can be seen that a huge amount of the population is suffering from diabetes. The aim of the discussion is to critically evaluation of a health promotion need including current influence on health problems. Concerning to the aim of the discussion, diabetes has been considered to discuss. It is a present worldwide issue as well as has one of the biggest prevalence rates in among poor indigenous Australian people. Hence, the essay will be highlighting the current context of health issues including whom these issues impact indigenous Australians’ and why is an important issue. Along with that, the discussion will also be covering the current policy response to this health need nationally and health promotion interventions designed to address this need. Besides that, it would also be discussing the current barriers of the health issue in policy and potential intervention that would be working enough to address the need in the future including those in the other countries.

The current context of health issues, and to whom issues are impacting on and why it is important
When discussing the present health complication of the world, the most common metabolic disease that has been considered is diabetes. As per the world health organization, a survey conducted in 2014 highlights the fact that the occurrence of diabetes among 18 years old age and adults has risen from 4.7% in 1980 to 8.5% in 2014; the prevalence has just become doubled. With time diabetes is being a worldwide issue for every age person. When focusing on the statistical data of the prevalence of diabetes in Australia, it has been seen that a huge amount of people are being affected by this metabolic disorder (Gupta et al., 2019). As commented by the Australian Bureau of Statistics (ABS), the survey which has been conducted by the National Health survey 2017 to 2018 estimated that 1.2 million people are affected by diabetes, which is 4.9% of the total population. This estimated data evaluate the fact that nearly half of the population is affected by diabetes, and has reduced their life expectancy.

The impact is quite commonly seemed over the poor indigenous people of Australia. The occurrence of diabetes among the indigenous people is found to the 3 to 4 times of the non-indigenous Australian. It has been observed that the indigenous population of Australia is not only facing diabetes at a higher rate, they are suffering a number of complications at a much higher rate as compared to non-indigenous people of Australia. The rate of complications faced by the indigenous people of Australia is quite high. The uttermost reason for diabetic impact over the indigenous Australian is because of the increasing rate of obesity, declining physical activity, nutritional gap due to dietary changes, and the high aging population. Apart from this, the unemployment, lack of education, and excessive stress among the young people of indigenous Australia are leading to an increase in their level of stress, making them more prone to diabetes. According to Wang, Hoy, and Si, (2014) in an 11 year of prospective cohort study it was found that the 2.2 per 1000 person-years for those below 25 years and 39.9 per 1000 person-years for those above 45 years where affected by diabetes. Hence the lifestyle they are leading is letting them face these metabolic complications.

Hence, the increasing rate of diabetes due to their lifestyle and poor living standard making metabolic disorders one of the important health issues of poor indigenous Australian. As the indigenous people have higher prevalence of obesity, high blood pressure, high levels of triglycerides in their blood, impaired glucose tolerance hence bound them to face a life expectancy of a much lower level than the non-indigenous Australian. The sudden change in the lifestyle patterns of these people has to lead to face the genetic change in them. Hence, these changes are making the genes to be unhealthier and more prone to metabolic diseases (Crowshoe et al., 2017). The health issues are building up a future generation that will be having disease from the time of the birth and will persist much lower immunity to fight with any other complication. The present condition of the health of the indigenous Australian will be leading to a diseased future. Hence, diabetes is an important health issue of the indigenous Australian (Zimmet, Moylan & Colagiuri, 2017).

Need for health promotion to address diabetes
As explained before health promotion is a procedure that enables individuals to increase control over, and improve their health condition. The need for the change in the area or need for health promotion to address diabetes in indigenous Australian is because of the increasing prevalence of diabetes among them. Increasing diabetes will be leading them to face several other consequences related to diabetes in the future (da Rocha Fernandes et al., 2016). This would lead to an unhealthier future generation. It is seen that the indigenous Australian are less educated, hence it is obvious to have little knowledge about diabetes and its consequences they are facing. The health promotion will be a solid source to make these be aware of the complication related to diabetes and its consequence. These programs will be educating them about each and every aspect related to the improvement of their health. The promotion will make people acknowledge the fact that how vital it is to change their living standards to ensure a bright future. The indigenous Australian are facing a number of issues in their life like employment, scarcity of food, no house to live, and many more. These entire factors are contributing to an increase in the level of diabetes in them. The health promotion will be helping them to get information on how they can improve their survival to avoid the occurrence of diabetes. Health promotion will be focusing on the need to increase the sustainability of life. The more the poor indigenous Australian will understand these factors related to health issues, the more they will be changing their lifestyle and will be leading a healthy life (Chow, E., & Chan et al., 2017).

Current national strategy responses to diabetes as a health issues
In the year 1996 the diabetes become the first National Health priority; Australia was the nation to introduce the government-supported assistance for self-monitoring blood sugar and self-management for the very first time. From then it is being one of the uttermost priorities of the government of Australia to decrease the prevalence of diabetes in their country. The Australian government has made a commitment for developing a new strategy to overcome the prevalence of diabetes especially focusing the poor part of the Australia. The policy was made acknowledging the factor such as social and economic burden that leads to diabetes in the Australian people especially poor indigenous Australians. The purpose of the policy was to focus on a number of factors for reducing diabetes in the Australian people (Speight, 2016). The valuable opportunity developed in through the National diabetes strategy was

  • Identifying the current approach to diabetes care and services that are available in the country.
  • Identifying the role of the government at every level to manage every stakeholder related to the complications.
  • Evaluating the fact that the current approaches and investments are able to identify the present needs of the issues.
  • Increasing the efficiency of using the existing resource, limiting the health care resources to perverse it for the future.
  • Identifying the vision for preventing, detecting, and managing diabetes.
  • Improving the coordination among the health professional to ensure a high level of care and services for treating diabetic people.
  • Improving the coordination of health resources among the all government resources.
  • Incorporating the different approaches of the world health organization 2013, to provide an action plan for preventing and control of the non-communicable disease.
  • Ensuring a framework to monitor the occurrence of metabolic disorders (Zimmet, 2016).

For Managing the entire factor as above mentioned the government of Australia has made a National Diabetes Strategy Advisory Group. The committee consists of different stakeholders from various fields. The program seeks to reduce a number of diabetes developing people (National Diabetes Strategy Advisory Group, 2015). It identifies the people or groups that are at higher risk of diabetes or pre-diabetes. The AUSDRISK is the currently endorsed screening tool for recognize people with a higher risk of diabetes. The programme will also be promoted the healthy in a community.

Health promotion interventions designed to address diabetes
For the health promotion intervention, national diabetes programs were constructed which include and emphasize a number of actions. These programs initiated with changes in the environment to support a healthier lifestyle by encouraging people to enhance the level of physical activity and reduce the activity that is sedentary. Incorporation of physical activities and healthy eating habits on a daily basis in the individual’s workplace, schools, and communities will be an initial step towards prevention of diabetes. Introducing education and campaigns on social media to encourage a higher level of physical activities and healthy eating habits (Speight, 2016) would be quite supportive for health promotion. These campaigns were focusing on educating the parent about nutrition and physical activity. Increasing the availability of healthier food and reducing the availability of food that is unhealthy to eat. This promotion will be mainly focusing the poor indigenous Australian people. Encouraging individual’s to reduce the exposures of their children and other family members to the marketing, advertising, promotion, and many other things that are leading to attract energy-dense and nutrient-poor foods. Improving primary health care services to increase they are strengthened to support the proper care and services to public health. Focusing on the child, family, and maternity health to enhance the growth pattern of the future, is quite necessary to observed. Searching out the people at risk and provide prevention programs. The promotions were provided with the help of the group campaign, telephones, and web-based programs. Apart from that, the programs also focused on educating the primary health care practitioner to recognize the symptoms and signs of the type of diabetes (Keel et al., 2017). Educating the community people such as parent, teacher, and other health care professionals to identify the sign and symptoms would be a part of program. Increasing availability of AUSDRISK screening tool for everyone will be an importance step to prevent diabetes. Introduction of the electronic medical record to keep solid data about the prevalence of diabetes will help a lot.

Current barriers to address diabetes in policy or program
The present barriers to address diabetes in policy or program are following

Clinical guidelines: There are a number of guidelines for diabetes that are present in Australia. Every guideline output incorporates slow, costly, and rigid planning to reduce the prevalence of diabetes. This is making the government tougher to act on the policy to provide a guideline that would be reflecting speedy, low cost, and less rigid interventions.

Availability of devices: The availability of the device to detect diabetes and therapies for reducing diabetes is creating huge problems in implementing the policy. The screening tools are not available at every public health care center, making it difficult to identify the existence of diabetes.

Information technology: Electronic health has a very high potential impact to cure people with diabetes. The government is building up the infrastructure to incorporate every technology that can help to reduce the prevalence of the disease, yet has a lot to work on to achieve the target.

Quality improvement: At present, there is a lack of treatment seen in people with diabetes, as 50% of the people are not recommended for the other check related to diabetes like eye examinations and many other complications. Hence, no proper guidelines are being provided to the people who came to checkups (Chamberlain et al., 2016).

Workforce capacity: In the present situation, there is a lack of a workforce that would be providing guidelines to the people. The lacking of appropriately well knowledge and certified healthcare professionals for diabetes care spectrum leading to issues related to the implementation of the proper treatment. There is an inefficient treatment available due to the lack of healthcare professionals. Delivery of evidence-based best practice on an consistent way is required to ensure a higher level of health products to the people (Voaklander et al., 2020).

Lack of education: As the people belonging to the indigenous group of Australia are lacking behind in education are making them isolated from the treatment. They do not understand the importance of the policy and its implementation.

Lack of unemployment: The lack of employment is letting them avoid the care available to them. The financial crisis forces them to avoid any kind of additional burden of money over their head, hence ignoring the need to go through the proper amount of treatment and increasing the need to improve their future (Australian Government., 2020).

Potential intervention that will be addressing the need of the future
The interventions that will be addressing the need of the future and will be applicable to the current context are several. There are several ways to implement potential interventions like depending on the single guidelines. Availitbity of single guidelines that is easy to follow and quite a low price is needed to be implemented on a regular basis. The support would be providing the implementation and monitoring of an updated version. Improvising the present quality of care in Australia, and educating the healthcare professionals to work over their skills will be quite beneficial. Strengthening the prevention programs and promoting the healthcare intervention to every single individual and group. In the present situation of the world, the use of the digital world to make people aware of diabetes and information related to it is quite easy. Social media will be playing as the best platform to promote the importance of diabetes care. Incorporation of technology like the electronic medical record will be one the major revolutionary step for the medical industry. It would be providing data that will be ensuring the level of treatment is provided to the patient with diabetes. The country like the United Kingdom has focused on the need for self-management (Reddy et al., 2016). Self-management in diabetes plays an important role in cure oneself. For this, the government has incorporated the many such topics that are related to health issues and ways to manage them in the course of education. This has improved a scope to incorporate knowledge from base level people, hence will be improving all the need to manage diabetes. Ensure programs that would be guiding the people through face to face conversation, via telephone or online mode. Initiating courses and social marketing campaigns focusing on the groups, that at higher risk of diabetes and along with the high level of primary healthcare professionals would be beneficial. Providing access to flexible telemedicine consultation, this would be helping to provide medicines to those who are living far away in the rural areas. The programs should be including programs like eye screening and telephone-based consultant. This would provide a broader area of improvement for the people who are not at an approaching distance but need a high level of cure (Arnold et al., 2017). Ensuring the availability of updated, connected, and consistent supply of the programs or software’s that would be helping to improve the management of diabetes will be working well for the government. Incorporation of the technology that would be providing care plans for the diabetic patient along with it would also be remaindering diabetes-related complication screening. And finally developing and designing efficient evidence-based best practices, which can be applicable and will be able to monitor the glucose very quickly. Upskilling and gathering information that would be helping to provide a much better and higher level of services, should be an part of promotion (Hughes et al., 2017).

Conclusion
From the above discussion, it can be concluded that Australia is facing a higher rate of issues related to diabetes. Half of the population of Australia seems to be affected by diabetes; especially those who are belonging to the poor indigenous group seem to be suffering higher than the non-indigenous population of Australia. Observing these facts, the government seems to be alert from the past number of years but still the prevalence of diabetes is increasing day-by-day. The Australian government has incorporated a number of facilities and programs and still upgrading them to achieve targets of diabetes controlling policy or strategy, due to lack of infrastructure, lack of well skilled and knowledgeable workforce, and a number of other factors letting the mission to be un-impactful. There are a number of ground-level factors which is interrupting health promotion like lack of education, lack of employment, and lack of high-quality food. All these factors are leading to a decrease in the need to care and concern for health promotion for diabetes. The government needs to observe the ground-level issues related to diabetes before incorporating the policy for reducing the prevalence of diabetes. The more the government will be able to improve the living standard of the indigenous and poor Australian people, the lesser there would be an increasing occurrence of diabetes among the Australian people. Hence, the rate of prevalence of diabetes in Australia would be reduced and will have healthier future generations. Hence, the need for health promotion becomes an important factor to prevent diabetes.

Reference
Arnold, L. W., Hoy, W. E., Sharma, S. K., & Wang, Z. (2016). The Association between HbA1c and cardiovascular disease markers in a remote indigenous Australian community with and without diagnosed diabetes. Journal of diabetes research, 2016.

Australian Government. (2009). Australia: the healthiest country by 2020.

Chamberlain, C. R., Oldenburg, B., Wilson, A. N., Eades, S. J., O'Dea, K., Oats, J. J., & Wolfe, R. (2016). Type 2 diabetes after gestational diabetes: greater than fourfold risk among indigenous compared with non?indigenous Australian women. Diabetes/metabolism research and reviews, 32(2), 217-227.

Chow, E., & Chan, J. C. (2017). Explaining the high prevalence of young-onset diabetes among Asians and Indigenous Australians. Med J Aust, 207, 331-332.

Crowshoe, L., Dannenbaum, D., Green, M., Henderson, R., Hayward, M. N., & Toth, E. (2018). Type 2 diabetes and Indigenous peoples. Canadian journal of diabetes, 42, S296-S306.

da Rocha Fernandes, J., Ogurtsova, K., Linnenkamp, U., Guariguata, L., Seuring, T., Zhang, P., ... & Makaroff, L. E. (2016). IDF Diabetes Atlas estimates of 2014 global health expenditures on diabetes. Diabetes research and clinical practice, 117, 48-54.

Gupta, R., Ghosh, A., Singh, A. K., & Misra, A. (2020). Clinical considerations for patients with diabetes in times of COVID-19 epidemic. Diabetes & metabolic syndrome, 14(3), 211.

Hughes, J. T., O’Dea, K., Piera, K., Barzi, F., Cass, A., Hoy, W. E., ... & Maple-Brown, L. J. (2016). Associations of serum adiponectin with markers of cardio-metabolic disease risk in Indigenous Australian adults with good health, diabetes and chronic kidney disease. Obesity research & clinical practice, 10(6), 659-672.

Keel, S., Xie, J., Foreman, J., Van Wijngaarden, P., Taylor, H. R., & Dirani, M. (2017). The prevalence of diabetic retinopathy in Australian adults with self-reported diabetes: the National Eye Health survey. Ophthalmology, 124(7), 977-984.

Keel, S., Xie, J., Foreman, J., Van Wijngaarden, P., Taylor, H. R., & Dirani, M. (2017). The prevalence of diabetic retinopathy in Australian adults with self-reported diabetes: the National Eye Health survey. Ophthalmology, 124(7), 977-984.

National Diabetes Strategy Advisory Group. (2015). A strategic framework for action. Advice to the government on the development of the Australian National Diabetes Strategy 2016–2020.

Reddy, M., Rilstone, S., Cooper, P., & Oliver, N. S. (2016). Type 1 diabetes in adults: supporting self management. Bmj, 352.

Saeedi, P., Petersohn, I., Salpea, P., Malanda, B., Karuranga, S., Unwin, N., ... & Shaw, J. E. (2019). Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas. Diabetes research and clinical practice, 157, 107843.

Speight, J. (2016). Behavioural innovation is key to improving the health of one million Australians living with type 2 diabetes. Medical journal of Australia, 205(4), 149-151.

Speight, J. (2016). Managing diabetes and preventing complications: what makes the difference. Med J Aust, 198(1), 16-17.

Voaklander, B., Rowe, S., Sanni, O., Campbell, S., Eurich, D., & Ospina, M. B. (2020). Prevalence of diabetes in pregnancy among Indigenous women in Australia, Canada, New Zealand, and the USA: a systematic review and meta-analysis. The Lancet Global Health, 8(5), e681-e698.

Wang, Z., Hoy, W. E., & Si, D. (2014). Incidence of type 2 diabetes in Aboriginal Australians: an 11-year prospective cohort study. BMC public health, 10(1), 487.

World Health Organization. (2016). Global report on diabetes.

Zimmet, P. Z. (2016). Can we avert a diabetes catastrophe in Australia?. The Medical Journal of Australia, 199(4), 225-226.

Zimmet, P. Z., Moylan, J., & Colagiuri, S. (2017). Behavioural innovation is key to improving the health of one million Australians living with type 2 diabetes. The Medical Journal of Australia, 206(3), 141-142.

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