A Remote Area ( Isolation ) Can Impact On The Health Outcomes

Lower incomes, lower levels of education and employment, and poorer access to health services are among the social ...good health and wellbeing in rural and remote Australia determinants of poor health for people in rural and remote areas, who are also disadvantaged by a higher prevalence of common risk factors for health, such as higher rates of smoking, greater rates of disability and lower rates of physical activity.

Aboriginal health standards are so low today that all most half aboriginal men and a third of the women die before they are 45. Aboriginal people can expect to live 20 years less than non-indigenous Australians. Aboriginals generally suffer from more health problem and are more likely to suffer from diabetes, liver disease and glaucoma. The causes of their poor health and low life expectancy are poverty, poor nutrition, poor housing, dispossession of their traditional land, low education level, high unemployment, drug and substance use, unsafe sex, limited health care and diseases.

Australia is one of the world’s most culturally diverse societies and it is commonly assumed that the country offers free and fair opportunities to all its inhabitants. However, on close observation it is clearly evident that the country’s indigenous population is at a social and economic disadvantage when compared to their non-indigenous counterparts and as a consequence the present aboriginal health is in a grave situation.

As health professionals, we must look beyond individual attributes of Indigenous Australians to gain a greater understanding and a possible explanation of why there are such high rates of ill health issues such as alcoholism, depression, abuse, shorter life expectancy and higher prevalence of diseases including diabetes, heart disease and obesity in our indigenous population. Looking at just the individual aspects and the biomedical health model, we don’t get the context of Aboriginal health. This is why we need to explore in further detail what events could have created such inequities in Aboriginal health. Other details that we should consider are the historical and cultural factors such as, ‘terra nullius’, dispossession and social

Living in a remote area has always been thought to have negative influences on the individual. There are 35 % of the total population in Australia living in rural area(Phillips, 2009).Rural areas in Australia and all over the world are not geographically isolated and disadvantaged only but also culturally and economically deprived which has great consequences on the health status of the population. The main two factors that have a major effect on rural health are socioeconomic status and cultural issues(Beard, Tomaska, Earnest, Summerhayes, & Morgan, 2009).

The health inequality between Aboriginal and Torres Strait Islander Australians, and Non-Indigenous Australians is evident, (Empirical)

The health status of Indigenous Australians is significantly lower than that of non-Indigenous Australians, this could be due to a large amount of Australia’s Indigenous population living in either remote rural areas and or in a low social economic areas. In rural remote areas individuals have poorer access to health services and support services, limited access to transport, lower employement options and fewer accomidation options. In addition, to this cultural and spiritual differences may also be a barrier for indigenous Australian’s accessing services within their community.

The aboriginal population in Canada is growing, and it is known that 56% of Aboriginals live on an rural reserve or community (Government of Canada, 2014; NCCAH, 2011). It is important to note that those Aboriginals living on reserves and in communities have a significantly higher rate of health issues than those living in cities (NCCAH, 2011). This stems from the limited access to healthcare that Aboriginal rural areas receive (NCCAH, 2011). The lack of healthcare causes higher numbers in diseases, conditions, and disorders among the Aboriginal people of Canada (NCCAH, 2011).

Although a lack of high-quality data limits an accurate assessment of the health disparities between indigenous and nonindigenous populations in many countries, the disparity between Indigenous and non-Indigenous Australians ' health status and care has been widely documented6. The causes of the health status inequalities are multi-factorial; with the major contributors related to social and environmental determinants of indigenous health7.

It is well established that Indigenous Australian’s have a lower state of health and wellbeing than non-Indigenous people (Paradies, Harries, and Anderson, 2008). Aboriginal people have a diverse culture with a rich and compelling history and the impact of colonisation, legislation and the stolen generation has created significant hardships for Indigenous Australians, putting them as the most disadvantaged group (Paradies, Harries, and Anderson, 2008). It is known that their life expectancy is seventeen years less than other Australians.

There is a clear relationship between the social disadvantages experienced by Indigenous people and their current health status. These social disadvantages lead to a number of critical health issues. In Australia 2.5 per cent of the population is made up of Indigenous people. Within this population only 3% are 65 years of age or older, whereas 16.3% of the Australian population is over 65. (Australian Bureau of Statistics. 2012).

Australia boasts much multicultural diversity, embracing various ways of life and promoting an egalitarian society. However, Indigenous Australians represent the most disadvantaged peoples in this country. Many Indigenous Australians exhibit poorer physical and mental health and longevity (Bramley, Hebert, Jackson, & Chassin, 2004). Some of these issues stem from the impact of transgenerational trauma created by European colonisation (Nutton & Fast, 2015). Subsequently, there has been some effort to create awareness of these facts and turn these statistics around. Nevertheless, while there have been many strategies aimed at improving the overall wellbeing of Indigenous populations, progress remains slow and a substantial gap still exists (Australian

The Aboriginals also known as the Indigenous people are the first people’s inhabitants of mainland Australia (WIKIPEDIA). Historically, Aboriginals enjoyed better health before any invasions from non-Indigenous peoples. They didn’t suffer from any major illnesses though they did have other type of health issues, but their life was happier and content. Everything started to change after 1788 when non-Indigenous people introduced illnesses where the mortality rate of Aboriginals population started to increase, and this affected their life and the community (http://www.healthinfonet.ecu.edu.au/health-facts/overviews/the-context-of-indigenous-health). There are various factors that contribute to the poor health status of Indigenous people, and this is part of the social determinants of health which should been seen in a broader context (1)(2). Factors such as employment, income, stress, gender, education, behavioral aspects, working and living conditions, social networks and support, are interrelated and complex, and are part of the social

CR and other secondary prevention interventions need to be flexible and adapted to meet the needs, preferences and cultural safety of Indigenous individuals (7). Patient-centred access to health care must be approachable, acceptable, available, affordable and appropriate (7). A drive time of over an hour is a common barrier of access to CR for individuals living rurally and is linked to the lack of referral to and enrolment in CR (7). Approximately 15% of Indigenous Australians live in geographical regions with poor physical access to CR-providing health services (7). A possible solution to this is the utilisation of alternative methods of delivery such as home-based CR via telehealth or mobile health platforms (7). Coordination to ensure continuity of care for Indigenous patients is necessary to address the lack of knowledge of and referral to CR services (7). Partnerships and information flow between health services and referral pathways create integrated networks (7). While metropolitan public hospitals are a major referral pathway for

Remote areas have a decreasing amount of access to medical facilities. This can cause an unequal health care as individuals living in remote areas do not get the same amount of health care as those in the city. Social determinants disadvantage individuals as there is less access phone coverage and higher rates of unemployment then cities. Remote areas of Australia are also disadvantaged as they do not have access to some technology, or they have trouble accessing these services as they may be far away.