Tutor Blog Post

Identify and discuss how two (2) social determinants of health

31 Mar 2019 403 Views Sarah

Question 1:

The social determinants of health inform the way we use primary health care to help communities to maintain health and wellness. Using relevant examples from the video, identify and discuss how two (2) social determinants of health helped determine the need for the project.

The project for Kalumburu community in Western Australia in the form of Healing circle has been the outcome of two key social determinants of health as social isolation/ exclusion and lower educational level (Department of Health, 2013). The number of cases of child neglect and abuse with mental trauma in Australia has more than doubled in last one decade. As per the research Fennell, Hull, Jones & Dollman (2018), the families who are hard to provide loving and safe environment to their children are isolated in some way. The families who have strong social networks like good connected with friends, extended families, and neighbors, the families are less likely to abuse or neglect their children. This is visible in this video. The Kalumburu community has suffered from huge number of young man in 2007 being arrested on charges of child sexual assault (Department of Health, 2013). The video reveals that the elders of the community clearly stated that before the colonization of Europeans, their children used to go to the schools, learn well, and eat well, but now there is no school for them because their land has been hitched from them and their rights are not given to them as required and they need money (Fennell et al., 2018). They have been socially isolated which has resulted in lack of education, income, and employment causing more health issues. Due to lack of knowledge, they are in confusion and shame with intense pain. This program is making them feel safe and included in the society. Their children do not go to schools due to shortage of money and transportation facilities and lack of trust in the national system due to European abusive experiences and land theft. This project has been the need to enhance their social inclusion with respect for their cultural values and needs and improve their educational level for improved future (Department of Health, 2013).   

Social inclusion and good education are presented as the strong messages that a strong community needs for children’s development and wellbeing. The knowledge and strength of the entire community is essential to raise healthy and happy children (Department of Health, 2013).

Question 2:

Using relevant examples from the video, identify and explain how 2 primary health care principles guided the project in the video.

The very first primary healthcare principle which guided the project in the video for Kalumburu community program in Western Australia is “Genuine local Indigenous community engagement to maximise participation.” (Department of health, 2008). The program “Healing Circle” was designed with the cooperation of the elders, women and men of the Kalumburu community to foster care and support for all, certainly children in this community. The project itself is community instilled (World Health Organization, 2017). The term CIRCLE stands for Collaborative Indigenous Research Centre for Learning and Educare. The program includes the formal structures in a way controlled by the community within the key involvement of elders of this community to talk about stories, experiences, issues and their solutions through images, pictures, and other interactive modes under a mango tree (Department of health, 2008). With water, a healing safety circle is made around the mango tree which is defined as the community’s own land to come and discuss openly. It is to connect with their community healing systems and beliefs (Department of Health, 2017). For making this genuine local indigenous community engagement, the project team has worked hard to establish trust in the community people as they themselves are being abused by Europeans and ended up abusing their new generations. Their maximized participation will improve their understanding and education about the surrounding world and commitments to their healthy community (Fennell et al., 2018).  

The second primary healthcare principle followed in this video project is a “multidisciplinary team approach.” This program has crucially involved the local Kalumburu community people in the program as key members for training and supporting the community people in building a happy and secure future (Department of health, 2008). It is also visible as one of the community youth Ian has been accepted at the Southern Cross University (its professor is the leader of this program) in Lismore with the support and opportunities provided by the program team (Department of Health, 2017). He is a young Kalumburu who is passionate and loving towards his culture. Seeing him, other youth members of this community will also get motivated and come forward for excelling and getting best education possible (Fennell et al., 2018). The community people themselves are allowed to suggest best ways of education and types of education required with team’s guidance and to be a part of the educational team of this program. The program team honour the courage of the community elders for their commitment and participation (NACCHO, 2016).  

Question 3:

Identify one National Health Priority Area that will be impacted on as a result of the program. Explain how this has the potential to impact the health of children or adults in the community, now or in the future.

The National Health Priority Area that will be impacted on as a result of the Healing Circle program is “Mental Health.” (Australian Indigenous Health InfoNet, 2017). It is because this program is focusing on reducing the loss of health and well-being in the Kalumburu community of Western Australia along with their social functioning linked with increasing mental health issues and mental disorders probably in the youth generation (HealthInfo Net, 2017). The World Health organization defines mental health term as the state of social and emotional wellbeing which helps the person to cope with the normal life stresses and to realise their potentials (Healing Foundation, 2017). This community is also indigenous and the statistics revealed that the 2012-2013 AATSIHS stated that social and emotional wellbeing of these people had been compromised as over 30% of indigenous respondents of age 18 years and above had extreme level of psychological distress (HealthInfo Net, 2017). The mental health issues are 2.7 more in indigenous Australian communities than non-indigenous (Australian Indigenous Health InfoNet, 2017). This program also impacted the mental health priority area because there is a strong relationship between the level of education and their employment status and psychological distress level of indigenous people. The mental trauma in the indigenous community people like Kalumburu is intense due to their loss of land, rights, lack of money for education and lack of employment opportunities at equity base (Healing Foundation, 2017). The social exclusion and lack of opportunities in comparison to non-indigenous Australians has been contributing to their trauma level and disturbed mental health. Colonisation held a profound impact on their health leading to unresolved trauma which is passing down to new generations (Australian Indigenous Health InfoNet, 2017).

This program of Healing Circle is supporting the children as well as adults of this community to heal themselves via the incorporation of their cultural and traditional practices with the combination of broader aspects of western methodologies to attain secure and safe future, (Healing Foundation, 2017). This effective healing program is showing the positive impacts on the community individuals, communities, and families regarding identity and self-worth. They are becoming knowledgeable as exampled through Ian (youth of the community accepted in university) (Healing Foundation, 2017). This program is enabling the community people to identify and accomplish their journey in terms of unfinished trauma and grief due to emotional abuse, sexual abuse, domestic violence, and other issues. The involvement of traditional leaders of this community is enhancing the positive impact of this program (Australian Indigenous Health InfoNet, 2017).

Question 4:

Define cultural competence and cultural safety. Discuss why these concepts are important considerations when developing a program like the one in the video. Provide at least one example from the video where these concepts are demonstrated.

Cultural competence is defined as the behaviours, policies, and attitudes which together develop an efficacious cross cultural working relationship. This means to be responsive and respectful towards the health practices and beliefs as well as the linguistic and cultural needs of the diverse populations (Fennell et al., 2018). The development of cultural competence is a dynamic and evolving process which takes time and usually establishes along the continuum. The term cultural safety is defined as the environment that is safe for people (NACCHO, 2016). Such environment presents no assault, no identity denial, and no challenge to people to get confused over what they require and who they are. The cultural safety is regarding shared meaning, shared respect, shared experience, shared knowledge and learning together with effective listening and dignity (Department of Health, 2017).  

These concepts are the most important considerations when the programs like Healing Circle shown in the video are develop because this helps in creating the environment where the indigenous people are treated well with shear respect to their cultural values, practices, beliefs, and needs (Fennell et al., 2018). These concepts also help the programs to be capable in empowering the marginalized groups to participate effectively in interactions and making them believe that they are valued, and understood. These concepts make the program healthy and capable enough to support culturally significant service delivery (Halliday & Segal, 2012).

From the video, it is clearly visible that the team of Healing Circle program is highly focused on supporting the community people to get educated in a way that fits their lifestyle (NACCHO, 2016). It is because the community elders believe that education must be based over their strong culture to keep their generations attached with it. The tasks in the program are linked with their cultural aspects to make them feel safe and connected to their land (Halliday & Segal, 2012). The program involves the elders to communicate about their experiences and stories and listen to each other under a mango tree which is made safe with the circle of water. They are involved in making their cultural food items and share with everyone with freedom and support (Department of Health, 2017).


Australian Indigenous Health InfoNet. (2017). Overview of Aboriginal and Torres Strait Islander health status 2016. Accessed from http://www.healthinfonet.ecu.edu.au/health-facts/overviews

Department of health (2008). Principles for success for primary health care. Accessed from http://www.health.gov.au/internet/publications/publishing.nsf/Content/health-oatsih-pubs-linkphc~health-oatsih-pubs-linkphc-local~principles

Department of Health (2013). The social determinants of health. Accessed from http://www.health.gov.au/internet/publications/publishing.nsf/Content/oatsih-healthplan-toc~determinants

Department of Health (2017). Indigenous Health. Accessed  from https://www.health.gov.au/internet/main/publishing.nsf/Content/Aboriginal+and+Torres+Strait+Islander+Health-1lp

Fennell, K. M., Hull, M., Jones, M., & Dollman, J. (2018). A comparison of barriers to accessing services for mental and physical health conditions in a sample of rural Australian adults. Rural & Remote Health18(1).

Halliday, D., & Segal, L. (2012). What works in Indigenous primary health care health reform? Accessed fromhttp://www.unisa.edu.au/global/health/sansom/documents/hespg/what%20works%20in%20indigenous%20phc%20reform.pdf

Healing Foundation. (2017). Aboriginal and Torres Strait Islander Healing Programs. Available at- https://healingfoundation.org.au/app/uploads/2017/02/Aboriginal-and-Torres-Strait-Islander-Healing-Programs-A-Literature-Review.pdf

HealthInfo Net. (2017). Social and emotional wellbeing (including mental health). Available at- http://www.healthinfonet.ecu.edu.au/health-facts/overviews/selected-health-conditions/mental-health

NACCHO (2016). Aboriginal Health in Aboriginal Hands. Accessed from http://www.naccho.org.au/

World Health Organization (2017). Chapter 7: Health Systems: principled integrated care. Accessed from http://www.who.int/whr/2003/chapter7/en/index1.html