Social Determinants of Health and Community Rebuilding Project Kalumburu

Discuss about the  Primary Health Care In Action and Principles.

As per the given video by Rural Health Channel  (2018), two social determinants that seems to be focused are the social isolation and community environment as both found to be major risk factor for the sexual assault, child abuse and neglect like issues. Both factors play an important role in use of health and social care services. Therefore, the program from the rural health education foundation developed project targeted, Kulumburu village devastated with colonisation, and several negative experiences. The rationale for targeting the community rebuilding project is the maximum complains of past history of trauma and lack of feeling of safety, breach of trust, learning and educational needs, confusion and feeling of shame due to past experiences of abuse.  These factors are associated with poor use of primary health care to maintain health and wellness (Bishop, Seirup,  Pincus & Ross, 2016).

Lack of adequate resources in the community is the other reason people fail to execute their functional role. According to Heiman & Artiga (2015), community support and participation is very important as people can access closer network of people and access more support when in needs. Poor community support is associated with social isolation. Social support network is associated with good health (Park et al., 2013). This project creates strong network for elderly women by promoting their socialisation. They are educated on coping with daily life stress. With the help of the experts’ advice and sharing stories, they can deal with daily life challenges and stress.  With the help of such support, it is possible to address the child neglect problems and promote their well being as well of parents. In turn it impacts the positive mental health development across life span (Lin, 2017). In the Kulumburu village project targeted in the given video, woman and men were given care and support. Meeting with other members of the community under Mango tree, can help them build bigger social network. These strategies are based on evidence and are part of the successful community education program that promotes physical and mental well being (Lin, 2017).

The two primary health care principles guided the project in the video are health promotion and the community participation (McMurray & Clendon, 2015). According to Bath & Wakerman (2015) community participation refers to helping the community to take ownership of the wellness and health. On the other hand the health promotion is the promotion of good health by strengthening the socio-economic condition (McMurray & Clendon, 2015). One of the prerequisites of the health focused in this video is the “education”, social justice and equity, and peace.  In the community building project Kalumburu, an Indigenous community, the project focused on education of elderly women with experiences of sexual assault and men coming together for greater social network through open circles and group meetings.  The project focuses on the principle of community participation and health education.  It is evident from the use of the community resources in promoting health while addressing the problems of health at grassroots level (McMurray & Clendon, 2015).

Health Promotion and Community Participation Principles

Further, the principle of health promotion is used for this project to treat the whole person that is at holistic level by including elders, teenagers, young adults, grandparents, and middle age adults. Overall this promotes social inclusion and collaboration (Nielsen et al., 2015).  Activities like dancing, story-telling, paintings are evidenced based approaches for Indigenous communities adopted by PHC (primary health care) organisations. It acts as a medium to vent of anger and resentment. It will help people help each other with health problems. In addition to contributing to the health equity it also promotes community responsiveness to child maltreatment and other mental health risk factor It will help promote community health by delivering tailored information on healthy lifestyle and healthy aging (Bath & Wakerman, 2015). Illness can be prevented by the above strategies as they contribute to the personal care. These community rebuilding strategies with holistic approach has the potential for community self-determination, women empowerment (Park et al., 2013). Also these strategies are taking into consideration not only social but also the cultural determinants of health.  This community rebuilding project uses the two health principles to maximise the community and individual’s self reliance, control and participation. For example, the meetings in circle will help address any health inequality in the community.

Mental health is the one National Health Priority Area (NHPA) that may affect the program’s results. To address the mental health issues is the main priority of the National Mental health strategy.  It is focused on development of mental health of Australian communities. These goals can be fulfilled by the Kalumburu community project by building the strong communities and support network. It will help in effective functioning of the families by promotion of safe and healthy environment. The strategies used in this project may reduce the social isolation. It helps support families even before the child neglect and abuse can occur. The strategies like dancing; playing, group singing, is an evidenced based option to reduce stress and depression (Negele et al., 2015). The results of the strategies will positively reinforce the community mental health. It will enhance the health and wellbeing of children as it is targeted to people of all age groups. Childhood trauma and depression turns to chronic illness in the adulthood. It is in turn the risk factor for emotional neglect and physical abuse (Truong, Paradies & Priest, 2014). According to Clift, Gilbert & Vella-Burrows (2018), group singing allows increased level of social connectedness. The same is used in the Kulumburu com unity project and has the potential to develop social capital by promoting the sense of belongingness, reduced personal stress, emotional and physical benefits. Thus, the results will positively impact on the relational and community levels (McMurray & Clendon, 2015). In conclusion, the program as a whole has the potential to improve the community mental well being.

Importance of Cultural Competence and Cultural Safety in Health and Social Care

Cultural competence in the health and social care refers to the ability of the system to provide care to people irrespective of their ethnicity, values, beliefs and behaviors, by tailoring strategies to meet the cultural, social and linguistic needs of all the community members.  Cultural competence is the ability to interact effectively with the people of different cultures by being responsive and respectful to their health beliefs (Garneau & Pepin, 2015). Cultural safety refers to practices and environment that are emotionally, socially, physically and culturally safe where people can have no fear of assault or losing their identity (Garneau & Pepin, 2015).

The benefits of considering the factors of cultural competence and cultural safety in program like this are to help the organizations to assess people’s experiences of working with diverse communities. It helps to assess the range of values and beliefs of people targeted to allow working with focus communities. It will help develop policies and procedures for making inclusion possible. Thus, culturally competent projects will use resources to strengthen relationships with groups and communities. It will help consider the target population in all aspects of prevent planning (Garneau & Pepin, 2015). On the other hand considering the cultural safety is important to encourage their sense of identity and self.

The key characteristics of the project targeted to Indigenous population include “Communication, information sharing and transfer of care, cultural education programs and building relationships”. These characteristics align with the key characteristics of the culturally competent care (Truong, Paradies & Priest, 2014).). For instance, the project is promoting supporting relationships with the Indigenous women and men through story telling. It is helping to build the kinship network that involves large extended family members of all age groups.

In this project the culture safety is maintained by truly listening to the people’s concern. The project promoted learning and education of the community people together in a manner that maintained their dignity and relationship of trust, collaboration, and respect to better understand the health issues and access care services. In this project, with the help of circles under Mango tree, people are allowed to be comfortable with themselves to vent their feelings. Not only adults but children are also provided with the safe, positive and nurturing environment, where they can express their culture through dancing and painting like activities.  The same is supported by their family. 

It can be said that it was justified to consider the factors of cultural safety and cultural competence in the project as the health promoting staff can reduce the risk of discrimination or stereotyping.  It will help reduce disparity in accession of health care services by tee community people.  According to Truong, Paradies & Priest (2014) there are positive health outcomes of staff training on cultural competency and safety. It will help develop interventions that address the needs of the target people.

References

Bath, J., & Wakerman, J. (2015). Impact of community participation in primary health care: what is the evidence?. Australian Journal of Primary Health, 21(1), 2-8, Doi: 10.1071/PY12164.

Bishop, T. F., Seirup, J. K., Pincus, H. A., & Ross, J. S. (2016). Population of US practicing psychiatrists declined, 2003–13, which may help explain poor access to mental health care. Health Affairs, 35(7), 1271-1277. DOI: https://doi.org/10.1377/hlthaff.2015.1643

Clift, S., Gilbert, R., & Vella-Burrows, T. (2018). Health and Well-Being Benefits of Singing for Older People. In Music, Health and Wellbeing (pp. 97-120). Palgrave Macmillan, London. DOI: https://doi.org/10.1057/978-1-349-95284-7_6

Garneau, A. B., & Pepin, J. (2015). Cultural competence: A constructivist definition. Journal of Transcultural Nursing, 26(1), 9-15, Retrieved from: https://journals.sagepub.com/doi/abs/10.1177/1043659614541294

Heiman, H. J., & Artiga, S. (2015). Beyond health care: the role of social determinants in promoting health and health equity. Health, 20(10), 1-10. Retrieved from: https://www.issuelab.org/resources/22899/22899.pdf

Lin, N. (2017). Building a network theory of social capital. In Social capital (pp. 3-28). Routledge. Retrieved from> https://www.taylorfrancis.com/books/e/9781351490542/chapters/10.4324%2F9781315129457-1

McMurray, A., & Clendon, J. (2015). Community Health and Wellness-E-book: Primary Health Care in Practice. Elsevier Health Sciences. Retrieved from: https://books.google.co.in/books?hl=en&lr=&id=C4-bBgAAQBAJ&oi=fnd&pg=PP1&dq=models+of+Social+Determinants+of+Health+and+Principles+of+Primary+Health+Care+from+Chapter+1,+McMurray+and+Clendon+(2015).+&ots=Z695UQhrTk&sig=TOpOXozbYTmqtjGIxNc9CQARou0&redir_esc=y#v=onepage&q&f=false

Negele, A., Kaufhold, J., Kallenbach, L., & Leuzinger-Bohleber, M. (2015). Childhood trauma and its relation to chronic depression in adulthood. Depression research and treatment, 2015, doi:  10.1155/2015/650804

Nielsen, L., Meilstrup, C., Nelausen, M. K., Koushede, V., & Holstein, B. E. (2015). Promotion of social and emotional competence: Experiences from a mental health intervention applying a whole school approach. Health Education, 115(3/4), 339-356. DOI: https://doi.org/10.1108/HE-03-2014-0039

Park, J., Kitayama, S., Karasawa, M., Curhan, K., Markus, H. R., Kawakami, N., … & Ryff, C. D. (2013). Clarifying the links between social support and health: Culture, stress, and neuroticism matter. Journal of health psychology, 18(2), 226-235, DOI: 10.1177/1359105312439731

Rural Health Channel.  (2018).  It Takes a Village. YouTube. Retrieved 13 April 2018, from https://www.youtube.com/watch?v=XcXGuq_k2K8

Truong, M., Paradies, Y., & Priest, N. (2014). Interventions to improve cultural competency in healthcare: a systematic review of reviews. BMC health services research, 14(1), 99, doi:  10.1186/1472-6963-14-99