Assessment 1: Report- Social Determinants of Health

Introduction 

Diabetes is a leading public health problem in Australia. According to Fenwick et al. (2018), around 25 per cent to 35 per cent reports forms of diabetes ranging from type 2 diabetes mellitus, gestational diabetes to diabetic retinopathy. In over 16 per cent of the Australian population living with diabetes, diabetic macula oedema arises (AIHW, 2020). The total indirect cost of visual impairment in Australia associated with diabetic macular oedema is estimated to be $2.27 billion annually (Koye et al., 2019). It is more than $30,000 per patient with diabetic macular oedema. High blood pressure, overweight and lack of physical activity or sedentary behaviour are the key risk factors for diabetes and this potential risk is modifiable by preventive health education (Hare et al . , 2018). The variability of the socioeconomic status of diabetes has been also demonstrated by epidemiological trials. This assessment aims at highlighting diabetes in Australia. Also, it deals with the analysis of diabetes among the low socioeconomic status Australians. This is followed by .showcasing burden of disease in terms of prevalence and mortality, a public health intervention to address the social determinants of health and involvement of health sectors.  

Social determinants of diabetes for low socioeconomic population

The lower socioeconomic status is that in certain communities in Australia, health disparities are attributed to external causes and circumstances that are beyond the public's influence. People in these demographic groups have had a greater chance of developing diabetes due to poverty and other socioeconomic challenges (Mendenhall et al., 2017).

The burden of diabetes within the low socioeconomic population

Figure 2: Prevalence of diabetes by remoteness, sex and socioeconomic areas

Prevalence 

In the Australian population, the prevalence of diabetes demonstrates a prominent reciprocal socioeconomic continuum, rising progressively as the socioeconomic status region declines. It was recorded that the nationwide prevalence of diabetes was 5.6 per cent and that a twofold high prevalence of Type 2 diabetes mellitus was correlated with low region socioeconomic status. According to the Australian Institute of Health and Welfare (2020), hospitalisation rates attributable to diabetes were significantly higher among the low socioeconomic status. Also, as per AIHW (2020), in 2017-2018, the prevalence of diabetes was higher among the socioeconomically disadvantaged people as compared to the general population and remoteness areas.

Mortality 

In comparison, in communities with lower socioeconomic status compared to those with higher social status, healthcare organizations such as the Australian Institute of Health and Welfare (AIHW) have recorded increasing fatalities due to diabetes. Following the trends of mortality rates due to diabetes, it accounted for 16,700 deaths in 2018 in Australia (AIHW, 2020). Also, mortality rates were higher among the low socioeconomic status and remote populations.  For people living in low socioeconomic status, the deaths were as higher as twice compared to high socioeconomic status (77 per cent and 33 per cent respectively) (AIHW, 2020).

Influence of social determinants of health on the burden of diabetes within the low socioeconomic population

The Social Determinant of Health (SDH) is focused on the environments in which people live, both environmental and economic. Socioeconomic status, which encompasses working status, wages and educational achievement, can be classified in several distinct respects. Few people are living in a more favourable socioeconomic gradient, while many people are already living in disadvantaged situations. Globally, social inequalities are correlated with the risk of acquiring diabetes (Frier et al., 2018). According to AIHW (2020), having higher education and academic skills, the better their health will likely to be. Since greater education could increase employability and better income (Hill et al., 2017). However, while an Australian has a higher qualification rate, according to one study, they are also susceptible towards higher occupational-related stress, leading to inaccessibility or less preparation time for cooking and food, and thus with a high likelihood of intake from a fast-food chain or ready to serve foods (Hill et al., 2017). In terms of high scholastic success, this socioeconomic status and behavioural determinant will improve Australian diabetes acquisition.

Another socioeconomic variable factor that impacts diabetes is income. In general, the higher income earner will have a higher social status and better health for a person. This analysis of inverse socioeconomic gradient and wealth disparity and inequity indicates that in the low-income group prevalence to develop diabetes is higher and access to appropriate health care at the same time impedes them to provide due to the increased expense (Northwood et al . , 2018).  

Living in low socioeconomic areas typically raises the patterns of addiction to smoke cigarettes, inadequate intake of food and insufficient physical activity and overweight, as per the NSW health survey (Hall, 2018). According to the NSW health survey, living under low socioeconomic area generally increases the rates of exposure smoking tobacco, insufficient food consumption and lack of physical activity and obesity (Hall, 2018). Hypertension can also arise from behavioural health determinants such as poor diets. Intake of junk goods containing salt and fat or consuming fast foods serving acidic and unhealthy fats often is adversely correlated with an increased rate of diabetes. Therefore, socio-economically underprivileged communities typically eat certain kinds of food (Thornton et al., 2016). Also, as per AIHW (2016), those from the low socio-economic category were much more likely to smoke every day as estimated back in 2015. 21 per cent of those aged 16 and above in this category smoked daily, four times larger in the high socioeconomic group, and people that smoke consistently is estimated to experience diabetes at 30-40 per cent more frequently (AIHW, 2016).

An intervention to address social determinants of diabetes for low socioeconomic population 

Public health intervention to prevent diabetes in low socioeconomic population and collaborations with other sectors

Diabetes treatment in Australia's low socioeconomic regions requires discussing the root social determinants of diabetes. Identifying the socioeconomic factors, promoting education, employment, work conditions as unequal distribution of these factors can contribute to health disparities as in the underprivileged communities, lack of education has led to ignorance on behavioural risks like smoking and unhealthy eating habits which contribute to diabetes (Thornton et al., 2016). This is why one public intervention to address the low socioeconomic of Australian residence is changing behaviour and creating awareness through mass media integrating a comprehensive analysis of the social determinants of health. Such considerations have included the provision of a homeless person's health care requirements, the promotion of screening, the efficient treatment of chronic diseases and the integration of primary health care for immigrants (Brown et al., 2019). Open collaborations across industries, strong citizen involvement and a dedication to long-term strategies are needed for this approach. 

One public initiative to promote diabetes prevention is via risk factor management, by communicating information and applying evidence and examples of successful strategies and encouraging health habits by mass media. Coordination with multiple entities is necessary for this process of awareness, such as communication networks such as a television network, and integrating awareness through advertisements.  In addition, it will help to mitigate socioeconomic factors common with people living in rural areas by making nutritious vegetables and fruit accessible in the marketplace around which people are unemployed and face difficulty in earning money and or encouraging the agriculture sector to perform workshops and seminars about how to grow vegetables for individuals with poor socioeconomic status (Coupe et al., 2018). In order to improve medical health maintenance service, the government must construct a medical centre for easy connectivity to the closest city hall (Coupe et al . , 2018). Community nurses travel through the towns and region of some countries to monitor their citizens' overall health and this plan works well, maybe using this method would help recognise the need for diabetes intervention and so a correct referral can be carried out (Gourevitch & Thorpe, 2019).

An emerging consensus that economic inequality is a central issue in health policy that politicians and the administration need to address. Raising minimum incomes and increasing levels of assistance for those who are unable to work will be offered direct government benefits to the most vulnerable Australians in order to address income inequalities. This measure would assist citizens with low socioeconomic status to begin a healthier lifestyle (Mendenhall et al., 2017). In order to ensure that charges should not exclude children from educational establishments from low-income backgrounds, there must be a proposal that the Australian Government would provide enhanced flexibility of tuition fees for university and college schooling. This will increase the job qualifications of such children’s (Gourevitch & Thorpe, 2019).

National and regional organisations need to be formally allowed to enter into arrangements to address unemployment for low socioeconomic people, which provide the minimum job opportunities and job for everyone. To sustain the government in decision-making and to provide a precise and up-to-date representation of job protection in Australia, further policy-relevant studies must be carried out (Manios et al., 2018). The low-income family will have a quality life, a stable individual and will also be able to prevent diabetes if the government will take measures on this.

Conclusion 

In conclusion, diabetes is one of the main public health problems, and with the current population shift in Australia and internationally, this disease is projected to have greater importance in the future! Socioeconomic status and its economic gradients, which are wages, education and employment, have been discussed as the determinants of wellbeing. It was analysed that low socioeconomic would likely to develop diabetes especially those who smoke regularly. They are more vulnerable to smoke, insufficient physical activity, unhealthy food intake and obesity. A public health intervention that addresses the determinants of health is the use of social media and online networking sites for awareness and education; therefore, in the treatment of diabetes, authorities and politicians are urged to adapt to these recommendations.