No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
'Think global - act local': Defining roles to address health inequalities.
... A World Health Organization (WHO) commissioned report, The solid facts: Social determinants of health, suggests how research on the social determinants of health can inform national policy development and help reduce health inequalities within countries (Wilkinson & Marmot, 1998). In Australia in 1999, the Population Health Division of Health and Aged Care commissioned a report to inform the development of a long term Australian health inequalities research program contributing to the development of policies and interventions aimed at reducing these inequalities (Harvey, Tsey, Hunter, Cadet-James, Brown, Whiteside & Minniecon, 2001). This report, Socioeconomic determinants of health: ...
... Downstream factors encompass psycho-physiological stress responses whereby accumulated anxiety, insecurity, low self esteem, social isolation and lack of control over social circumstances can result in compromise of the body's homeostatic mechanisms, including the immune system. This, in turn, can lead to increased vulnerability to a range of patho-physiological outcomes including depression, increased susceptibility to infections and chronic disease (Harvey et al., 2001;Turrell et al., 1999). Oldenburg, Mc Guffog and Turrell (2000) state that the framework suggests the following key elements in the development of appropriately targeted interventions and policies; strategies need to be multi-level -addressing both upstream and downstream factors, upstream factors are important in addressing health inequalities at a population level, the setting in which people live and work influences their psychosocial wellbeing and therefore has an impact on their health, policies and interventions outside the health sector impact on health and require intersectoral collaboration. ...
... Emphasising the first four categories of activities, and based on a review of the evidence base in these areas, the authors suggest that further research and development should focus on a model which combines macro-level strategies with individual behavioural change and lifestyle factors (Oldenburg et al., 2000). The last two categories (involving local communities in health initiatives and empowering individuals and improving their social and family networks) incorporate interventions based on the principles of community participation and personal and social development, which form the basis of the Ottawa Charter for Health Promotion (Harvey et al. 2001). The authors noted that, as yet, there was little evidence that these types of initiatives can have an impact on health inequalities (Harvey et al., 2001;Oldenburg et al., 2000). ...
... • individual (psychological) empowerment: improved perception of selfworth and mutuality with social environment • organisational empowerment: stronger social networks and community or organisation competence to collaborate and solve problems • community empowerment: actual improvements in environmental or health conditions (Harvey 2001) ...
... Policies and strategies need to be multilevel and multifaceted. 3,13 Despite all this activity, the question of where to start addressing social determinants of health in Indigenous settings remains a real issue for practitioners in the field. It has been noted this is an area notoriously difficult to research, resource intensive and requiring a long-term commitment as well as the development of appropriate methodologies. ...
Objective: To explore links between the social determinants of health, the ‘control factor’, and an Aboriginal empowerment program.
Methods: The evidence that rank or social status is one of the most important determinants of health is briefly presented. This is followed by a critique of the Australian policy and intervention framework for tackling and reducing social inequalities. The concept of ‘control’ as an important element in addressing social determinants of health is examined next and the Family Wellbeing empowerment program is analysed to illustrate how the concept of control might be operationalised at program or intervention level. Implications for health practitioners are identified.
Results: By providing a safe group environment for participants to explore sets of critical questions about themselves, their families and communities, through the process of participatory action research, Family Wellbeing has demonstrated its potential to ‘enable’ Indigenous people to take greater control and responsibility for their situation. While program participants first address personal and immediate family issues, evidence is emerging of a ripple effect of increasing harmony and capacity to address issues within the wider community
Conclusions: The social determinants of health are complex and multi-layered and so addressing them needs to involve multilevel thinking and action. The control factor is only one element, albeit an important one, and Family Wellbeing is providing evidence that ‘control’ can be addressed in Indigenous settings. For empowerment programs to achieve their full potential, however, there is a need to ensure that such programs reach a critical mass of the target group. It is also imperative that policy-makers and practitioners take a longer-term approach, including properly resourced longitudinal studies to document and enhance the evidence base for such interventions. As health practitioners it is vital we consider our work within this broader context, creatively seek to enhance linkages between services and programs, and support processes for change or intervention at other levels.
This paper aims to describe the growth of a regionally-based mental health team providing services to remote Indigenous communities in far north Queensland.
By drawing on their experience, the authors are able to identify factors supporting the development and sustained capacity of integrated mental health teams, working in challenging remote settings.
ResearchGate has not been able to resolve any references for this publication.