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HLTC23H3 Issues In Child Health And Development

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HLTC23H3 Issues In Child Health And Development Questions: 1) Choose a child health and development issue from the following list of possible topics. Where you are required to compare the Canadian context with elsewhere, you are encouraged to choose only one or two countries or smaller regions for comparison. i. Child labour in Canada versus a gerontocracy ii. Genetic discrimination in Canada versus elsewhere iii. Marginalization of mothers of children with fetal alcohol spectrum disorder (FASD) in Canada versus elsewhere iv. Indigenous children’s access to health care in Canada versus elsewhere v. Media’s influence on child health in Canada versus elsewhere vi. Children and food (in)security in Canada versus elsewhere vii. Child protection and child soldiers (include a discussion of Canada’s responses) viii. HIV among children/adolescents in Canada versus elsewhere 2) Choose your lenses: in other words, select two (2) to four (4) aspects of your topic to focus upon. Your essay should explore the ways that these factors intersect. political legal economic historical social-cultural Answers: Introduction In between 1910-1970, several indigenous children from Australia were forcibly separated from their families, due to certain government policies. These generations of the children who were removed from their families, under the influence of the government came to be known as the Stolen Generations (Hamilton, 2017). On the other hand, approximately 40% of the indigenous children residing in Canada have been found to live in poverty (Symbol of the Government of Canada, 2018). It is often considered self-evident that appropriate health care services play an important role in improving the health status among children. When compared with the impacts of access to medical care on overall mortality rates, the services prove their role as an essential determinant of children’s health status. In the words of Levesque, Harris and Russell (2013) health care also is also determined by the place, time, and contexts. In other words, access to health care services has been identified important for maintaining and promoting health, preventing diseases, and effectively managing them. Thus, if the indigenous children are provided with adequate access to these services, the rates of unnecessary disability and premature death can be lowered. There is mounting evidence for the discrepancies that exist in the socioeconomic status of the indigenous and their non-indigenous counterparts in both Canada and Australia. This essay will contain draw a comparison between Australia and Canada indigenous children’s access to health care services, in relation to the social-cultural and economic domains. Social-cultural lens- Reports from data published by the government indicates that the Aboriginal and Torres Strait Islander individuals (including children) naturally die at much earlier ages, in comparison to other Australians and manifest an increased likelihood to suffer from disability and poor quality of life. The indigenous children were found less likely than non-Indigenous counterparts for complete immunised in 2009 (, 2011). Time and again it has been proved that there exists an association between health and social and cultural factors (Flottorp et al., 2013). Poverty can be theorised as an exposure persuading the health of persons at dissimilar levels of the society such as, within families and neighbourhoods in which persons reside (Loignon et al., 2015). Furthermore, these diverse stages of influence often co-exist and interrelate with each other to produce health. Some of the major social and cultural variables comprise of socioeconomic status, gender and acculturation and immigration status, poverty, social networks, deprivation, and social support, in addition to collective characteristics of the environments such as, income distribution of income, social capital, and collective efficacy. According to Akinyemiju et al. (2013) low socioeconomic status are manifested by an increase in rates of unemployment, less educational attainment, and poor household size. Absence of health insurance are linked with health care access problems. It has been found that Indigenous Australians manifest greater unemployment rates, when compared to non-Indigenous Australians. In 2006, unemployment rate was 16% that increased to 20% in 2011, and dropped to 18% in 2016 (, 2018). Unemployed indigenous people have lesser household incomes. It has been established that unemployment is related to lack of adequate health insurance. Thus, it can be stated that the indigenous Australians do not get all-inclusive health insurance coverage, which in turn prevents them the children from accessing proper healthcare services. On the other hand, prior to the 2008-20096 recession time, Aboriginals of Canada faced a difficult time in seeking employment opportunities. The typical employment rate for Aboriginals was 57.0% in 2009, compared to 61.8% for non-Aboriginal people (Symbol of Statistics Canada, 2018). Furthermore, unemployment rates also saw a sharp increase for the Canada Aboriginals from 10.4-13.9% in 2008. However, even the unemployed people in Canada have an option of obtaining reasonable health insurance plans, with investments based the household size and income. Hence, the income and household size determines the health coverage and access the indigenous of Canada are entitled to. Marginalised sections of the society that comprises of the vulnerable indigenous population are most affected and deprived of proper access to health services and money, which are considered imperative in the prevention and management of diseases (Morris, Sikora, Tosteson & Davies, 2013).  Price of doctors’ fees, drugs and conveyance to reach healthcare centres are most often devastating, both for the indigenous children and their relatives who require to care for the kids and pay for their treatment. Under worst circumstances, families that are poor often have to sell their property under the encumbrance of their child’s illness. Government reports suggested that on an average, the indigenous Australians earn almost half the income of non-indigenous Australians (, 2018). In contrast, as per data from the Chair in Indigenous Governance (2018) although the regular discrete income of the entire population was an estimated $29,769, but merely $19,132 for a Canadian person of Aboriginal ancestry, and an overwhelming $14,616 for a Canada Aboriginal existing on reserve. Time and again it has been suggested that poverty is a major contributing factor to ill health and acts as a barrier to children’s access to the health amenities. The poor indigenous people of both Australia and Canada cannot pay for good health, together with adequate quantities of food and health care facilities (Agarwal, Satyavada, Kaushik & Kumar, 2018). Mossialos, Wenzl, Osborn and Sarnak (2016) affirms that health care system in Canada is under the protection of the federal law and the services are informed by five discrete principles namely, comprehensiveness, universality, portability, accessibility, and public administration (Chambers & Burnett, 2017). Thus, it can be stated that for both Canada and Australia, indigenous children living in poverty are less likely to procure treatment services from family physicians and/or to acquire preventive and secondary care, thus being more susceptible to report adverse familiarities of care. Traditional education amid most indigenous children of Canada was achieved with the use of different techniques such as, practice and socialisation, observation, community participation, and oral teachings (Kim & Dionne, 2014). Government statistical reports also reveal that the First Nations students obtain 30% less education subsidy, when compared to the non-Indigenous Canadian children. Furthermore, only 62% Canada Aboriginals have high school educational attainment, in contrast to the 78% of the general population (People for Education, 2018). This is in clear contrast with the increase in proportion of indigenous Australians who complete year 12, by as much as 10% in 2016 (, 2017). Reports from 47% Aboriginals and Torres Strait Islanders on the completion of 12 years in school or equivalent indicates that the Canadian government is taking greater efforts in resolving the discrepancy that exists, in relation to educational attainment amid the indigenous population. According to Lam, Broaddus and Surkan (2013) educational status of parents (especially mother) has long been identified as an important predictor of major health consequences, and economic tendencies in the developed world. This in turn has intensified the association between health and education. Poor educational attainment can be cited as a major reason for reduced access to healthcare services among the indigenous population owing to the fact that it is in schools that individuals learn about the ways to live a healthy lifestyle and the different causative factors for preventable diseases. Years of education have been found to be negatively correlated with mortality risk for educational attainment fewer than high school graduation (Syed, Gerber & Sharp, 2013). Hence, less educational attainment among the Aboriginals of Canada and Australia make both the population disadvantaged as they cannot make their children adopt healthy lifestyle. Attaining positive health consequences in the contemporary health care environment necessitates an assortment of factors to arise together that may be exaggerated by scholastic attainment and an amalgamation of soft and hard skills (Baidawi, Mendes & Saunders, 2017). In other words, the indigenous children having educated parents most often benefit from their ability to comprehend their health requirements, track or read instructions, campaign for themselves and their kin, and interconnect efficiently with health providers.  Evidences have also been established for pure gender prejudice in non-treatment working against both poor and non-poor females, with little transformations between the unfortunate and mediocre households (Khera, Jain, Lodha & Ramakrishnan, 2014). Furthermore, there is mounting evidence for the fact that women are found to seek health care facilities for themselves and their children much later, when compared to males. This in turn can also be associated clinically significant outcomes owing to the fact that gender differences play a major role in affecting the health insurance consequences, based on the hypothetical connection between care wanted later and the readiness of insurance companies to provide coverage to females and children. Females have been found to account for 50% of the indigenous Australian population in 2016 (, 2016). Though indigenous girls and women comprise of only 4% of the female Canadian population, they were found to represent an estimated 16% of all woman homicides from 1980-2012 (Amnesty international, 2014). Thus, it can be stated that gender differences are more in amid the Canada Aboriginals, when compared to Australia. This might account for the fact that the women of Canada seek less health care access for their children in Canada. Economic lens- According to The Guardian (2016), the aboriginal disadvantage in Canada is identical that of the Indigenous population residing in Australia. The reason behind this is both the population are the survivors of colonialism. From the Canadian perspective, it can be said that the health of the Canadian population has both private and public part. Canadian populations not only care about their own health, but are also equally conscious about the health of their family. However, the collective state of population health in Canada has significant implications on the overall health care system and the economic system of the country. The economic considerations in turn have significant consequences on the health of the Canadian along with the fiscal sustainability of the healthcare system (The Conference Board of Canada, 2018). As per the reports published by () there occurs a significant health disparities between the Aboriginals and the non-Aboriginal Canadian children. This economic disparity cast a prominent impact on the healthcare access of the indigenous children residing in Canada. According to National Collaboration Centre of Aboriginal Health (2011), census data collected during 2006 stated that there are fewer Aboriginal people residing in Canada (age group: 25 to 34) who have attained high schools level of degree in comparison to the non-indigenous group of population. The lack of awareness of the basic diseases and anatomy of body create a gap in knowledge about the importance of availing healthcare facilities. Their restricted level of knowledge about healthcare is also forbids them in accessing the healthcare services. Thus lack of initial treatment of the children increases the severity of the disease. When the severity of the disease is surfaced, they visit the doctor but at this time the disease prognosis s negatively hampered, increasing the overall healthcare cost. The economic perspective in the in-equal access of the indigenous children health in Canada can also be defined from other perspective. As majority of the children are paralysed or are affected with severe syndrome during their childhood, they are unable to perform regularly in school. It is due to their poor academic degree that they become unsuccessful in getting a job increasing the economic crisis of the family further. However, in order to fight against this health access disparity among the Indigenous children of Canada, the Government of Canada has come up with new policies and funding. For example Indigenous and Northern Affairs Canada (INAC), the federal body responsible for the satisfying the Government of Canada’s commitments and obligations to First Nations, Metis and Inunit has released special funding in order to increase the healthcare access of the Indigenous children so that their basic healthcare demands are meet. Moreover, the Canadian government has also come up with special facility f the residential schools under the funding of $8 billion given by INAC in order to meet their healthcare and educational needs. Moreover, the indigenous communities residing in Canada have special tax benefits known as Child Tax Benefit. The Child Tax Benefit mainly exempts the expenses done against the childhood education and healthcare. However, the majority of the Canadian Indigenous population are un-aware about this Tax Benefit (The Canadian Encyclopedia, 2018). In Australia also, the picture of the Indigenous children access to healthcare is same like that of Canada. Improper access to the healthcare by the Indigenous children residing in Australia has increased the chances of inequality. The inequality in the healthcare access and lack of healthcare awareness has increased the level of smoking and smoking related illness among the people who are aged 14 years and above. Moreover, 1.1 million of the indigenous children suffer from different chronic diseases during the tenure of 2014 to 2015 (Australian Institute of Health and Welfare, 2016). The increase in the burden of diseases has increased the modifiable risk factors behind the use of tobacco. The increase in the tendency of smoking has increased the chances of cancer among the indigenous children and the condition is more pronounced in Australia in comparison to the Canadian sub-continent. This increase in the prevalence of the cancer tendency among the indigenous children and indigenous race of Australia has increased the overall economic burden of healthcare (Australian Institute of Health and Welfare, 2016). The increase in the consumption of the tobacco by the Aboriginal children might have increased the sales figure of the tobacco industry in Australia but at the same time increased the economic cost burden over the Aboriginal family. Australian Institute of Health and Welfare (2016) stated that among the indigenous population residing in Australia, especially to the one living in the remote areas, proper access of the healthy food is very limited. Moreover, children refuse to go to schools and indulge in different in-toxication. This lack of availability of the proper diet and other healthy living conditions make them victims of several non-communicable diseases like diabetes. The cost of care of these diseases is high and thus creating the healthcare burden. At times the Indigenous family are called upon to educate and to increase the healthcare awareness under the community health setup. But under remote areas, setting up the community health setup for education and awareness increases the overall cost burden over the government. Thus significant among of the funding is wasted under community healthset-up. In order to promote the equality of health among the Indigenous group of population in Australia, the government of Australia has come with special policy known as Closing the Gap (Australian Human Rights Commission, 2018). According to the Australian Human Rights Commission (2018), the aim of Closing the Gap policy is to close the health and life-expectancy of the aboriginal and the Torres Strait Islanders and the Aboriginal population residing in Australia. However, Zhao, Vemuri and Arya (2016) are of the opinion that the long term goals of Closing the Gap is not effective is reducing the economic burden of healthcare access among the indigenous population. Effective government initiatives are required to be undertaken in order to reduce the discrimination and at the same time developing local economies. Conclusion- To conclude, it is imperative for all individuals to have adequate access to wide-ranging, quality health care services. Thus, according to Hofstede’s model, there is no difference in the economic and social-cultural aspects of indigenous population between Australia and Canada. Proper access to healthcare facilities will ensure that the entire population is likely to receive best outcomes. However, an analysis of the findings presented above suggests that although the governments of both Canada and Australia have identified the existing health disparities between their indigenous and non-indigenous population, they have not been able to avert the inequalities to a greater extent. Poor economic subsidies, low educational attainment, high rates of unemployment, poverty and lack of health access for the females, who form a considerable part of the indigenous population of both the counties have resulted in threatening situation for the children, by increasing their risk of suffering from chronic conditions. Poor access to health care increases premature death among the children. Owing to the fact that no significant differences were observed among both the nations, the governments must take a collaborative approach to conduct a root-cause analysis and identify the factors that reduce healthcare access among children. References (2017). Strong improvements in Aboriginal and Torres Strait Islander education outcomes. Retrieved from (2018). 2076.0 – Census of Population and Housing: Characteristics of Aboriginal and Torres Strait Islander Australians, 2016. Retrieved from!OpenDocument. Agarwal, S., Satyavada, A., Kaushik, S., & Kumar, R. (2018). Urbanization, urban poverty and health of the urban poor: status, challenges and the way forward. Retrieved from (2018). Aboriginal Australians and poverty. Retrieved from (2011). Access to health and services for Aboriginal and Torres Strait Islander people. Retrieved from Akinyemiju, T. F., Soliman, A. S., Johnson, N. J., Altekruse, S. F., Welch, K., Banerjee, M., … & Merajver, S. (2013). Individual and neighborhood socioeconomic status and healthcare resources in relation to black-white breast cancer survival disparities. Journal of cancer epidemiology, 2013. Amnesty international. (2014). VIOLENCE AGAINST INDIGENOUS WOMEN AND GIRLS IN CANADA: A SUMMARY OF AMNESTY INTERNATIONAL’S CONCERNS AND CALL TO ACTION. Retrieved from Australian Human Rights Commission (2018). Closing the Gap. Access date: 3rd December 2018. Retrieved from:  Australian Institute of Health and Welfare. (2016). Australia’ Health 2016. Access date: 3rd December 2018. Retrieved from:  Baidawi, S., Mendes, P., & Saunders, B. J. (2017). The complexities of cultural support planning for Indigenous children in and leaving out?of?home care: the views of service providers in Victoria, Australia. Child & Family Social Work, 22(2), 731-740. doi: 10.1111/cfs.12289. (2016). 2016 Census: Aboriginal and/or Torres Strait Islander Peoples QuickStats. Retrieved from Chair in Indigenous Governance. (2018). First Nations Poverty in Canada. Retrieved from Chambers, L., & Burnett, K. (2017). Jordan’s Principle: the struggle to access on-reserve health care for high-needs Indigenous children in Canada. American Indian Quarterly, 41(2), 101-124. DOI: 10.5250/amerindiquar.41.2.0101 Flottorp, S. A., Oxman, A. D., Krause, J., Musila, N. R., Wensing, M., Godycki-Cwirko, M., … & Eccles, M. P. (2013). A checklist for identifying determinants of practice: a systematic review and synthesis of frameworks and taxonomies of factors that prevent or enable improvements in healthcare professional practice. Implementation Science, 8(1), 35. Hamilton, P. (2017). Sale of the century?: memory and historical consciousness in Australia. In Memory, History, Nation (pp. 136-152). Routledge. Khera, R., Jain, S., Lodha, R., & Ramakrishnan, S. (2014). Gender bias in child care and child health: global patterns. Archives of disease in childhood, 99(4), 369-374. Kim, E. J. A., & Dionne, L. (2014). Traditional Ecological Knowledge in science education and its integration in grades 7 and 8 Canadian science curriculum documents. Canadian Journal of Science, Mathematics and Technology Education, 14(4), 311-329. Lam, Y., Broaddus, E. T., & Surkan, P. J. (2013). Literacy and healthcare-seeking among women with low educational attainment: analysis of cross-sectional data from the 2011 Nepal demographic and health survey. International journal for equity in health, 12(1), 95. Levesque, J. F., Harris, M. F., & Russell, G. (2013). Patient-centred access to health care: conceptualising access at the interface of health systems and populations. International journal for equity in health, 12(1), 18. Loignon, C., Hudon, C., Goulet, É., Boyer, S., De Laat, M., Fournier, N., … & Bush, P. (2015). Perceived barriers to healthcare for persons living in poverty in Quebec, Canada: the EQUIhealThY project. International journal for equity in health, 14(1), 4. Morris, L. G., Sikora, A. G., Tosteson, T. D., & Davies, L. (2013). The increasing incidence of thyroid cancer: the influence of access to care. Thyroid, 23(7), 885-891.  Mossialos, E., Wenzl, M., Osborn, R., & Sarnak, D. (2016). 2015 international profiles of health care systems. Canadian Agency for Drugs and Technologies in Health. Retrieved from National Collaboration Centre of Aboriginal Health. (2011). An Overview of Aboriginal Health in Canada. People for Education. (2018). What matters in Indigenous education: Implementing a Vision Committed to Holism, Diversity and Engagement. Retrieved from Syed, S. T., Gerber, B. S., & Sharp, L. K. (2013). Traveling towards disease: transportation barriers to health care access. Journal of community health, 38(5), 976-993. Symbol of Statistics Canada. (2018). Aboriginal peoples. Retrieved from Symbol of the Government of Canada. (2018). Aboriginal Peoples: Fact Sheet for Canada. Retrieved from The Canadian Encyclopedia. (2018). Economic Conditions of Indigenous Peoples in Canada. Access date: 3rd December 2018. Retrieved from: The Conference Board of Canada. (2018). Health Matters: An Economic Perspective. Access date: 3rd December 2018. Retrieved from: The Guardian. (2016). ‘It’s the same story’: How Australia and Canada are twinning on bad outcomes for Indigenous people. Access date: 3rd December 2018. Retrieved from: Zhao, Y., Vemuri, S. R., & Arya, D. (2016). The economic benefits of eliminating Indigenous health inequality in the Northern Territory. Medical Journal of Australia, 205(6), 266-269.

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