Health Promotion Need Leadership Roles in population health

Introduction

Cardiovascular disease is a big health issue in Australia, many young people are suffering from the disease and increased risk of stroke, and heart attack. The government is working actively through different health program and in collaboration and consideration World Health Organization to lift this health burden from the nation, as more than 50% of people suffering cardiovascular disease, especially young people, specifically in the indigenous community. As we know that this disease can be due to different reasons, hormonal change, genetics, bad food choices, lifestyle, physical inactivity, etc. thus a comprehensive discussion should be made to understand the seriousness and cause of this health disparity. It is been identified that Indigenous people are the one who is most affected by the disease, due to language barrier, inattentiveness toward health, tobacco smoking, alcohol consumption, food choices, obesity, socio-economic condition, poor nutrition etc. are a few reasons for the escalated issue in the community. In this essay, we are going to discuss this health disparity, vital national and international campaign considering community need and clinical relevance, and in end a conclusion relevant to it will be given.  

Discussion

Major community needs and issues of clinical relevance with particular focus on vulnerable community

Cardiovascular disease is major health burden as estimated 1.4 million people suffer from the disease, young people age 18-40 (more men than women) suffer from the disease, there are various reason the cause the vascular disease among adults, the data shown by Australian Institute of Welfare in 2018 highlights the fact that people who has socio-economic disadvantage are more likely to suffer from the disease (Roever, Tse & Biondi-Zoccai, 2018). About 6% of Aboriginal and Torres Strait Islander people has suffered from stroke, or cardiovascular disease as per ABS Health Survey 2018-2019 (Adair & Lopez, 2020), about 10% of indigenous males suffer from the vascular disease compared to 7% of indigenous females (Sarink et al., 2018), Australia National Health Survey has shown that about 500K people every year suffer from cardiovascular or another heart-related issue, the disease affect blood vessels and heart and the leading cause of death in the nation, as we know that obesity is another health burden in Australia and it’s also lead to the cardiovascular condition, thus we can say that its coexisting issue.

Aboriginal and Torres Strait Islander people are more likely to suffer from the disease compare to non-indigenous people.

• Indigenous people are likely to have heart attack compared to non-indigenous (Labrosciano et., 2017).
• Indigenous people are at higher risk to suffer from coronary heart disease and 1.2 times having a blood pressure issue.
• About 40% of indigenous people aged 15 and over are active tobacco smoker and its 2.8% high compare to non-indigenous 
• Rate of alcohol consumption is also higher which increase the risk of cardiovascular disease.
• Poor diet choice also one of the reason of heart related disease, economic disadvantage contribute to bad diet choices. Self- Reported 2015 highlights fact that young children age 15 and over has inadequate daily nutrition increasing risk of cardiovascular disease (Bank et l., 2016).
• Inadequate physical activity also increase risk of cardiovascular disease, about 60% of adult age 18 and over in non-remote area are physically inactive.
• Inattentiveness toward health, language and cultural barrier also a big hurdle for health promoters.

Leadership Roles in population health and health promotion (Nursing)

In nursing, the leadership skills help in improving healthcare system and health of people as it support nurses and other health professional to identify and address patients need. As cardiovascular disease is big health issue in both indigenous and non-indigenous community, but to different obstacles there is delay in receiving care for indigenous people, such as remote area, economic disadvantage, cultural and language barrier etc. (Eriksson et al., 2017). Nurses play vital role in health promotion as nurse-led innovation in health care field can help in recognising patient need so that effective patient-centered care can be provided to meet those need in compliance to national and organization health care standards. Transitional leader are developing system in healthcare, advocating for people who suffered from health issue is one of the biggest responsibility for health professionals, through different health campaign or direct conversation in hospital with patients to explain information about the healthy lifestyle, promote healthy wellbeing in consideration to patient needs is very efficient, facilitating psychological need of patient with physical wellbeing, coordinating with different organization or with own work place staff to address patient need, using skill  and knowledge to improve patient care. Leadership in nursing is capable to change healthcare field, as there is government led implementation and initiative to promote healthy wellbeing and address health disparity of vulnerable population , there are different challenges and opportunities for nurses in nurse based programs, for which training and experience is supportive in addressing larger population of patients to seek health services. Leadership in health care should be adaptable and nurses must as per organizational and individual needs in compliance to workplace policy and their ethical responsibility. 

• In health promotion identifying population health issue, establishing clear goal and communicate those effectively to address the health disparity.
• Collaboration is other effective way in health promoting to break down the barrier in health promotion, and it’s supportive in conflict resolution, for instance, being community oriented and collaborating with local NGO or translator to break the hurdle of language and culture to provide care and promote healthy wellbeing in indigenous community.
• Being aware of priorities, expectation and patients to create safe approaches to address issue. Mentoring the colleagues, demonstrating therapeutic skills to promote health and wellbeing the community.
• Nurse leader have vital strategic skills that are helpful in creating positive change in health care field.

In health promotion to address the need of patients, and promote healthy wellbeing leadership skills are essential to influence others, transitional care model for economical access to health care for patient, use and implementation of technology to reach wider audience and ensure continues care without any obstacle (Hoert, Herd & Hambrick, 2018),   diverse workforce and training to address the need of population of indigenous group and reduce disparities, quality communication for effective health promotion.

National and internal framework for primary healthcare and health promotion initiative with reference to word health organization.

Indigenous people in Australia has more health issue than other Australian, there is high mortality rate due to cardiovascular disease which concerns the government

Mortality Rate Due to Cardiovascular disease in indigenous Community

Coronary Heart Disease	6.0
Heart Failure	2.5
Total Cardiovascular Disease	6.2%

 

There are number of government led program to address and reduce this health disparity, there are different study and government report that’s highlights the government intervention to improve cardiovascular health of indigenous people. It is been shown that very few program are especially designed for indigenous community as most of government led program include both indigenous and non- indigenous Australians, though many health promoter believe specific intervention or program for indigenous people are more effective to improve cardiovascular health. Indigenous people suffer many disadvantages such as poor income, cultural barrier, etc. that result in reduce quality of life.  Through Council of Australian Governments, the government has tried to address and reduce this health inequality, over the decade there were many health care policies and strategies to improve indigenous health, in order to monitor the effectiveness of these program. Cultural sensitivity, geographical isolation are some hurdle face by government in these program.  The government such as heart health foundation Australia was able to identify the root cause of cardiovascular disparity in indigenous Australian that is economic and social forces influence in the community, all the program are established to identify the cause of the problem, method to deliver the care, prevention of deterioration of health, promoting healthy wellbeing to self-manage their cardiovascular health (Hua et al., 2017).

What work well in the past and existing programs?

National Heart Foundation of Australia program work on promoting bad effect of poor lifestyle choices of health and educate people to detect and manage the side effect those at risk, from promotion of obesity prevention in children, healthy diet, to follow clinical guidelines to avoid the heart related issue.  The close the gap campaign is another such campaign that work on improving overall health of Aboriginal and Torres Strait islander so that risk of cardiovascular disease could be mitigated the campaign main target to improve indigenous people health by 2030 (Crengle et al., 2018). They share report of improvement as developed a comprehensive effective plan to meet the targeted audience need and attain goal for improve quality of life of aboriginal and Torres Strait islander, the campaign ensure there is full participation by community and their representative to address the health needs. As World Health Organization stated that cardiovascular are caused by tobacco use, poor diet, alcohol consumption, physical inactivity, therefore, addressing these behavioural risk in the campaign can help governments and other private organization who work on reducing the CVD (cardiovascular disease prevalence in the community as controlling the behavioral risk already help in managing and avoiding the risk of cardiovascular disease (Reath & O’ Mara, 2018).

What does not work well in the past and existing programs?

The challenges face by health promoter in addressing the need of indigenous people are geographical isolation, lack of access to healthcare, poor distribution of resources, and cultural sensitivity issue of people not preferring to work, communicate outside the community causing poor socio-economic condition. Aboriginal and Torres Strait Islander people didn’t like to talk people outside their community, thus, language barrier is the main reason people in the community unaware about the importance of the campaign conducted by government. This hurdle is consistent in all past program, however, through technology and diverse workforce in the healthcare this gap is narrowing, but still it is not a widely adapted approach by all health institution (Arnold, Hoy & Wong, 2016). The health care system in present work on hiring diverse workforce and collaborate with local NGO to address the bad effect of lifestyle choices on health, as nursing staff in hospital industry are the one who closely work with patient in caring phase, thus, nurses can be trained to promote the healthy choices to care receipt through using therapeutic skills.

Though government has established strategies and effective action plan to identify the hurdles in health promotion and address the disease caused by use of tobacco, alcohol, etc. however, there is no significant or specific national action plan for cardiovascular disease that cause 30% of death and one of the biggest health burden on the nation, there is significant gap in approach to address and control of cardiovascular disease in the country, but much can be done however in cost effective way to avoid the mortality due to this disease and improve life of people living in the indigenous community. 

Recommendation: your recommendation for improvement to past and existing program

As we mentioned above, that how there are different effective campaign and program run by government in consideration to WHO guidelines to identify and manage the risky behaviour that can increase the risk of cardiovascular disease, in consideration to that, there are different campaign that work on addressing side effect of alcohol and tobacco, importance of healthy diet to avoid heart related issue, obesity management campaign all these issue that can eventually led to cardiovascular disease (Knox et al., 2020), though specific campaign for indigenous people to avoid the risk of cardiovascular disease, through including community representative and local NGO to avid language barrier, and training staff involve in the campaign to use therapeutic skills to comfort the patient and explain them about lifestyle choices effecting health or worsening CVD condition (Thurber & Bell, 2019).  Cut in hospital admission can also reduce the immense economic burden and will definitely improve the health in the indigenous community. 

The importance of planning sustainable health program that aims to improve the health outcome of vulnerable population group.

It vital in health promotion in prevention of cardiovascular disease to depend on program value and support organization goal to promote and facilitate health program, for sustainability of program the continued commitment is important attain the goal significantly, for instance, the Gap camping by government to improve quality of life by 2030 is established on the goal to facilitate continuous improvement to attain desired health goal in the community.  Increasing capacity of local system, training to improve knowledge and attitude and ensure collaboration in consideration to relevant polices to ensure program effectiveness in long term in vital in attaining sustainability of health program, identifying indicator for evaluation and seeking feedback from community stakeholder (Calabria et al., 2018), both manual and electronic documentation of the data to measure progress, and establishing long and short term strategies for continuous improvement, identifying risk and making plan to mitigate or eliminate the risk, for instance, making plan to avoid geographic, cultural, language barrier, etc. to ensure effective participation from the community to ensure sustainability of the program.  

 Conclusion

Indigenous people in Australia has more health issue than other Australian, there is high mortality rate due to cardiovascular disease which concerns the government. In health promotion to address the need of patients, and promote healthy wellbeing leadership skills are essential to influence others, transitional care model for economical access to health care for patient, use and implementation of technology to reach wider audience and ensure continues care without any obstacle,   diverse workforce and training to address the need of population of indigenous group and reduce disparities, quality communication for effective health promotion.  Cultural and language barrier with geographical isolation are key hurdle in both past and existing program and lack of specific national plan to address cardiovascular issue in Aboriginal and Torres strait islander is another fact of increase health disparity in the community, though other health related campaign which address poor health choices causing cardiovascular disease directly or indirectly address the issue.  I recommend including community representative and local NGO to avoid language barrier, and training staff involve in the campaign to use therapeutic skills to comfort the patient and explain them about lifestyle choices effecting health to improve the existing campaign to attain the desired goal and to maintain the sustainability of program understanding the need of vulnerable group, including element like electronic documentation of the data to measure progressl and establishing long and short term strategies for continuous improvement, identifying risk and making plan to mitigate or eliminate the risk, for instance, making plan to avoid geographic, cultural, language barrier, etc. to ensure effective participation from the community to ensure the sustainability of the program.

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Reference

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