The nature and extent of the health inequalities

Nature
- impact and prevalence of chronic disease will rise with age

The nature of health inequalities for elderly Australians is that impact and incidence of most
diseases increase. The impact of chronic diseases such as cardiovascular disease, diabetes and
some cancers increase significantly in prevalence and morbidity.

Nature
- Risk of hospitalization due to falls increases at older ages

The risk of hospitalization due to fall increases with age and they often result in fractures or
other serious injuries, with considerable cost to the individual and the health system.

Nature
- mental health problems increase in prevalence with age

Risk of getting a mental health problem increases with age in particular, elderly females. These
include depression, psychological distress and dementia which accounts for the highest burden
of disability.

- main causes of mortality

o coronary heart disease
o cerebrovascular disease
o dementia and Alzheimer’s disease
o cancer (lung, prostate, breast, colorectal)
o chronic pulmonary obstructive disease

extent
- almost 100% have long term health conditions
- higher morbidity rates
- higher mortality rates

Almost 100% of elderly Australians have a long-term health condition. The most common include
eyesight problems, arthritis, hypertension, deafness, musculoskeletal problems, elevated blood
pressure, and elevated cholesterol levels. In general the elderly have higher morbidity and
mortality rates.
Sociocultural, socioeconomic and environmental determinants
Sociocultural
- racial discrimination
- culture related beliefs

Health determinants can be positive in their effect or negative. Social determinants are those
conditions in which people are born, grow, live, work and age, including the health system. These
circumstances are shaped by the distribution of money, power and resources. Sociocultural can
include their health related behaviours These can lead to barriers such as negative mental health
outcomes.
Those of ethnic backgrounds may experience racial discrimination when preference is over them
in situations such as waiting lines. Their culture may encourage smoking and drinking and thus
lead to ill-health.

Socioeconomic
- education
- employment
- income and wealth
- family and neighbourhood
- access to services
- housing

Having minimal or no education in their junior years may have led to a lack of employment. This
would mean that they would have had no stable income or superannuation, affecting how much
they can spend on stable housing and they would have a lower chance of being able to pay for
medical bills.
Elderly people with consistent family or professional support have higher levels of psychological
health and wellbeing than those with limited or no social support; such as having nobody to talk
to and attaining a mental disease, or lack of transport to medical facilities or services.

Environmental

- quality of air, food and water

- housing
- geographic
- food safety

Environmental determinants can be direct/indirect, immediate/delayed, obvious /subtle. The

quality of air, food and water are fundamental to human life, health and well being. They are
whatever surrounds us, both social and physical. The environment in which elderly may live could
have bushfires or dust storms.
Many elderly live in nursing homes where there may or may not be central heating, insulation,
crowding and insufficient protection against noise. These are factors that would greatly affect
the elders health by causing them to get sicknesses or stress.
Food poisoning is a major health risk that can be found in nursing homes where food is
distributed.
The roles of individuals, communities and governments in addressing the health inequities

Individuals

- family members and partners are relied on to provide support

Many older people rely on family members and even partners to provide the necessary support
to maintain their health status and quality of life. Family can help greatly to support the elderly
and recognize the inequities that face them. It is important for individuals to make a stand
against the health inequities that the elderly experience such as what Ewy mentioned.

Communities

- provide aged care

- provide assistant teams and programs

The non-government sector has provided aged care and sustains most of the residential and
community-care centres for a long time. 94% of Australian elderly live in private homes which
means that they greatly rely on the people and services within their community.
Aged Care Assistant Teams (ACAT) determine the eligibility of older people for specific aged care
services including Home and Community Care (HCC) programs which include home nursing
services, delivered meals and transport and shopping assistance.
Most health services are provided in a local community via a partnership between government
and non-government agencies.

Governments

- funding
- general policy

Funding and general policy are the main responsibilities of the Australian government in
addressing the needs of the elderly.
Policies and support programs that improve outcomes relate to dementia, falls, transport and
mobility and the welfare of carers.

Government programs include:

- medicare
- pharmaceutical benefits scheme (PBS)
- aged pension

These are major government programs that contribute significantly to the health of older
Australians. Governments also provide aged care, housing and disability services.

Federal government: provides main source of income support

The Federal government is the main source of income support for people with disability. These
including the Disability Support Pension, Mobility Allowance, Sickness Allowance, Carer
Allowance and Wife Allowance.