Reducing health inequities for asylum seekers with chronic non-communicable diseases : Australian context
- Nkhoma, Gloria, Lim, Chiao, Kennedy, Gerard, Stupans, Leva
- Authors: Nkhoma, Gloria , Lim, Chiao , Kennedy, Gerard , Stupans, Leva
- Date: 2021
- Type: Text , Journal article
- Relation: Australian Journal of Primary Health Vol. 27, no. 2 (2021), p. 130-135
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- Description: Asylum seekers are susceptible to chronic non-communicable diseases pre- and post-arrival due to poor living conditions, unhealthy lifestyles and restrictive and poor access to health services. Despite their need for constant and continuous health care access due to poor health, they face healthcare services access restrictions dependent on their visa conditions in Australia. Some visas only allow access to hospital services with restrictions on primary health services access such as GPs and free or discounted pharmaceutical products. In comparison, disadvantaged host populations have access to free/discounted pharmaceutical products and unrestricted access to primary and secondary health care. Ten professionals who constantly engage with asylum seekers in three large asylum seeker centres in Melbourne were interviewed either face-to-face or over the phone. The interviews were essential to understand how health inequities may be addressed for asylum seekers. Interviews were audio-recorded, transcribed verbatim and analysed using a thematic analysis framework. Their recommendations, based mainly on their experience and evaluation of programs, were: (1) cultural competence training (2) use of interpreters (3) free access to health services and medications (4) use of English learning to promote health literacy and community integration (5) robust chronic non-communicable diseases screening and (6) health promotion and accessible food programs. © 2021 La Trobe University.
- Authors: Nkhoma, Gloria , Lim, Chiao , Kennedy, Gerard , Stupans, Leva
- Date: 2021
- Type: Text , Journal article
- Relation: Australian Journal of Primary Health Vol. 27, no. 2 (2021), p. 130-135
- Full Text:
- Reviewed:
- Description: Asylum seekers are susceptible to chronic non-communicable diseases pre- and post-arrival due to poor living conditions, unhealthy lifestyles and restrictive and poor access to health services. Despite their need for constant and continuous health care access due to poor health, they face healthcare services access restrictions dependent on their visa conditions in Australia. Some visas only allow access to hospital services with restrictions on primary health services access such as GPs and free or discounted pharmaceutical products. In comparison, disadvantaged host populations have access to free/discounted pharmaceutical products and unrestricted access to primary and secondary health care. Ten professionals who constantly engage with asylum seekers in three large asylum seeker centres in Melbourne were interviewed either face-to-face or over the phone. The interviews were essential to understand how health inequities may be addressed for asylum seekers. Interviews were audio-recorded, transcribed verbatim and analysed using a thematic analysis framework. Their recommendations, based mainly on their experience and evaluation of programs, were: (1) cultural competence training (2) use of interpreters (3) free access to health services and medications (4) use of English learning to promote health literacy and community integration (5) robust chronic non-communicable diseases screening and (6) health promotion and accessible food programs. © 2021 La Trobe University.
Chronic ill health in a regional Victoria setting: A 13-year comparison
- Glenister, Kristen, Bourke, Lisa, Terry, Daniel, Simmons, David
- Authors: Glenister, Kristen , Bourke, Lisa , Terry, Daniel , Simmons, David
- Date: 2019
- Type: Text , Journal article
- Relation: Australian Journal of Rural Health Vol. 27, no. 6 (2019), p. 527-534
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- Description: Objective: High-quality data regarding the prevalence of chronic disease in rural areas are essential in understanding the challenges faced by rural populations and for informing strategies to address health care needs. This study compared the prevalence of a range of self-reported chronic conditions and utilisation of GP services and emergency department in a regional Victorian setting between two studies conducted in the same region in 2001-2003 and 2014. Design: Repeat cross-sectional studies conducted over a decade apart. Setting: The projects were conducted in the Goulburn Valley in regional Victoria. Participants: The earlier study randomly selected households from local government lists. The later study randomly selected householders from the telephone directory. Main outcome measures: Participants were asked whether they had been diagnosed with a range of chronic health conditions and how often they had visited a general practitioner or emergency department in the past 12 months. Results: The age-standardised prevalence of depression was higher in the 2014 study than the 2001-2003 study in men (increased by 8.0% (95% CI 4.5, 11.5%)) and women (increased by 13.7% (95% CI 8.4, 19.0%)). Similarly, the prevalence of age-standardised diabetes and hypertension was higher in 2014 than 2001-2003 (men increased by 3.6% (95% CI 0.7, 6.5% (diabetes)) and 13.6% (95% CI 8.6, 18.6% (hypertension)), women increased by 3.1% (95% CI 0.3, 6.5% (diabetes)) and 8.4% (95% CI 2.3, 14.5% (hypertension))). Conclusion: The results of this study indicate that the prevalence of self-reported depression, diabetes and hypertension has increased in this regional Victorian area over the past 13 years. The reasons for these observed increases and the subsequent impact on the health care needs of regional communities warrants further investigation. © 2019 National Rural Health Alliance Ltd.
- Authors: Glenister, Kristen , Bourke, Lisa , Terry, Daniel , Simmons, David
- Date: 2019
- Type: Text , Journal article
- Relation: Australian Journal of Rural Health Vol. 27, no. 6 (2019), p. 527-534
- Full Text:
- Reviewed:
- Description: Objective: High-quality data regarding the prevalence of chronic disease in rural areas are essential in understanding the challenges faced by rural populations and for informing strategies to address health care needs. This study compared the prevalence of a range of self-reported chronic conditions and utilisation of GP services and emergency department in a regional Victorian setting between two studies conducted in the same region in 2001-2003 and 2014. Design: Repeat cross-sectional studies conducted over a decade apart. Setting: The projects were conducted in the Goulburn Valley in regional Victoria. Participants: The earlier study randomly selected households from local government lists. The later study randomly selected householders from the telephone directory. Main outcome measures: Participants were asked whether they had been diagnosed with a range of chronic health conditions and how often they had visited a general practitioner or emergency department in the past 12 months. Results: The age-standardised prevalence of depression was higher in the 2014 study than the 2001-2003 study in men (increased by 8.0% (95% CI 4.5, 11.5%)) and women (increased by 13.7% (95% CI 8.4, 19.0%)). Similarly, the prevalence of age-standardised diabetes and hypertension was higher in 2014 than 2001-2003 (men increased by 3.6% (95% CI 0.7, 6.5% (diabetes)) and 13.6% (95% CI 8.6, 18.6% (hypertension)), women increased by 3.1% (95% CI 0.3, 6.5% (diabetes)) and 8.4% (95% CI 2.3, 14.5% (hypertension))). Conclusion: The results of this study indicate that the prevalence of self-reported depression, diabetes and hypertension has increased in this regional Victorian area over the past 13 years. The reasons for these observed increases and the subsequent impact on the health care needs of regional communities warrants further investigation. © 2019 National Rural Health Alliance Ltd.
Health professional students' rural placement satisfaction and rural practice intentions : a national cross-sectional survey
- Smith, Tony, Sutton, Keith, Pit, Sabrina, Muyambi, Kuda, Terry, Daniel, Farthing, Annie, Courtney, Claire, Cross, Merylin
- Authors: Smith, Tony , Sutton, Keith , Pit, Sabrina , Muyambi, Kuda , Terry, Daniel , Farthing, Annie , Courtney, Claire , Cross, Merylin
- Date: 2018
- Type: Text , Journal article
- Relation: Australian Journal of Rural Health Vol. 26, no. 1 (2018), p. 26-32
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- Description: Objective: The aim of this study was to profile students undertaking placements at University Departments of Rural Health (UDRHs) and investigate factors affecting students' satisfaction and intention to enter rural practice. Design: Cross-sectional survey comprising 21 core questions used by all UDRHs. Setting: Eleven UDRHs across Australia that support students' placements in regional, rural and remote locations. Participants: Medical, nursing and allied health students who participated in UDRH placements between July 2014 and November 2015 and completed the questionnaire. Main outcome measures: Key dependent variables were placement satisfaction and rural practice intention. Descriptive variables were age, gender, Aboriginal or Torres Strait Islander (ATSI) background, location of placement, healthcare discipline, year of study and type and length of placement. Results: A total of 3328 students responded. The sample was predominantly female (79%), the mean age was 26.0 years and 1.8% identified as ATSI. Most placements (69%) were >2 but ≤12 weeks, 80% were in Modified Monash 3, 4 or 5 geographical locations. Public hospitals and community health made up 63% of placements. Students satisfied with their placement had 2.33 higher odds of rural practice intention. Those satisfied with Indigenous cultural training, workplace supervision, access to education resources and accommodation had higher odds of overall satisfaction and post-placement rural practice intention. Conclusions: The majority of students were highly satisfied with their placement and the support provided by rural clinicians and the UDRHs. UDRHs are well placed to provide health professional students with highly satisfactory placements that foster rural practice intention. © 2017 National Rural Health Alliance Inc.
- Authors: Smith, Tony , Sutton, Keith , Pit, Sabrina , Muyambi, Kuda , Terry, Daniel , Farthing, Annie , Courtney, Claire , Cross, Merylin
- Date: 2018
- Type: Text , Journal article
- Relation: Australian Journal of Rural Health Vol. 26, no. 1 (2018), p. 26-32
- Full Text:
- Reviewed:
- Description: Objective: The aim of this study was to profile students undertaking placements at University Departments of Rural Health (UDRHs) and investigate factors affecting students' satisfaction and intention to enter rural practice. Design: Cross-sectional survey comprising 21 core questions used by all UDRHs. Setting: Eleven UDRHs across Australia that support students' placements in regional, rural and remote locations. Participants: Medical, nursing and allied health students who participated in UDRH placements between July 2014 and November 2015 and completed the questionnaire. Main outcome measures: Key dependent variables were placement satisfaction and rural practice intention. Descriptive variables were age, gender, Aboriginal or Torres Strait Islander (ATSI) background, location of placement, healthcare discipline, year of study and type and length of placement. Results: A total of 3328 students responded. The sample was predominantly female (79%), the mean age was 26.0 years and 1.8% identified as ATSI. Most placements (69%) were >2 but ≤12 weeks, 80% were in Modified Monash 3, 4 or 5 geographical locations. Public hospitals and community health made up 63% of placements. Students satisfied with their placement had 2.33 higher odds of rural practice intention. Those satisfied with Indigenous cultural training, workplace supervision, access to education resources and accommodation had higher odds of overall satisfaction and post-placement rural practice intention. Conclusions: The majority of students were highly satisfied with their placement and the support provided by rural clinicians and the UDRHs. UDRHs are well placed to provide health professional students with highly satisfactory placements that foster rural practice intention. © 2017 National Rural Health Alliance Inc.
Integrated and consumer-directed care : a necessary paradigm shift for rural chronic ill health
- Ranson, Nicole, Terry, Daniel, Glenister, Kristen, Adam, Bill, Wright, Julian
- Authors: Ranson, Nicole , Terry, Daniel , Glenister, Kristen , Adam, Bill , Wright, Julian
- Date: 2016
- Type: Text , Journal article , Review
- Relation: Australian Journal of Primary Health Vol. 22, no. 3 (2016), p. 176-180
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- Description: Chronic ill health has recently emerged as the most important health issue on a global scale. Rural communities are disproportionally affected by chronic ill health. Many health systems are centred on the management of acute conditions and are often poorly equipped to deal with chronic ill health. Cardiovascular disease (CVD) is one of the most prominent chronic ill health conditions and the principal cause of mortality worldwide. In this paper, CVD is used as an example to demonstrate the disparity between rural and urban experience of chronic ill health, access to medical care and clinical outcomes. Advances have been made to address chronic ill health through improving self-management strategies, health literacy and access to medical services. However, given the higher incidence of chronic health conditions and poorer clinical outcomes in rural communities, it is imperative that integrated health care emphasises greater collaboration between services. It is also vital that rural GPs are better supported to work with their patients, and that they use consumer-directed approaches to empower patients to direct and coordinate their own care. © La Trobe University 2016.
- Authors: Ranson, Nicole , Terry, Daniel , Glenister, Kristen , Adam, Bill , Wright, Julian
- Date: 2016
- Type: Text , Journal article , Review
- Relation: Australian Journal of Primary Health Vol. 22, no. 3 (2016), p. 176-180
- Full Text:
- Reviewed:
- Description: Chronic ill health has recently emerged as the most important health issue on a global scale. Rural communities are disproportionally affected by chronic ill health. Many health systems are centred on the management of acute conditions and are often poorly equipped to deal with chronic ill health. Cardiovascular disease (CVD) is one of the most prominent chronic ill health conditions and the principal cause of mortality worldwide. In this paper, CVD is used as an example to demonstrate the disparity between rural and urban experience of chronic ill health, access to medical care and clinical outcomes. Advances have been made to address chronic ill health through improving self-management strategies, health literacy and access to medical services. However, given the higher incidence of chronic health conditions and poorer clinical outcomes in rural communities, it is imperative that integrated health care emphasises greater collaboration between services. It is also vital that rural GPs are better supported to work with their patients, and that they use consumer-directed approaches to empower patients to direct and coordinate their own care. © La Trobe University 2016.
Asian migrants' lived experience and acculturation to western health care in rural Tasmania
- Terry, Daniel, Ali, Mohammed, Lê, Quynh
- Authors: Terry, Daniel , Ali, Mohammed , Lê, Quynh
- Date: 2011
- Type: Text , Journal article
- Relation: Australian Journal of Rural Health Vol. 19, no. 6 (2011), p. 318-323
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- Description: Objectives: The study was designed to explore the lived experience of Asian migrants' health care-seeking behaviour in Tasmania, to discern the acculturation process by which Asian migrants are enabled to use the health system and to identify strategies, which assist migrants to understand and use the health system better. Methods: Qualitative research was adopted. Semistructured interviews were conducted with 36 Asian migrants residing in North, South and North West Tasmania, which were recruited through purposive sampling. Results: Six main themes emerged from the interviews: the acculturation process, interactions with the health care system, access issues, culturally appropriate health care, positive health care in Tasmania and suggestions for improving health care. Conclusions: The findings indicated that Asian migrants' views affected their health care-seeking behaviours because of the lack of information, poor communication, limited access and choices in Tasmania. Interestingly, those married to local Tasmanians had the shortest trajectory to health system acculturation. The study recommended developing health and well-being for Asian migrants by increasing access to information regarding navigating the health system and improving access to and awareness of language services. In addition, ensuring adequate, appropriately written, culturally specific and congruent information should be available to assist migrants' transition into a new health care system. Lastly, greater cultural awareness within the health profession to meet the needs of culturally specific individuals and communities is required when they seek care. © 2011 The Authors. Australian Journal of Rural Health © National Rural Health Alliance Inc.
- Authors: Terry, Daniel , Ali, Mohammed , Lê, Quynh
- Date: 2011
- Type: Text , Journal article
- Relation: Australian Journal of Rural Health Vol. 19, no. 6 (2011), p. 318-323
- Full Text:
- Reviewed:
- Description: Objectives: The study was designed to explore the lived experience of Asian migrants' health care-seeking behaviour in Tasmania, to discern the acculturation process by which Asian migrants are enabled to use the health system and to identify strategies, which assist migrants to understand and use the health system better. Methods: Qualitative research was adopted. Semistructured interviews were conducted with 36 Asian migrants residing in North, South and North West Tasmania, which were recruited through purposive sampling. Results: Six main themes emerged from the interviews: the acculturation process, interactions with the health care system, access issues, culturally appropriate health care, positive health care in Tasmania and suggestions for improving health care. Conclusions: The findings indicated that Asian migrants' views affected their health care-seeking behaviours because of the lack of information, poor communication, limited access and choices in Tasmania. Interestingly, those married to local Tasmanians had the shortest trajectory to health system acculturation. The study recommended developing health and well-being for Asian migrants by increasing access to information regarding navigating the health system and improving access to and awareness of language services. In addition, ensuring adequate, appropriately written, culturally specific and congruent information should be available to assist migrants' transition into a new health care system. Lastly, greater cultural awareness within the health profession to meet the needs of culturally specific individuals and communities is required when they seek care. © 2011 The Authors. Australian Journal of Rural Health © National Rural Health Alliance Inc.
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