Compare the impact of social factors on the health of young rural people to those of young people living in an Australian city.

Question

The ability of young Australians to maintain good health is related largely to the following social factors – socioeconomic status, employment, education, gender, ethnicity, aboriginality, geographical location, sexual orientation, peer influence.

Compare the impact of these social factors on the health of young rural people to those of young people living in an Australian city.

In your answer propose explanations of how each social factor might impact on the health of both groups and discuss any differences, similarities and inequalities that exist. (Approx 1500 words)

Response

“Health” to the World Health Organisation is: ‘a state of complete physical, mental and social wellbeing, and not merely the absence of diseases or infirmity.’ Young people are 12-24 years

(Australia’s Young People: Their Health and Wellbeing 2003).

In June 2003 there were 3.6 million young people. Approximately 16% of them were born overseas. Nearly 70% lived in major cities, 19% lived in inner regional areas and around 11% lived in outer regional and remote areas.

A person’s health is impacted by biomedical and genetic factors; health behaviours; socioeconomic factors; environmental factors; and general background factors (example: culture, politics and policies, media). The health, behaviour and attitudes of young people today are Australia’s future health. Young Aboriginal and Torres Strait Islander people do not share the same good health.

Various social factors contribute to the health of young people

Socioeconomic status

The socially disadvantaged people live shorter lives and suffer more illness than those who are well off. Even those at the middle levels of society exhibit poorer health than the wealthy.

A socioeconomic disadvantaged person may have low income (unable to buy best health services); have poor education and limited access to health services; be unemployed; live in poor housing; and/or working in an unrewarding or menial job. Over time, the disadvantages affect their health and wellbeing. They suffer from anxiety, low self-esteem and social isolation, which influence health-related behaviours and health itself. Socioeconomic status impacts health outcomes and health services delivery, more markedly on the disadvantaged in the rural areas.

Young persons from lower socioeconomic groups are more likely to have lifestyle risk factors (smoking, lack exercise, overweight or obesity risk drinking, lack fruit consumption), report fair or poor health, and suffer from mental retardation, epilepsy, higher hospitalisation rate (especially single mothers). The 2001 National Health Survey found that disadvantaged persons suffer from long-term health conditions including diabetes, diseases of circulatory system and the ear, and arthritis. They have greater use of doctors and hospital outpatient/casualty services, but are less likely to use preventive health services. Disadvantaged indigenous persons have greater risk of ill health, early death and reduced wellbeing.

Australia’s Young People: Their Health and Wellbeing 2003 reported that injury is the leading cause of death of young people, particularly young males (more involved in risk-taking behaviours) who are socioeconomically disadvantaged, people who live in remote and rural areas, and indigenous Australians. Causes of injury varied with socioeconomic status. Persons from low socioeconomic status commit suicide, harm themselves or be killed or assaulted; mid-range socioeconomic groups have transport accidents other than pedestrian injury; and both the very high and very low socioeconomic groups experience pedestrian injuries and drug overdoses.

Studies also found that more likely: female-headed one-parent ...

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Studies also found that more likely: female-headed one-parent families are disadvantaged; homeless young people have mental health problem, often suffer from asthma, bronchitis, HIV infection and tubercolosis; people living in rented premises report fair or poor health status, are smokers, and have serious health problems; unemployment leads to suicide; low socioeconomic status leads to low occupational prestige; and health of prisoners is poor, and they suffer from commicable diseases.

Employment

In a self-assessed health status of labour force, published in Australia’s young people: their health and well being 2003, more employed than unemployed rated their health as ‘excellent’ or ‘very good’; and more unemployed rated their health as ‘poor’ or ‘fair’; and those who were not in the labour force rated their health as better than those who were employed or unemployed.

The 2003 Report found that the unemployed and those not in the labour force were also more likely to suffer from a mental disorder. Anxiety disorders and substance use disorders were most prevalent among young unemployed people and depressive disorders were more prevalent among young people not in the labour force. Unemployment may also lead to isolation, lower socioeconomic status, risks of poverty, poor nutrition, and lack of coping skills.

A study in 1995 found that for the 15-24 year old males, suicide rates were significantly higher for blue-collar occupation, and females showed higher suicide rates in administrative and managerial positions.

Education

Education provides the knowledge and skills to attain good health, and it also provides occupational opportunities and income potential.

In 2002 around 75% of students stayed at school until Year 12 (females 81%, males 70%), but for indigenous students, it was 38%.

The 2003 Report found that people who have completed Year 12 were more likely to rate their health as ‘excellent’ or ‘very good’ compared to those who have completed Year 9.

Data from the Australian Bureau of Statistics show that high levels of psychological distress in young people are more likely caused by poor educational and employment outcomes. The highest levels of psychological distress were found in people who only completed Year 9. Psychological wellbeing is also associated with physical health problems.

Young people who did not complete Year 12 were more likely to be males and were in government schools and in rural areas. They were also more likely to be from a lower socioeconomic background and from English-speaking families and of Aboriginal descent.

Gender

In 2001, within the age groups 12-14 and 18-24 years, males and females were hospitalised at similar rates. In the age group 15-17 years, females were hospitalised at a rate 1.5 times that for males. The main causes of hospitalisation are:

The most frequent diagnosis groups for young women were depressive episode and eating disorders (mainly anorexia nervosa). In addition: males are more likely than females to: suffer from drug dependendence disorder; hospitalised (twice those over females); commit suicide; seek treatment for alcohol and cannabis; injecting drugs; drink alcohol under 18; use cannabis; verbally and physically abuse someone under influence of alcohol or other drugs; consume more fats than recommended; and not eat fruits (males 15-24); and females are more likely than males to: Self-inflict injury associated with mental health problems (1.5 times over males); seek treatment for drugs other than alcohol and cannabis; smoke; be occasional drinkers; diet or exercise to control weight; to not participate in physical activity; and be overweight or obese.

Ethnicity

Migrants generally enjoy good health. They have lower: death rates (Asian migrants); hospitalisation and disability rates; lifestyle-related risk factors (example alcohol and related problems with Islamic migrants); cardiovascular mortality; mortality rate from melonoma; and suicide rates (migrants from Islamic and Catholic countries). They are less overweight and obese but lack physical activity, and exercise (Asian migrants). They have higher death rates from lung cancer, breast cancer (UK and Ireland migrants), cervical cancer (Asian migrants), and diabetes. Some refugee migrants have been traumatised by their experience and suffer from mental health problems.

Because of cultural differences some migrants have problems using the Australian health care system, especially in preventive health care.

Aboriginality

Aboriginal and Torres Strait Islander people have poorer health than the rest of the population. Between 15-24 years their death rates are three times higher; more of them are smokers, and drink alcohol at high risk; and they are overweight. They belong to the lowest socioeconomic groups (in terms of education, employment and income) they suffer from higher rates of illness and mortality.

A number of factors have contributed to their disadvantage: nearly 20% of them live in remote areas where health and welfare services are limited; lack of indigenous health staff to help their community; their sense of loss of control over their lives, and feelings of hopelessness and their marginalisation and exclusion from wider society; live in housing conditions which are unacceptable by general Australian standards (lacking shelter, safe drinking water and sewerage provisions), and being overcrowded they risk infectious diseases such as meningococcal disease, rheumatic fever, tuberculosis and respiratory infections; and significantly less of them had completed Year 12 or had skills training.

Geographical Location

In 2001, more outer regional and remote young people rated their health as ‘fair/poor’ than in 1995. The proportion rating their health as ‘good’ also decreased.

Generally, those who live outside major cities tend to have higher levels of health risk factors and mortality rates. They are more likely to be smokers; drink alcohol in hazardous quantities; be overweight or obese; be physically inactive; have lower levels of education; and have poorer access to work, particularly skilled work; have less access to specialist medical services and a range of other health services; serviced by less general practitioners and other health worker; working in physically risky occupations (farming, forestry, fishing and mining); and travelling on dangerous (higher speeds, fatigue) country roads.

In these areas there is a lack of educational and employment opportunities; prices of commodities such as food and petrol are higher; and limited choice for recreational and leisure activities. Boredom and frustration leads young people to reckless behaviour causing injury or death (poisoning and injury rates being higher than in metropolitan areas).

Sexual Orientation

Sexual health is the capacity to manage sexual and reproductive behaviour in accordance with accepted social and personal ethic. Sexual development is a normal part of adolescence.

About 10% of students surveyed in 1997 were either attracted to the same sex, both sexes or were unsure of their sexuality. They are at risk of marginalisation and isolation. Gay men may be at increased risk of contracting a sexually transmitted infection like HIV/AIDS. Also both males and females in rural areas were found to be more sexually active.

Risks involved with engaging in sexual activity include contracting sexually transmissible diseases and unwanted pregnancy, as well as emotional risks involved with coercion and unwanted sexual activities.

In 2001 more females were affected by chlamydia and syphillis, while both males and females were equally affected by gonorrhoea, and more males suffered from HIV.

Peer Influence

Peer influence may be positive or negative to a person. Where it is negative it may lead to health risks relating to binge drinking, use of illicit drugs especially cannabis, unsafe sex, road injuries, unsafe dieting, and smoking.

For many, alcohol consumption is a group behaviour. Binge drinking can increase the risk of injury from falls, assault, road accidents, fights and other violence, and can foster coercive sexual activity and unprotected sex. Serious binge drinking can lead to alcohol poisoning, coma and death. Long-term excessive use of alcohol can lead to physical, emotional and social problems, including alcohol addiction, poor diet, stomach problems, liver, heart and brain damage, depression, family and relationship problems, and legal and financial difficulties.