Additional Information
Book Details
Abstract
Australia’s Rural, Remote and Indigenous Health 3e is a practical guide to the delivery of health care in rural and remote Australia. Drawing on personal experiences of rural and remote practitioners, historical accounts, literature analysis and epidemiology, this frank and engaging text examines the economic, social and political forces that shape healthcare in rural and remote Australia.
With limited current resources to support studies in rural and remote healthcare, this title bridges the gap by offering valuable insights into Indigenous life and social determinants of health through the use of storytelling. It is the perfect guide for anyone working in or planning to work in rural, remote or Indeginous Australia; and for those undertaking culturual studies, or social policy.
- Only text covering both rural and remote health in Australia
- Placement preparation with StudentConsult video interviews of experienced rural and remote practitioners providing first-hand experience of rural and remote practice
- Pause and Think questions provide a frame
- Pause and think question boxes train the reader to critically assess and apply concepts to practical situations.
- New Chapter: Working with Indigenous Australians – Written by Shannon Springer, describes how to consult with Indigenous patients and draws on his experience in clinical practice. It offers consultation signposts and practical principles for working with Indigenous Australians.
- New Chapter: Remote health practice – Written by Sue Lenthall, this chapter examines the differences and commonalities between the remote communities and then applies this information to a case study on 'a day in the life of a remote area nurse'. It presents a remote client consultation model and a StudentConsult audio consultation between a nurse and a distant doctor, as well as tips for working in remote practice. The audio consultation gives a first-hand account of the experience of a remote area nurse managing an emergency case.
- Video and audio content – video interviews of experienced rural, remote and Indigenous health practioners as well as students. The videos contain first-hand experience of rural and remote practice as well as tips to help prepare those new to rural or remote practice.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Inside Front Cover | ifc1 | ||
| Australia's Rural, Remote and Indigenous Health: A Social Determinant Perspective | i | ||
| Copyright Page | iv | ||
| Table Of Contents | v | ||
| Video Contents | vii | ||
| Preface | viii | ||
| Foreword | x | ||
| Acknowledgements | xi | ||
| List of Reviewers | xii | ||
| Dedication | xiii | ||
| About the Author | xiv | ||
| About the Contributing Authors | xv | ||
| Introduction | xvii | ||
| Commonly Used Terms | xviii | ||
| 1 Setting the Scene | 1 | ||
| 1 Advance rural Australia | 1 | ||
| Who lives in rural Australia? | 2 | ||
| The first inhabitants | 3 | ||
| ‘Settling’ the country: 1788–1900 | 4 | ||
| Growing the state differences | 6 | ||
| Prostitution | 8 | ||
| Mateship | 8 | ||
| Rural Australia: 1900–2000s | 10 | ||
| Saving the country souls | 11 | ||
| Volunteering rural women | 12 | ||
| Migration | 13 | ||
| Rural decline | 14 | ||
| ‘Country-mindedness’ | 14 | ||
| Leaving the country | 15 | ||
| Rural political forces: enter Hansonism | 16 | ||
| Rural Australia today | 17 | ||
| Conclusion | 19 | ||
| References | 20 | ||
| 2 Defining rural and remote Australia | 23 | ||
| Urban Australia | 24 | ||
| Non-urban Australia | 25 | ||
| What does inner regional Australia look like? | 28 | ||
| What does outer regional or rural Australia look like? | 29 | ||
| Remote Australia | 30 | ||
| What does remote look like? | 31 | ||
| Isolated | 32 | ||
| Why define regional, rural and remote? | 32 | ||
| Classifying for urban, regional and remote regions | 33 | ||
| The three main classification systems used in health | 34 | ||
| Applying the classification to practice in very remote Australia | 37 | ||
| Providing health services in very remote areas | 38 | ||
| Classifying for disadvantage | 40 | ||
| Conclusion | 41 | ||
| References | 42 | ||
| 3 Culture and health | 45 | ||
| What is culture? | 46 | ||
| What is worldview? | 48 | ||
| Understanding health culture | 49 | ||
| Recognising difference | 50 | ||
| International perspectives | 50 | ||
| Rites and rituals | 50 | ||
| Australian culture | 52 | ||
| Typical Aussies | 52 | ||
| Rural culture | 53 | ||
| Medical culture | 55 | ||
| Cultural safety | 55 | ||
| Principles of cultural safety | 56 | ||
| How do you achieve cultural safety? | 57 | ||
| Cultural awareness domain | 57 | ||
| Cultural sensitivity domain | 58 | ||
| Cultural safety domain | 58 | ||
| Cultural safety in Australia | 59 | ||
| What does a culturally safe health care environment look like? | 59 | ||
| Power, authority and health care outcomes | 61 | ||
| Racism | 66 | ||
| What is racism? | 66 | ||
| Stereotyping | 67 | ||
| Prejudice | 67 | ||
| Discrimination | 67 | ||
| Types of racism | 67 | ||
| Institutional racism | 67 | ||
| Cultural racism or ethnocentrism | 68 | ||
| Individual racism | 68 | ||
| Overt and covert racism | 68 | ||
| Dealing with racism – building resilience | 69 | ||
| Social justice | 69 | ||
| Conclusion – It’s a matter of respect | 71 | ||
| References | 72 | ||
| 2 Indigenous Australians' Health | 76 | ||
| 4 Indigenous Australia | 76 | ||
| Setting the scene | 77 | ||
| Who are Indigenous Australians? | 77 | ||
| Colonising the world | 79 | ||
| British colonisation of Australia | 81 | ||
| Australian policies of the day | 82 | ||
| Policy 1 – Colonisation: European settlement 1788–1880 | 82 | ||
| Policy 2 – The White Australia Policy: 1850s–1973 | 83 | ||
| Policy 3 – ‘Protection’ through segregation: 1890s–1950s | 83 | ||
| Policy 4 – Assimilation: 1950s–1960s | 84 | ||
| Policy 5 – Integration: 1967–1972 | 84 | ||
| Policy 6 – Self-determination: 1972–1975 | 84 | ||
| Policy 7 – Self-management 1: 1975–1988 | 84 | ||
| Policy 8 – Self-management 2: 1988–2004 | 84 | ||
| Policy 9 – Shared responsibility: 2004–2014 | 85 | ||
| Policy 10 – Indigenous Advancement Strategy 2014–current | 85 | ||
| Health policy timeline: 1967–2016 | 86 | ||
| Indigenous stereotyping | 97 | ||
| Conclusion | 98 | ||
| References | 99 | ||
| 5 Putting Indigenous policy into practice – the double whammy | 104 | ||
| Putting policy into practice | 107 | ||
| Wages policy | 108 | ||
| The outcome | 115 | ||
| Was it genocide? | 117 | ||
| Assimilation policy | 117 | ||
| ‘Sorry’ seems to have been the hardest word | 120 | ||
| Conclusion – Reconciliation | 120 | ||
| References | 122 | ||
| 6 Working with Indigenous people | 124 | ||
| What is good health? | 125 | ||
| Looking back and going forward | 126 | ||
| Why so many funerals for our mob? | 128 | ||
| What are the causes of the health gap? | 131 | ||
| Improving Indigenous health and wellbeing | 133 | ||
| Risky behaviours for chronic disease | 134 | ||
| Tobacco smoking | 135 | ||
| Obesity | 135 | ||
| Physical inactivity | 136 | ||
| Government and organisational leadership | 137 | ||
| Providing access to appropriate health services | 138 | ||
| Imagine this situation | 138 | ||
| Aboriginal community controlled services | 139 | ||
| Accessing appropriate safe care | 141 | ||
| Effective communication in Indigenous health care | 143 | ||
| The consultation | 143 | ||
| Useful communication tips | 146 | ||
| Twelve principles for working effectively with Australian Indigenous peoples | 148 | ||
| Principle 1: Stand back, be quiet, listen, hear and wait | 148 | ||
| Principle 2: Get to know the local community | 148 | ||
| Principle 3: Be respectful at all times | 148 | ||
| Principle 4: Find a local cultural mentor for advice and guidance | 148 | ||
| Principle 5: Have an open heart | 149 | ||
| Principle 6: Don’t assume you know because you are experienced | 149 | ||
| Principle 7: Communication in practice is King | 149 | ||
| Principle 8: Don’t participate in racist behaviour | 149 | ||
| Principle 9: Learn to laugh at yourself and with others at you | 149 | ||
| Principle 10: The health status | 150 | ||
| Principle 11: Community control | 150 | ||
| Principle 12: Be cognisant of the cycle of staffing | 150 | ||
| Conclusion | 150 | ||
| References | 151 | ||
| 7 Remote Indigenous health | 155 | ||
| Indigenous health | 157 | ||
| Remote infrastructure: The facts | 159 | ||
| FACT: Housing | 159 | ||
| FACT: Water | 159 | ||
| FACT: Electricity | 159 | ||
| FACT: Sewerage | 159 | ||
| FACT: Basic maintenance | 159 | ||
| Employment, food and grog: The facts | 161 | ||
| FACT: Unemployment | 161 | ||
| FACT: CDEP or RJCP | 161 | ||
| FACT: Access to food | 161 | ||
| FACT: Cost of food | 161 | ||
| FACT: Alcohol consumption | 161 | ||
| FACT: Violence against women | 161 | ||
| Lifestyle and education: The facts | 163 | ||
| FACT: Overcrowding | 163 | ||
| FACT: Life expectancy | 163 | ||
| FACT: Cardiovascular disease | 163 | ||
| FACT: Family violence | 163 | ||
| FACT: Access to education | 164 | ||
| FACT: Maternal education | 164 | ||
| FACT: Internet access in remote communities | 164 | ||
| Diseases of poverty: The facts | 165 | ||
| FACT: Income | 165 | ||
| FACT: Diabetes | 165 | ||
| FACT: Renal disease | 165 | ||
| Birth, lifestyle and death: the facts | 167 | ||
| FACT: Maternal mortality | 167 | ||
| FACT: Premature birth incidence | 167 | ||
| FACT: Smoking incidence | 167 | ||
| FACT: Substance abuse | 167 | ||
| FACT: Detention | 167 | ||
| FACT: Suicide | 167 | ||
| Spinning out of control | 169 | ||
| Health expenditure | 171 | ||
| International comparison | 172 | ||
| Mortality rates | 174 | ||
| Infant mortality | 174 | ||
| Breaking the poverty cycle | 176 | ||
| Indigenous statistics | 177 | ||
| Good remote stories | 178 | ||
| Conclusion | 179 | ||
| References | 182 | ||
| 3 The Rural Health Landscape | 188 | ||
| 8 Determining health | 188 | ||
| Health perspectives | 189 | ||
| An international perspective | 189 | ||
| A rural perspective | 190 | ||
| An Indigenous perspective | 192 | ||
| Patient-centred care | 193 | ||
| Contemporary views of health | 194 | ||
| What makes us healthy? | 195 | ||
| Health indicators | 196 | ||
| National health priority areas | 196 | ||
| The determinants of health | 197 | ||
| Determining indigenous Australians’ health | 199 | ||
| Australian colonial determinants of health | 202 | ||
| The cycle of poverty | 203 | ||
| Conclusion | 204 | ||
| References | 206 | ||
| 9 Rural people’s health | 209 | ||
| Healthy Australians | 210 | ||
| The health of rural Australians | 211 | ||
| The triple whammy | 211 | ||
| Age discrimination | 213 | ||
| Older people | 213 | ||
| Young people | 214 | ||
| Cultural discrimination | 214 | ||
| Geographical discrimination | 215 | ||
| Diabetes and the triple whammy | 216 | ||
| Rural culture | 217 | ||
| Providing rural health services | 217 | ||
| Government blame-shifting processes | 218 | ||
| Prioritising rural people’s health | 219 | ||
| Conclusion | 224 | ||
| References | 225 | ||
| 10 Caring for the population | 228 | ||
| Upstream, midstream and downstream approaches to health | 230 | ||
| Public health approach | 231 | ||
| Population health approach | 232 | ||
| What does this mean for the rural and remote primary health care practitioner? | 234 | ||
| ‘Acute’ model versus ‘chronic’ model of care | 234 | ||
| Chronic care | 235 | ||
| Health promotion | 237 | ||
| Principles for health promotion | 238 | ||
| Health promotion should be everyone’s business | 239 | ||
| Primary health care approach | 240 | ||
| Applying the principles of primary health care | 241 | ||
| Yvonne’s and Julie’s different approaches to health | 244 | ||
| Yvonne – The biomedical approach | 244 | ||
| Julie – The primary health care approach | 245 | ||
| Community-controlled health service approach | 246 | ||
| Conclusion | 248 | ||
| References | 249 | ||
| 4 Providing Health Care Services | 251 | ||
| 11 Providing health services – the workforce | 251 | ||
| International workforce perspectives | 253 | ||
| The australian health workforce | 253 | ||
| The rural and remote health workforce | 255 | ||
| The nursing workforce | 255 | ||
| Geographical nursing distribution | 256 | ||
| Rural and remote nurses | 256 | ||
| Rural nurses | 256 | ||
| Remote area nurses | 258 | ||
| Nursing workforce trends | 260 | ||
| Nursing workforce shortages | 260 | ||
| Ageing workforce | 261 | ||
| The medical workforce | 262 | ||
| Geographical distribution | 263 | ||
| Medical specialists | 264 | ||
| Rural medical generalism | 264 | ||
| Remote medical practice | 264 | ||
| Medical workforce trends | 265 | ||
| Cultural change | 266 | ||
| Medical indemnity insurance | 266 | ||
| Feminisation of the medical workforce | 266 | ||
| International medical graduates | 267 | ||
| Indigenous health practitioner workforce | 268 | ||
| Role of the Indigenous health worker | 269 | ||
| Allied health workforce | 270 | ||
| Rural pharmacy workforce | 271 | ||
| Geographical distribution | 272 | ||
| Age and gender profile | 272 | ||
| Pharmacist rural roles | 272 | ||
| Supporting the rural and remote workforce | 272 | ||
| Why do they go and why do they stay? | 273 | ||
| Who goes? | 273 | ||
| Recruitment and retention | 274 | ||
| Why they leave | 275 | ||
| Are we in the right forest? | 276 | ||
| National data-collecting systems | 277 | ||
| Conclusion | 277 | ||
| References | 279 | ||
| 12 Remote health practice | 285 | ||
| Professional roles | 287 | ||
| Scope of practice | 287 | ||
| Key remote health factors | 288 | ||
| The context | 288 | ||
| Common context | 289 | ||
| The common content | 291 | ||
| Remote practice as a separate discipline | 293 | ||
| The remote area nurse | 294 | ||
| RANs – who are they? | 294 | ||
| Where are they? | 295 | ||
| Who do they work for? | 295 | ||
| What do they do? | 295 | ||
| How do they do it? – The RAN Model of Client Consultation | 301 | ||
| Occupational stress | 305 | ||
| Tips in preparing for remote health practice | 306 | ||
| Implications for funders, managers and educational designers | 309 | ||
| Common learning – Interprofessional | 309 | ||
| Interdisciplinary approaches in remote Australia | 311 | ||
| Conclusion | 311 | ||
| References | 313 | ||
| 13 A rural future | 316 | ||
| Social capital | 317 | ||
| Key factors for social capital | 319 | ||
| Trust | 319 | ||
| Business and civic-mindedness … ‘bloody banks’ | 320 | ||
| Volunteering | 321 | ||
| Rural community building | 321 | ||
| Growing health services | 322 | ||
| The rural health movement: two decades of action | 322 | ||
| Planting the organisational seeds | 323 | ||
| Growing the infrastructure | 323 | ||
| Advancing rural Australia’s health | 325 | ||
| A framework for the future | 326 | ||
| Barriers to ‘just’ health services | 326 | ||
| Retarding rural health | 326 | ||
| Appropriate education | 327 | ||
| Conquering the stigma | 327 | ||
| Conclusion – Advance rural Australia | 328 | ||
| References | 329 | ||
| Index | 334 | ||
| A | 334 | ||
| B | 335 | ||
| C | 335 | ||
| D | 336 | ||
| E | 337 | ||
| F | 337 | ||
| G | 337 | ||
| H | 338 | ||
| I | 339 | ||
| J | 340 | ||
| K | 340 | ||
| L | 340 | ||
| M | 340 | ||
| N | 341 | ||
| O | 342 | ||
| P | 342 | ||
| Q | 343 | ||
| R | 343 | ||
| S | 344 | ||
| T | 345 | ||
| U | 345 | ||
| V | 346 | ||
| W | 346 | ||
| X | 346 | ||
| Y | 346 |