HND Diploma in Health and Social Care
June 27, 2020Bridging the gap between general and special education
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Introduction
The Hmong American community is one of the many non-white communities in the Australian continent that faces a high degree of health disparity due to a wide range of factors including gender, the place of their residence, socioeconomic position, racism and early life influences (Hmong Australians, 2018).
The Hmong group basically belongs to southern China, Northern Vietnam and China. All these components come into the picture and increase the gap associated with health inequality and social disparity (Hmong Australians, 2018). Here one of the core social determinants i.e. the place of residence of the Hmong American community has been assessed to understand how this component interacts with the other upstream, midstream and downstream determinants.
Evidence-based definition of the social determinant – Place of Residence
The place of residence is a major social determinant of health for the Hmong American in Australia that involves the location of his or her stay. According to Danielle C Ompad, the place of residence and a person’s status in the location act as the major factors that influence the health conditions of the community members (Ompad et al., 2007). Various sub-factors exist in this setting such as the pollution issues, industrial activities, housing model and the natural and man-made disasters that affect the health and well being in the community context. The health condition of Hmong American living in the ethnic enclaves within the city is different from the health conditions of the Hmong American immigrants that live in the Australian setting (Ompad et al., 2007).
The place of residence is a key factor that not just determines the characteristics of the population’s attributes but it also has a major impact on the social structure and the access that the people have to different kinds of healthcare facilities. According to the research study by Eleni Lahana and Evelina Pappa, the place at which people of a community live plays a vital role to influence their healthcare needs, health and well-being condition and the health-related disparities that exist in the social setting (Lahana, Pappa & Niakas, 2011).
Impact of the interaction of “Place of Residence”
The place of residents of the Hmong American community members does not function in isolation. It in fact interacts with a number of upstream, midstream and downstream determinants and has a major influence on the health outcome of these community people. The public health framework has been used to capture the core health determinants that have an impact on the public health of the Hmong American people (Fang & Stewart, 2018). In the macro (upstream) setting the major factors that exist include the policies that are introduced by the Australian government relating to their economic conditions, welfare, housing facilities, taxation model. The core determinants of their health condition include the education, employment, occupation and income level, the working conditions, and the place of their stay (Abdelkerim & Grace, 2012).
As most of the Hmong Americans that reside in Australia have transitioned through refugee camps in Thailand, their place of stay is unhygienic and unhealthy. One of the major challenge faced by people includes a high rate of unemployment and poverty. The FECCA New and Emerging Community Policy 2010 have been introduced to support different communities including the Hmong people that reside in Australia (Abdelkerim & Grace, 2012). One of the major positive moves for the Hmong populations is that they are being offered to resettle in Australia based on the Humanitarian Program. There is further scope to design upstream actions by the government such as health policies welfare tools and community-based approach so that the healthcare challenges can be addressed in the process (Lin, Her & Gloria, 2015).
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The key factors that exist in the midstream section of the public health framework include the psychosocial factors and the health behaviours that are adopted by the Hmong American community members at the individual level. The major psychosocial elements that have a direct impact on their health and well-being include the perception, the stress level, the control model, and the self-esteem of the community members, anger, hostility and isolation (Hmong Australians, 2018).
The major health behaviours that have an impact on the health conditions of the minority group living in Australia include the smoking and drinking habits, the self-harm, the nutrition model, the physical activities of the people and the access to the suitable healthcare facilities. Before consulting the physicians about their health, the Hmong American community members take time to discuss it with their family members (Juang & Meschke, 2017). This delays the treatment process and increases health disparity. Due to the culturally and genetically distant nature of the community members, the Hmong people especially men suffer from the Sudden Unexplained Nocturnal Death Syndrome (SUNDS) (Hmong Australians, 2018).
It mainly affects healthy young male members of the community that are in their mid-20s or 30s. Similarly, these people have a high level of stress or trauma due to the exposure to war and their extended stay in refugee camps. Similarly, the health beliefs of people lead to different illness (Vang & Hein, 2017). The natural causes of health disparity include poor quality food, heredity, exposure to bacteria. The other factors include superstitious beliefs and traditional beliefs. All these midstream elements have an association with the place of the residence of the community members which does not give them the chance to get the required exposure about healthy and hygienic habits (Hmong Australians, 2018).
The core micro (downstream) determinants that come into play and have an impact on the health and well being of the Hmong American community members include the physiological system of the population such as the immunity system and the endocrine system, the health attributes such as the life expectancy, the mortality rate and the morbidity rate, and the biological reactions including the blood lipids, intolerance to glucose, the suppressed immune system and their body mass index (Hmong Australians, 2018).
All these downstream factors vary from an individual to individual and thus affect the health condition of the community members living in Australia. When a member of the Hmong community suffers from an illness, the superstitious people think that the illness is the result of the loss of one of the 12 souls of the people. The headaches, back pains, chest pain and abdominal pain are some of the common issues suffered by the Hmong community members that are believed to be caused due to built-up pressure in the human body (Hmong Australians, 2018).
All the upstream, midstream and downstream factors play a vital role along with the identified social determinant relating to the place of residence of the Hmong Americans living in Australia. In fact, the location where the people of the Hmong community live is among the important upstream elements that affect the health condition of the people (Zhou et al., 2018). Since the community members originally not belong to Australia, they face various challenges in different spheres of life which ultimately has a major influence on their health conditions and increases the level of disparity in terms of their mental health, physical health and overall well-being (VHA.org, 2018). Thus there is a direct or indirect linkage between all these determinants that affect the health conditions of the Hmong people. Their location of living along with the other health determinants does not allow them to have access to the required healthcare services that can boost their well-being (Hmong Australians, 2018).
Strategies being adopted currently
A number of strategic models are being implemented in the current times so that the major health determinant i.e. the “place of residence” can positively affect the health conditions of the Hmong people. A Humanitarian Program has been introduced which basically offers the Karen people from the Burma region and the Hmong people of Laos to resettle in Australia so that they can lead a normal life (Peng & Solheim, 2015). One of the best initiatives that have taken place for the Hmong community in the international level is the introduction of the Hmong National Development model that came into existence in the year 1993. The HND has come into existence with the intention to provide all sorts of assistance to the community members so that their overall vulnerability can be reduced and they can lead a normal life.
Over the past decade, the issues of the Hmong community members have grabbed a lot of attention at the international and national setting. A wide range of activities has been introduced in order to enhance the effectiveness of the Hmong community settlement in different parts of the globe. According to “The Hmong of Australia – Culture and Diaspora”, a number of holistic health practices are being introduced for the community members so that the disparity that exists due to their poor health and well being can be minimized in the near future (Allan, 2007).
According to Julian, a wide range of cultural and social factors come into play including the place of the residence of the people that influences the health condition of the members of this community. The religious beliefs of the Hmong people act as a major factor that does not allow the members to have access to proper health and hygiene services. Thus the current focus of different healthcare providers that exist in the national and international setting is to educate these people about a suitable housing model and healthy approaches that must be adopted in order to improve the health conditions (Julian, 2004).
A number of research studies have been carried out in Australia for the purpose of capturing the core factors that affect the health and well being of the community members. The government-sponsored or local community surveys indicate that some of the core elements that need to be strengthened to improve the health conditions of the people include the employment, population, housing, access to healthcare facilities, etc. (Lo, 2017).
In the Australian context, the government has understood the seriousness of the matter relating to the settlement of the Hmong people. Even though the Hmong community is one of the smallest language groups that reside in the island nation, the government has been trying its level best to support and assist the community members so that they can settle in Australia and have access to the basic necessities of life including the food, housing and education. Australia has, in fact, joined the international chorus condemning Thailand’s deportation of the Hmong members (Tapp & Lee, 2010). Due to the constructive initiatives by the Australian government, thousands of the Hmong community members have moved to the country to start a new and healthy life (Ben Doherty, 2018).
The health aspect is one of the major areas that the government is focusing on so that the new generations from the Hmong community can lead a normal life in the national setting. According to the research study titled “Adaptive language strategies of the Hmong – From Asian Mountains to American ghettos” by William A Smalley, a number of language-based strategic frameworks are being introduced by different governments (Smalley, 1985). The fundamental purpose of this kind of the strategic model is to simplify the communication and interaction between the members of the Hmong community members so that they can be aware of the various schemes that have been introduced by them for their housing and health (Vang, 2016). In the current times, one of the major reasons for the poor health condition of the Hmong people is the communication gap which does not allow them to access the appropriate healthcare services. The fundamental intention of the strategic model relating to improved communication is to empower the Hmong community and its members at the national setting.
The government is even focusing on the literacy rate of the people from the Hmong community so that they can get the education and knowledge of healthy living. Many Hmong people have not completed the basic formal education which has an adverse implication on heir health condition and overall well-being. The government is trying to introduce holistic strategic frameworks that shall not just positively influence their health and well being but also constructively influence their entire life (Hmong Australians, 2018).
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The government had been adopting a stable and cultural approach so that the Hmong community members can understand the significance of the basic elements of life such as education, housing, living conditions, income, employment and health. The fundamental objective of the introduced strategic elements is to address the “Place of Residence” determinant within the Hmong American culture so that they can settle in a safe and secure setting and have access to all the basic necessities that can improve their health conditions and minimize the level of health disparity (Lee, 2015).
Recommendations
The current efforts that have been introduced to address the main factors that increase the health disparity among the Hmong community members are not sufficient because there is still scope to improve the physical health, psychological health and overall well being of the community members. A few recommendations have been highlighted that could minimize the health disparity and improve the place of their residence.
The government must capture the key demographic trends relating to the Hmong American community members so that the most effective relocation approaches can be introduced in place. Such an assessment of the demographic aspects forms the very basic element to design the necessary and suitable strategic model to strengthen the education model, the housing model, the employment scene and the health conditions of the people (Aapidata.com, 2018). There is a need to strengthen the overall employment opportunities that are available for the Hmong community members so that their jobs can secure their future and help them to move to better places of residence.
More number of manufacturing jobs can be made available for them so that they can get the opportunity to interact with different society members. It would basically stabilize their income generation capability and help them to enhance their skills and capabilities that can be used in a different industrial setting (Aapidata.com, 2018). Similarly, strategic models could be introduced to reduce the level of poverty among the Hmong community members in the social setting.
This strategy would be linked to the employment opportunities that are introduced for them and it would help them to generate a decent level of income o order to sustainably lead they’re lived in the national setting. The most effective and appropriate policy initiatives could be introduced at the state level and at the centre level of different nations so that they could get better job opportunities and the relevant job training (Aapidata.com, 2018).
There is a need to introduce suitable educational programs for the Hmong community members so that they could be trained and guided to professionally grow in the competitive industrial setting. Such an approach is very necessary that would make sure that the Hmong community members can develop the necessary skills and expertise to meet the future employment and job demands and thus live in decent places of residence. Along with an improved education system, there is a need for better strategic models that could enhance their current housing facilities (Aapidata.com, 2018).
The joblessness, issues relating to credit and lack of exposure of the Hmong community members affect their housing approach which in turn has a major impact on their health and well brings condition. Such issues relating to their housing and residence could be reduced or mitigated by introducing the appropriate policies and rules that can support them in terms of financial literacy, job creation and small business development. Such initiatives at the national level could play a vital role to address the identified social determinant of the health condition of the Hmong community members relating to their “place of residence” (Aapidata.com, 2018).
A large number of factors lead to the increase n the health disparity among the Hmong community members. There is a need to introduce stringent strategic frameworks that focus on minimizing the existing disparity relating to the health conditions and the living conditions of the members of the Hmong community. In the current times, a number of diseases such as cancer diabetes, cardiovascular diseases, etc affect the members of the Hmong community and lead to a high mortality rate (Aapidata.com, 2018).
The public policymakers must ensure that the health-based data can be widely disaggregated among all the people including the Hmong people so that they can be aware of the existing health disparities and the suitable health practices that can enhance their health condition and overall well-being.
Similarly, frameworks and policies can be introduced mainly focusing on the living conditions, the neighbourhood setting of the Hmong population so that they can get the opportunity to live and sustain in a healthy environment (Chiang et al., 2015). Such a strategic move would be useful as it would positively influence their mental and physical health. In fact, future scholars are being motivated to introduce research protocols that can provide more insight and depth about their living conditions and their impact on health and well-being (Aapidata.com, 2018).
The initiatives that are being introduced must adopt a cultural approach so that the Hmong community members can logically understand the significance of a healthy living setting and its impact on their health conditions. These strategic models would be necessary for the purpose of reducing the health disparity gap that currently exists and increases the level of vulnerability of the Hmong community members. Such recommendations have been specifically designed in order to minimize the existing health disparity among the Hmong community members including the men, women, children and the elderly members (Aapidata.com, 2018). He better housing and place of residence would naturally mean the improved health condition of the Hmong people.
Conclusion
The public health framework has been used to capture that link that exists between one of the key social determinants of health namely the place of residence with the other factors that exist in the upstream, midstream and downstream setting. The data that has been used here about the health condition of the Hmong Americans that live in the Australian setting shows that there is high inequality in terms of health and well being of the community members. The place of their stay plays a vital role to mould their thoughts about different components relating to health such as the treatment approach, use of anaesthesia and the surgical procedures.
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