Home' Australian Pharmacist : Australian Pharmacist August 2012 Contents 640 Australian Pharmacist August 2012 I ©Pharmaceutical Society of Australia Ltd.
Continuing Professional Development
The articles in this series are independently researched and compiled by PSA commissioned authors and peer reviewed.
determinants of health. There may be
relevant services you can introduce or
expand including health in pregnancy,
immunisation programs, opiate
replacement programs, or risk screening
for cardiovascular disease and diabetes.
You may also wish to examine the manner
in which these services are delivered.
For example, a systematic approach to
screening, whereby at-risk individuals
are actively identi ed and approached,
might facilitate more equitable service
delivery than a patient-driven approach.
If individuals are likely to have di culty
accessing onward referrals (for reasons of
a ordability, proximity, opening hours or
cultural appropriateness), there is a greater
professional obligation to facilitate further
care for patients as part of screening or
disease management processes.
Handling cultural issues appropriately
can be very important in establishing
e ective relationships with consumers.
Pharmacists should strive to ensure
clear communication of information
and encourage questions -- assume
low health literacy levels unless proven
otherwise. Evidence-based behavioural
change strategies should be applied
where necessary to help shift individual
perceptions of what is 'normal' and
healthy. Consult local cultural and ethnic
group representative organisations about
requirements for culturally appropriate
care. Overall, ATSI peoples have some of
the greatest health disparities compared
with the general Australian population.
Cultural awareness training is highly
recommended for any pharmacist with ATSI
clients. Non-Aboriginal health professionals
will bene t from initial support and training
to deliver culturally appropriate care, even if
they have the best of intentions.
Local and national health policies are
also important determinants of access
to quality healthcare for such groups.
The e ects of co-payment increases,
un(der)subsidised professional pharmacy
services and screening programs, and
underuse of home medicines review (HMR)
services may adversely a ect the health
of the most vulnerable in society. Hence
advocacy by pharmacists and pharmacy
organisation is also a crucial aspect of our
The fact that health disparities exist for
certain groups suggests that conventional
clinical approaches are insu cient
for their care. Pharmacists, as highly
accessible health professionals, have an
ethical responsibility to consider how
social determinants of health a ect the
care they provide to patients, and to
advocate for health policy that promotes
access to quality health services for
1. Commission on Social Determinants of Health. Social
determinants of health -- key concepts. World Health
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Australia: Mortality. Health Inequalities Monitoring Series No.
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Australian men and women living outside the capital city
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Australia 2003. Canberra: AIHW; 2007.
7. Murray, KE, Davidson GR, Schweitzer RD. Psychological
wellbeing of refugees resettling in Australia. Melbourne:
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8. Weber M, Banks E, Smith D, et al. Cancer screening among
migrants in an Australian cohort; cross-sectional analyses from
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Aboriginal and Torres Strait Islanders in Mount Isa. Aust J Rural
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to rehabilitation for Aboriginal Australians with disabilities:
the need for culturally safe rehabilitation. Rehabil Psychol
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screening: which groups have inequitable participation and
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on food security in high-income countries. Nutr Rev
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1. Which of the following is NOT a
social determinant of health?
a) Social isolation.
c) Inappropriate healthcare.
d) Penicillin allergy.
2. Which of the following statements is
a) ATSI life expectancy is at least 10--15
years less than the general Australian
b) The adverse health consequences
of socioeconomic disadvantage are
obvious only at the extreme end of the
c) Overall migrant health status is as
good, or better, than that of the
d) Blue-collar workers have higher
mortality rates than their white-collar
3. Which of the following social
circumstances help to explain long-
term di erences in health status?
a) Poor fetal development.
b) Poor health literacy.
c) Chronic stress.
d) All of the above.
4. Which of the following is CORRECT?
a) There is no clear association between
work-related stress and chronic
b) Access issues are only a legitimate
social determinant of health for rural
and remote communities.
c) Peer in uence has a signi cant e ect
on individual health behaviours.
d) All of the above.
A score of 3 out of 4 attracts 0.75 CPD credits.
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