http:/www.myhotessays.com 留学生论文专业定制代写网站留学生Essay写作土著母亲健康的社会决定因素Aboriginal and Torres Strait Islander people,referred to asIndigenous Australians,experience significantly poorer health outcomes than non-Indigenous Australians.This is particularly true for Indigenous women.The difference in life expectancy between Indigenous and non-Indigenous women is some 9.5 years,and Indigenous mothers are three times as likely as non-Indigenous mothers to die during childbirth(AIHW,2014a;AIHW,2014b).There are many complex,interrelated social factors which impact the health of Indigenous people.This paper provides a critical analysis of the social determinants of health for Indigenous mothers in particular.Education is one of the most fundamental social determinants of health,and this is particularly true for Indigenous Australians.Education enables Indigenous women to access and interpret health-related information to prevent ill health,and it also improves their capacity to engage effectively with the health care system when necessary(Jones et al.,2014).In Indigenous women,higher levels of education are directly linked with positive health outcomes;for example,an Indigenous woman is less likely to smoke if she completes secondary schooling(Australian Government Department of Health&Ageing,2012;Biddle&Cameron,2012).However,Indigenous women have poor rates of formal education attainment;just 29%of Indigenous people complete Year 12 compared with a national average of 73%(ABS,2012).Indigenous women with a lower standard of education are more likely to bear a child in their adolescent years,a particular problem for Indigenous women generally,and are also more likely to have a child with a low birthweight(Comino et al.,2009;Osborne et al.,2013).Additionally,Indigenous mothers with lower standards of education are more likely to children with poor educational outcomes;this highlights the significant problems associated with the intergenerational transfer of health and social risk in Indigenous communities(Benzies et al.,2011).Education is related directly to an Indigenous womans level of economic participationspecifically,her ability to gain employment and earn an adequate income,both of which are key predictors of health(Osborne et al.,2013).Research suggests that an Indigenous persons chance of gaining employment increases by 40%if they complete Year 10 and by 53%if they complete Year 12(New South Wales Government Department of Education&Training,2004).However,as with low education,low employment is a significant problem for Indigenous women;indeed,rates of unemployment for Indigenous women are above 16%,compared with a national average of just 4%(ABS,2013).Economic disadvantage resulting from unemployment is a significant predictor of poor health.Booth and Carrol(2008)suggest that economic variables can explain up to 50%of the disparity in health between Indigenous and non-Indigenous Australians.Additionally,and demonstrating the cyclical nature of socioeconomic disadvantage and poor health in Indigenous communities,research also suggests that poor health may explain 60%of the disparity in employment participation between Indigenous and non-Indigenous women(Kalb et al.,2011).Unemployment and socioeconomic disadvantage may affect the health of Indigenous women in a range of ways.Primarily,limited disposable incomein combination with a lack of food storage and cooking facilities within households and,particularly within remote communities,lack of access to fresh food itselfmeans indigenous women have reduced access to nutritionally-appropriate foods and lower food security(Osborne et al.,2013;Browne et al.,2014).Indeed,the diets of Indigenous people in many regions are characterised by a high intake of saturated fats,refined carbohydrates and salt,and little to no intake of fresh fibre-rich foods(ABS,2006).In Indigenous women,as in all women,nutrition is fundamental to health in the ante-,intra-and post-partum periods(Browne et al.,2014).Poor dietary intake leads to high rates of gestational diabetes mellitus among Indigenous mothers5.1%,compared with a national average of 4.5%(2000-2009 estimate)(Chamberlain et al.,2014）.Poor nutritional status also underpins the burden of chronic disease evident in Indigenous women and particularly chronic diseases related to obesity,which are a significant problem in Indigenous communities(Liaw et al.,2011).Around 60%of Indigenous women aged 25-55 years have a body mass index which indicates they areobese(ABS,2006).Because of the risks posed by chronic disease,Indigenous mothers are significantly more likely than non-Indigenous mothers to require antenatal hospital admission（Badgery-Parker et al.,2012).Additionally,maternal chronic disease means that around 11%of indigenous neonates have a low birthweight(ABS,2014).This is an important marker for increased risk of chronic disease,again demonstrating the cyclical nature of socioeconomic disa