Gold Coast City Council (GCCC) is the local government in the Gold Coast, Queensland, Australia comprising a large population of Australians. With a population of 593,209 people according to 2016 records, the city registered the largest population growth rate of all local government regions in Queensland by rising to 620,437 in 2019 (Cunningham et al., 2019). The local government area has an adequate healthcare workforce of 8,300 staff that works on a $1.7 billion budget for the 2020-2021 financial period (Gold Coast HHS Service Agreement, 2021). The effective utilization of this expenditure is through identifying the social determinants of health to eliminate challenges and improve care provision, which reiterates the aims of the project.
Aims of the Study
To determine the extent to which the Gold Coast City Council incorporates health equity and considers social health determinants when formulating the municipal policies and processes.
Research Question
How does the Gold City Council consider social determinants of health and health equity in their processes and policies?
Methods
The Rationale of the Research Methods
This research utilizes the qualitative method to assess the healthcare approaches integrated into the health facilities in Gold Coast City to uphold fairness and equal access to adequate care by the whole population. The qualitative method introduces multiple designs to determine the type of data collected, long-term research goals, and perceived outcomes and benefits. Healthcare research often relies on quantitative research to investigate the effectiveness of a given intervention or health policy. This method enables medical researchers to establish the relationship between variables and get a numerical representation of the care effectiveness to give factual representation (Raskind et al., 2019). However, recent changes in the social constructs of healthcare settings to consider perspectives, opinions, and ideas of caregivers and patients to provide holistic, patient-centered, and evidence-based care have led to the introduction of qualitative approaches to medical studies. As a result, this research follows the qualitative methodology since it assesses social determinants of health, which influences relationships, opinions, and expectations (Gold Coast Health, 2021). According to Renjith et al. (2021), qualitative research examines the “how” and “why” of decision-making to rationalize decisions and establish the reasons for healthcare outcomes. As a result, it enables researchers to identify the areas worth improving after recognizing the motives and methods of influencing change.
The goals and methodology of qualitative research fulfill the needs of this study, which affirms the data collection and analysis techniques. Reportedly, the socio-demographic data on the population distribution and healthcare needs of Queensland residents show disparity and gaps worth filling to promote holistic care of the community (Queensland Government, 2021). This approach requires researchers to assess the reasons for the existence of the gap and disparity. The main advantage of this method is its focus on the subjective view of the population and caregivers on the service delivery. These groups are the main stakeholders and influencers of care delivery efforts. The population dictates the level of care they need, while caregivers determine the quality of offered services (Karaca & Durna, 2019). As a result, understanding their perspectives help revamp care provision to address the social determinants of health. However, the subjective view of healthcare limits the use of facts since the study relies on opinions instead of tested and proven approaches to care (Ravindran, 2019). As a result, researchers should not deviate from facts when observing beliefs to assess the construct of healthcare and means of promoting the population’s well-being.
Study Design
Primarily, this research utilizes qualitative perspectives to understand people’s relationships with the care providers to recognize the areas worth improving. This study uses phenomenological, ethnographical, and grounded theory to govern the data collection and analysis to recognize the social health determinants and methods of improving care in the GCCC area. Phenomenological research design investigates people’s lived experiences by describing their traits and relationship with the research topic (Tomaszewski et al., 2020). This design fits the research since it will collect data from Gold Coast City residents to investigate how social determinants of health influence the quality of care they receive. They will illustrate their experience with care quality by elaborating the equality context of care to provide an overview of social determinants of health in the region.
On the other hand, ethnographic design illustrates the cultural perspectives of care to assess the impacts of ethnicity, social background, and culture on the quality of care issued to the patient. As a result, researchers will collect data from a broad cultural context to investigate the individual needs of the residents. Specifically, this design enables researchers to collect unbiased data on the influence of social differences on care quality. This design approach to data collection by attempting to make sense out of their experience and knowledge to emphasize its role in understanding other people’s views of the world (Harwati et al., 2019). Therefore, this method enables researchers to obtain clear insights into the topic and integrate efficient data collection and analysis methods to influence decisions in the healthcare sector of Queensland. Additionally, the grounded theory enriches the research by enabling researchers to formulate a theory for the practice to achieve the required outcomes (Harwati et al., 2019). This design evaluates the collected data, analyzes it, and creates a model for practice to eradicate possible challenges while improving care.
Setting
The population diversity of the Gold Coast City Council makes it the ideal region to investigate the social determinants of health and health equality since various community members have unique needs. The population also introduces unique perspectives, as evident in ethnographic design’s goal of making sense of a particular group’s behaviours by recognizing their responses to specific scenarios (Jones & Smith, 2017). GCCC focuses on providing equitable and top-level care, as evident in its interdisciplinary workforce comprising qualified workers. The city employs 8,300 staff members who perform various medical activities, including diagnosing, prescribing medications, treating patients, interacting with patients’ family members, and communicating disease prevention methods at the community levels to enhance the residents’ wellness. With a budget of $1.2 billion, the city avails high-quality services (Gold Coast Health, 2016). However, the budget does not effectively serve a diverse population with unique needs since they require patient-centred and evidence-based care to achieve good health. The city has a steadily growing population of 679,127 residents, according to 2019 data, a commendable rise from 593,209 people in 2016 (Queensland Government, 2020). The large population makes it the most populous city in Queensland. It also registers the fastest population growth rate.
The population is culturally diverse, as evident in unique practices and multiple languages. Census report shows that 25.2% of GCCC residents were born overseas and brought unique cultures in the region, which promotes cultural diversity. Additionally, Chinese languages – Mandarin, Cantonese, and others – are the most spoken languages after English (The Local Government & Municipal Knowledge Base, 2021). Further, a considerable segment of GCCC residents speaks Japanese, German, and Spanish. The indigenous communities, Aboriginal and Torress Strait Islanders, comprise a small population segment of 1.7% residents (City of Goldcoast, 2021). Their population is significantly lower in this region than in other parts of Queensland at 4%. Additionally, they are younger than the non-indigenous groups, with 32.8% of them being younger than 15 years (City of Goldcoast, 2021). Their population structure is different from non-indigenous communities.
The population structure of the non-indigenous Australians defines the national demographics since they form the largest population segment. Notably, GCCC’s population distribution indicates that most of the population is aged between 25 and 44 years, comprising 30% of the population (PHN Gold Coast, 2021). The city has more women (51.4%) than men (48.6%) (Australian Bureau of Statistics, 2021). This diverse population requires adequate social amenities, such as schools and health facilities, to achieve well-being (Gold Coast Australia, 2021a). The city has hundreds of primary schools, adequate secondary schools, and three major universities – Griffith University, Bond University, and Southern Cross University – which educate the residents to promote their social well-being (Gold Coast Australia, 2021b). These learning centres are the central stage for embracing diversity to integrate indigenous communities into the city.
Data Collection
This study heavily relied on the published records on social health determinants, population distribution, diversity, and health care needs of various members of the population. The reliable sources included government publications from the national bureau of statistics, which avails the public records on the population size and distribution, demographic information on diversity, and age and gender distribution. The inclusion criteria for the data collection methods involved relying on documents published by the Gold Coast City Council to uphold the accuracy and credibility of the collected data. Additionally, the criteria included information on social determinants of health and health equality data to gauge the effectiveness and accessibility of health services to all populations. The social determinants of health included education, safety, and socioeconomic status of the people. Additionally, researchers investigated the behavioral risks of the population, such as nutrition, alcohol consumption, violence, injuries, and physical activity. Collecting this data provided an overall view of the region’s demographics and healthcare needs. The study also used exclusion criteria to eliminate studies that focused on the population as a unit without contemplating disparities and cultural diversity. Ultimately, the data collection method was intended to eradicate bias and promote understanding of health care disparities in the Gold Coast City Council.
Moreover, the researcher used interviews and questionnaires to collect the opinions and perspectives of caregivers and the public to recognize discrepancies and inadequacies in the healthcare system to improve the quality of care and promote the community’s wellness. The success of qualitative research involves evaluating data from the participants’ perspectives to improve their well-being and satisfaction with the offered service. Consequently, it enriches data collection in the healthcare setting by suggesting necessary improvements to improve care. The inclusion criteria for this data collection involved selecting people who have experienced inequality in hospitals, particularly the indigenous communities, to suggest the areas that require improvement.
Data Analysis
The data analysis stage follows the data collection and utilizes the frameworks of the previously listed research designs – phenomenological, ethnographical, and grounded theory. The phenomenological method investigates people’s experiences, which ascertains the importance of collecting primary data from the respondents. Using this information, the researchers can construct tables and graphs to analyze and plot the variables – experiences and elements of care – to illustrate the need for improving service delivery (Qutoshi, 2018). On the other hand, the published records presented valuable information for performing ethnological data analysis, which investigates diversity and the needs of particular groups. For instance, using SPSS software allows researchers to form relationships between the impacts of gender, age, and ethnicity and the quality of care received (Lester, 2020). In essence, content analysis is the primary mode of data collection since the published records present reliable and unbiased data, enabling researchers to make informed decisions. The data source is key to formulating the grounded theory to introduce the best care model for patients.
The comparative analysis of data from the Alliance for Healthy Cities (AFHC) provided the basis for revamping care in Gold Coast City since it suggests the methods for improving care across cultures. The data helps to formulate the grounded theory for improving care quality across the multicultural environment by assessing the needs of individual communities and eliminating the disparity faced by minority communities, particularly the Aboriginals and Torres Strait Islanders, to avail equitable care. The grounded theory enables researchers to investigate individual needs and the population’s perspectives and integrate medically proven and research-supported interventions to promote public wellness (Qutoshi, 2018). The collection of in-depth and extensive data enables the GCCC to formulate healthcare policies that improve the well-being of city dwellers and minority groups.
References
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