CVD management and prevention in Indigenous Australians is complicated by rural and remote living conditions, lower socio-economic status, cultural differences and the psychosocial losses suffered by the Indigenous due to colonization.
As was previously briefly discussed, cardiac rehabilitation (CR) is well recognised as being effective in CVD management and secondary prevention and is a common intervention, supported by the Australian state and federal government policy (7, 8). (7, 8). Improved clinical and behavioural outcomes have been found due to CR, such as a reduction in successive cardiovascular events and hospitalisation as well improved survival rates (7). CR services are multi-factorial and deliver guidance and education for
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These low attendance rates indicate issues in the healthcare service (7). Referral rates vary from 10 to 60% and are an organisational barrier to access (7). Barriers to CR use include extended family responsibilities, problems with family support and understanding, socio-cultural appropriateness of programs, lack of knowledge about CR, financial issues and connection between colonisation and health services (7).
CR and other secondary prevention interventions need to be flexible and adapted to meet the needs, preferences and cultural safety of Indigenous individuals (7). Patient-centred access to health care must be approachable, acceptable, available, affordable and appropriate (7). A drive time of over an hour is a common barrier of access to CR for individuals living rurally and is linked to the lack of referral to and enrolment in CR (7). Approximately 15% of Indigenous Australians live in geographical regions with poor physical access to CR-providing health services (7). A possible solution to this is the utilisation of alternative methods of delivery such as home-based CR via telehealth or mobile health platforms (7). Coordination to ensure continuity of care for Indigenous patients is necessary to address the lack of knowledge of and referral to CR services (7). Partnerships and information flow between health services and referral pathways create integrated networks (7). While metropolitan public hospitals are a major referral pathway for
Medical travel can be very stressful physically, emotionally, and financially. Moreover, due to very high unemployment rate most of the families cannot afford to have their own transportation vehicles to access primary care in the community. Transportation issue can also lead to missing appointments or delayed treatments. There are minimal health care services in the aboriginal communities, particularly those that are in rural, remote, and in north with limited to access to medical technology, equipment, supplies and medications (HCC, 2013). Majority of Aboriginals do not have access to technology, therefore, access to health information and promotion is limited. Telehealth and other virtual or mobile health care programs are available; the problem is that communities do not always have adequate information and communication technology and other infrastructures to reliably deliver these programs. The lack of a modern
Another social determinant of the aboriginal health is the poor compatibility linking the core values of their customary health beliefs and the modern health system. The westernized medical system is mostly interested in the detection and treatment of diseases and illnesses. On the other hand, the traditional aboriginal medication seeks to offer a meaningful justification for illnesses and reacts to the family, personal, and community issues related to the illness (Broome, 2002). This explains why
Local Aboriginal community control in health is important as this classifies the Aboriginal entire health. Thus, it allows Aboriginal communities to find out their own relationships, protocols and procedures. NACCHO represents local Aboriginal community control at a national level. By making sure that Aboriginal people have a greater right of entry to valuable health care within Australia. A coordinated holistic response is provided by NACCHO from the community sector. Therefore, it is promoting for culturally respectful and approaches to needs requirement. This shows the improvement in health and wellbeing through ACCHSs with better outcome.
The introduction to the western/European way of living, loss of ancestral land, intolerance and the economic disadvantages that Indigenous Australians suffer fuels socially related conditions within their communities such as substance abuse, violence, increased degrees of infectious diseases and chronic diseases etc. culminating in higher mortality rates than non-Indigenous Australians (Duckett & Willcox, 2011, p. 34-35). Stephens, Porter, Nettleton and Willis (2006) state that “infectious disease burden persists for Indigenous communities with high rates of diseases such as tuberculosis, and inequality also exists in the prevalence of chronic disease, including diabetes and heart disease” (p.2022). Statistics show mortality for most age groups of the
As health professionals, we must look beyond individual attributes of Indigenous Australians to gain a greater understanding and a possible explanation of why there are such high rates of ill health issues such as alcoholism, depression, abuse, shorter life expectancy and higher prevalence of diseases including diabetes, heart disease and obesity in our indigenous population. Looking at just the individual aspects and the biomedical health model, we don’t get the context of Aboriginal health. This is why we need to explore in further detail what events could have created such inequities in Aboriginal health. Other details that we should consider are the historical and cultural factors such as, ‘terra nullius’, dispossession and social
According to Vass, Mitchell, and Dhurrkay (2011), the incidence of chronic diseases such as type 2 diabetes, renal disease, cardiovascular disease and chronic obstructive airway disease among Indigenous Australians is quite significant. In addition, the presence of mental health conditions and infectious diseases such as scabies, skin infections and rheumatic fever has also attributed considerably to the disease burden (Vass, et al, 2011). As a disability support worker, I had the opportunity to look after indigenous clients. With my experience working with them, it shed some light on me with how they value their culture and gave me an insight on their view about health concerning issues. I had my misconceptions about how aboriginal people
There has been some major improvement in the health and wellbeing of Indigenous people in the past years, there is still some health issues that remain a problem in the indigenous community which still increase the percentage of mortality and morbidity among the group. As of June 30, 2011, there was an estimated 669,900 Indigenous people across Australia which represent the 3% of total Australian population, where the majority of indigenous Australian live in metropolitan or regional and 8% lives in remote areas of Australia according to Australian Bureau of Statistics (2013). The death rates for indigenous population are much higher compare to non-indigenous population across all age group and largest contributory cause of death are circulatory diseases (Australian Institute of Health and Welfare, 2011).
The benefits of this would be the staff understanding the culture and giving advice and health care that is appropriate to the individual’s needs. Once again by encouraging Indigenous Australians to in fact become the health care workers will also have benefits to these rural communities as they will see that the healthcare is nothing to be afraid of and will seek help when required rather than only when the illness is at its worst. Education is also an important key to Indigenous Australians accessing healthcare, if community leaders are educated to the healthcare that is available then they can pass this on to their community members, also if the community sees that the leaders are comfortable in accessing the health care then this would encourage them to also access the health care. Trust is important as if you do not have the trust within the community then it will quickly spread throughout that the healthcare setting is not to be trusted and Indigenous Australians will be too frightened to attend. Word of mouth is important within the community but you do not want people to have bad experiences then go back to their community and spread the word that they had a bad experience. As quoted by Florence Nightingale “unless we are making progress in our nursing every year, every month, every week, take my word for it we are going backwards.” (Nursing Schools.net,
“The status of Indigenous health in contemporary Australia is a result of historic factors as well as contemporary socio-economic issues” (Hampton & Toombs, 2013, p. 1).
This paper will examine the healthcare of Indigenous Australian peoples compared to non-indigenous Australians. The life expectancy gaps between the two are a cause for alarm when statistics show Indigenous Australian peoples die on average 17 years earlier than non-indigenous Australians (Dick 2017). This paper will examine the social determinants of health to explore these factors and what interventions are in place to improve health status and life expectancy gaps for equality. The Federal Government has seen the implementation of the Northern Territory Intervention and the Closing the Gap Initiative. This essay will examine these two strategies and discuss the effectiveness of both policies. It will explain the differences, similarities and look at the success so far to
As health professionals, we must look beyond individual attributes of Indigenous Australians to gain a greater understanding and a possible explanation of why there are such high rates of ill health issues such as alcoholism, depression, abuse, shorter life expectancy and higher prevalence of diseases including diabetes, heart disease and obesity in our indigenous population. Looking at just the individual aspects and the biomedical health model, we don’t get the context of Aboriginal health. This is why we need to explore in further detail what events could have created such inequities in Aboriginal health. Other details that we should consider are the historical and cultural factors such as, ‘terra nullius’, dispossession and social
The health plan has six key priority areas addressing the main issues concerning health in Aboriginal Victorians (Victorian
Indigenous people are more likely to be obese, have higher mortality rates, higher hospitalisation rates and higher infant mortality rates. The rate of hospitalisation of Indigenous Australians for mental health problems was nearly twice that for other Australians. Injury, poisoning and dialysis were the main causes of hospitalisation for Indigenous Australians. The most common injuries were those inflicted by another person and accidental falls. It has been reported that indigenous people are less likely to seek medical help when feeling ill, and also less likely to continue treatment of an illness.
The concern of social issue in this study is the disproportionate burden of chronic kidney disease in Indigenous Australians. Aboriginal and Torres Strait Islander suffer considerably higher rates of chronic kidney disease than the non-Indigenous population in which 11% of those getting treatment for end-stage kidney disease (ESKD) are Indigenous people. On the other hand, the population of Indigenous Australians is only around 3% of the total population in Australia (Anderson, Cunningham, Devitt, & Cass, 2013; Anderson, Devitt, Cunningham, Preece, & Cass, 2008). Therefore, such condition indicates a serious public health problem due to several barriers that affect Indigenous people’s response towards ESKD and its treatments. Living in remote area with poor health facilities creates a constraint for Aboriginal people to receive equitable treatments while renal specialist, renal transplantation and dialysis services tend to be allocated in the urban area (Cass, Cunningham, Snelling, Wang, & Hoy, 2004; Preston-Thomas, Cass, & O 'Rourke, 2007). Patients with ESKD have to attend dialysis treatment three times a week. Hence, Indigenous people who come from a remote area must leave their community to get dialysis medication. Coming from low socio-economic status and education level, Indigenous people also have to face some difficulties to engage with the treatment services. Effective communication between Indigenous people and health providers during the treatment process might
The Aboriginals also known as the Indigenous people are the first people’s inhabitants of mainland Australia (WIKIPEDIA). Historically, Aboriginals enjoyed better health before any invasions from non-Indigenous peoples. They didn’t suffer from any major illnesses though they did have other type of health issues, but their life was happier and content. Everything started to change after 1788 when non-Indigenous people introduced illnesses where the mortality rate of Aboriginals population started to increase, and this affected their life and the community (http://www.healthinfonet.ecu.edu.au/health-facts/overviews/the-context-of-indigenous-health). There are various factors that contribute to the poor health status of Indigenous people, and this is part of the social determinants of health which should been seen in a broader context (1)(2). Factors such as employment, income, stress, gender, education, behavioral aspects, working and living conditions, social networks and support, are interrelated and complex, and are part of the social