HLTH3001 Aboriginal And Torres Strait Islander Health

Introduction

Cardiovascular disease (CVD) is the heart and blood vessels disorder, and most of them are associated with life-threatening events. The common CVDs include high blood pressure, heart failure, coronary heart disease, and stroke. CVD is a major health issue affecting Aboriginal and Torres Strait Islander (A & TSI)  people.

Major health issue affecting the A & TSI people

According to Stoner, Stoner, Young, and Fryer (2012),  CVD in most cases are linked to atherosclerosis, which is a gradual accumulation of fats inside the arteries and high risk of blood clot. It is also linked to the destruction of arteries in body organs like the heart, brain, and kidney. Coronary heart disease is caused by blockage of the flow of oxygenated blood to heart muscle (Stoner et al., 2012). The obstruction strains the heart and can lead to heart failure, heart attack, and angina. Stroke is caused by blood supply to parts of the brain beig cut off, resulting in brain damage and probably deaths. High blood pressure caused by too much pressure that is applied to the arterial walls.

The causes of CVD isn’t apparent, but there are various risk factors associated with it. It is caused by multiple elements which increase the risk of an individual getting it known as risk factors. The risk factors are directly proportional to cardiovascular diseases. Hunter (2010) denotes that, high blood pressure is a common risk factor for CVD. If it increases, it damages the blood vessels. Diabetes is a condition that raises blood sugar levels. The high levels of blood sugars narrow the blood vessels causing their damage. Tobacco use which includes smoking is a primary CVD risk factor due to the harmful substances in tobacco which narrows blood vessels. High cholesterol increases the risk of causing a blood clot and also causes narrowing of the blood vessels. Inactive individuals, e.g., not exercising regularly as noted by Stoner et al. (2012) are more likely to have high cholesterol levels, high blood pressure and being overweight, all of which are CVD risk factors. There has been evidence of psychological factors playing a role in the development, etiology and outcome of CVD. Most common factors include depression, anxiety, and stress.

CVD affects most of the A & TSI people. According to Australian Aboriginal and Torres Strait Islander health survey (AATSIHS), in the year 2012 – 2013, 13% of this population had some forms of CVD (Artuso, Cargo, Brown, & Daniel, 2013). One in twenty-five were reported to have a stroke and heart failure, while one in twenty people had high blood pressure. In the same year, more women had CVD than the men. Several of the A & TSI people in the isolated areas reported having heart diseases than those in non-isolated areas. In 2014 – 2015, 6% of the hospitalizations were caused by CVD. Coronary heart disease caused 40%, heart failure 15%, stroke 7%, peripheral vascular disease 4%, rheumatic disease 4% and hypertensive heart disease 3%. In 2015, the A & TSI people were twice likely to die from ischaemic heart disease compared to the non-indigenous Australian population.

Main social determinants associated with CVD concerning A & TSI peoples

Disparities in health are caused due to the conditions in which people live, grow, work and the systems put in place to counteract the health issues. Various studies have shown that there is a health gap between one-third and one-half A & TSI peoples and non-Indigenous Australians. The gap is linked to the differences in socioeconomic status which include employment, income, and education (Hampton & Toombs, 2013). The social determinants of health can affect a person’s risk of disease, health status, harm and access to health services.

In the year 2012 – 13, high rates of high blood pressure were reported to be higher to those who completed year ten at 38% compared to those who completed year twelve at 18%. Brown, Mentha, Howard, Rowley, Reilly, Paquet and O’Dea (2016) notes that there is a link between health and education which is further associated with economic opportunities. A greater number of A & TSI peoples who complete year twelve are not daily smokers unlike those who school to year ten and below. Addiction has been perceived to offer the indigenous people an escape from deteriorated lifestyles, though it worsens the situation. Drug and alcohol misuse is a risk factor for CVD. Employment and training are the significant health of the A & TSI peoples. Those unemployed undergo heart diseases, anxiety and depression (Shepherd, Li, & Zubrick, 2012). Those facing CVD related issues have poor health and therefore are unlikely to be employed.

A rise in socioeconomic disadvantage results to living unaffordable, insecure or poor quality housing with poor health conditions. Stress, anxiety, and depression related to the housing challenges adversely contribute to CVDs. Indigenous health disadvantage is a creation of accrued life experiences of socioeconomic disparities. Early childhood is critical in physiological and psychological development. Exposing children to stressors according to Weetra, Glover, Buckskin, Ah Kit, Leane, Mitchell and Kit (2016) in economic and social dispossession have long-lasting and negative impacts which include CVDs.

Existing approach to address CVD in the Aboriginal and Torres Strait Islander peoples

CVD contributes significantly to the A & TSI people’s poor health and reduced life expectancy. Due to this fact, a program known as Better Cardiac Care for A & TSI  People project was created by the Australian Health Ministers’ Advisory Council (AHMAC). The initiative aimed to reduce illness and mortality among the indigenous Australian’s. The reduction of morbidity and mortality according to King, Smith, and Gracey (2013) is accomplished by improving care conditions, managing risk factors and treating them in a better way and enhancing access to health services.

The approach was developed to enhance primary preventive care which entails early CVDs assessment and management. It was also created to get Australia aligned with best practices guidelines nationally and internationally for chronic diseases and cardiac care. It was also informed by the service standards that are critical for equitable national cardiovascular care (Mills, Gatton, Mahoney, & Nelson, 2017). AHMAC developed the program by identifying five areas of primary concern. Seventeen actions were recognized, whereby, the Australian government is accountable to one, territory and state government are responsible for six and the ten all the governments are accountable.

There have been various outcomes achieved through the program. Since 2015, there has been optimization of health services in the recognition, intermediation, rehabilitation, and management of patients linked to Aboriginal and Torres Strait Islander especially in Queensland. There have been cardiology education forums carried out to community staff working with A & TSI. There has also been a successful cardiology education with about forty participants attending different services through teleconference or within the community.

The approach used is strength- based due to various stuff that has worked. There has been involvement of partnerships, shared leadership, and networks which are created by an element of working together. The government and other agencies have shown interest through AHMAC and varied hospitals in improving CVDs among the A & TSI people (Cox, 2014). The program shows that there is a commitment to work with and assist the indigenous people to counteract the CVDs. Cox (2014) notes that there is a need to have a cooperative relationship between the recipients, funder, and providers of the services. The decisions made should enhance the indigenous Australian’s knowledge and ambitions.

References

Artuso, S., Cargo, M., Brown, A., & Daniel, M. (2013). Factors influencing health care utilisation among Aboriginal cardiac patients in central Australia: a qualitative study. BMC Health Services Research, 13(1), 1–13. https://doi.org/10.1186/1472-6963-13-83

Brown, A., Mentha, R., Howard, M., Rowley, K., Reilly, R., Paquet, C., & O’Dea, K. (2016). Men, hearts and minds: developing and piloting culturally specific psychometric tools assessing psychosocial stress and depression in central Australian Aboriginal men. Social Psychiatry & Psychiatric Epidemiology, 51(2), 211–223. https://doi.org/10.1007/s00127-015-1100-8

Cox, E. (2014). Forrest report ignores what works and why in Indigenous policy. The Conversation. Available at: https://theconversation.com/forrest-report-ignores-what-works-and-why-inindigenous-policy-30080

Hampton, R. & Toombs, M. (2013). Indigenous Australians and health: the wombat in the room. South Melbourne, VIC, Australia: Oxford University Press.

Hunter, E. (2010). Hearts and minds: Evolving understandings of chronic cardiovascular disease in Aboriginal and Torres Strait Islander populations. Australian Aboriginal Studies, 2010(1), 74–91. Retrieved from https://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=53017752&site=ehost-live

King, M., Smith, A., & Gracey, M. (2009). Indigenous health part 2: the underlying causes of the health gap. The Lancet, 374(9683), 76-85.

Mills, K., Gatton, M. L., Mahoney, R., & Nelson, A. (2017). “Work it out”: evaluation of a chronic condition self-management program for urban Aboriginal and Torres Strait Islander people, with or at risk of cardiovascular disease. BMC Health Services Research, 17, 1–10. https://doi.org/10.1186/s12913-017-2631-3

Shepherd, C. C. j., Li, J., & Zubrick, S. R. (2012). Socioeconomic disparities in physical health among Aboriginal and Torres Strait Islander children in Western Australia. Ethnicity & Health, 17(5), 439–461. https://doi.org/10.1080/13557858.2012.654768

Stoner, L., Stoner, K. R., Young, J. M., & Fryer, S. (2012). Preventing a Cardiovascular Disease Epidemic among Indigenous Populations through Lifestyle Changes. International Journal of Preventive Medicine, 3(4), 230–240. Retrieved from https://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=75332239&site=ehost-live

Weetra, D., Glover, K., Buckskin, M., Ah Kit, J., Leane, C., Mitchell, A., … Kit, J. A. (2016). Stressful events, social health issues and psychological distress in Aboriginal women having a baby in South Australia: implications for antenatal care. BMC Pregnancy & Childbirth, 16, 1–12. https://doi.org/10.1186/s12884-016-0867-2