Evidence based3 Executive Summary Indigenous Australian peoples are the original residents of Australia and they comprise of different Aboriginal communities with different local languages and cultures. The poor health of the community has significantly been linked to health inequalities such as lack of access to quality healthcare. As a result, the community has a greater burden of disease of 2.3 times more than their counterparts. This essay will consider the most prevalent cardiovascular diseases among the Indigenous community namely Cholesterol, Blood Pressure, Obesity, Diabetes and depression. Emphasis is laid on the prevalence, causes and effects. Recommendations for prevention of these diseases have been provided as well.
Evidence based4 Introduction Aboriginal and Torres Strait Islander peoples are the native residents of Australia who consists of different Aboriginal communities with varying local dialect and cultures. They are historical dwellers of mainland Australia, Tasmania or in most of the offshore islands. The poor health status of the community is a recognized fact. There are considerable disparities between the Indigenous and non-Indigenous Australians chiefly concerning long-term and infectious illnesses, childhood health, mental health and life expectation. According to the Australian Institute of Health and Welfare (AIHW) (2018), the prevalence among the Torres Islander communityis 2.3 times much more than their counterparts, with19% being caused by disorders associated with mental illnesses and drug abuse related problems (AIHW, 2018a). hence there is a need for more studies to assess the most debilitating diseases affecting the community. This paper will, therefore, assess five common cardiovascular diseases affecting the community namely;Cholesterol, Blood Pressure, Obesity, Diabetes and depression. Cholesterol Excess cholesterol in the blood forms plaque in the artery which further narrows them and prevents blood flow from the heart causing atherosclerosis with time. This hardens the heart leading to heart attack 25.0% of the Indigenous Australian adults have extremely high total cholesterol levels based on the results of blood tests. 34.9% of the Indigenous Australians aged between 45 and 54 years had excess cholesterol and 23.3% of those aged 55 years and above had high excess cholesterol (ABS, 2014). The predisposing factors for cholesterol include overweight, smoking and high blood pressure (ABS, 2014). Blood Pressure Atherosclerosis impedes blood flow to the heart causing inadequate blood supply to the heart leading to ischemic heart disease. High blood pressure or hypertension is majorly caused by poor
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Evidence based5 diet, excessive consumption of alcohol, obesity, increasing age and lack of sufficient physical activity. In 2011, 5% of the diseases among them was due to high blood pressure and a difference of 8% in the health between the two communities (AIHW, 2018b). 64% of the Indigenous Australians suffered from hypertensive heart disease, 61% suffered from a stroke and 37% suffered from coronary heart disease and this was caused by high blood pressure, which is also a major cause of most of the cardiovascular diseases which account for high mortality rates of the Indigenous community (Department of Prime Minister and Cabinet, 2014). Obesity Obesity increases LDL levels which causes a layer of plaque on the arteries thus clogging them causing coronary heart disease. It also increases blood pressure causing the heart to strain in pumping blood through the arteries causing coronary heart disease. Obesity or overweight is a lifestyle disease that is caused by poor nutrition and it is a predisposing factor for multiple health problems like type 2 diabetes and other cardiovascular disorders. Obesity is one of the factors that foster the existing health differences between Indigenous Australians and non-Indigenous Australians. 40% of Indigenous Australians in inner regional areas were obese and 32% of Indigenous Australians who were obese were from very remote areas. 40% of the Indigenous Australian women had a higher rate of obesity 26% of the Indigenous Australian had a lower rate of overweight compared with Indigenous Australian men who had 34% and 31% respectively. The rates of overweight/ obesity for both genders increased with age, 80% of the Indigenous males and females aged 55 years and above being obese or overweight. 73% of Torres Strait Islanders population were obese/overweight compared to 65% of the Aboriginal Population (AIHW, 2018c).
Evidence based6 Diabetes High blood glucose overtime damages blood vessels and nerves that regulate heart and blood vessels causing stroke and heart attack. Diabetes is a chronic condition characteristic of excessive blood sugar levels. Diabetes among Indigenous people is caused by dietary changes, decreased rates of physical activity and high obesity cases. In 2012, type 2 diabetes was the most common in Australia among the Indigenous Australian which accounted for 85% (AIHW, 2019). 11% of Indigenous Australians of ages 18 and over had diabetes in 2012-2013. 9.6% of the Indigenous Australians aged 18 years and above knew they were diabetic and 1.5% of the Indigenous Australian adults were newly diagnosed with diabetes. An estimated 14% of diabetes incidences were initially diagnosed (AIHW, 2019). Depression Depression increases the risk of lifestyles linked to poor physical health such as drinking, overeating, and smoking. These behaviors predispose one to cardiovascular disorders such as high blood pressure, diabetes, and obesity which leads to ischemic heart disease, and coronary heart disease respectively. Depression is a mental health condition marked by low mood, a constant state of sorrow and disinterest in initial pleasures. Depression in the Aboriginal community is caused by social isolation, poverty, and hopelessness. The survey by ABS (2014), reported that one in three Indigenous had advanced depression and this was thrice higher than for other Australians. Between 2001-2010 (ABS, 2014) 100 Indigenous Australians ended their lives each year through suicide due to depression. 33% of Indigenous Australians who are early teens were found to have developed marked depressive symptoms. This was twice the number compared to otherAustralians.
Evidence based7 Conclusion Aboriginal and Torres Strait Islander peoples have a greater burden of disease than the non- indigenous peoples. Some of the chronic diseases include Cholesterol, Blood Pressure, Obesity, Diabetes and depression. The high prevalence of the cardiovascular disease among the Australian Indigenous is attributed to multiple disposing factors such as lack of access to healthy foods, unhealthy nutrition habits among others. Each of these diseases has varying effects on the quality of life and the predisposing factors in the community that increase their prevalence among the non-indigenous community. Recommendations Poor nutrition is the major cause of the lifestyle diseases among Indigenous Australians. Therefore, there is a need for nutrition education, proper dietary intake, and interventions to help Indigenous Australians access healthy food, education on nutrition, financial management, cooking programs and group-based lifestyle change programs. There is a need for programs to increase food supply like focusing on food retail outlets, community food production by Indigenous Australians (Leon, & Maddox, 2015). This will be a significant holistic method of improving the health outcomes of the Indigenous Australians.
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Evidence based8 References Australian Institute of Health and Welfare (AIHW). (2018a).Aboriginal and Torres Strait Islander Health Performance Framework (HPF) report 2017. Retrieved from https://www.aihw.gov.au/reports/indigenous-health-welfare/health-performance- framework/contents/overview Department of Prime Minister and Cabinet. (2014).Aboriginal and Torres Strait Islander Health Performance Framework 2014 Report: High blood pressure.Retrieved from https://www.pmc.gov.au/sites/default/files/publications/indigenous/Health-Performance- Framework-2014/tier-1-health-status-and-outcomes/107-high-blood- pressure.html#content-area Australian Institute of Health and Welfare (AIHW). (2018b).Aboriginal and Torres Strait Islander Health Performance Framework (HPF) report 2017. Retrieved from https://www.aihw.gov.au/reports/indigenous-health-welfare/health-performance- framework/contents/tier-1-health-status-and-outcomes/1-07-high-blood-pressure Australian Institute of Health and Welfare (AIHW). (2018c).Health behaviors of Indigenous Australians.Retrieved fromhttps://www.aihw.gov.au/getmedia/9677d3dc-c48e-4bef- 8c26-9ecead8e1fc8/aihw-aus-221-chapter-6-5.pdf.aspx Australian Institute of Health and Welfare (AIHW). (2019). Diabetes. Retrieved from https://www.aihw.gov.au/reports/diabetes/diabetes-snapshot/contents/how-many- australians-have-diabetes
Evidence based9 Australian Bureau of Statistics (ABS). (2014). 4704.0 -The Health and Welfare of Australia's Aboriginal and Torres Strait Islander Peoples, Oct 2010. Retrieved from https://www.abs.gov.au/ausstats/abs@.nsf/mediareleasesbytitle/3C18155D35250456CA2 574390029C0E5?OpenDocument Leon, B. M., & Maddox, T. M. (2015). Diabetes and cardiovascular disease: Epidemiology, biological mechanisms, treatment recommendations and future research.World journal of diabetes,6(13), 1246. Australian Bureau of Statistics (ABS). (2014).4727.0.55.003 - Australian Aboriginal and Torres Strait Islander Health Survey: Biomedical Results, 2012-13. Retrieved from https://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/4727.0.55.003~2012- 13~Main%20Features~Cholesterol~121