Inequity between Indigenous and non-Indigenous Australians in Cardiovascular Disease

This article discusses the reasons for inequity between Indigenous and non-Indigenous Australians in relation to cardiovascular disease. It explores the impact of cultural knowledge and sensitivity in healthcare access and provides an example of a primary health care intervention for Indigenous Australians. The article also highlights the importance of addressing these issues to reduce inequity in healthcare.

Health and Society
Assessment 3
Extended ResponseTemplate
Using you health issue from assessment item 2:
Answer all of the three questions below based upon this one health issue. (cardio vascular
disease)
Each extended response should be approximately 500 words in length each.
The reference list for all three extended response should be provided under the references heading
of this template.

Question 1
Discuss two different reasons for inequity between Indigenous Australians and non-Indigenous
Australians in relation to your identified health issue. (cardio vascular disease)
In Australia, the problem of cardiovascular disease is one of the major contributor
of the overall disease burden of the country and from the report, it is observed that,
almost 12% of total disease burden is contributed by this cardiovascular disease.
The main reason of higher prevalence rate of cardiovascular disease among
indigenous Australians than that of the non-indigenous Australians.
One of the primary reason of higher prevalence rate of cardiovascular disease
among the indigenous people is lack of healthy lifestyle among that population
group. According to the traditional aboriginal lifestyle, they gather their required
daily expenditure by hunting and it is quite evident that, as a result they have not
adequate nutrition from their foods. Moreover, it is also reported that, the smoking
behavior is also very common among the aboriginal people of Australia than that
of the non-indigenous people and it is quite evident that, smoking is one of the
primary risk factors of cardiovascular disease. In 2012-13, it is reported that 42%
of indigenous people in the age group of 15 years and more has daily smoking
behavior and it is 2.6 times greater than that of the non-indigenous people of
Australia (Australian Institute of Health and Welfare, 2015). Not only, this smoking
behavior, but the consumption of alcohol is also higher among the indigenous
Australians than that of their non-indigenous counterpart. Such kind of unhealthy
life style behavior among the indigenous people are also promoting the risk factors
of cardiovascular disease among the indigenous people. Aboriginal people
generally live in their traditional lands and lead their lifestyle in their own traditional
manner. According to the report of Australian Institute of Health and Welfare
(2016), it is reported that, the tobacco smoking is one of the major risk developing
factors of cardiovascular disease among indigenous Australian. In 2012-13, it is
reported that, overall 44% of indigenous were current smokers and among them
2% were weekly and 42% were daily smokers (Australian Institute of Health and
Welfare 2016). Lack of proper healthy diet sue to the poor economic condition of
the indigenous people is another contributing factor of developing cardiovascular
problems among indigenous people of Australia. Moreover, in various studies, it is
observed that, maintenance of healthy diet can improve the cardiovascular
problems. In addition to this, another reason of health inequality among
indigenous people than that of the non-indigenous is that the indigenous people
are generally living in a very remote location and as a result they have not access
adequate health care services in their location. In addition to this problem of
remoteness, it is also reported that due to their remote location, the unemployment
rate was also very high among the indigenous people and this factor also
contribute in restriction of taking healthy diet as a part of their healthy living
behavior (Australian Institute of Health and Welfare 2015).
Hence it can be concluded that, these two are the major contributor of inequality in
between indigenous and non-indigenous Australians.

Question 2
Provide one example of a Primary Health Care intervention that is addressing this health issue for
Indigenous Australians. Explain the impact this intervention is having on reducing inequity.
As a part of the ;primary health care initiative for addressing the cardiovascular
health problem among indigenous Australians, the name of The Better Cardiac
Care for Aboriginal and Torres Strait Islander project can be mentioned. This
project is a joint venture from Australian Government and State and territory
government.
In this, primary health care intervention, there are a few a primary health care
goals for addressing the problems of indigenous people of Australia. As a primary
goal of this primary health care project, detection of cardiovascular risks was
promoted. As a part of this primary health care project, a health assessment
program for addressing the cardiovascular problems of the indigenous people was
organized and for managing the condition appropriately, follow-up of the identified
risk factors can be recommended (Schmidt, Smith & Battye 2017). In addition to
this, life style modification can also be used for providing primary health car.
Primary prevention of this condition as a part of health care intervention is one of
important cardiovascular management technique and it may provide long term
results regarding the health of the indigenous people of the country. This health
assessment program is named as Medicare Benefits Schedule (MBS) and people
of 25 years or above would assessed under this program. From the data of
Australian report, it is reported that only 26% of total indigenous people within the
age group of 25 years or above, had the MBS health assessment program in
2013-14 (Australian Institute of Health and Welfare 2015). After adjusting the, the
age differences in the population group, it was reported that , the rate of having a
health assessment program was higher among the non-indigenous than that of the
indigenous people. According the study of Mbuzi, Fulbrook and Jessup (2018), it
is also reported that use of appropriate health assessment program will improve
the condition of indigenous cardiovascular patients. From the report of Australian
government it is reported that, although rate of attending the MBS program by the
indigenous people was low still it had helped in improving the condition of
indigenous people. Due to the enhancement of knowledge regarding this disease,
it is observed that, the in 2012-13, almost 87% of indigenous people checked their
blood pressure as a part of the MBS health assessment program. The proportion
of indigenous people who checked their blood pressure was highest in the
Northern Territory (almost 91%). In addition this, it is also reported that due to the
commencement of this health assessment program, the proportion of indigenous
population receiving interventions for their disease condition, was also enhanced
(Thompson et al. 2016). In 2004-05, the percentage of receiving PCI treatment
among the indigenous Australians was almost 25% and in 2012-13, condition
improved and the percentage of having treatment for cardiovascular disease was
almost 46%. In addition to this, the percentage of receiving diagnostic angiography
for acute coronary symptoms was also enhanced to 45% in between 2010-13 and
this treatment receiving percentage was 29% in 2004-05. Moreover, due to timely
identification of cardiovascular disease, the mortality rate of indigenous Australians

was also reduced. In 2004-07, the mortality rate in hospitals was almost 7% and
after the improvement, it was reported that, the mortality rate was reduced to 4% in
2010-13 time period (Australian Institute of Health and Welfare 2015).
Hence, it can be concluded that, early assessment of cardiovascular problems can
be very useful for management of cardiovascular problems of indigenous
problems.

Question 3
Discuss how cultural knowledge and sensitivity in health care may affect access Primary Health
Care services. Provide one example based on your chosen health issue. ( cardio vascular disease)
It is quite evident that, during the delivery of care to any indigenous people, it is
very important to maintain a culturally safe environment as cultural knowledge and
sensitivity plays a major role while delivering care to the indigenous population.
Indigenous population have believe in certain type of cultures and values. Hence,
it is observed that indigenous Australians have a different perspective regarding
any disease. So, it is obvious that they will not agree on the conventional process
of managing any disease condition due to their own believes and principles.
Moreover, indigenous Australians speaks in their own language and as a result,
the health care providers may face difficulties in understanding their requirements.
It may hamper the quality of care provided by the health care providers. It is
reported that, the cultures of indigenous people in Australia, poses different ideas
regarding any disease, and help-seeking behavior, symptoms of disease of that
disease (Li 2017). Moreover, in some cases, it is observed that, the health care
providers are showing less respects to the indigenous people while providing care
and this may impact the care process of indigenous people in a direct manner.
Therefore, it can be said that, lack of cultural knowledge among the health care
providers will allow them to show racially discriminative approach to the indigenous
people and thus lack in cultural knowledge acts as barrier for providing adequate
care to those people. Moreover, language barrier is another barrier for providing
good quality care to the indigenous people as it may happen that due to lack of
cultural competency, the health care provider communicate in their own language
to the indigenous patient and it may hurt the cultural believe and of the indigenous
people and simultaneously the person may feel offended. As a consequence of
this, the aboriginal people may refuse to take care from that health care providers
(Gibson et al. 2015). According to the study of Davidson et al. (2016), a
multicultural health care provider can provide a culturally competent health care
services without promoting any culturally incompetent behavior to the patient.
Moreover, those culturally competent health care providers will resolve the issues
of cultural barrier in order to provide a better care to them. Along with this, it is
obvious that, an indigenous people will feel comfortable to receive care from a
culturally competent care providers and it will allow them to participate more in the
treatment process. The study of (), also supported the fact that a culturally
competent care providers will deliver better care as they have adequate
knowledge regarding cultural competency. In another study by Hole et al. (2015), it
is reported that, there is a lack of positive culturally safe environment in the health
care delivery process and it is directly impacting the quality of health care
delivered to the indigenous people.

References
Australian Institute of Health and Welfare 2015, The health and welfare of Australia’s Aboriginal
and Torres Strait Islander peoples. Australian Government . Retrieved from-

https://www.aihw.gov.au/getmedia/584073f7-041e-4818-9419-39f5a060b1aa/18175.pdf.aspx?
inline=true
Australian Institute of Health and Welfare 2015, Better Cardiac Care measures for Aboriginal and
Torres Strait Islander people: first national report 2015. Cat. no. IHW 156. Canberra: AIHW.
Australian Institute of Health and Welfare 2016, Australian Burden of Disease Study: Impact and
causes of illness and death in Aboriginal and Torres Strait Islander people 2011. Australian
Burden of Disease Study series no. 6. Cat. no. BOD 7. Canberra: AIHW. Retrieved from-
https://www.aihw.gov.au/getmedia/e31976fc-adcc-4612-bd08-e54fd2f3303c/19667-bod7-atsi-
2011.pdf.aspx?inline=true
Davidson, P.M., Phillips, J.L., Dennison-Himmelfarb, C., Thompson, S.C., Luckett, T. & Currow, D.C.
2016, Providing palliative care for cardiovascular disease from a perspective of sociocultural
diversity: a global view. Current opinion in supportive and palliative care, 10(1), pp.11-17.
Gibson, O., Lisy, K., Davy, C., Aromataris, E., Kite, E., Lockwood, C., Riitano, D., McBride, K. & Brown,
A. 2015, Enablers and barriers to the implementation of primary health care interventions for
Indigenous people with chronic diseases: a systematic review. Implementation Science, 10(1),
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Hole, R.D., Evans, M., Berg, L.D., Bottorff, J.L., Dingwall, C., Alexis, C., Nyberg, J. & Smith, M.L. 2015,
Visibility and voice: Aboriginal people experience culturally safe and unsafe health
care. Qualitative health research, 25(12), pp.1662-1674.
Li, J.L. 2017, Cultural barriers lead to inequitable healthcare access for aboriginal Australians and
Torres Strait Islanders. Chinese Nursing Research, 4(4), pp.207-210.

Mbuzi, V., Fulbrook, P. & Jessup, M. 2018. Effectiveness of programs to promote cardiovascular
health of Indigenous Australians: a systematic review. International journal for equity in
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Schmidt B, Smith D J & Battye K. 2017. Strategies for implementing best practice primary and
secondary preventative interventions in chronic disease in remote Australia. Australian
Commission on Safety and Quality in Health Care Sydney: ACSQHC.
Thompson, S.C., Haynes, E., Woods, J.A., Bessarab, D.C., Dimer, L.A., Wood, M.M., Sanfilippo, F.M.,
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