Reasons for Inequity in Cardiovascular Disease
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This article discusses the reasons for inequity between Indigenous Australians and non-Indigenous Australians in relation to cardiovascular disease. It explores cultural factors, access to healthcare, and interventions to reduce the disparities. The article emphasizes the importance of understanding cultural beliefs and practices in healthcare provision.
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Reasons for inequity between Indigenous Australians and non-Indigenous Australians
in Relation to Cardiovascular disease
Cardiovascular disease has been reported as the leading cause of mortality in the
world. Indigenous people account for a total of 370 million in the world. Cardiovascular
diseases like stroke, sclerosis, and coronary thrombosis and heart problems have been
reported to have higher prevalence on indigenous communities as compared to non-
indigenous communities in Australia. There are various cultural factors that have led to the
inequality between the indigenous and non-indigenous communities in Australia. Despite the
sensitization of the public on the implications of cardiovascular diseases, the disparities in the
incidences the disease persists in Australia. Evidence-based practices provide effective
strategies to be used in the reduction of chronic cardiovascular disease in most parts of the
world (Semsarian, Ingles, Maron and Maron, 2015, p. 1250). The application of health
promotion strategies in health care services has led to a reduction in the cases of
cardiovascular disease in most non-indigenous communities than I indigenous communities.
The strategies include the education of the people on the contribution of geographical,
environments, cultural and educational factors to the increase in the incidences of
cardiovascular diseases.
First, cultural beliefs and practices contribute to the inequity in the prevalence of the
cardiovascular disease among the indigenous people in Australia. For example, most of the
Aboriginal population are drug addicted. The aboriginal young men are smokers as compared
to non-indigenous communities. Prolonged use of drugs, especially smoking increases the
risks of contracting cardiovascular diseases among users (Brown, 2012, p. 102). The
indigenous adults are the leading groups of people with multiple problems related to the heart
of a vascular system. Prolonged smoking of tobacco leads to heart attack and septic shock,
therefore, causing organ dysfunction. Bronchitis results in congestion in the thoracic cavity.
in Relation to Cardiovascular disease
Cardiovascular disease has been reported as the leading cause of mortality in the
world. Indigenous people account for a total of 370 million in the world. Cardiovascular
diseases like stroke, sclerosis, and coronary thrombosis and heart problems have been
reported to have higher prevalence on indigenous communities as compared to non-
indigenous communities in Australia. There are various cultural factors that have led to the
inequality between the indigenous and non-indigenous communities in Australia. Despite the
sensitization of the public on the implications of cardiovascular diseases, the disparities in the
incidences the disease persists in Australia. Evidence-based practices provide effective
strategies to be used in the reduction of chronic cardiovascular disease in most parts of the
world (Semsarian, Ingles, Maron and Maron, 2015, p. 1250). The application of health
promotion strategies in health care services has led to a reduction in the cases of
cardiovascular disease in most non-indigenous communities than I indigenous communities.
The strategies include the education of the people on the contribution of geographical,
environments, cultural and educational factors to the increase in the incidences of
cardiovascular diseases.
First, cultural beliefs and practices contribute to the inequity in the prevalence of the
cardiovascular disease among the indigenous people in Australia. For example, most of the
Aboriginal population are drug addicted. The aboriginal young men are smokers as compared
to non-indigenous communities. Prolonged use of drugs, especially smoking increases the
risks of contracting cardiovascular diseases among users (Brown, 2012, p. 102). The
indigenous adults are the leading groups of people with multiple problems related to the heart
of a vascular system. Prolonged smoking of tobacco leads to heart attack and septic shock,
therefore, causing organ dysfunction. Bronchitis results in congestion in the thoracic cavity.
The congestion affects the gaseous exchange and subsequent cardiac output, therefore,
interfering with the normal functioning of the heart. The interference of the heart function
increases the susceptibility to cardiovascular disease. Research is done on the Aboriginal; and
Torres communities have a shown a clear indication that indigenous communities are affected
by the cardiovascular diseases due to their cultural practices and beliefs.
The second factor that leads to inequality in the incidence of cardiovascular diseases is the
inability of the indigenous communities to access improvised medical and health care
services in the country. There are factors that affect the availability if medical therapies in the
country. Non-indigenous communities are able to access modern and quality medical services
as compared to indigenous communities like Torres and Aboriginals. The cardiovascular
specialists in the country require a lot of money to attend to the patients (Chew et al, 2016, p.
125). The indigenous communities are comprised of poor people. Poverty has become the
main challenge the indigenous people, therefore increasing the incidence of cardiovascular
diseases among these poor communities. The limited access to quality health care is also
caused by a low level of literacy among the indigenous communities. Illiteracy leads to
ignorance, therefore, increasing the risks of exposure to this disease. Limits access to the
cardiovascular therapeutic procedure may also occur due to geographical barriers, for
instance, the indigenous communities live in remote areas, therefore, making it difficult for a
researcher to exploit the areas and implement appropriate interventions for reducing the
incidences of cardiovascular disease and mortality rates in the country.
Primary Health Care intervention in Addressing the Health Issue
The increase in mortality rates due to cardiovascular diseases is attributed to the
change in the lifestyle adopted by many people in the world (Derrick, Haynes, Chapman and
Hall, 2011, p. 45). There is a need to minimize the disadvantages encountered by these
interfering with the normal functioning of the heart. The interference of the heart function
increases the susceptibility to cardiovascular disease. Research is done on the Aboriginal; and
Torres communities have a shown a clear indication that indigenous communities are affected
by the cardiovascular diseases due to their cultural practices and beliefs.
The second factor that leads to inequality in the incidence of cardiovascular diseases is the
inability of the indigenous communities to access improvised medical and health care
services in the country. There are factors that affect the availability if medical therapies in the
country. Non-indigenous communities are able to access modern and quality medical services
as compared to indigenous communities like Torres and Aboriginals. The cardiovascular
specialists in the country require a lot of money to attend to the patients (Chew et al, 2016, p.
125). The indigenous communities are comprised of poor people. Poverty has become the
main challenge the indigenous people, therefore increasing the incidence of cardiovascular
diseases among these poor communities. The limited access to quality health care is also
caused by a low level of literacy among the indigenous communities. Illiteracy leads to
ignorance, therefore, increasing the risks of exposure to this disease. Limits access to the
cardiovascular therapeutic procedure may also occur due to geographical barriers, for
instance, the indigenous communities live in remote areas, therefore, making it difficult for a
researcher to exploit the areas and implement appropriate interventions for reducing the
incidences of cardiovascular disease and mortality rates in the country.
Primary Health Care intervention in Addressing the Health Issue
The increase in mortality rates due to cardiovascular diseases is attributed to the
change in the lifestyle adopted by many people in the world (Derrick, Haynes, Chapman and
Hall, 2011, p. 45). There is a need to minimize the disadvantages encountered by these
indigenous people in the world to promote equity and healthy living. The analysis of the
factors that lead to a disparity between indigenous communities and non-indigenous
communities in Australia in relation to prevalence and incidences of cardiovascular disease.
Intervention for reducing and preventing the cases of cardiovascular disease are discussed.
Public health and other specialized organizations have established some of the appropriate
interventions to be used in minimizing the gap between the indigenous and non-indigenous
communities in Australia, therefore, minimizing the effects that resulted to the inequalities in
the disease prevalence. The interventions focus on the improvement of social and health
outcomes of the indigenous communities in the country and minimize the gaps that exist in
the provision of medical services. The main intervention is reducing the risks that lead to
cardiovascular disease (Downing, Kowal and Paradies, 2011, p. 130). This strategic
intervention includes a series of public planning activities and sensitization of the people on
the dangers of these diseases to their lives. The reduction and prevention of the discussed
factors that lead to inequalities in the incidence and prevalence of cardiovascular diseases is
the main objective in the implementation and adoption of health care interventions.
The reduction of the risks involves implementation of legislation to regulate the use of
drugs and prevent addiction on the people (Gibson et al, 2015, p. 71). The national
government and local authorities have made a focus passing some laws to prohibit the sale
and consumption of drugs like tobacco, alcohol, and cannabis. The legislation on the harmful
drugs in the country will reduce the risks of organ dysfunction, therefore, minimizing the
incidences of cardiovascular disease among the indigenous communities living within
Australian territories. The prevention and reduction of the risks factors require the active
participation of all people in the country. Effective reduction of the risks of cardiovascular
diseases is attained through the national campaigns are critical in the reduction of risks
factors related to cardiovascular diseases (Rogers et al, 2010, p. 310). The comparing is
factors that lead to a disparity between indigenous communities and non-indigenous
communities in Australia in relation to prevalence and incidences of cardiovascular disease.
Intervention for reducing and preventing the cases of cardiovascular disease are discussed.
Public health and other specialized organizations have established some of the appropriate
interventions to be used in minimizing the gap between the indigenous and non-indigenous
communities in Australia, therefore, minimizing the effects that resulted to the inequalities in
the disease prevalence. The interventions focus on the improvement of social and health
outcomes of the indigenous communities in the country and minimize the gaps that exist in
the provision of medical services. The main intervention is reducing the risks that lead to
cardiovascular disease (Downing, Kowal and Paradies, 2011, p. 130). This strategic
intervention includes a series of public planning activities and sensitization of the people on
the dangers of these diseases to their lives. The reduction and prevention of the discussed
factors that lead to inequalities in the incidence and prevalence of cardiovascular diseases is
the main objective in the implementation and adoption of health care interventions.
The reduction of the risks involves implementation of legislation to regulate the use of
drugs and prevent addiction on the people (Gibson et al, 2015, p. 71). The national
government and local authorities have made a focus passing some laws to prohibit the sale
and consumption of drugs like tobacco, alcohol, and cannabis. The legislation on the harmful
drugs in the country will reduce the risks of organ dysfunction, therefore, minimizing the
incidences of cardiovascular disease among the indigenous communities living within
Australian territories. The prevention and reduction of the risks factors require the active
participation of all people in the country. Effective reduction of the risks of cardiovascular
diseases is attained through the national campaigns are critical in the reduction of risks
factors related to cardiovascular diseases (Rogers et al, 2010, p. 310). The comparing is
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important in the provision of public health education, especially the effects of changes in
lifestyle to the health of the people. Nutritional education may also accentuate the mitigation
of cardiovascular diseases. The reduction in the cholesterol level in the diets is another way
of reducing the risks of getting cardiovascular diseases.
Construction of modern systems for diagnostic and therapeutic procedures may also
contribute to a reduction in the risks of the health issues. Early diagnosis and effective
treatment of cardiovascular disease is pivotal in reducing the mortality rates in the country.
Better facilities improve the quality of medical services offered to patients. This plan ensures
that the indigenous communities are able to access specialists and intensive care like the non-
indigenous communities. This reduces the gap in the prevalence of the disease, therefore,
creating equality between the two groups of communities.
Effects of Cultural Knowledge and Beliefs on Health Care Provision
Some cultural values and practices that lead to the inequity and are discussed in
detailed. The effects of cultural practices on the preventive and healthcare services are
described in relation to cardiovascular disease. Promotion of public health of the people in
the community is an inclusive process that requires a cognitive understanding of all health
care issues. A strong financial support and modern medical and health facilities may not lead
to the achievement of complete health promotion in the country, therefore, an understanding
of the cultural factors is crucial because communal support comprehends the public health
promotion process (Tsey et al, 2010, p. 168). cultural barriers to health care provision affect
the general p[performance and reduction of the risks factors, therefore, the gaps between the
indigenous and the non-indigenous communities will persist in the country. cultural beliefs
are the main barriers to health care promotion and healthy living in the Australian territories.
The perception of the indigenous people on modern therapeutic procedures does not support
lifestyle to the health of the people. Nutritional education may also accentuate the mitigation
of cardiovascular diseases. The reduction in the cholesterol level in the diets is another way
of reducing the risks of getting cardiovascular diseases.
Construction of modern systems for diagnostic and therapeutic procedures may also
contribute to a reduction in the risks of the health issues. Early diagnosis and effective
treatment of cardiovascular disease is pivotal in reducing the mortality rates in the country.
Better facilities improve the quality of medical services offered to patients. This plan ensures
that the indigenous communities are able to access specialists and intensive care like the non-
indigenous communities. This reduces the gap in the prevalence of the disease, therefore,
creating equality between the two groups of communities.
Effects of Cultural Knowledge and Beliefs on Health Care Provision
Some cultural values and practices that lead to the inequity and are discussed in
detailed. The effects of cultural practices on the preventive and healthcare services are
described in relation to cardiovascular disease. Promotion of public health of the people in
the community is an inclusive process that requires a cognitive understanding of all health
care issues. A strong financial support and modern medical and health facilities may not lead
to the achievement of complete health promotion in the country, therefore, an understanding
of the cultural factors is crucial because communal support comprehends the public health
promotion process (Tsey et al, 2010, p. 168). cultural barriers to health care provision affect
the general p[performance and reduction of the risks factors, therefore, the gaps between the
indigenous and the non-indigenous communities will persist in the country. cultural beliefs
are the main barriers to health care promotion and healthy living in the Australian territories.
The perception of the indigenous people on modern therapeutic procedures does not support
the health systems (McDonald, Ross, Jocelyn and David, 2012, p. 432). Some indigenous
communities does not believe in modern medication because of the strong cultural beliefs and
values they hold in their localities. This negative attitude to the medication reduces the
efficacy of the health care practices provided to the concerned communities. Overemphasis
on gender sensitivity is another social factor that effects prevention, control, and treatment of
cardiovascular diseases (Semsarian, Ingles, Maron, and Maron, 2015, p. 24). Evidence-based
practices provide a clear indication of the effects of cultural beliefs on the prevalence of the
disease and mortality rates caused by the disease in the country. The indigenous communities
have different religious and cultural beliefs as compared to non-indigenous communities,
therefore, leading to the inequity and the gap between the two groups of communities.
The effect of the cultural beliefs may arise due to a misunderstanding on the delivery of
important concepts on the health promotion in the public. The misunderstanding is due to
language barriers that may exist between the communities. Language barrier as an obstacle
may also occur between the indigenous communities and health care provider, especially if
the people in the society are not literate (Rumbold, et al, 2011, p. 16). The cultural sensitivity
affects the practices arranged for promoting health care education and sensitization of the
public because the communities with negative beliefs may rebel the operation and fail to
comply with the interventions and legislation provided against ignorant activities that
increase the incidence of the cardiovascular diseases. Primary care services provided by
medical facilities like hospital and clinics are impacted by the cultural beliefs because the
efficacy of the therapeutic agents depends on the trust of the patient in that particular drug
prescribed against a disease.
It is recommended that the health care providers and professional adhere to the
cultural beliefs of the indigenous communities before the actual sensitization of the people on
the importance of early diagnosis and treatment of the cardiovascular diseases (Slade et al,
communities does not believe in modern medication because of the strong cultural beliefs and
values they hold in their localities. This negative attitude to the medication reduces the
efficacy of the health care practices provided to the concerned communities. Overemphasis
on gender sensitivity is another social factor that effects prevention, control, and treatment of
cardiovascular diseases (Semsarian, Ingles, Maron, and Maron, 2015, p. 24). Evidence-based
practices provide a clear indication of the effects of cultural beliefs on the prevalence of the
disease and mortality rates caused by the disease in the country. The indigenous communities
have different religious and cultural beliefs as compared to non-indigenous communities,
therefore, leading to the inequity and the gap between the two groups of communities.
The effect of the cultural beliefs may arise due to a misunderstanding on the delivery of
important concepts on the health promotion in the public. The misunderstanding is due to
language barriers that may exist between the communities. Language barrier as an obstacle
may also occur between the indigenous communities and health care provider, especially if
the people in the society are not literate (Rumbold, et al, 2011, p. 16). The cultural sensitivity
affects the practices arranged for promoting health care education and sensitization of the
public because the communities with negative beliefs may rebel the operation and fail to
comply with the interventions and legislation provided against ignorant activities that
increase the incidence of the cardiovascular diseases. Primary care services provided by
medical facilities like hospital and clinics are impacted by the cultural beliefs because the
efficacy of the therapeutic agents depends on the trust of the patient in that particular drug
prescribed against a disease.
It is recommended that the health care providers and professional adhere to the
cultural beliefs of the indigenous communities before the actual sensitization of the people on
the importance of early diagnosis and treatment of the cardiovascular diseases (Slade et al,
2011, p. 32). In this case, the communities will feel appreciated. The acknowledgment of
diversity is important in achieving the support from the indigenous communities and
minimizing the cases of resilience from these people.
diversity is important in achieving the support from the indigenous communities and
minimizing the cases of resilience from these people.
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References
Brown, A., 2012. Addressing cardiovascular inequalities among indigenous
Australians. Global Cardiology Science and Practice (1), p.2.
Chew, D.P., Scott, I.A., Cullen, L., French, J.K., Briffa, T.G., Tideman, P.A., Woodruff, S.,
Kerr, A., Branagan, M. and Aylward, P.E., 2016. National Heart Foundation of
Australia and Cardiac Society of Australia and New Zealand: Australian clinical
guidelines for the management of acute coronary syndromes 2016. Medical Journal
of Australia, 205(3), pp.128-133.
Derrick, G.E., Haynes, A., Chapman, S., and Hall, W.D., 2011. The association between four
citation metrics and peer rankings of research influence of Australian researchers in
six fields of public health. PloS one, 6(4), p.e18521.
Downing, R., Kowal, E., and Paradies, Y., 2011. Indigenous cultural training for health
workers in Australia. International Journal for Quality in Health Care, 23(3), pp.247-
257.
Gibson, O., Lisy, K., Davy, C., Aromataris, E., Kite, E., Lockwood, C., Riitano, D., McBride,
K., and 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), p.71.
McDonald, E., Ross B., Jocelyn G., and David B., 2012. An ecological approach to health
promotion in remote Australian Aboriginal communities. Health Promotion
International 25, p. 42-53.
Rogers, S., McIntosh, R.L., Cheung, N., Lim, L., Wang, J.J., Mitchell, P., Kowalski, J.W.,
Nguyen, H., Wong, T.Y. and International Eye Disease Consortium, 2010. The
Brown, A., 2012. Addressing cardiovascular inequalities among indigenous
Australians. Global Cardiology Science and Practice (1), p.2.
Chew, D.P., Scott, I.A., Cullen, L., French, J.K., Briffa, T.G., Tideman, P.A., Woodruff, S.,
Kerr, A., Branagan, M. and Aylward, P.E., 2016. National Heart Foundation of
Australia and Cardiac Society of Australia and New Zealand: Australian clinical
guidelines for the management of acute coronary syndromes 2016. Medical Journal
of Australia, 205(3), pp.128-133.
Derrick, G.E., Haynes, A., Chapman, S., and Hall, W.D., 2011. The association between four
citation metrics and peer rankings of research influence of Australian researchers in
six fields of public health. PloS one, 6(4), p.e18521.
Downing, R., Kowal, E., and Paradies, Y., 2011. Indigenous cultural training for health
workers in Australia. International Journal for Quality in Health Care, 23(3), pp.247-
257.
Gibson, O., Lisy, K., Davy, C., Aromataris, E., Kite, E., Lockwood, C., Riitano, D., McBride,
K., and 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), p.71.
McDonald, E., Ross B., Jocelyn G., and David B., 2012. An ecological approach to health
promotion in remote Australian Aboriginal communities. Health Promotion
International 25, p. 42-53.
Rogers, S., McIntosh, R.L., Cheung, N., Lim, L., Wang, J.J., Mitchell, P., Kowalski, J.W.,
Nguyen, H., Wong, T.Y. and International Eye Disease Consortium, 2010. The
prevalence of retinal vein occlusion: pooled data from population studies from the
United States, Europe, Asia, and Australia. Ophthalmology, 117(2), pp.313-319.
Rumbold, A.R., Bailie, R.S., Si, D., Dowden, M.C., Kennedy, C.M., Cox, R.J., O'Donoghue,
L., Liddle, H.E., Kwedza, R.K., Thompson, S.C. and Burke, H.P., 2011. Delivery of
maternal health care in Indigenous primary care services: baseline data for an ongoing
quality improvement initiative. BMC pregnancy and childbirth, 11(1), p.16.
Semsarian, C., Ingles, J., Maron, M.S. and Maron, B.J., 2015. New perspectives on the
prevalence of hypertrophic cardiomyopathy. Journal of the American College of
Cardiology, 65(12), pp.1249-1254.
Slade, G.D., Bailie, R.S., Roberts‐Thomson, K., Leach, A.J., Raye, I., Endean, C., Simmons,
B. and Morris, P., 2011. Effect of health promotion and fluoride varnish on dental
caries among Australian Aboriginal children: results from a community‐randomized
controlled trial. Community dentistry and oral epidemiology, 39(1), pp.29-43.
Tsey, K., Whiteside, M., Haswell‐Elkins, M., Bainbridge, R., Cadet‐James, Y. and Wilson,
A., 2010. Empowerment and Indigenous Australian health: a synthesis of findings
from Family Wellbeing formative research. Health & Social Care in the
Community, 18(2), pp.169-179.
White, S.L., Polkinghorne, K.R., Atkins, R.C. and Chadban, S.J., 2010. Comparison of the
prevalence and mortality risk of CKD in Australia using the CKD Epidemiology
Collaboration (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) Study
GFR estimating equations: the AusDiab (Australian Diabetes, Obesity and Lifestyle)
Study. American Journal of Kidney Diseases, 55(4), pp.660-670.
United States, Europe, Asia, and Australia. Ophthalmology, 117(2), pp.313-319.
Rumbold, A.R., Bailie, R.S., Si, D., Dowden, M.C., Kennedy, C.M., Cox, R.J., O'Donoghue,
L., Liddle, H.E., Kwedza, R.K., Thompson, S.C. and Burke, H.P., 2011. Delivery of
maternal health care in Indigenous primary care services: baseline data for an ongoing
quality improvement initiative. BMC pregnancy and childbirth, 11(1), p.16.
Semsarian, C., Ingles, J., Maron, M.S. and Maron, B.J., 2015. New perspectives on the
prevalence of hypertrophic cardiomyopathy. Journal of the American College of
Cardiology, 65(12), pp.1249-1254.
Slade, G.D., Bailie, R.S., Roberts‐Thomson, K., Leach, A.J., Raye, I., Endean, C., Simmons,
B. and Morris, P., 2011. Effect of health promotion and fluoride varnish on dental
caries among Australian Aboriginal children: results from a community‐randomized
controlled trial. Community dentistry and oral epidemiology, 39(1), pp.29-43.
Tsey, K., Whiteside, M., Haswell‐Elkins, M., Bainbridge, R., Cadet‐James, Y. and Wilson,
A., 2010. Empowerment and Indigenous Australian health: a synthesis of findings
from Family Wellbeing formative research. Health & Social Care in the
Community, 18(2), pp.169-179.
White, S.L., Polkinghorne, K.R., Atkins, R.C. and Chadban, S.J., 2010. Comparison of the
prevalence and mortality risk of CKD in Australia using the CKD Epidemiology
Collaboration (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) Study
GFR estimating equations: the AusDiab (Australian Diabetes, Obesity and Lifestyle)
Study. American Journal of Kidney Diseases, 55(4), pp.660-670.
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