Indigenous Health Perspectives: Healthcare Assignment Report

This report presents a healthcare assignment focusing on Alex Evans, a 45-year-old Wurundjeri man from Melbourne, who developed Type-II Diabetes Mellitus. The assignment explores Alex's health journey, starting with his knee injury and subsequent diagnosis of diabetes, highlighting his unhealthy lifestyle choices including smoking, poor diet, and lack of exercise. It emphasizes the prevalence of Type II Diabetes among the indigenous population in Australia and discusses the associated health complications such as high blood pressure, high triglycerides, and the risk of further health issues. The report analyzes Alex's lifestyle and recommends immediate changes, including quitting smoking, weight loss through diet and exercise, and adherence to prescribed medication. The assignment also stresses the importance of testing Alex’s wife Martha and offering counseling for stress management. The report concludes by highlighting the impact of diabetes on the indigenous community, referencing relevant literature and statistical data, and emphasizing the need for early intervention and lifestyle changes to improve health outcomes. The report also discusses the importance of addressing the broader determinants of health in the Indigenous community, including socio-economic factors and access to healthcare.

Running head: HEALTHCARE ASSIGNMENT
HEALTHCARE ASSIGNMENT
Name of the Student:
Name of the University:
Author Note:

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Alex Evans is a 45 year old man who hails from the Wurundjeri tribe and stays in
Melbourne with his wife and two children in a 1 BHK apartment. Alex works as a banker
in the public domain. Alex had injured his knee while playing soccer with his children a
month ago. The wound did not seem to heal. Initially, Alex applied antiseptics without
consulting a GP and thought the wound would heal. He mentions that the injury was
minor and he had followed the same routine as a kid himself. However, the wound did
not seem to get any better. Two weeks had passed but there was no sign of healing. It
was at that moment, Alex’s wife, Martha aged 38 years had urged him to seek medical
advice. Alex visited the outpatient department, where a RN had conducted a wound
assessment and the GP had ordered few clinical tests. At that point of time, Alex’s BP
(140/90) and heart beat was substantially elevated (102 beats per minute) but other
vitals were within the normal range. The clinical reports indicated a high blood glucose
level (150 mg/dL), 30mg/dL (HDL) which indicated lower level of HDL and (200 mg) of
Triglycerides which represented high level of Triglycerides. The clinical examination
reports confirmed that Alex had developed Type-II Diabetes Mellitus.
On inquiring about the symptoms, Alex reported to feel fatigued and said he
always had a headache. On asking about his lifestyle and food habits, Alex mentioned
that he smoked heavily and had trouble getting a sound sleep. He further stated that
both Alex and his wife Martha were smoked heavily as they were too stressed about
their work and the kids. He further mentioned that because of work they relied heavily
on takeaway meals and it was only during the weekends that Martha cooked. The
information provided by Alex indicated that he had been living a sedentary and an
unhealthy life style which if not regulated immediately would lead to increased health
problems.
According to Reading and Greenwood (2015), it has been mentioned that Type II
Diabetes (TIIDM) in Australia is one of the fastest growing chronic illness that affects the
indigenous population. Studies have indicated that Aboriginal and Torres Islander are
three to four times at a higher risk of developing TIIDM compared to the non-indigenous
Australians (Harris et al., 2013; Stoneman et al., 2014). In addition to this, statistical
figures have also suggested that TIIDM affects the indigenous population based at

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Australia at a much younger age compared to the non-indigenous Australian population.
As stated by Burrow and Ride (2016), lack of knowledge and reduced awareness about
available medical help has led to the emergence of the present scenario. In addition to
this a report published by Jacklin et al. (2017), TIIDM was responsible for 4.1% of the
deaths among indigenous people and also heavily contributed to the indigenous
disease burden. In addition to this, TIIDM also contributed to 8% of the health gap
between the indigenous as well as the non-indigenous female and 7% within the
indigenous and the non-indigenous male (Zimmet etal., 2016). 68% of early death was
found to occur among indigenous Australians due to Diabetes (Zimmet et al., 2016).
Additionally, poor access to health care facilities and poor socio-economic statuses
contributed to the rise of disease burden due to TIIDM among the indigenous
population.
Type II Diabetes can be defined as a chronic illness condition which is
characterized by high blood glucose level and reduced or null level of insulin production
by the body to metabolize the glucose. TIIDM is laden with a number of health
complications which include Kidney disease, problems with vision, a higher risk of a
stroke or heart attack, erectile dysfunction and neurological problems which might result
in traumatic injury or infection (Harris et al., 2013). In other words, elevated blood
pressure level and triglycerides level and the persisting infection of the wound can
already be defined as problematic for Alex. On analyzing Alex’s food habits and
lifestyle, it can be said that Alex needs to make immediate changes to lead a healthy
life. Alex needs to immediately quit smoking, lose weight and consume a balanced diet
to remain healthy (Reading & Greenwood, 2015). Further, Alex needs to essentially cut
down on carbohydrates and could consult a dietician for an appropriate meal plan for a
Diabetic patient. In addition to this, Alex needs to lose weight for which he would need
to engage in mild physical exercises (Dunkley et al., 2014). This would help in
controlling his body weight and at the same time improve his fatigue symptoms. In
addition to this, Alex would have to actively take the medication prescribed by the GP o
control his blood glucose level, pressure level and Triglycerides.

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As has already been discussed, TIIDM is a major health problem among the
indigenous aboriginal community based at Australia. Alex, needs to adapt the previously
discussed measures in order to lead a healthy life. It is important that Alex also gets his
wife Martha tested. Early identification could help the progression of the disease to an
adverse extent. It is also recommended that both Alex and Martha are offered
counseling for their work level and family life stress so as to help them stay positive and
healthy. Some of the other symptoms of Diabetes include high level of anxiety and
depression. Alex’s depression symptoms could affect his family members and he could
turn aloof to them. This could potentially weaken the family bonding. In addition to this, if
Alex does not comply with the prescribed recommendations his symptoms would
eventually worsen and that would increase the disease burden as well as the cost
related to the medical expenditure. This could potentially deprive the family of a stable
life free from stress and depression. This could eventually worsen the physical as well
as the mental health of the family members.
TIIDM in the aboriginal indigenous people are most commonly characterized by
the high rate of obesity, ageing population and lifestyle changes. Studies suggest that
the indigenous community was the community of hunter gatherers and there are no
substantial evidences of high blood pressure or blood vessel diseases. However, with
the transition to western lifestyle and adapting westernized food low in fibre and higher
in fat and increased inclination to smoking and consumption of alcohol, the probability to
be affected from cardiovascular diseases and Diabetes has heightened.

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References:
Burrow, S., & Ride, K. (2016). Review of diabetes among Aboriginal and Torres Strait
Islander people.pp.70-75. Retrieved from:
https://ro.ecu.edu.au/ecuworkspost2013/2226/
Dunkley, A. J., Bodicoat, D. H., Greaves, C. J., Russell, C., Yates, T., Davies, M. J., &
Khunti, K. (2014). Diabetes prevention in the real world: effectiveness of
pragmatic lifestyle interventions for the prevention of type 2 diabetes and of the
impact of adherence to guideline recommendations: a systematic review and
meta-analysis. Diabetes care, 37(4), 922-933. DOI: https://doi.org/10.2337/dc13-
2195
Harris, S. B., Bhattacharyya, O., Dyck, R., Hayward, M. N., & Toth, E. L. (2013). Type 2
diabetes in Aboriginal peoples. Canadian journal of diabetes, 37, S191-S196.
DOI: https://doi.org/10.1016/j.jcjd.2013.01.046
Jacklin, K. M., Henderson, R. I., Green, M. E., Walker, L. M., Calam, B., & Crowshoe, L.
J. (2017). Health care experiences of Indigenous people living with type 2
diabetes in Canada. Cmaj, 189(3), E106-E112. DOI:
https://doi.org/10.1503/cmaj.161098
Reading, C., & Greenwood, M. (2015). Structural determinants of aboriginal people's
health (p. 1). Toronto, Ontario, Canada: Canadian Scholars’ Press.pp.111-116.
Retrieved from: https://books.google.co.in/books?
hl=en&lr=&id=jblaDwAAQBAJ&oi=fnd&pg=PA3&dq=Reading,+C.,+
%26+Greenwood,+M.+(2015).+Structural+determinants+of+aboriginal+people
%27s+health+(p.+1).+Toronto,+Ontario,+Canada:+Canadian+Scholars
%E2%80%99+Press.&ots=4BEjkoJGG6&sig=JERgH3b716gC4JgbM7dxmoruGy
U#v=onepage&q&f=false
Stoneman, A., Atkinson, D., Davey, M., & Marley, J. V. (2014). Quality improvement in
practice: improving diabetes care and patient outcomes in Aboriginal Community
Controlled Health Services. BMC health services research, 14(1), 481.

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Zimmet, P., Alberti, K. G., Magliano, D. J., & Bennett, P. H. (2016). Diabetes mellitus
statistics on prevalence and mortality: facts and fallacies. Nature Reviews
Endocrinology, 12(10), 616. DOI: https://doi.org/10.1038/nrendo.2016.105