Improving Cardiovascular Health in Australian Adults: A Policy Brief

This policy brief aims to improve the cardiovascular health status of Australian adults, with a special focus on Aboriginals and Torres Strait Islanders. It discusses the high rate of occurrence of cardiovascular disease among these populations and highlights the modifiable risk factors. The brief critiques the current policy options and provides recommendations for improving cardiovascular health in Australia.

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

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Executive Summary
The following policy brief aims towards improving the cardiovascular (CVD) health
status of the Australian Adults with the special focus to the Aboriginals and the Torres Strait
Islanders. CVD is a non-communicable disease common in 4.2 million Australian adults
during 2014-15. The rate of occurrence is double among the Aboriginals and the Torres Strait
Islanders population. The main risks factors behind the disease development are modifiable
risk factors like unhealthy lifestyle habits. The Australian policy for the CVD control include
increasing the primary care services and educating the Aboriginal and Torres Strait
Islandersabout improvement of the health lifestyle habits. However, improvement in policy
planning will be focused towards the budget differentiation in equal areas along with proper
smoking and alcohol prevention policies.

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According to the World Health Organisation (2006), the knowledge base of the
healthcare workers must be improved rapidly such that the policy decisions taking place at
the local or at the international levels can be designed as per the evidence-based practice and
responsive towards increasing the requirement for the healthcare workers and the overall
challenges for meeting this health needs. For the information of the health workforce system
for the designing of the policy, the information in the domain of the health-related gap must
be aligned with particular country. The following policy brief is set over the healthcare
context of Australia and will mainly highlight the cardiovascular diseases. Cardiovascular
disease (CVD) is an umbrella term that used to describe the heart and blood vessels disease.
The term commonly encompass diseases like the heart failure, coronary heart disease,
cardiomyopathy, peripheral vascular disease, congenital heart disease and stroke. The
majority of the conditions are life threatening.
Context and importance of the problem
According to the reports published by Kreatsoulas and Anand (2010), cardiovascular
disease resultsin more than one thirds of the death in the developed countries. It is also
regarded as one of the leading cause of mortality and morbidity in developing nations as well,
accounting to nearly 25% of the total death. Under the Australian context, it can be stated that
the cardiovascular disease (CVD) is one of the main cause of death in Australia creating a
high level of disease burden. During 2014-15, at least 4.2 million Australian adults reported
to have been diagnosed with CVD and this include 1.2 million of population have
encountered stroke and 2.6 million population reported for having hypertension. As per the
Aboriginal Statistics, at least 69,000 Aboriginal and Torres Strait Islander have CVD during
2014-15 that this equals to 15.7% of the Aboriginal population. The rate is thrice as higher in
comparison to the non-indigenous population (Australian Government Department of Health,

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2016).Apart from the high rate of occurrence among the indigenous population, the
Australian who resides in the remote areas have 30% higher death rates in comparison to the
major cities. People who belong to the poor socio-economic groups are also associated also
suffers higher rate of occurrence of CVD in comparison to the people who resides in the
higher socio-economic groups in Australia (Australian Institute of Health and Welfare
[AIHW], 2018). Higher rate of hospitalizations due to CVD mainly arise from stroke,
coronary heart disease and heart failure. On the basis of the gender related disease
occurrence, it can be said that men are the prime victims of the disease in comparison to
women across all the age group.
(Source: AIHW, 2019)
However, AIHW (2018) reports that the occurrence of the disease has decreased since
2008 to 2013, however, the there is a high level of disparity between the rate of occurrence
depending on the parameters like gender, socio-economic status and ethnicity.

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The main risk factor behind the disease development is advancing age, genetic
history, ethnicity and gender. The modifiable risk factors behind the development of CVD
include behavioural factors like the smoking of tobacco, lack of proper physical activity, lack
of proper diet planning and excessive consumption of alcohol. Biomedical factors also play
an important role behind the disease development and these are high blood pressure, high
level of blood cholesterol and over-weight/obesity. The presence of chronic, yet non-
communicable diseases like type 2 diabetes, chronic liver and kidney diseases also increase
the vulnerability of developing CVD. Though the exact interaction of the chronic diseases
with the development of CVD is not well-understood but research has confirmed that
predisposition to type 2 diabetes double the risk of developing CVD in comparison to the
general population (Australian Government Department of Health, 2016).
The American Heart Association (AHA) committee has defined guideline for
monitoring the CVD health status (Waters, Trinh, Chau, Bourchier & Moon, 2013). The
study conducted by Peng and Wang (2018) aimed towards estimating the CVD health status
among the Australian adults. The approach used is the guidelines of AHA. The study used
data from national representative sample consisting of 7499 adults who are aged 18 during
2011 to 2012 from Australian Health Survey in order to estimate the disease status. The
analysis of the results highlighted that ideal status is mainly prevalent among the fasting level
of plasma glucose (83.6%) and minimally developed pattern of the dietary habits (4.8%). The
average percentage of the standard cardiovascular health was found to be 0.15% among the
Australian adults. 0.52% of adults residing in Australia have all the four factors that define
the ideal CVD health. Age and sex differences are there for the ideal stats of the individual
CVD metric. At last the authors concluded that the percentage of the ideal cardiovascular
health in adults of Australia is below the normal range (Peng & Wang, 2018). Peng and

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Wang (2018) recommended that proper public health policies must be implemented for
improving Australian population-wide cardiovascular health.
Thus policy will be directed towards the improving the lifestyle habits of the Australia
adults with a special focus to the Aboriginals. Improvement of the lifestyle habits will help
reduce the modifiable risk factors or CVD and thus improving the overall health status and at
the same time reducing the health inequalities among the aboriginal population. The main
target for the policy will thus include Australian adults (both indigenous and non-indigenous
population).
Critique of policy option(s)
CVD health strategy in Australia is known as National Strategy for Heart, Stroke and
Vascular Health in Australia (February 2004). The main aim of this strategy is to promote the
overall CVD status of Australian population. Specified goals of the strategy include reduction
in the health in-equalities in the overall cardiac health outcomes and other vascular diseases
through specific focus on the preventive procedures. It also focus on the management
practices in relation to the Aboriginal and the Torres Strait Islander peoples. Other over-
reaching goal of this CVD health promotion strategy in Australia includes effective care and
management of the cardiovascular stroke and vascular diseases across the different areas of
care and to optimise the outcomes by promoting and identifying the proven interventions.
The policy also promotes dissemination. It also facilitates proper uptake of the optimal
prevention practices in relation to heart, vascular disease and stroke and at the same time
promote consistency in this practices. At last goal of this policy is the increase the role of the
consumers in managing their own health-related outcomes in CVD (Australian Government
Department of Health and Ageing, 2004).

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The main strength of the current policy of Australia it aims towards eliminating the
gap in the health status between the Aboriginal and Torres Strait Islander people and the rest
of the non-indigenous Australian population. This is done by primary health care capacity,
educating the aboriginal service users under the presence of the aboriginal nursing
professionals and giving family focused interventions for the promoting food security and
improvement in the socio-economic status of the people residing in the remote areas or
Aboriginal families who are unemployed and suffer from financial crisis. Freeman et al.
(2014) are of the opinion that the increasing the provision for the primary healthcare service
and at the same time increasing the strength of the Aboriginal nursing workforce is effective
in reducing the health inequalities among the Aboriginal population. However, the current
healthcare statistics highlight that the health inequality still persists among the Aboriginal and
Torres Strait Islanders population in Australia (AIHW, 2018).
Thus it is required for the Australian government to provide more grass root level
policy planning in order to uproot the increased incidence of CVD among the Aboriginal
population. De Goeij et al. (2015) are of the opinion among the aboriginal population the
chances of CVD is high due to increased prevalence of the alcohol consumption and high rate
of tobacco smoking. There are excised high alcohol taxation rate in Australia. The lasts rule
though framed is only implemented on February 2019 (Australian Government Taxation
Office., 2018). However, this taxation rate only covers alcohol purchase at registered
restaurants and bar parlous. However, the Aboriginals purchase alcohol from illicit means or
the victims of the illicit alcohol use and thus increasing the rate of occurrence of CVD.
Australian Government however has no distinct polices or stringent laws that prevent the
access of the illicit alcohol to the aboriginals. Increase access to primary intervention and
health education is not effective as the primary concern behind consumption of alcohol is

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lack of proper employment and increased rate of depression due to financial crisis and social
exclusion (De Goeij et al., 2015).
In case of tobacco smoking it can be said that the though the Australian government
has imposed taxes in the overall cost of tobacco or cigarette, the rate of smoking is high
among both the Aboriginals and the non-Aboriginal population. The reason behind this is
anti-tobacco campaigns in Australia is not impactful. Moreover, the anti-tobacco smoking
campaigns fail to reach to the people residing in the remote areas of Australia and thereby
increasing the CVD vulnerability among the people residing in the remote areas (Gould et al.,
2014). The AIHW also shows that prevalence of CVD is higher among the men, however, so
specific planning is made for by the Australian policy for CVD prevention targeting the men.
Policy recommendation
According to the Australian Heart Foundation while Australia generally does well
under the parameters of the international standards, when it comes for the prevention and
effective management of the CVD, there are gaps in current approach. The main gap in the
current approach is lack of proper investment planning in different areas of the CVD disease
like the over-weight and obesity management and cessation of tobacco smoking and alcohol
consumption. Centre of Disease Control and Prevention (2018) stated that American is taking
active initiative for the effective prevention of CVD. The United States of America (USA)
have invested more than $100 million fund dedicatedly for the prevention of the heart disease
and stroke prevention in the fiscal year of 2017. The special focus of investment includes all
the 50 states and District of Columbia along with 12 tribes and 23 tribal serving organizations
along with 3 territories and 4 other large cities. The special focus over the tribal population
helps in reducing the disease inequalities. The policy of USA also provides special focus on
the women and gives them proper behavioural support in order to prevent health-inequalities

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across the gender. The government of America also provides special sodium restricted diet
plan under the community level interventions in order to improve the CVD health status of
the mass. However, CVD policy of Australia lack special sodium restricted diet plan.
Thus, the first practical step measures that needs to be implemented under the
Australian perspective include proper budget planning for CVD policy. This budget planning
must be done in such a way that the distribution of money will occur depending on the
priority needs of CVD occurrence like health education, diet planning exercise planning and
proper awareness about the self-management of the disease. Proper budget planning will also
include separate provision for the men in Australia and the rate of occurrence of CVD is
higher among the men. After the effective budget planning, efforts must be undertaken in
order to restrict the alcohol and the tobacco access to the people residing in the remote areas
Aboriginals (Angell, Levings, Neiman, Asma & Merritt, 2014). Smoking in public has been
band in the UK (Smoke Free England, 2007). In Australia, smoking in prohibited in enclosed
public places but in open public gatherings smoking is allowed. Moreover such strict banning
is not implemented in remote areas leading to increased rate of smoking among the
Aboriginals(Angell, Levings, Neiman, Asma & Merritt, 2014). Australian government must
come forward with proper surveillance system in order to ban smoking in public in the
remote areas. The anti-smoking messages must be impactful and must be specifically
designed for the Aboriginals and Torres Strait Islanders (Gould et al., 2014).
Thus overall it can be said that Australian Government must come forward with a
proper planning of CVD along with redistribution of budget depending upon the priority
needs in order to generate comprehensive reduction of CVD across the entire population.

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