Public Health Report: Type 2 Diabetes and Aboriginal Health

This report provides a comprehensive overview of Type 2 diabetes within Aboriginal communities, highlighting the significant health disparities and high prevalence rates. It delves into key demographic factors such as age, gender, genetics, and education levels, illustrating their impact on diabetes risk. The report examines the specific challenges faced by Aboriginal people, including obesity, lack of physical activity, and genetic predispositions. Furthermore, it explores contemporary health strategies, emphasizing culturally appropriate programs, preconception education, and interventions to improve access to fresh foods and healthcare services. The report also identifies barriers to healthcare delivery, such as funding limitations, lack of qualified personnel, language barriers, and physical geography, while recognizing the enablers that can improve health outcomes. The conclusion underscores the critical need for targeted interventions and culturally sensitive approaches to address the growing public health challenge of Type 2 diabetes within Aboriginal populations.

Running head: FIRST PEOPLE’S HEALTH 1
First people’s health
Students Name
Institutional Affiliation

FIRST PEOPLE’S HEALTH 2
Introduction
Type 2 diabetes is a chronic condition resulting from insulin deficiency or when the
peripheral tissues are resistant to Insulin. The complications associated with the disease include
high risk of stroke or heart attack, kidney disease, eye disease, nerve damage and death. Type 2
diabetes is a growing public health challenge worldwide. The disease has been declared an
epidemic in Australia and globally. The condition is more prevalent among the indigenous
people and those from low socio-economic status backgrounds.
The Aboriginal and Torres Islander people have high cases of diabetes type 2, and their
risk of acquiring the diseases is thrice that of the non-indigenous Australians. The risk of
developing gestational diabetes among Aboriginal women is also twice that of the non-
indigenous Australians. Research also indicates that the risk of Aboriginal children developing
type 2 diabetes is eight times more than that of the non-indigenous children. The mortality rate of
the diseases is also high among the Aboriginal people as research shows that their risk of dying
from the disease is six times more than that of the non-indigenous people. The reason I have
chosen Diabetes type 2 among the Aboriginal people is because of the high prevalence of the
disease and the high mortality of the disease among the population. In 2011, diabetes type 2
accounted for 4.1 of the population disease burden. In 2011 to 2015, 8% of the Aboriginal people
deaths were as a result of type 2 diabetes (Burrow 2016).
Key factor
The demographic factors that increase the risk of type 2 diabetes among the Aboriginal
people are Age, gender, genetics and level of education. The prevalence of diabetes among the
indigenous people is more prevalent among adults aged 45 and above. The prevalence is also
high among the adolescents, children and the youths (Zheng, Ley and Hu 2018, p.88). A research

FIRST PEOPLE’S HEALTH 3
conducted to ascertain the incidence rate of type 2 diabetes among the different age groups of the
Aboriginal people shows that the incidence rate of the indigenous people aged 15 to 24 years was
9.8%. The incidence rate among those aged 25 to 34 was 21.8%, 35 to 54 was 37.4% and 55
years and above was 47.6%. This shows that the risk of developing type 2 diabetes increases
with an increase in age among the Aboriginal people (Islam and Fitzgerald 2016, p.30).
The risk of diabetes among the Aboriginal people is high among the seniors aged 45
years and above because they exercise less, lose muscle mass and gain excess weight leading to
obesity (Azzopardi et al. 2018, pp.766-782). The increased prevalence among children and
young adults is also attributed to lack of physical activity and poor healthy habits among the
aboriginal people leading to obesity (Titmuss 2019). Research indicates that the risk of becoming
obese among the senior Aboriginal people is higher which predisposes them to conditions such
as Type 2 diabetes as compared to the younger people. 80% of the aboriginal people are
overweight, and 60% of them are suffering from type 2 diabetes (Sushames, van and Gebel
2016, p.129).
Obesity among these seniors, children and young adults caused type 2 diabetes in two
main ways. Firstly, it affects the inflammatory response due to the accumulation of excess
abdominal fat which stimulates the release of pro-inflammatory chemicals from the fat cells. The
pro-inflammatory chemicals result in the body becoming less sensitive to the insulin it produces
by affecting the ability of the responsive cells to respond to insulin. Secondly, obesity disrupts
fat metabolism by stimulating changes in an individual's metabolism. These changes trigger the
fat tissue to produce fat molecules into one's blood which then affect the insulin-responsive cells
and hence leading to a decrease in insulin sensitivity (Fan and Wang 2018).

FIRST PEOPLE’S HEALTH 4
There are differences between the prevalence and incidence of type 2 diabetes among the
male and female genders of the aboriginal people. The prevalence of type 2 diabetes is higher
among females than males. Research indicates that the risk of developing Type 2 diabetes
among Aboriginal females is two times that of the Aboriginal men. This is attributed to the fact
that indigenous females are more obese compared to men. In 2015, the rates of obesity among
the Aboriginal men and women were 34% and 40% respectively. The risk of the obese
Aboriginal people developing type 2 diabetes is seven times more than that of the normal weight
women. This shows that obesity among the indigenous women has a strong relationship with
increased prevalence and incidence of type 2 diabetes (Kautzky-Willer, Harreiter and Pacini
2016, pp.278-316).
The increase in the prevalence and incidence of type 2 diabetes among Aboriginal people
can be attributed to genetics. 73% of the aboriginal people with type 2 diabetes have moderate to
high genetic risk factors. The fact that type 2 diabetes can be genetic means that if the Aboriginal
mother and father carry the gene, the Aboriginal child is more likely to develop type 2 diabetes.
The fact that the aboriginal people have poor health-seeking behaviour makes it difficult to
identify and offer timely intervention for type 2 diabetes and hence leading to high mortality
rates (Chow and Chan 2017, pp.331-332).
The level of education among the aboriginal people affects the prevalence and incidence
of type 2 diabetes mellitus. Research indicates that the major risk factors of type 2 diabetes are
Genetics and obesity. The more educated people tend to be more aware of the consequences of
poor health habits, and hence they practice good health behaviours. The prevalence and
incidence of type 2 diabetes among the educated Aboriginal people are lower than that of the less
educated. This is because the well-educated indigenous people understand the effects of obesity

FIRST PEOPLE’S HEALTH 5
on their health. As a result, they tend to engage in physical activities to help them lose excess
calories as well as keep fit. They also consume the healthy foods that have fewer calories such as
vegetables and fruits and hence preventing them obesity (Suka et al. 2015, pp.660-668).
The well-educated Aboriginal people also have good health-seeking behaviour and hence
cases of type 2 diabetes are easy detected and managed. As a result, they do not have a high
mortality rate from the disease compared to the less educated Aboriginal people. The well-
educated Aboriginal people know more about diseases and their causes, and hence once they
notice their parents have type 2 diabetes, they understand that they are at risk of developing it.
As a result, they tend to make healthy choices to ensure that they do not develop the disease
(Suka et al. 2015, pp.660-668).
Health care strategy
The contemporary health strategies that can help the incidence and prevalence of type 2
diabetes among the Aboriginal people include developing and implementing culturally
appropriate programs that can help educate the people on the adverse health effects of type 2
diabetes. The health education should be offered to the Aboriginal people in a culturally sensitive
way such as translating the services and materials. Also, there should be the promotion of
programs that improve the health of the Aboriginal people as well as detect gestational diabetes
to ensure that it is appropriately managed (Smith, Fatima and Knight 2017, pp.236-242).
Secondly, Aboriginal women should be offered preconception education to promote
healthy eating as well as reduce the use of tobacco, alcohol and other drugs. In addition, there
should be the creation of a healthy environment that encourages Aboriginal people to engage in
physical activity as well as reduce unhealthy behaviours. Physical activity can be encouraged by

FIRST PEOPLE’S HEALTH 6
educating the people on its importance. It can also be encouraged by improving access to places
where people can engage in physical activities. (Mendham, Duffield, Marino and Coutts 2015,
pp.438-443).
Thirdly, the interventions that can help increase the affordability, the availability and the
use of fresh foods should be developed. This will help reduce the use of high fat, high salt, high
sugar and processed foods. As a result, there will be reduced cases of obesity and hence leading
to a reduction in the cases of type 2 diabetes. Also, there should be improved access to
specialists to ensure that the Aboriginal people that the adverse complications as a result of type
2 diabetes are well treated. This will reduce the mortality rate of the disease among the people.
Fourthly, the primary health care services should be encouraged to identify the diabetes cases
early enough to prevent the deaths from the disease (Zimmet 2017, p.1).
The Aboriginal people should also be encouraged to properly manage the disease, and
they should also give the indigenous type 2 diabetes patients the opportunity to self-manage their
diabetes. Also, there should be an increase in the educator workforce working with the
indigenous people and within their primary health care settings mostly in Aboriginal Community
Controlled Health Services. There should also be capacity development of the health workforce
to help ensure that there is improved access to evidence-based and high-quality type 2 diabetes
care. There should also be more focus on the family, child and maternal health to improve the
early life of the Aboriginal people as well as their growth patterns. Lastly, there should be
adequate intervention programs that can help address the environmental and social determinants
of the Aboriginal people and hence reducing their prevalence to the disease (Thurber et al. 2018,
pp.491-498).

FIRST PEOPLE’S HEALTH 7
The barriers to the healthcare delivery of Aboriginal people include lack of adequate
funds. The lack of sufficient funds to increase the number of healthcare facilities that can
improve the access of the Aboriginal people to healthcare services affects the delivery of
healthcare. Lack of adequate income to buy medical equipment and drugs is also a barrier to the
delivery of care. Secondly, the lack of qualified personnel who can offer culturally appropriate
care is also a barrier to the delivery of health services. The aboriginal people need treatment that
addresses all their cultural needs, and hence there is a need for more practitioners who can offer
this type of care (Gibson and Segal 2015, p.154).
Thirdly, language barrier among the Aboriginal people makes it hard to deliver health
services. For a health provider to offer adequate services to a person, he or she needs to
understand the language the patient uses. The presence of a language barrier, therefore, makes it
hard for proper communication between the health care provider and the patient. The language
barrier also makes it hard for the Aboriginal people to understand the health-related information
the health care professionals give them. This, therefore, makes the delivery of preventive
healthcare services such as offering health education through the use of educational pamphlets
difficult (Gibson et al. 2015, p.71).
Lastly, physical geography is also a barrier to health care delivery by making it difficult
for health care professionals to reach the most marginalised areas of the Aboriginal people. As a
result, the people living in the area fail to receive timely healthcare and hence leading to
increased morbidity and mortality. The enablers to the delivery of healthcare services include the
increase in the number of qualified healthcare personnel who can offer culturally appropriate
healthcare. This is because the presence of health care professionals who can offer health care
services that addresses the needs of the Aboriginal people increases the delivery of healthcare.

FIRST PEOPLE’S HEALTH 8
Proper funding of health programs that deal with Aboriginal health is an enabler to the delivery
of healthcare services among the indigenous people (Gibson et al. 2015, p.71).
Conclusion
In conclusion, Type 2 diabetes is a serious disease that has adverse health complications
such as kidney disease, nerve damage, high risk of stroke or heart attack and death. Type 2
diabetes is a growing health challenge in Australia, especially among the Aboriginal and Torres
Islander people. The aboriginal people have a high risk of acquiring type 2 diabetes compared to
their non-indigenous counterparts. Their mortality rate is also high compared to the rest of the
population. The demographic factors that influence the prevalence and incidence of type 2
diabetes include gender, age, genetics and level of income. Strategies that can help reduce the
risk of type 2 diabetes include encouraging physical activity, healthy eating and improving the
primary health care services of the Aboriginal people. The barriers to the delivery of health care
services include language barrier, lack of income, physical geography and lack of adequate
health care services who can offer culturally competent care.

FIRST PEOPLE’S HEALTH 9
References
Azzopardi, P.S., Sawyer, S.M., Carlin, J.B., Degenhardt, L., Brown, N., Brown, A.D. and Patton,
G.C., 2018. Health and wellbeing of Indigenous adolescents in Australia: a systematic
synthesis of population data. The Lancet, 391(10122), pp.766-782.
Burrow, S. and Ride, K., 2016. Review of diabetes among Aboriginal and Torres Strait Islander
people.
Chow, E. and Chan, J.C., 2017. Explaining the high prevalence of young-onset diabetes among
Asians and Indigenous Australians. Med J Aust, 207, pp.331-332.
Fan, Z. and Wang, L., 2018. Chronic Conditions (related to Nutrition) in Australia.
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.
Gibson, O.R. and Segal, L., 2015. Limited evidence to assess the impact of primary health care
system or service level attributes on health outcomes of Indigenous people with type 2
diabetes: a systematic review. BMC health services research, 15(1), p.154.
Islam, S. and Fitzgerald, L., 2016. Indigenous obesity in the news: a media analysis of news
representation of obesity in Australia’s Indigenous population. BMC obesity, 3(1), p.30.
Kautzky-Willer, A., Harreiter, J. and Pacini, G., 2016. Sex and gender differences in risk,
pathophysiology and complications of type 2 diabetes mellitus. Endocrine reviews, 37(3),
pp.278-316.

FIRST PEOPLE’S HEALTH 10
Mendham, A.E., Duffield, R., Marino, F. and Coutts, A.J., 2015. A 12-week sports-based
exercise programme for inactive Indigenous Australian men improved clinical risk
factors associated with type 2 diabetes mellitus. Journal of science and medicine in
sport, 18(4), pp.438-443.
Smith, K., Fatima, Y. and Knight, S., 2017. Are primary healthcare services culturally
appropriate for Aboriginal people? Findings from a remote community. Australian
journal of primary health, 23(3), pp.236-242.
Suka, M., Odajima, T., Okamoto, M., Sumitani, M., Igarashi, A., Ishikawa, H., Kusama, M.,
Yamamoto, M., Nakayama, T. and Sugimori, H., 2015. Relationship between health
literacy, health information access, health behavior, and health status in Japanese
people. Patient education and counseling, 98(5), pp.660-668.
Sushames, A., van Uffelen, J.G. and Gebel, K., 2016. Do physical activity interventions in
indigenous people in Australia and New Zealand improve activity levels and health
outcomes? A systematic review. International Journal of Behavioral Nutrition and
Physical Activity, 13(1), p.129.
Thurber, K.A., Joshy, G., Korda, R., Eades, S.J., Wade, V., Bambrick, H., Liu, B. and Banks, E.,
2018. Obesity and its association with sociodemographic factors, health behaviours and
health status among Aboriginal and non-Aboriginal adults in New South Wales,
Australia. J Epidemiol Community Health, 72(6), pp.491-498.
Titmuss ., 2019. Emerging diabetes and metabolic conditions among Aboriginal and Torres
Strait Islander young people. The Medical Journal of Australia. Available at:

FIRST PEOPLE’S HEALTH 11
https://www.mja.com.au/journal/2019/210/3/emerging-diabetes-and-metabolic-
conditions-among-aboriginal-and-torres-strait [Accessed May 14, 2019].
Zheng, Y., Ley, S.H. and Hu, F.B., 2018. Global aetiology and epidemiology of type 2 diabetes
mellitus and its complications. Nature Reviews Endocrinology, 14(2), p.88.
Zimmet, P.Z., 2017. Diabetes and its drivers: the largest epidemic in human history?. Clinical
diabetes and endocrinology, 3(1), p.1.