Communications, partnerships critical in improving Indigenous health
Effective communication and partnerships are crucial factors in improving the health of Aboriginal and Torres Strait Islander people, according to the directors of the Poche Centre for Indigenous Health at the University of Sydney.
Latest studies show that in their interactions with health services, Indigenous patients are sensitive to power imbalances, and miscommunication between those providing care and their patients is widespread and often unrecognised. This directly impacts on the quality of care provided, and can be life-threatening.
The University of Sydney has today launched the Poche Centre for Indigenous Health, to address the inequities and barriers to access of healthcare for Indigenous Australians.
The Centre will work closely with Aboriginal communities, health services and individuals. Developing strategies to improve communication and encourage shared decision making, is one of the priority tasks.
"When healthcare for Indigenous patients is built around trust, reciprocity and shared decision making, health programs and interventions are more effective," said Professor Alan Cass, appointed this month as co-director of the Poche Centre.
The establishment of the Poche Centre for Indigenous Health follows a donation of $10 million in February this year by philanthropist Mr Greg Poche. The Centre has three primary aims: to work with local and community health services to improve Indigenous health in western NSW and the Northern Territory, to conduct essential research into critical aspects of Indigenous health, and to educate medical and health students in matters concerning the health of Aboriginal and Torres Strait Islander people.
"The development of the Poche Centre represents a fantastic opportunity to promote change and reduce disparities in Aboriginal and Torres Strait Islander health and social justice outcomes," said Associate Professor Ngiare Brown, a co-director with Professor Cass.
"It is very much a cross sectoral collaboration - it brings together a philanthropic donation from the private sector with the medical and academic expertise of Australia’s leading universities, and links that with Aboriginal communities and health services. The aim is to address priorities and gaps in health services and capacity," she said.
The Centre ran its first health clinics in western NSW towns Brewarrina and Bourke in June, and the program will now expand.
The next phase includes gathering together teams of health and medical professionals with expertise in focused areas, including child and maternal health, vascular risk and chronic disease, mental health, and social and emotional well-being.
"Chronic diseases affect Indigenous Australians in young adulthood and in the most productive years of life. On average, Indigenous Australians who die with kidney disease lose more than 25 years of life compared to the general population. Kidney disease, diabetes and heart disease are not diseases of ageing among Indigenous Australians," Professor Cass said.
"Early childhood physical and psychological development is dependent on a number of complex factors, including maternal and child nutrition, substance abuse and others. We must address these foundational issues if we are to ensure health and productive futures for Aboriginal and Torres Strait Islander people," said Associate Professor Brown.
The Centre for Indigenous Health was launched by the Chancellor of the University of Sydney, Professor Marie Bashir.
Background
- Inequities and barriers to access for Indigenous Australians are an entrenched feature of our healthcare system. This manifests in a set of stark statistics for Indigenous health — including a 17 year life expectancy gap.
- Early mortality due to chronic disease is a major contributor to this gap. Compared to non-Indigenous Australians, Aboriginal and Torres Strait Islander people have:
- 14 times higher mortality due to diabetes;
- 8 times higher mortality due to kidney disease; and
- 5 times higher mortality due to heart disease.
- Aboriginal and Torres Strait Islander infants and children are at increased risk of low birth rate, higher rates of neonatal and infant mortality, social exclusion and poorer educational outcomes.
- 23% of Indigenous women who give birth are under 20 years compared with 4% in general population
- 13% of indigenous babies have low birthweight compared with 6% in general population
- maternal mortality rates are 5 times higher for Indigenous women
- perinatal mortality is 2 times greater
- Effective communication is a key to achieving good health outcomes. The Sharing the True Stories research project, which documented the extent of miscommunication in healthcare delivery for Indigenous Australians with kidney disease, revealed that:
- Miscommunication is pervasive;
- Miscommunication often went unrecognized; and
- A shared understanding of key issues of wellbeing and illness, treatment and health priorities was rarely achieved.
- This directly impacts on the quality of healthcare and is potentially and actually life-threatening.
Associate Professor Ngiare Brown is an Aboriginal woman from NSW with family connections to the Wadi Wadi, Tharawal, Yuin and Dhanghutti peoples. She is one of the first Aboriginal medical graduates in Australia, and an advocate for Indigenous health and social justice. Her interests lie in human rights, Indigenous affairs and bioethics. She played a key role in the establishment of the Australian Indigenous Doctors Association and is a founding member of the Pacific region Indigenous Doctors’ Congress. In her previous position she was Assistant Director at the Menzies School of Health Research in Darwin, where she developed a program around child health and human rights within the Child Health Division.
Professor Alan Cass returned to the University of Sydney in 2003 as a senior researcher, and then Director, of the Renal Division of the George Institute for International Health and Associate Professor in the Faculty of Medicine. He is a national leader in the development of policy regarding the co-ordinated delivery of chronic disease prevention and management services for Indigenous Australians. His research has repeatedly broken new ground, including Sharing the True Stories, which documented the extent of miscommunication in cross-cultural healthcare. After graduating BA MBBS from the University of Sydney in 1989, Alan trained as a specialist physician and nephrologist at Royal Prince Alfred Hospital. In 2003, he gained his PhD from the University for his thesis exploring the social determinants of chronic kidney disease among Indigenous Australians. He received an Australian Harkness Fellowship in Health Care Policy in 2002-3.