Mini-Symposium
Bridging the Survival Gap Between Indigenous and Non-Indigenous Australians: Priorities for the Road Ahead

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The life-expectancy gap between Indigenous and non-Indigenous Australians remains one of contemporary Australia's most enduring health divides. The reduction of observed health outcome disparity between population groups based on measures of socioeconomic status, geography, or ethnicity stands as a key target of coordinated societal and health system reform.

CVD remains the principal cause of death among all Australian population groups, including Aboriginal males and females, and is the primary contributor to the 17-year life-expectancy gap between Aboriginal and non-Aboriginal Australians.

This paper discusses the challenges inherent, from the perspective of broader policy frameworks and health system reform, to reducing disparity between population groups within Australia, and outlines the opportunities for change that could contribute benefit to Aboriginal and mainstream Australians in regards to reducing the burden of CVD and related conditions.

Further, through mapping adverse outcomes to acute cardiac events it seeks to discuss several key targets for reform that may serve to reduce health disparity between Aboriginal and non-Aboriginal Australians.

Section snippets

Background

The life-expectancy gap between Indigenous and non-Indigenous Australians remains one of contemporary Australia's most enduring health divides [1]. In fact, on an international stage, few within-country health differentials are as large or as consistent [2].

From a health policy perspective, the reduction of observed health outcome disparity between population groups based on measures of socioeconomic status, geography, or ethnicity stands as a key target of coordinated societal and health

CVD and the Life-Expectancy Gap

There is growing recognition of the contribution of cardiovascular disease (CVD) to the profound gap between Indigenous and non-Indigenous Australians. CVD remains the principal cause of death among all Australian population groups, including Aboriginal males and females, and is the primary contributor to the life-expectancy gap. Between 1996 and 2000, CVD alone accounted for almost one third of the 17 years less that an Indigenous child could expect to live when compared to a non-Indigenous

Challenges to Reducing the Gap for Aboriginal Australians

Data deficiencies are only one challenge on a list of many impediments to the health and well-being of Indigenous Australians. The context in which ‘Indigenous health’ and, in particular ‘Indigenous health disparity’, is being constructed and discussed has shifted, all the more noticeable as a result of the year long “Northern Territory Intervention” [5]. Indigenous affairs are now being framed by the false notion that Aboriginal people are unable to manage any element of their lives and

Getting It Right-Opportunities for Australia

Despite the challenges, there exist significant opportunities in the pursuit of improved CVD outcomes for Aboriginal people. Given the age-related burden of diabetes, cardiovascular and renal disease, in isolation and as co-morbid conditions, the synergistic impact of these ailments among Indigenous people may offer a window into the transition of disease patterns already observed and which we can expect to escalate within Australian society in the coming decades. This affords an opportunity to

Outcomes of Acute Coronary Syndromes in Aboriginal People

Unfortunately, little data beyond cross sectional community surveys have been available to guide the development of systems that can better respond to the needs of Aboriginal people with CVD. Linked jurisdictional data from Queensland has previously demonstrated the sub-optimal delivery of appropriate invasive cardiovascular procedures and adverse medium-term outcomes in Aboriginal people experiencing AMI [16]. Recent national registry data from multiple jurisdictions has failed to capture

Reducing Adverse Outcomes in Aboriginal CVD

There are clear opportunities for improving outcomes through increased access to evidence-based investigation and care, including cardiac rehabilitation (CR), discharge medication, and appropriate invasive procedures. The challenge rests on establishing the data to better identify Aboriginal patients at elevated risk of adverse outcomes and to more aggressively target necessary intervention points. This will require, as a priority, significant improvements in the recording of Indigenous status

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