Closing the gap in Indigenous health

Indigenous Australians are dying about 10-years earlier than non-Indigenous Australians. A major contributor is a largely invisible condition called Rheumatic Heart Disease (RHD), which if caught early is easy to treat.

RHD highlights the gap in health care between Aboriginal and non-Aboriginal Australians, which is caused by a cycle of social, environmental and health factors and simply shouldn’t be happening.

Access to health care for Aboriginal Australians is a complex problem. Issues like access to transport, medical costs, and health literacy are major barriers. In some affluent areas of capital cities like Melbourne and Sydney there is roughly one GP for every 500 people. But in poorer, rural areas the numbers can soar to one GP for every 4,000 people. For some people, seeing a doctor can seem like an impossible task.

The First Peoples of Australia have among the highest rates of RHD in the world. It starts with a sore throat or infected skin sores in children aged 5-15 years. Left untreated, RHD can lead to permanent heart damage, disability, stroke and premature death.

If the infection is caught early, it’s easy to treat with injections of penicillin.  This is known as Acute Rheumatic Fever (ARF). However, repeated attacks or sore throat infections from this bacteria left untreated can cause the development of little nodules on the valves of the heart. This is known as Rheumatic Heart Disease. When that happens the valves start to thicken and stop working causing heart failure. Children as young as ten are actually going into heart failure and need to have heart surgery with mechanical valves put in.

This disease evolves from a simple sore throat to a very complex health condition. It needs continual heath care. When this occurs in places where access to health care is poor, the problem becomes very serious.

aboriginal girl and baby

On closer inspection RHD is the tip of the iceberg when it comes to the differences in health between Aboriginal and non-Aboriginal Australians. It’s a disease that occurs in poor, marginalised communities that should not occur, because it's preventable. We’re one of the richest countries on earth and shockingly, we have a disease of poverty that’s taking the lives of beautiful young children.

The gap between health and life expectancy in Aboriginal and non-Aboriginal Australians comes down to a lack of access to health services, low health literacy levels, poor housing (overcrowding), unemployment and poor food nutrition. As these basic needs are improved the disease starts to disappear and this has been echoed in other countries around the world.

A common misconception about RHD and other illnesses in Indigenous communities is that Aboriginal people are genetically predisposed. Whilst there may be some type of genetic involvement, health conditions like RHD are strongly related to poverty. Every child in this country needs to have access to the right health care, they need to have healthy food and nutrition, and they need to have a roof over their head and a school to go to. The causes of RHD are generally the cause of many other common health problems in Indigenous people. If we work towards eradicating RHD, we’re going to start to eradicate other things like cardiovascular disease and diabetes.

A greater awareness is needed within the broader community, in communities where the disease occurs and for the health professionals that work in that community. We need integrated health management. All cases need to be recorded in a register and be followed up with adequate and appropriate care and a dedicated health workforce. And we need fair and equitable access to cardiac surgical services.  There are currently three different vaccines under trial with the aim to prevent this disease through immunisation.

Bupa has formed a partnership with the Moonshine Movies to shine a light on this disease through a project called Take Heart. At a local level we’re working with a number of communities, on community lead control. We’re working with health organisations and NGOs in the area, and we’re working with a number of organisations that have an interest in social reform and social change because that’s what needs to happen. We can all support change in RHD by taking the time to learn about this disease and sharing the Take Heart story within our own communities.

Moonshine Movies has released a powerful and provocative documentary Take Heart: The Quest to Rid Australasia of Rheumatic Heart Disease

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