Contemporary Nurse
ISSN: 1037-6178 (Print) 1839-3535 (Online) Journal homepage: http://www.tandfonline.com/loi/rcnj20
Making the case for a more accurate cardiovascular disease risk assessment tool for Indigenous Australians Alex Chan To cite this article: Alex Chan (2015) Making the case for a more accurate cardiovascular disease risk assessment tool for Indigenous Australians, Contemporary Nurse, 50:1, 92-93, DOI: 10.1080/10376178.2015.1010251 To link to this article: http://dx.doi.org/10.1080/10376178.2015.1010251
Accepted author version posted online: 10 Apr 2015. Published online: 10 Jun 2015. Submit your article to this journal
Article views: 76
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Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=rcnj20 Download by: [Universite Laval]
Date: 06 November 2015, At: 06:49
Contemporary Nurse, 2015 Vol. 50, No. 1, 92–93, http://dx.doi.org/10.1080/10376178.2015.1010251
Making the case for a more accurate cardiovascular disease risk assessment tool for Indigenous Australians Alex Chan*
Downloaded by [Universite Laval] at 06:49 06 November 2015
School of Health Sciences, University of Tasmania, 1 Leichhardt Street, Darlinghurst, NSW 2010, Australia
Cardiovascular Disease (CVD) is the leading cause of premature death in Indigenous Australians (Australian Indigenous HealthInfoNet, 2014). Statistics show that the morbidity and mortality from CVD among Indigenous Australians are significantly higher than non-Indigenous Australians (Abbott, Davison, & Moore, 2008; Braidshaw, Alfonso, Finn, Owen, & Thompson, 2011). In 2012–2013, 12% of Indigenous Australians reported living with a CVD (Australian Indigenous HealthInfoNet, 2014). CVD is a preventable non-communicable disease and the intensity of preventive treatment should be based on individuals’ risk assessment score (National Vascular Disease Prevention Alliance, 2009; Wang & Hoy, 2005). However, many possible contributing factors of CVD among Indigenous Australians such as cultural and historical factors, environmental and socioeconomic factors, psychosocial stressors and limited access to both preventive and clinical health care (Australian Indigenous HealthInfoNet, 2014), are not considered in the current CVD risk assessment tools. Therefore, there is currently a lack of an accurate CVD risk assessment tool tailored to meet the needs of Indigenous Australians. There were 548,400 people identified as Indigenous Australians in the 2011 census (Australian Bureau of Statistics, 2011). However, some Indigenous Australians may choose not to disclose their Indigenous status in the census and/or with other government agencies (Braidshaw et al., 2011; Coory & Johnston, 2006). More importantly, some agencies are not using the national standard Indigenous status question or response options (Australian Institute of Health and Welfare, 2013). This inconsistent data collection and recording practice not only has a negative impact on the accuracy of the national health databases, but also increases the difficulties in health-care planning, resource allocation and service delivery for these groups of the population. On the other hand, health-care professions should acknowledge that the Indigenous view of health may be different to the mainstream Australian culture. Their concept of health is often holistic in nature, including the aspects of social, emotional and environmental, as well as the total wellbeing of their community (Aboriginal Health and Medical Research Council of NSW, 2010). Therefore, a CVD risk assessment tool specifically designed for Indigenous Australians would improve the accuracy and consistency of CVD assessment. Eventually, it may improve the quality and accessibility of cardiovascular services for Indigenous populations. As discussed previously, many CVD risk factors can be managed through lifestyle modification and preventive treatment (National Heart Foundation of Australia & Australian Healthcare and Hospitals Assocation, 2010). A clinical guideline issued by the National Vascular Disease Prevention Alliance (2009) recommends that effective cardiovascular preventive strategies
*Email: [email protected] © 2015 Taylor & Francis
Contemporary Nurse
93
must be based on estimated absolute risk. This risk assessment is aimed to identify high-risk patients for early preventive treatment. Framingham function is the most popular cardiovascular risk assessment but, unfortunately, it underestimates the absolute risk in Indigenous Australians, especially in women and young adults (Wang & Hoy, 2005). This may lead to a negative effect on individuals’ decision in starting preventive treatment and the compliance with the prescribed risk factor management. Research in cardiac risk assessment among Indigenous Australians is very limited. Therefore, further study is required to improve the quality and participation of preventive CVD services in indigenous populations.
Downloaded by [Universite Laval] at 06:49 06 November 2015
References Abbott, P., Davison, J., & Moore, L. (2008). Too many of us have gone early: Priorities in heart health education for Aboriginal people. Australian Family Physician, 37(4), 266–268. Aboriginal Health and Medical Research Council of NSW. (2010). Definition of aboriginal health. Retrieved May 17, 2014, from http://www.ahmrc.org.au/index.php?option=com_content&view=article&id= 35&Itemid=37 Australian Bureau of Statistics. (2011). Census of population and housing - Counts of aboriginal and Torres Strait Islander Australians, 2011 (Cat. no. 2075.0). Canberra, Australia: ABS. Australian Indigenous HealthInfoNet. (2014). Overview of Australian Indigenous health status, 2013. Retrieved July 16th, 2014, from http://www.healthinfonet.ecu.edu.au/health-facts/overviews Australian Institute of Health and Welfare. (2013). Healthy for life: Results for July 207 - June 2011 (Cat. no. IHW 84). Canberra, Australia: AIHW. Braidshaw, P. J., Alfonso, H. S., Finn, J., Owen, J., & Thompson, P. L. (2011). A comparison of coronary heart disease event rates among urban Australian aboriginal people and a matched non-aboriginal population. Journal of Epidemiology and Community Health, 65(4), 315–319. Coory, M., & Johnston, T. (2006). Trends in the annual prevalence of hospitalisation for remote indigenous communitites in Queensland, 1997/98 to 2004/05. Australian and New Zealand Journal of Public Health, 30(5), 440–443. National Heart Foundation of Australia, & Australian Healthcare and Hospitals Assocation. (2010). Better hospital care for Aboriginal and Torres Strait Islander people experiencing heart attack. Canberra, Australia: National Heart Foundation of Australia and Australian Healthcare and Hospitals Assocation. National Vascular Disease Prevention Alliance. (2009). Guidelines for the assessment of absolute cardiovascular disease risk. Canberra, Australia: National Heart Foundation of Australia. Wang, Z., & Hoy, W. E. (2005). Is the Framingham coronary heart disease absolute risk function applicable to Aboriginal people? Medical Journal of Australia, 182(2), 1–9.
ISSN: 1037-6178 (Print) 1839-3535 (Online) Journal homepage: http://www.tandfonline.com/loi/rcnj20
Making the case for a more accurate cardiovascular disease risk assessment tool for Indigenous Australians Alex Chan To cite this article: Alex Chan (2015) Making the case for a more accurate cardiovascular disease risk assessment tool for Indigenous Australians, Contemporary Nurse, 50:1, 92-93, DOI: 10.1080/10376178.2015.1010251 To link to this article: http://dx.doi.org/10.1080/10376178.2015.1010251
Accepted author version posted online: 10 Apr 2015. Published online: 10 Jun 2015. Submit your article to this journal
Article views: 76
View related articles
View Crossmark data
Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=rcnj20 Download by: [Universite Laval]
Date: 06 November 2015, At: 06:49
Contemporary Nurse, 2015 Vol. 50, No. 1, 92–93, http://dx.doi.org/10.1080/10376178.2015.1010251
Making the case for a more accurate cardiovascular disease risk assessment tool for Indigenous Australians Alex Chan*
Downloaded by [Universite Laval] at 06:49 06 November 2015
School of Health Sciences, University of Tasmania, 1 Leichhardt Street, Darlinghurst, NSW 2010, Australia
Cardiovascular Disease (CVD) is the leading cause of premature death in Indigenous Australians (Australian Indigenous HealthInfoNet, 2014). Statistics show that the morbidity and mortality from CVD among Indigenous Australians are significantly higher than non-Indigenous Australians (Abbott, Davison, & Moore, 2008; Braidshaw, Alfonso, Finn, Owen, & Thompson, 2011). In 2012–2013, 12% of Indigenous Australians reported living with a CVD (Australian Indigenous HealthInfoNet, 2014). CVD is a preventable non-communicable disease and the intensity of preventive treatment should be based on individuals’ risk assessment score (National Vascular Disease Prevention Alliance, 2009; Wang & Hoy, 2005). However, many possible contributing factors of CVD among Indigenous Australians such as cultural and historical factors, environmental and socioeconomic factors, psychosocial stressors and limited access to both preventive and clinical health care (Australian Indigenous HealthInfoNet, 2014), are not considered in the current CVD risk assessment tools. Therefore, there is currently a lack of an accurate CVD risk assessment tool tailored to meet the needs of Indigenous Australians. There were 548,400 people identified as Indigenous Australians in the 2011 census (Australian Bureau of Statistics, 2011). However, some Indigenous Australians may choose not to disclose their Indigenous status in the census and/or with other government agencies (Braidshaw et al., 2011; Coory & Johnston, 2006). More importantly, some agencies are not using the national standard Indigenous status question or response options (Australian Institute of Health and Welfare, 2013). This inconsistent data collection and recording practice not only has a negative impact on the accuracy of the national health databases, but also increases the difficulties in health-care planning, resource allocation and service delivery for these groups of the population. On the other hand, health-care professions should acknowledge that the Indigenous view of health may be different to the mainstream Australian culture. Their concept of health is often holistic in nature, including the aspects of social, emotional and environmental, as well as the total wellbeing of their community (Aboriginal Health and Medical Research Council of NSW, 2010). Therefore, a CVD risk assessment tool specifically designed for Indigenous Australians would improve the accuracy and consistency of CVD assessment. Eventually, it may improve the quality and accessibility of cardiovascular services for Indigenous populations. As discussed previously, many CVD risk factors can be managed through lifestyle modification and preventive treatment (National Heart Foundation of Australia & Australian Healthcare and Hospitals Assocation, 2010). A clinical guideline issued by the National Vascular Disease Prevention Alliance (2009) recommends that effective cardiovascular preventive strategies
*Email: [email protected] © 2015 Taylor & Francis
Contemporary Nurse
93
must be based on estimated absolute risk. This risk assessment is aimed to identify high-risk patients for early preventive treatment. Framingham function is the most popular cardiovascular risk assessment but, unfortunately, it underestimates the absolute risk in Indigenous Australians, especially in women and young adults (Wang & Hoy, 2005). This may lead to a negative effect on individuals’ decision in starting preventive treatment and the compliance with the prescribed risk factor management. Research in cardiac risk assessment among Indigenous Australians is very limited. Therefore, further study is required to improve the quality and participation of preventive CVD services in indigenous populations.
Downloaded by [Universite Laval] at 06:49 06 November 2015
References Abbott, P., Davison, J., & Moore, L. (2008). Too many of us have gone early: Priorities in heart health education for Aboriginal people. Australian Family Physician, 37(4), 266–268. Aboriginal Health and Medical Research Council of NSW. (2010). Definition of aboriginal health. Retrieved May 17, 2014, from http://www.ahmrc.org.au/index.php?option=com_content&view=article&id= 35&Itemid=37 Australian Bureau of Statistics. (2011). Census of population and housing - Counts of aboriginal and Torres Strait Islander Australians, 2011 (Cat. no. 2075.0). Canberra, Australia: ABS. Australian Indigenous HealthInfoNet. (2014). Overview of Australian Indigenous health status, 2013. Retrieved July 16th, 2014, from http://www.healthinfonet.ecu.edu.au/health-facts/overviews Australian Institute of Health and Welfare. (2013). Healthy for life: Results for July 207 - June 2011 (Cat. no. IHW 84). Canberra, Australia: AIHW. Braidshaw, P. J., Alfonso, H. S., Finn, J., Owen, J., & Thompson, P. L. (2011). A comparison of coronary heart disease event rates among urban Australian aboriginal people and a matched non-aboriginal population. Journal of Epidemiology and Community Health, 65(4), 315–319. Coory, M., & Johnston, T. (2006). Trends in the annual prevalence of hospitalisation for remote indigenous communitites in Queensland, 1997/98 to 2004/05. Australian and New Zealand Journal of Public Health, 30(5), 440–443. National Heart Foundation of Australia, & Australian Healthcare and Hospitals Assocation. (2010). Better hospital care for Aboriginal and Torres Strait Islander people experiencing heart attack. Canberra, Australia: National Heart Foundation of Australia and Australian Healthcare and Hospitals Assocation. National Vascular Disease Prevention Alliance. (2009). Guidelines for the assessment of absolute cardiovascular disease risk. Canberra, Australia: National Heart Foundation of Australia. Wang, Z., & Hoy, W. E. (2005). Is the Framingham coronary heart disease absolute risk function applicable to Aboriginal people? Medical Journal of Australia, 182(2), 1–9.
