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DC209 Health and Society : Smoking and Coronary heart disease


Choose one health issue from the list below:

  • Smoking
  • Coronary heart disease

Answer all of the three questions below based upon this one health issue.

1. Discuss two different reasons for inequity between Indigenous Australians and non-Indigenous Australians in relation to this health issue. 

2. Provide one example of a Primary Health Care intervention that is addressing this health issue for Indigenous Australians. Explain the impact this intervention is having on reducing inequity.


3. Discuss how cultural knowledge and sensitivity in health care may affect access Primary Health Care services. Provide one example based on your chosen health issue.



1.Indigenous Australians compared to non-indigenous Australians have poor health outcomes. Life expectancy with indigenous Australian is low; heart diseases are the leading cause of deaths among indigenous Australians the Aboriginal and Torres Strait Islanders are likely to suffer from heart attack and die without getting medical attention. According to studies, this group of Australians does not receive the needed medical procedur

es and diagnosis such as coronary bypass surgery (ROTHSTEIN, 2018, p.123). Although a significant number of indigenous Australians are admitted to hospitals with coronary related issues, the statistics do not account for the procedure rates. Regarding territory the western and northern territories parts of Australia, there are higher incidences of coronary diseases compared to New South Wales and Queensland that have lower rates. Indigenous Australians in the western region are thrice likely to experience heart diseases compare non-indigenous Australians. Another aspect to note is the likely hood of those living in remote areas reporting coronary related diseases unlike those living in urban areas.

Torres Strait Islanders and the aboriginals are a disadvantaged group regarding social indicators when compared to other Australians. Despite continued improvement in health care and reduction in mortality rates this group of people until exhibit poor health. The life expectancy of indigenous Australian according to 2015 research is 17 years; they develop chronic diseases in their early stages of growth, a reason for increased cases in the number of those hospitalized (SMITH, 2016, p.102). In the year 2004, the comparison of gender showed that the number of indigenous males and females hospitalized due to coronary heart diseases was higher compared to non-indigenous. Other prevalence reported in indigenous Australians included overweight, high blood pressure, smoking, and diabetes. Although behavioural and biomedical risk factors account for the incidences in indigenous population, other determinants included socioeconomic, environmental, historical and cultural factors (FUSTER& KELLY 2010, p.67).

Research on coronary heart diseases adds psychosocial especially social isolation, depression, and lack of social support as other factors that lead to coronary heart diseases. It is evident that there are inequalities in the Australian health sector affecting Torres islanders and the aboriginal; the disparity is the primary cause of deaths and reduced survival. A comparison of procedure and in-hospital fatality rates for indigenous Australians is worse compared to other Australians. The indigenous Australians suffering from coronary heart diseases are likely to die in hospital and cannot access required revascularization and angiography that other Australians can access (ICHOLS et al., 2016, p.345). Although indigenous Australians have, other co-occurring diseases influenced by among factors stated above, there is need to reduce the gap inequality in access to health and treatment of severe diseases as coronary heart diseases. To attain the equality and save lives it is vital that the planning and delivery of health services are aware of the factors leading to the inequality as this will aid in bridging the and coming up with comprehensive health service delivery.


2. Coronary heart disease and other cardiovascular diseases like stoke are the cause of premature death by Torres Strait Islanders and aboriginal in Australia. The understanding of cause and treatment of coronary heart disease in the recent years led to a reduction in mortality. The establishment of therapeutic and preventing strategies that are effective will reduce the mortality rates due to coronary heart diseases. The indigenous Australians inequalities exist in access and appropriateness of long-term care. The articulation of the deficiency in delivery, prevention programs, and treatment programs is an intervention that will monitor and improve the receipt and outcome of healthcare (CATANZARITI & SENES, 2010, p. 123). The response to health in Australia does not only center on coronary heart disease but other comorbidities like congestive heart failure, stroke, and rheumatic heart disease. The primary health care intervention groups the comorbidities into primordial prevention and primary prevention. Primordial prevention centers on healthy lifestyle, societal and cultural factors, and quality primary health care. On the other hand, primary intervention includes factor detection, treatment of diabetes, hypertension, and renal diseases. Additionally, the response looks at the acute phase of medical emergencies that is chronic rehabilitation and secondary prevention (GRAY & THOMSON, 2013, p.256). The primary challenge to the invasion is the low numbers of the aboriginal cardiovascular nurse; another impediment is the lack of training programs for the workforce needed in the implementation of healthcare intervention. The performance of the invasion cannot only base on shortfall but the potential impact on coronary heart disease health. Despite the geographical aspect in Australia, the intervention program expanded treatment and referral guidelines that support delivery of healthcare and the coordination of transfer from regional to the tertiary site.

Australia is a combination of culture, the provision of affordable health services in a culturally sensitive environment is critical to cohesiveness and development. The intervention to remedy the effect of coronary heart diseases in Australia increased the number of Torres Strait and Aboriginal Australians in the healthcare sector. Another response is the development of cardiovascular disease treatment program that aims at training on treatment and preventions. Additionally, primary caregivers are now working g closely with tertiary centers and rehabilitation facilities; this facilitates control of risk factor, monitoring of extended therapies and inclusive decision-making. The realization of this primary healthcare intervention, objectives is not yet attained. However, a journey improves through the enhancement of cultural awareness and support given during and through healthcare provision. A memorandum of understanding between caregivers at tertiary and primary centers strengthened due to formalization and mutual obligation. Measurement of performance identified priorities and achievements in the cardiovascular policy targeting coronary heart diseases in Torres Strait and aboriginal Australians language and culture is a factor that plays a significant role especially when patients are referred to city hospitals that are foreign to indigenous Australians (SMITH, 2016, p.112). The level of service delivery is enhanced by mapping out national outreach programs that build on existing services the success of the outreach needs continuous maintenance and strengthening.

3. Aboriginal Australians suffer on from health issues compared to the general Australian population, particularly in heart-related diseases. Although a disparity exists the aboriginals rarely use the health facilities in place. To improve access to the services it is essential that the population is given a clear understanding of the importance of the facilities to their health. The ability to communicate with aboriginals by the nonaboriginal health care providers is limited by the cultural differences existing between the two parties. The aspect of cultural appropriateness plays a significant role in Australian health sector. The leading cause of disagreement is the inability to provide gender-appropriate care that is highly regarded by the aboriginal. The cultural oversight determines patient’s future use of facility or mistrust on the system (CATANZARITI & SENES, 2010, p.87).

The Australian government countered the aspect of the culture in health provision by adopting Aboriginal liaison officer; government-funded interpreters and cultural workers that bridge barriers in language and aid in reducing fear and anxiety while undergoing a medical procedure. According to aboriginals, primary health primary health care includes essential and integrated care based on socially acceptable scientifically sound and practical systems and technologies that are accessible and to their proximity. The aboriginals believe they must participate in health procedures that affect their lives. The provision of health care in these communities requires a deep understanding of the community problems and their involvement in the regulation of adequate and appropriate channels of addressing the health problems. The ideal in the provision of healthcare in the aboriginals and Torres Strait needs to recognize the streets not only their weakness. The two groups have all along survived despite the policies that were in place; their culture remained paramount that communities have their strengths. The primary health care includes the engagements ins supporting and working with the resources in the community health workforce. It is critical to take into consideration health service delivery regarding focus education and training programs. The future of teaching models needs to integrate educational programs around communication strategies and lifestyle changes and the priority o audience (MULLER, L. (2014, p 97).

 The aboriginals resisted the use of western practices in health care. The approach by healthcare systems in place did not consider psychological, cultural, and social behavioural dimensions that were significant to the aboriginals. The western medical practices conflicted with the original view of the health care practices that perceived right. The clinical facilities failed to build a working relationship with the communities; they did not acknowledge cultural practices and living conditions (HEALEY, 2010, p78). The come lack of enabling factors influenced individual-level factors. The adverse experience due to culture difference affected the quality of-of care that patients received; this changed the continued use of health care facilities by the by the aboriginals. The resistance aggravated situations, and many aboriginals who needed specialized treatments did not get the required medical attention.

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