A health issue of concern that I have identified is the high incidence of Rheumatic heart disease in remote Aboriginal and Torres Strait Islander (hereby referred to as Indigenous) communities and, more specifically, the experiences of Indigenous patients living with Rheumatic heart disease and their access to equitable healthcare. Rheumatic heart disease is a life-threatening disease of the heart that causes damage to the hearts valves and muscle, resulting from one or more episodes of rheumatic fever caused by the Streptococcal bacteria (RHD Australia, 2021). Mortality rates from Rheumatic heart disease in Indigenous Australians are the highest reported globally and are responsible for the highest gap in life expectancy between Indigenous and non-Indigenous Australians (May et al., 2016). Rheumatic heart disease occurs almost exclusively in Aboriginal and Torres Strait Islander communities. As of December 2019, 5,385 people were living with Rheumatic heart disease, and 4 in 5 diagnoses were among Indigenous Australians. In 2015-2019, 72% of deaths reported from Rheumatic heart disease were Indigenous Australians (Australian Institute of Health and Welfare, 2021).
I am interested in the topic of Indigenous Australians in remote communities accessing equitable healthcare after spending time in a remote community and developing a deeper understanding of the healthcare challenges faced by those who live in remote communities. To construct a suitable research question, I looked for qualitative studies using the PICo format detailed below:
P = Rheumatic Heart Disease patients living in remote Indigenous communities
I = Experiences
Co = Accessing equitable care
Final Research Question: What are the experiences of Indigenous Rheumatic heart disease patients living in remote Indigenous communities with accessing equitable healthcare.
The two research articles that I have identified for my research question are a literature review conducted by Haynes et al. (2020) and a qualitative study completed by Artuso et al. (2013). These articles identified three key barriers faced by Indigenous patients in remote communities living with Rheumatic heart disease. Access and distribution of services, cultural appropriateness of services, and education and communication (Artuso et al., 2013; Haynes et al., 2020). Both articles identified that a barrier to accessing equitable health care was cultural oversights. A lack of gender-appropriate care was shown to impact a patient’s experience significantly. Non-Indigenous healthcare providers with little to no cultural training contributed to a feeling of disempowerment as services could not provide culturally appropriate care, ultimately providing inequitable healthcare services (Artuso et al., 2013; Haynes et al., 2020). Both Artuso et al. (2013) and Haynes et al. (2020) identified that a mistrust of the healthcare system due to a patient’s negative experience ultimately resulted in a reluctance to seek help from healthcare providers.
Education was identified as a key issue Indigenous Australians face living with Rheumatic heart disease in remote communities. Disease-related knowledge, treatment options and preventative care were shown to be insufficient (Artuso et al., 2013; Haynes et al., 2020). Ineffective communication was also identified, indicating that information provided in English and not the patient’s first language resulted in a limited understanding of the patient’s medical condition (Haynes et al., 2020).
The limited availability of specialist services and inconsistencies with community and personal transportation also resulted in a reluctance to seek ongoing treatment for Rheumatic heart disease (Artuso et al., 2013; Haynes et al., 2020). Many patients in remote Indigenous communities cannot receive appropriate care due to the limited availability of specialist services (Artuso et al., 2013). Both articles identified clear barriers experienced when accessing equitable healthcare services in remote Indigenous communities.
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References
Artuso, S., Cargo, M., Brown, A., & Daniel, M. (2013, March). Factors influencing health care utilisation among Aboriginal cardiac patients in central Australia: a qualitive study. BMC Health Services Research,13(1).https://doi.org/10.1186/1472-6963-13-83
Australian Institute of Health and Welfare. (2021, July). Acute rheumatic fever and rheumatic heart disease in Australia, 2015–2019.https://www.aihw.gov.au/reports/heart-stroke-vascular-diseases/acute-rheumatic-fever-and-rheumatic-heart-disease/contents/summary
Haynes, E., Mitchell, A., Enkel, S., Wyber, R., & Bessarab, D. (2020, February). Voices behind the Statistics: A Systematic Literature Review of the Lived Experience of Rheumatic Heart Disease. International Journal of Environmental Research and Public Health,17(4).https://doi.org/10.3390/ijerph17041347
May, J, P., Bowen, C, A., & Carapetis, R, J. (2016). The inequitable burden of group A streptococcal diseases in Indigenous Australians. The Medical Journal of Australia, 205(5), 201-203.https://doi.org/10.5694/mja16.00400
RHD Australia. (2021, February). What is rheumatic heart disease?.https://www.rhdaustralia.org.au/what-rheumatic-heart-disease
- Briefly clarify why you choose this health issue to respond to.
- Use two articles[different from peer’s ones]to discuss the health issue. Recent articles within the
last 5 yearslast 10 years should be included, from 2012 and onward. - Conclusion and future recommendations.
