The Health and Wellbeing of Indigenous Australians Flashcards
Aboriginal Social Structure
*Note: approx 1 million ABTSI in AUS
Peoples
Language group
Clan
Band
Family
(PLCBF)
History of Indigenous Australians
- BMI
- Diet
- BP, CHD, Cholesterol, Diabetes
- BMI = <20 (physically fit)
- Diet = 1 main meal/day, high fibre, potassium, magnesium & calcium. Low fat and sodium. Slowly digested carbohydrates.
- Low fasting glucose & cholesterol. No evidence of diabetes, CHD or BP issues.
What were the consequences of post European colonisation?
Mistreatment
Dispossession
Slavery
Conflict
Massacres
Illness
Social disruption
Lack of cultural understanding
Health effects post colonisation and three main risk factors?
- Android obesity (holding fat in the abdominal/chest/arms)
- hypertension
- Body mass and BP increase with age
- Type 2 (non-insulin dependent diabetes mellitus)
- CHD
- Elevated triglycerides & low HDL
- Hyperinsulinemia (insulin resistance)
Risk factors
- Dietary behaviours
- Physical inactivty
- Overweight and obesity
Median age for Indigenous vs Non-Indigenous?
Median Indigenous = 23
Median Non-Indigenous = 38
Significantly more skewed towards the lower age bracket for Indigenous (not many make it beyond 65)
Life expectancy Difference
Males (2015-17)
Indigenous = 71.6
Non-Indigenous = 80.2
Difference = 8.6
Females
Indigenous = 75.6
Non-Indigenous = 83.4
Difference = 7.8
Previous (2005-2007)
Males = 11.5
Females = 9.7
Note: access to health care, economic status etc are all factors but infant mortality is one of the biggest contributors
Factors contributing to chronic health conditions in Indigenous groups (HBP RE HEN)
- Historical
- Biomedical risks eg BP, lipids, BMI
- Psychosocial/cultural eg racism, depression, family/community violence
- Risk behaviours (smoking, diet, < PA)
- Environmental (housing, isolation, food, lack of transport)
- Health care system (eg access & $$)
- Economic (unemployment & poverty)
- Non-modifiable risk (age, gender, etc)
Contributes to chronic conditions (15% of ABTSI have heart disease - leading cause of death)
Dietary behaviours (fruit and veg intake compared to non-indigenous). Main barriers.
2x as likely to report no usual daily fruit intake than Non-Indigenous. 7x as likely to report no daily vegetable intake.
Barriers - cost and access to variety of fresh food.
Does not eat Vegetables daily
- Remote (Indigenous)
- Non- Remote (Indigenous)
- Non-Indigenous
Remote = 15%
Non-Remote = 2%
Non-Indigenous = 1%
Does not eat fruit daily
- Remote (Indigenous)
- Non- Remote (Indigenous)
- Non-Indigenous
Remote = 21/22%
Non-remote = 13%
Non-Indigenous = 7%
What percentage of Indigenous Australians are sedentary?
50% (approx 32% of non-Indigenous)
Overweight percentages
34% Males
24% Females
Obese percentages
28% Males
34% Females
Poor dietary behaviours, physical inactivity and obesity are risk factors associated with several preventable chronic diseases including:
CVD
Hypertension
Type 2 diabetes
Percentage with atleast one long-term health condition rising from ….% of Inidgenous children <14 years to ….% of those over 55 years
44%
97%
If they make it beyond 60, then 75-80% have 3 or more long term health condition.
Respiratory (Lung) disease prevalence & smoking prevalence
27% of population = lung disease
>51% smoke
Diabetes prevalence
12% (4% in non-Indigenous)
Renal incidence
76 per 100,000 (2008)
Doubled from 31 per 100,000 (1991)
Heart Disease
12% prevalence
Years of life lost = 24%
Model of Care For Aboriginal People
(RFIT & ETCS)
Black = Aboriginal Health Contribution to the Model.
- Referral
- Follow up
- Identification
- Trust
Red = Performed by non Aboriginal providers eg community health, GP, etc
- Education
- Treatment
- Clinical Indicators
- Screening and assessment
Yellow = Aboriginal person, family and community
Results of a 12 week study in women attending gym classes and nutritional education…
Decreased body weight, BMI, BP and no change in CRP. 40% compliance.
Hunter gather lifestyle intervention result
improved glucose and insulin to a 75 OGTT
Walking group study for diabetes
Protected from increases in plasma glucose and triglycerides
Benefits of Indigenous youths participating in PA
3.5 times more likely to report good general health and 1.6 times more likely to have no probable serious mental illness
UTS 12 week intervention for Indigenous communities
Day 1: Assessed anthropometry, blood pressure, venous blood, and glucose response (75g)
Day 2: Cycle Ergometry (peak oxygen consumption and workload)
Prescritpion
- Wednesday 45 min combined gym session (strength and cardio)
- Friday 60 minutes of boxing
- Sunday - 60 mins of small sided games eg touch football, futsal
Intensity = 70-85% MHR. Session RPE collected at end of every session
(W1-6 = 2 session & W7-12 = 3 sessions)
Results of the UTS intervention for Indigenous communities
1% reduction in mass (kg)
3% reduction in waist cirumernece
3% reduction in WHR (waist-hip ratio)
Lower insulin concentrations, small reduction in the amount of glucose and the rate of reduction. Less insulin required to remove glucose from the blood.
V02 peak > (pre = 30 & post = 35)
Peak workload > (pre=240 & post= 270) Duration (pre = 9.5 and post = 11)
What were the 3 main factors improved in the UTS intervention for Indigenous communities
Glucose regulation
Anthropometry
Aerobic capacity
Initiatives to promote sport and exercise in Indigenous communities
The Elite Indigenous Travel and Accomodation program (EITAAP)
Indigenous Marathon Project
NRL - Indigenous All-stars & Indigenous round
AFL - Indigenous round
NRL - NSW state knock out health challenge
