Healthcare Online Tutoring: Indigenous Australians and diabetes

Indigenous Australians and diabetes

Indigenous health indicates the physical, cultural, social and emotional well-being of  Indigenous Australians. According to the reports, unlike non-indigenous Australians, indigenous Australians are more likely to have health problems including respiratory diseases, mental health problems, cardiovascular disease, diabetes and chronic kidney disease. Due to which majority of them suffer from poorer health than other Australians and often die at very young age (Health Direct, 2018). Many indigenous Australians suffer from diabetes which is the fastest growing chronic disease of the world, especially in 21th century.

Diabetes is a common disease which is occurred when a person loses its tendency to produce their own insulin to control the glucose level of blood which increases the levels of glucose in the blood. It is a severe disease that eventually affects the entire body and there are three types of diabetes, type 1, type 2 and gestational diabetes (Australia, 2013). This essay aims to discuss the problem of diabetes type 2 in indigenous Australians, the vulnerable conditions of patients during this disease and how can it be Improved?

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An explanation of vulnerability of diabetes in Indigenous Australians

Inequalities and vulnerability in health results from inequalities in the society. The debate over large gap in life expectancies among Indigenous and non-Indigenous Australians indicates big social differences amongst the two communities. An extremely bad health of Australian Aboriginals and Torres Strait Islanders can be recognized. The socioeconomic deficit faced by these Australians is due to lack of change in areas such as early childhood development; education and skills development; jobs and work environments; minimum income for a good living standard; sustainable communities; and a prevention approach to social elements ( Marmot, 2011). It is due to these social inequalities that indigenous Australians go through worst health conditions and lower life expectancies.

According to the reports, higher levels of ill health are found in people of low social status because they usually lack in finance, knowledge and skills to attain the essential fundamentals of terrific health, such as good standard of living and housing, education, and nutritional diet etc. however, researchers have now established that even if poverty is not a factor, according to social position health still remains unevenly distributed (Tsey, Whiteside, Deemal, & Gibson, 2003).

Additionally, not only diabetes type 2 is the widely spread disease in Australia but it is very common in Aboriginal and Torres Strait Islander people (My dr, 2013). These people are exposed to diabetes type 2 at higher risk than the other population in Australia. It is observed that the indigenous Australians are suffering from type 2 diabetes 3 to 4 times more than non-indigenous Australians. This disease begins to develop higher risk of complications at a very young age in these people. The high rates of diabetes type 2 in indigenous Australians is due to both an unhealthy lifestyle and genetic tendency. The evidence from the researches have shown that Aboriginal people with modern lifestyle have high amounts of obesity, reduced glucose tolerance, high blood pressure, high levels of fats in the blood, and extremely high insulin levels in the blood.

Whether experiencing diabetes type 2 at a younger age or as an adult, there are many complications of the disease which includes kidney and eye disease, a higher risk of heart attack or stroke, erection issues, and damage of nerve, which can cause traumatic injury or infection leading to limp amputation. In order to have good health and curable diabetes type 2, government has promised to provide primary health care to indigenous people (My dr, 2013).

As stated in the principles of primary health care of Australia that “universal access to primary health care contributes to improving the health of disadvantaged and vulnerable groups and is an essential responsibility of governments. Also, maintaining good health is a collective as well as an individual responsibility”. ( Allen & Walker, 2014). It is reported that a total of more than $174 billion is healthcare costs related with diabetes and its complications in the Australia. Despite the crucial efforts towards prevention of diabetes, it is obvious that the millions of people with diabetes with strengthening healthcare costs will need better care models ( Stuckey, Adelman, & Gabbay, 2011).

Eric J. Warm (2007) researches have shown that there is a substantial gap between empirical diabetes care and real care delivery. In order to eliminate this gap and convert methodical information directly to the care of patients the Chronic Care Model (CCM) was developed. The CCM is a key health framework based on care that classifies the vital fundamentals of high-grade chronic disease care. It comprises of consideration to self-management support, design of delivery system, decision support, information technology, linkages to community, and the entire health care association.

As far as CCM is concern there are 6 elements of the model that needs to be focused on that is organization of health care service, self-care support, clinical decision support, clinical information systems, design of service delivery system and community resources. Talking about the health care services, the organization should emphasis on forming a culture and mechanism that encourages safe and high-quality care. Health care may also be improved if the administration of the service, the implementation of strategies to enable improvements and the management of errors and quality assurance issues are automatically improved. Besides this, the issue of miscommunication and health-care coordination must be prohibited. The communication gap should be eliminated between managers and service providers via agreements enabling contact and information flow between them. In order to have effective care for chronic conditions, such as diabetes type 2, is practically not feasible without an information network to guarantee population and person access to the key data (Baptista, D.R., 2016).

Recently McKittrick (2018) stated that the Australian Government Health Care Homes (HCH) model was applied in general practice targets people with chronic intricate conditions. This model was taken as a great opportunity for improved practice nurses’ role in an approach to teamwork to care with the general practitioners. In order to advance the practice nurses role and team-based care some challenges were recognized, including the medical domination of the health system and the important culture change needed by general practices to implement the model completely.

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Conclusion

Indigenous Australians has always been terribly neglected by the government of Australia and other Australians. However, government of Australia has promised to improve the lives of Aboriginal and/or Torres Strait Islander peoples by closing the gap. Its main purpose is to eliminate the gap of indigenous disadvantage in areas such as housing, education, employment and most importantly health.

In order to improve the access of HealthCare services for Aboriginal and/or Torres Strait Islander people Australian government has taken number of initiatives that are vital in improving health and life expectancy, reducing child mortality and controlling the diabetes type 2 disease. Proper care and management are necessary and according to reports management is a challenge, especially in situation where settings are resource-limited. Apart from changing the lifestyle, frequent medications are also essential that is both orally and insulin. Not only this, but it is recommended for individuals who have high risk of diabetes to have a screening test.

Treatment for chronic conditions such as diabetes may be difficult to provide for awareness and early detection consistent with comprehensive management. The reports note that the use of CCM elements individually does not seem necessary to enhance clinical outcomes; however, it is highly probable that enormous benefits may be obtained by measures that incorporate the six basics of CCM.

References

Allen, J., & Walker, J. (2014). Public Health Association of Australia: Policy-at-a-glance – Primary Health Care Policy. Public health association Australia. Retrieved from https://www.phaa.net.au/documents/item/2575

Azzopardi, P., Brown, A. D., Zimmet, P., Fahy, R. E., Dent, G. A., Kelly, M. J., . . . Wren, S. J. (2010). Type 2 diabetes in Indigenous Australian children and adolescents. wiley online library, 197(1). doi:10.5694/mja12.10036

10. S. (2019, Nov 25). The central concept of empowerment in Indigenous health and wellbeing. PubLMed. doi:10.1071/PY18097

Baptista, D. R., Wiens, A., Pontarolo, R., Regis, L., Reis, W. C., & Correr , C. J. (2016). The chronic care model for type 2 diabetes: a systematic review. Diabetology & Metabolic Syndrome. doi:https://doi.org/10.1186/s13098-015-0119-z

Diabetes Australia. (2013). Aboriginal and Torres Strait Islanders and diabetes action plan. Diabetes Australia. Retrieved from http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.636.7708&rep=rep1&type=pdf

Health Direct. (2018). Indigenous health. health direct. Retrieved from https://www.healthdirect.gov.au/indigenous-health

Marmot, M. (2011, May 16). Social determinants and the health of Indigenous Australians. The Medical Journal of Australia, Volume 194 Number 10. Retrieved from https://staging.mja.com.au/system/files/issues/194_10_160511/mar10460_fm.pdf

McKittrick, R., & McKenzie, R. (2018). A narrative review and synthesis to inform health workforce preparation for the Health Care Homes model in primary healthcare in Australia. Australian Journal of Primary Health, 317-329. doi:10.1071/PY18045

My dr. (2013). Diabetes in Indigenous Australians. My dr. Retrieved from https://www.mydr.com.au/diabetes/diabetes-in-indigenous-australians

Straw, S., Spry, E., Yanawana, L., Matsumoto, V., Cox, D., Cox, E., . . . Marley, J. V. (2019, January 1). Understanding lived experiences of Aboriginal people with type 2 diabetes living in remote Kimberley communities: Diabetes, it don’t come and go, it stays! Australian Journal of Primary Health, 25(5), 486-494. doi:10.1071/PY19021

Stuckey, H. L., Adelman, A. M., & Gabbay, R. A. (2011). Improving care by delivering the Chronic Care Model for diabetes. Future Medicine Ltd, 37–52. doi:10.2217/DMT.10.9

Tsey, K., Whiteside, M., Deemal, A., & Gibson, T. (2003). Social determinants of health,the ‘control factor’ and the Family Wellbeing Empowerment Program. Australasian Psychiatry, Vol 11. doi:https://doi.org/10.1046/j.1038-5282.2003.02017.x

Warm, E. J. (2007). Diabetes and the Chronic Care Model: A Review. Current Diabetes Reviews, 3(4). doi: 10.2174/1573399076

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