Week 8. Current Issues in Aboriginal and Torres Strait Islander peoples' Health

What are key barriers to interpersonal communication between health practitioners and Aboriginal patients?

• Lack of cultural understanding – different values of how the Aboriginal people perceive or express health concerns 

• Language barriers as English may not be their first language 

• The use of medical jargon 

• Lack of absence of communication – verbal and non-verbal 

• Mistrust 

• Perceived racism 

• Lack of wellbeing and diseased focused 

• Negative health experience 

What are three elements of a Clinician Yarn? 

1. Social yarn – building patient rapport, finding common ground, touching on values and beliefs, past medical experiences. 

2. Diagnostic yarn – why have they come in, past medical history, using non-judgmental communication (active listening), do they understand their medical history, not using too many medical jargon. 

3. Management yarn – direct straight up health information, use stories and metaphors to explain condition and health, develop or agreed shared plan of care. 

What factors contribute to poor mental health among Aboriginal and Torres Strait Islander peoples?

Intergenerational trauma, discrimination, social disadvantage, increased suicide and self-harm rates.

What are major chronic diseases impacting Aboriginal and Torres Strait Islander peoples?

Cardiovascular disease, type 2 diabetes, kidney disease, and respiratory conditions.

Why is substance use higher among Aboriginal and Torres Strait Islander peoples?

Often used as a coping mechanism for trauma and social hardship.

What are the barriers to healthcare access for Aboriginal people?

Geographical isolation, cultural misunderstandings, transport issues, cost, and mistrust of healthcare systems

How do housing, education, and employment influence Aboriginal health outcomes?

Poor housing, lower education levels, and high unemployment negatively affect health.

How does racism affect healthcare for Aboriginal and Torres Strait Islander people?

It reduces trust, engagement, and leads to culturally unsafe care.

What is the National Agreement on Closing the Gap (2020) focused on?

Aboriginal leadership, community control, and 17 socio-economic targets to improve life outcomes.

What are the four Priority Reforms of the National Agreement on Closing the Gap?

• Shared decision-making with Indigenous people

• Strengthening community-controlled sectors

• Transforming mainstream government institutions

• Access to and use of local, relevant data

What data is collected in the National Aboriginal and Torres Strait Islander Health Survey (NATSIHS)?

Chronic conditions, risk factors, nutrition, obesity, emotional wellbeing, and service access.

What were key findings from the 2018–19 NATSIHS?

• 46% had at least one chronic condition

• 43% of adults smoked daily

• 1 in 3 reported high psychological distress

What are the 5 leading causes of death for Aboriginal people in NSW?

Circulatory disease, cancer, injury/poisoning, respiratory disease, and endocrine disorders.

How do death rates for Aboriginal people in the Nepean Blue Mountains compare to the general population?

• Circulatory: 59% higher

• Cancer: 31% higher

• Injury/Poisoning: 99% higher

• Respiratory: 99% higher

• Endocrine: 190% higher

What social disadvantages are more common among Aboriginal people in NSW?

Higher unemployment, lower education, no internet access, low income, overcrowded housing.

How does the Nepean Blue Mountains LHD work with Aboriginal communities?

Through local partnerships, Aboriginal Health Committees, and consultation with Elders.

What is the purpose of the Aboriginal Engagement Program (Sharing and Learning Circles)?

To identify priority health issues and inform local health planning and service design.

How does research link to improving Aboriginal health outcomes?

Research informs culturally safe, tailored programs that reflect community values and needs.

Name 4 programs that aim to improve Aboriginal health outcomes.

• Aboriginal Community Controlled Health Services (ACCHSs)

• Deadly Choices

• Tackling Indigenous Smoking

• Birthing on Country