Register      Login
Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
RESEARCH ARTICLE

Providing guideline-recommended preventive cardiovascular care to Aboriginal and Torres Strait Islander women: exploring gender differences with a medical record review in primary health care

Katharine McBride https://orcid.org/0000-0002-9401-5136 A B * , Natasha J. Howard B C , Christine Franks B D , Veronica King D E , Vicki Wade D F , Anna Dowling D G , Janice Rigney D , Nyunmiti Burton D H , Julie Anne Mitchell D I , Susan Hillier A , Stephen J. Nicholls J , Catherine Paquet A K § and Alex Brown B C §
+ Author Affiliations
- Author Affiliations

A Allied Health and Human Performance, University of South Australia, Adelaide, SA 5000, Australia.

B Wardliparingga Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia.

C Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA 5000, Australia.

D Aboriginal Women’s Advisory Group, Adelaide, SA, Australia.

E Central Australian Aboriginal Congress, Alice Springs, NT 0870, Australia.

F Menzies School of Health Research, Casuarina, NT 0811, Australia.

G College of Medicine and Public Health, Flinders University, Bedford Park, SA 5042, Australia.

H Ngaanyatjarra, Pitjantjatjara, Yankunytjatjara Women’s Council, Alice Springs, NT 0870, Australia.

I The Heart Foundation of Australia, Woolloomooloo, NSW 2011, Australia.

J Victorian Heart Institute, Monash University, Clayton, Vic. 3168, Australia.

K Faculté des Sciences de l’Administration, Université Laval, Québec, QC G1V 0A6, Canada.

Australian Journal of Primary Health 28(6) 498-507 https://doi.org/10.1071/PY22064
Submitted: 11 September 2021  Accepted: 14 July 2022   Published: 19 August 2022

© 2022 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University

Abstract

Background: For Aboriginal and Torres Strait Islander women, the premature burden of cardiovascular disease is affecting their capacity to fulfil roles in society, and promote the health and wellbeing of future generations. In Australia, there is limited understanding of the difference in primary preventive cardiovascular care experienced by women, despite knowledge of sex and gender differentials in health profile and receipt of guideline-based acute care. This paper sought to explore the health profile and receipt of assessment and management of cardiovascular risk for Aboriginal and Torres Strait Islander women accessing preventive primary health care, and investigate gender differentials.

Method: Records of 1200 current clients, 50% women, aged 18–74 years from three Aboriginal Health Services in central and South Australia for the period 7/2018–6/2020 were reviewed.

Results: Twelve percent had documented cardiovascular disease. Compared with men, women with no recorded cardiovascular disease had a greater likelihood of being overweight or obese, a waist circumference indicative of risk, diabetes, and depression. Women were less likely to report being physically active.

Conclusions: The research concluded that gaps exist in the provision and recording of guideline-recommended primary preventive care regardless of sex. These are stark, given the evident burden.

Keywords: Aboriginal and Torres Strait Islander people, Australia, cardiovascular disease prevention and control, health equity, healthcare quality assurance, Indigenous peoples, primary health care, women.


References

Adegbija O, Hoy W, Wang Z (2015) Prediction of cardiovascular disease risk using waist circumference among Aboriginals in a remote Australian community. BMC Public Health 15, 57
Prediction of cardiovascular disease risk using waist circumference among Aboriginals in a remote Australian community.Crossref | GoogleScholarGoogle Scholar |

Agostino JW, Wong D, Paige E, Wade V, Connell C, Davey ME, Peiris DP, Fitzsimmons D, Burgess CP, Mahoney R, Lonsdale E, Fernando P, Malamoo L, Eades S, Brown A, Jennings G, Lovett RW, Banks E (2020) Cardiovascular disease risk assessment for Aboriginal and Torres Strait Islander adults aged under 35 years: a consensus statement. Medical Journal of Australia 212, 422–427.
Cardiovascular disease risk assessment for Aboriginal and Torres Strait Islander adults aged under 35 years: a consensus statement.Crossref | GoogleScholarGoogle Scholar |

Anderson KM, Odell PM, Wilson PWF, Kannel WB (1991) Cardiovascular disease risk profiles. American Heart Journal 121, 293–298.
Cardiovascular disease risk profiles.Crossref | GoogleScholarGoogle Scholar |

Australian Institute of Health and Welfare (AIHW) (2016) ‘AIHW national key performance indicators database: user guide reporting period ending 30 June 2016.’ (AIHW: Canberra, ACT, Australia)

Australian Institute of Health Welfare (AIHW) (2021) Better cardiac care measures for Aboriginal and Torres Strait Islander people: fifth national report 2020. (AIHW: Canberra, ACT, Australia)

Banks E, Welsh J, Joshy G, Martin M, Paige E, Korda RJ (2020) Comparison of cardiovascular disease risk factors, assessment and management in men and women, including consideration of absolute risk: a nationally representative cross-sectional study. BMJ Open 10, e038761
Comparison of cardiovascular disease risk factors, assessment and management in men and women, including consideration of absolute risk: a nationally representative cross-sectional study.Crossref | GoogleScholarGoogle Scholar |

Benchimol EI, Smeeth L, Guttmann A, Harron K, Moher D, Petersen I, Sørensen HT, von Elm E, Langan SM, RECORD Working Committee (2015) The REporting of studies Conducted using Observational Routinely-collected health Data (RECORD) Statement. PLoS Medicine 12, e1001885
The REporting of studies Conducted using Observational Routinely-collected health Data (RECORD) Statement.Crossref | GoogleScholarGoogle Scholar |

Better Cardiac Care Forum (BCCF) (2014) National recommendations for better cardiac care for Aboriginal and Torres Strait Islander people: post-forum report. Australian Health Ministers’ Advisory Council (AHMAC) meeting, Canberra. (AHMAC: Canberra, ACT, Australia)

Commonwealth Scientific and Industrial Research Organisation (CSIRO) (2021) SMART health checks project. Available at https://confluence.csiro.au/display/PCDQFPhase2/SMART+Health+Checks+Project [Accessed 27 January 2022]

Eades A, Hackett ML, Liu H, Brown A, Coffin J, Cass A (2020) Qualitative study of psychosocial factors impacting on Aboriginal women’s management of chronic disease. International Journal for Equity in Health 19, 8
Qualitative study of psychosocial factors impacting on Aboriginal women’s management of chronic disease.Crossref | GoogleScholarGoogle Scholar |

Finlay SM (2019) Understanding the impacts of the national key performance indicators on Aboriginal Community Controlled Health Organisations. Thesis (PhD(Public Health)), University of South Australia, Adelaide, SA, Australia.

Hoy WE, Kondalsamy-Chennakesavan S, Wang Z, Briganti E, Shaw J, Polkinghorne K, Chadban S, The AusDiab Study Group (2007) Quantifying the excess risk for proteinuria, hypertension and diabetes in Australian Aborigines: comparison of profiles in three remote communities in the Northern Territory with those in the AusDiab study. Australian and New Zealand Journal of Public Health 31, 177–183.
Quantifying the excess risk for proteinuria, hypertension and diabetes in Australian Aborigines: comparison of profiles in three remote communities in the Northern Territory with those in the AusDiab study.Crossref | GoogleScholarGoogle Scholar |

Hyun KK, Redfern J, Patel A, Peiris D, Brieger D, Sullivan D, Harris M, Usherwood T, MacMahon S, Lyford M, Woodward M (2017) Gender inequalities in cardiovascular risk factor assessment and management in primary healthcare. Heart 103, 492–498.
Gender inequalities in cardiovascular risk factor assessment and management in primary healthcare.Crossref | GoogleScholarGoogle Scholar |

McBride KF, Franks C, Wade V, King V, Rigney J, Burton N, Dowling A, Howard NJ, Paquet C, Hillier S, Nicholls SJ, Brown A (2021) Good heart: telling stories of cardiovascular protective and risk factors for aboriginal women. Heart, Lung and Circulation 30, 69–77.
Good heart: telling stories of cardiovascular protective and risk factors for aboriginal women.Crossref | GoogleScholarGoogle Scholar |

McBride K, Nguyen J, Dowling A, Howard NJ, Franks C, Hillier S, Wade V, King V, Rigney J, Burton N, Mitchell JA, Nicholls SJ, Paquet C, Brown A (2022) A systematic review on assessment and management of preventive cardiovascular care in primary health for Aboriginal and Torres Strait Islander women and men. Australian Journal of Primary Health 28, 179–199.
A systematic review on assessment and management of preventive cardiovascular care in primary health for Aboriginal and Torres Strait Islander women and men.Crossref | GoogleScholarGoogle Scholar |

National Aboriginal Community Controlled Health Organisation (NACCHO), The Royal Australian College of General Practitioners (RACGP) (2018) ‘National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people.’ 3rd edn. (The Royal Australian College of General Practitioners: Melbourne, Vic., Australia)

National Vascular Disease Prevention Alliance (NVDPA) (2012) ‘Guidelines for the management of absolute cardiovascular disease risk.’ (National Vascular Disease Prevention Alliance: Canberra, ACT, Australia)

Peiris DP, Patel AA, Cass A, Howard MP, Tchan ML, Brady JP, De Vries J, Rickards BA, Yarnold DJ, Hayman NE, Brown AD (2009) Cardiovascular disease risk management for Aboriginal and Torres Strait Islander peoples in primary health care settings: findings from the Kanyini Audit. Medical Journal of Australia 191, 304–309.
Cardiovascular disease risk management for Aboriginal and Torres Strait Islander peoples in primary health care settings: findings from the Kanyini Audit.Crossref | GoogleScholarGoogle Scholar |

Peiris D, Usherwood T, Panaretto K, Harris M, Hunt J, Redfern J, Zwar N, Colagiuri S, Hayman N, Lo S, Patel B, Lyford M, MacMahon S, Neal B, Sullivan D, Cass A, Jackson R, Patel A (2015) Effect of a computer-guided, quality improvement program for cardiovascular disease risk management in primary health care. Circulation: Cardiovascular Quality and Outcomes 8, 87–95.
Effect of a computer-guided, quality improvement program for cardiovascular disease risk management in primary health care.Crossref | GoogleScholarGoogle Scholar |

Reilly RE, Doyle J, Bretherton D, Rowley KG, Harvey JL, Briggs P, Charles S, Calleja J, Patten R, Atkinson V (2008) Identifying psychosocial mediators of health amongst Indigenous Australians for the heart health project. Ethnicity & Health 13, 351–373.
Identifying psychosocial mediators of health amongst Indigenous Australians for the heart health project.Crossref | GoogleScholarGoogle Scholar |

Remote Primary Health Care Manuals (RPHCM) (2017) ‘CARPA standard treatment manual.’ 7th edn. (Centre for Remote Health: Alice Springs, NT, Australia)

Stehli J, Duffy SJ, Burgess S, Kuhn L, Gulati M, Chow C, Zaman S (2021) Sex disparities in myocardial infarction: biology or bias? Heart, Lung and Circulation 30, 18–26.
Sex disparities in myocardial infarction: biology or bias?Crossref | GoogleScholarGoogle Scholar |

Wang Z, Hoy WE (2004) Association between diabetes and coronary heart disease in Aboriginal people: are women disadvantaged? Medical Journal of Australia 180, 508–511.
Association between diabetes and coronary heart disease in Aboriginal people: are women disadvantaged?Crossref | GoogleScholarGoogle Scholar |

Wang Z, Hoy WE (2006) Population distribution of high sensitivity C-reactive protein values in Aboriginal Australians: a comparison with other populations. Clinical Biochemistry 39, 277–281.
Population distribution of high sensitivity C-reactive protein values in Aboriginal Australians: a comparison with other populations.Crossref | GoogleScholarGoogle Scholar |