Free Standard AU & NZ Shipping For All Book Orders Over $80!
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

Beyond the rhetoric: how can non-government organisations contribute to reducing health disparities for Aboriginal and Torres Strait Islander people?

Lisa Wood A D , Trevor Shilton B , Lyn Dimer B , Julie Smith B and Timothy Leahy C
+ Author Affiliations
- Author Affiliations

A Centre for the Built Environment and Health, School of Population Health, The University of Western Australia (M431), Crawley, WA 6009, Australia.

B Heart Foundation of Australia, Western Australian Division, 334 Rokeby Road, Subiaco, WA 6008, Australia.

C School of Medicine, University of Notre Dame, Fremantle, WA 6959, Australia.

D Corresponding author. Email: lisa.wood@uwa.edu.au

Australian Journal of Primary Health 17(4) 384-394 https://doi.org/10.1071/PY11057
Submitted: 14 May 2011  Accepted: 4 October 2011   Published: 15 November 2011

Abstract

The prevailing disparities in Aboriginal health in Australia are a sobering reminder of failed health reforms, compounded by inadequate attention to the social determinants shaping health and well-being. Discourse around health reform often focuses on the role of government, health professionals and health institutions. However, not-for-profit health organisations are also playing an increasing role in health policy, research and program delivery across the prevention to treatment spectrum. This paper describes the journey of the National Heart Foundation of Australia in West Australia (Heart Foundation WA hereafter) with Aboriginal employees and the Aboriginal community in taking a more proactive role in reducing Aboriginal health disparities, focusing in particular on lessons learnt that are applicable to other non-government organisations. Although the Heart Foundation WA has employed and worked with Aboriginal people and has long identified the Aboriginal community as a priority population, recent years have seen greater embedding of this within its organisational culture, governance, policies and programs. In turn, this has shaped the organisation’s response to external health reforms and issues. Responses have included the development of an action plan to eliminate disparities of cardiovascular care in the hospital system, and collaboration and engagement with health professional groups involved in delivery of care to Aboriginal people. Examples of governance measures are also described in this paper. Although strategies and the lessons learnt have been in the context of cardiovascular health disparities, they are applicable to other organisations across the health sector. Moreover, the most powerful lesson learnt is universal in its relevance; individual programs, policies and reforms are more likely to succeed when they are underpinned by whole of organisation ownership and internalisation of the need to redress disparities in health.


References

ACSQHC (2011) ‘Patient centred care: improving quality and safety through partnerships with patients and consumers.’ (Australian Commission on Safety and Quality in Health Care: Sydney)

AIHW (2011) ‘Contribution of chronic disease to the gap in adult mortality between Aboriginal and Torres Strait Islander and other Australians.’ (Australian Institute of Health and Welfare: Canberra)

Aitken L, Anderson I, Atkinson V, Best JD, Briggs P, Calleja J, Charles S, Doyle J, Mohamed J, Patten R, Rowley K, Simmons D (2007) A collaborative cardiovascular health program for Aboriginal and Torres Strait Islander People in the Goulburn-Murray Region: development and risk factor screening at Indigenous community organisations. Australian Journal of Primary Health 13, 9–17.

Anderson IPS, Ewen SC, Knoche DA (2009) Indigenous medical workforce development: current status and future directions. The Medical Journal of Australia 190, 580–581.

Australian Indigenous Health InfoNet (2010) Closing the gap. Available at http://www.healthinfonet.ecu.edu.au/closing-the-gap/key-facts/what-is-the-history-of-closing-the-gap [Verified 25 September 2011]

Carson B, Dunbar T, Chenhall RD, Bailie R (2007) ‘Social determinants of Indigenous health.’ (Allen & Unwin: Crows Nest, NSW)

Chapman S (2005) ‘Public health advocacy and tobacco control.’ (Blackwell Publishing: Oxford)

Coffin J (2007) Rising to the challenge in Aboriginal health by creating cultural security. Aboriginal and Islander Health Worker Journal 31, 22–24.

DiGiacomo M, Davidson PM, Taylor KP, Smith JS, Dimer L, Ali M, Wood MM, Leahy TG, Thompson SC (2010) Health information system linkage and coordination are critical for increasing access to secondary prevention in Aboriginal health: a qualitative study. Quality in Primary Care 18, 17–26.

Fielke K, Cord-Udy N, Buckskin J, Lattanzio A (2009) The development of an ‘Indigenous team’ in a mainstream mental health service in South Australia. Australasian Psychiatry 17, S75–S78.
The development of an ‘Indigenous team’ in a mainstream mental health service in South Australia.Crossref | GoogleScholarGoogle Scholar | 19579113PubMed |

Health Reform Committee (2004) ‘A healthy future for West Australians.’ (Western Australian Department of Health: Perth)

Hoy WE (2009) “Closing the gap” by 2030: aspiration versus reality in Indigenous health. The Medical Journal of Australia 190, 542–544.

Kaplan-Myrth N (2005) Sorry mates: reconciliation and self-determination in Australian aboriginal health. Human Rights Review 6, 69–83.
Sorry mates: reconciliation and self-determination in Australian aboriginal health.Crossref | GoogleScholarGoogle Scholar |

Katzenellenbogen JM, Sanfilippo FM, Hobbs MS, Briffa TG, Ridout SC, Knuiman MW, Dimer L, Taylor KP, Thompson PL, Thompson SC (2010) Incidence of and case fatality following acute myocardial infarction in Aboriginal and non-Aboriginal Western Australians (2000–2004): a linked data study. Heart, Lung and Circulation 19, 717–725.
Incidence of and case fatality following acute myocardial infarction in Aboriginal and non-Aboriginal Western Australians (2000–2004): a linked data study.Crossref | GoogleScholarGoogle Scholar | 20864399PubMed |

Larkin S (2006) Evidence-based policy making in Aboriginal and Torres Strait Islander health. Australian Aboriginal Studies 2, 17–26.

Lewis JM (2005) ‘Health policy and politics: networks, ideas and power.’ (IP Communications: Melbourne)

Mathur S, Moon L, Leigh S (2006) ‘Aboriginal and Torres Strait Islander people with coronary heart disease: further perspectives on health status and treatment.’ (Australian Institute of Health and Welfare: Canberra)

McGrath P (2007) ‘I don’t want to be in that big city; this is my country here’: research findings on Aboriginal peoples’ preference to die at home. The Australian Journal of Rural Health 15, 264–268.
‘I don’t want to be in that big city; this is my country here’: research findings on Aboriginal peoples’ preference to die at home.Crossref | GoogleScholarGoogle Scholar | 17617091PubMed |

National Heart Foundation of Australia (2009) ‘Championing hearts Aboriginal and Torres Strait Islander cardiovascular health.’ Available at http://www.heartfoundation.org.au/SiteCollectionDocuments/Championing-hearts-mid-strategy-report-July-2010.pdf [Verified 23 September 2011]

National Heart Foundation WA (2008) ‘Heart, stroke and blood vessel disease: a time for action in Western Australia.’ (National Heart Foundation: Perth)

National Public Health Partnership (2005) ‘Making the connections. Guidelines for effective approaches to Aboriginal and Torres Strait Islander public health.’ (NPHP: Melbourne)

NHMRC (2005) ‘Strengthening cardiac rehabilitation and secondary prevention for Aboriginal and Torres Strait Islander Peoples: a guide for health professionals.’ (National Health and Medical Research Council, Australian Government: Canberra)

NHMRC (2006) ‘Cultural competency in health: a guide for policy, partnerships and participation.’ (National Health and Medical Research Council, Commonwealth of Australia: Canberra)

O’Donoghue K, Granucci A, Maiorana A (2008) ‘Find thirty: concept testing.’ (TNS Social Research: Perth)

Pink B, Allbon P (2008) ‘The health and welfare of Australia’s Aboriginal and Torres Strait Islander peoples.’ (Australian Bureau of Statistics: Canberra)

Shilton T (2008) Creating and making the case: global advocacy for physical activity. Journal of Physical Activity & Health 5, 765–776.

Simpson A (2009) ‘Improving the health of rural and remote Aboriginal communities through state-wide education and employment initiatives.’ (10th National Rural Health Conference: Cairns)

Szoke H (2009) From welfare to rights. Health Issues 100, Spring, 20–21 Available at http://search.informit.com.au/documentSummary;dn=292823811126768;res=IELHEA [Verified 25 September 2011]

Taylor KP, Thompson SC (2011) Closing the (service) gap: exploring partnerships between Aboriginal and mainstream health services. Australian Health Review 35, 297–308.

Taylor KP, Smith JS, Dimer L, Ali M, Wilson N, Thomas TR, Thompson SC (2010) “You’re always hearing about the stats ... death happens so often”: new perspectives on barriers to Aboriginal participation in cardiac rehabilitation: letter. The Medical Journal of Australia 192, 602

Thompson SC, DiGiacomo ML, Smith JS, Taylor KP, Dimer L, Ali M, Wood MM, Leahy TG, Davidson PM (2009) Are the processes recommended by the NHMRC for improving Cardiac Rehabilitation (CR) for Aboriginal and Torres Strait Islander people being implemented?: an assessment of CR Services across Western Australia. Australia and New Zealand Health Policy 6, 29
Are the processes recommended by the NHMRC for improving Cardiac Rehabilitation (CR) for Aboriginal and Torres Strait Islander people being implemented?: an assessment of CR Services across Western Australia.Crossref | GoogleScholarGoogle Scholar | 20042097PubMed |

UN (2009) ‘United Nations declaration on the rights of Indigenous Peoples.’ (United Nations: New York)

Wood LJ, Rosenberg M, Clarkson J, Edwards F, Donovan RJ, Shilton T (2009) Encouraging young Western Australians to be Smarter Than Smoking. American Journal of Health Promotion 23, 403–411.
Encouraging young Western Australians to be Smarter Than Smoking.Crossref | GoogleScholarGoogle Scholar | 19601480PubMed |

Yach D, McKee M, Lopez AD, Novotny T (2005) Improving diet and physical activity: 12 lessons from controlling tobacco smoking. British Medical Journal 330, 898–900.
Improving diet and physical activity: 12 lessons from controlling tobacco smoking.Crossref | GoogleScholarGoogle Scholar | 15831879PubMed |