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Bad hearts, poor kidneys cause many an early death

Indigenous people are more than twice as likely as other Australians to report they are in poor health, suffering disproportionately high rates of chronic and life-threatening diseases and impairments that have a significant effect on their quality of life.

In a sobering reminder of just how far there is to go to close the health gap between Indigenous and on-Indigenous Australians, the Australian Institute of Health and Welfare has reported that Aboriginal and Torres Strait Islander people are far more likely to have cardiovascular diseases, breathing problems, mental illness, diabetes, kidney disease, and to have problems with their hearing and sight.

Underlining the scale of the health problems afflicting Indigenous Australians, the Institute estimated that each year the collectively lose 100,000 years of life to premature deaths caused by chronic diseases, disability and injuries.

Cardiovascular disease is the biggest killer, causing a quarter of all Indigenous deaths between 2008 and 2012, followed by cancer (20 per cent of deaths) and injuries and poisonings (15 per cent).

But in some respects the burden of diabetes weighs even more heavily on the Aboriginal and Torres Strait Islander community.

The Institute’s The health and welfare of Australia’s Aboriginal and Torres Strait Islander peoples 2015 report (http://www.aihw.gov.au/publication-detail/?id=60129550168) shows 11 per cent of Indigenous adults had diabetes in 2012-13, while a further 4.7 per cent were at risk of developing the disease.

Related to this, almost 2 per cent had long-term kidney disease – almost four times the rate of the broader community.

This comes at an enormous cost to the community. In 2012-153 alone, Indigenous adults were hospitalised almost 175,000 times because of chronic kidney disease, almost all of them to undergo same-day dialysis. In all, this accounted for almost half of all hospitalisations of Aboriginal and Torres Strait Islanders.

The health disparity between Indigenous Australians and the rest of the community were further underlined by a separate Institute report showing Aboriginal women were twice as likely to die because of complications arising from pregnancy and childbirth.

Between 2008 and 2012, 105 women died from complications of pregnancy and childbirth, a rate of 7.1 deaths per 100,000 women. But among Indigenous women the rate (13.8 per 100,000) was double that among non-Indigenous mothers (6.6 per 100,000).

The results have highlighted calls from the AMA and other health groups for governments around the country to redouble their efforts to the close the health gap.

AMA President Professor Brian Owler said that although there had been some encouraging improvements in child and maternal health, much more needed to be done.

Professor Owler said recently that access to primary health care was especially important in addressing Indigenous disadvantage.

“Achieving equality in health and life expectancy for Aboriginal and Torres Strait Islander peoples is a national priority, but there is still a way to go before we see meaningful and lasting improvements,” the AMA President said. “There is a need for a concerted effort to fund and resource primary health care service providers to detect, treat, and manage chronic health conditions in Aboriginal and Torres Strait Islander communities.”

He said the Federal Government should immediately scrap the Medicare rebate freeze would hit Aboriginal community controlled health services and Aboriginal Medical Services particularly hard, and place enormous pressure on efforts to close the gap.

National Aboriginal Community Controlled Health Organisation Chair Matthew Cooke said that despite some progress in reducing infant mortality, the Institute report highlighted continuing major shortcomings, including for teenagers.

The report found Indigenous children aged between 15 and 18 years were far more likely to be imprisoned than their non-Indigenous counterparts, and were five times more likely to take their own lives.

Adrian Rollins