“Chronic diseases account for 70 per cent of the life expectancy gap between Indigenous and non-Indigenous Australians.1”
Aboriginal heart health disparity in Western Australia
The University of Western Australia | 2012 | Early Career Fellowship | $307,946
Team members: Professor Sandra Thompson, Professor Michael Hobbs, Professor Matthew Knuiman, Professor Dawn Bessarab, Lyn Dimer, Dr Frank Sanfilippo, Emma Haynes, Dr Tiew Hwa Teng, Dr Derrick Lopez and Dr John Woods.
Cardiovascular diseases occur at much higher rates in Aboriginal than non-Aboriginal Australians—contributing 19 per cent of the total health gap. Doctor Judith Katzenellenbogen and her team at the University of Western Australia set out to compare health outcomes of Aboriginal and non-Aboriginal Australians. They used linked health data to study Aboriginal heart disease, examining system issues that influence service delivery in order to build capacity in Aboriginal health.
Dr Katzenellenbogen arrived in WA in 2002, soon realising she was at an epicentre of data linkage capability in Australia.
‘I used the opportunity of a PhD to hone my linked data analytic skills—applying these methods to the burden of stroke,’ she said.
After completing her PhD, Dr Katzenellenbogen was given the opportunity by Professor Sandra Thompson to research disparities in Aboriginal heart disease. The project had a strong translation focus resulting in enduring research partnerships and producing practical initiatives to improve Aboriginal heart disease.
‘The analytic methods developed will also assist in monitoring progress towards closing the gap in cardiovascular burden.’
Dr Katzenellenbogen published a large body of work describing wide-ranging aspects of the epidemiology of heart diseases in Aboriginal Western Australians for the first time. The high CVD rates at young ages, co-existing chronic conditions, and logistical and cultural barriers to service access underlie the poorer outcomes seen among Aboriginal patients.
‘The research suggested that a well-supported Aboriginal health workforce and better integration between services were the two most important health system improvements required to address heart health inequities.’
Dr Katzenellenbogen produced a comprehensive stakeholder report drawing on the experiences of Aboriginal and non-Aboriginal stakeholders, documenting successful initiatives and providing practical suggestions for improving cardiac outcomes. Workshops with policy makers and rural health professionals were held to build workforce capacity and promote system change to improve Aboriginal heart health.
‘We aim to use data to direct improvements in the health of Aboriginal people.’
‘I also used linked data to estimate the burden of acquired communication disorders (ACD), for example aphasia, in Aboriginal stroke and traumatic brain injured patients in collaboration with an innovative team of speech pathology researchers. A culturally safe screening tool for ACD was developed and will ensure better identification of ACD in the future,’ she concluded.
Next steps:
Dr Katzenellenbogen, now a Heart Foundation Future Leader Fellow, continues to analyse the impact of the Closing the Gap initiatives in Aboriginal cardiovascular outcomes.
She leads a multi-jurisdictional project to monitor the burden of rheumatic heart disease and is also engaged in a trial of culturally safe rehabilitation services for Aboriginal Western Australians with acquired brain injury.
1 Australian Institute of Health and Welfare (AIHW), 2016, Australian Burden of Disease Study: Impact and causes of illness and death in Aboriginal and Torres Strait Islander people
