Checking in on check-ups to help Close the Gap
An intervention designed to help Close the Gap, by increasing the number of Aboriginal and Torres Strait Islander people who receive an annual health check by their GP, will be implemented and evaluated by a new National Health and Medical Research Council (NHMRC) project.
Renowned population health researcher, Laureate Professor Rob Sanson-Fisher of the University of Newcastle and Hunter Medical Research Institute (HMRI)*, will lead a team of expert Aboriginal and non-Aboriginal researchers in the five-year research project – which was awarded $745,056 following a Targeted Call for Research** for Healthy Ageing of Aboriginal and Torres Strait Islander People.
Indigenous people die about eight years earlier than non-Indigenous Australians. For Aboriginal and Torres Strait Islander Australians born in 2015-17, the life expectancy is 71.6 years for men and 75.6 years for women – about 8.6 and 7.8 years less than non-Aboriginal men and women respectively.
Professor Sanson-Fisher said timely diagnosis and appropriate management was vital to improving health outcomes for Aboriginal and Torres Strait Islander people.
“Aboriginal people often receive a diagnosis at a more advanced stage of chronic disease, which means there’s less opportunity to prevent their condition and health deteriorating.”
Twenty-two mainstream general practice clinics within the central Coast and New England regions will participate in the research project.
The intervention package will comprise strategies such as continuing medical education, recall and reminder systems, and mailed invitations to patients. The project will also test whether the intervention increases doctors’ adherence to best practice care and improves patient outcomes.
More than 60 per cent of Indigenous people regularly visit mainstream general practice services – a key opportunity to deliver an annual ‘715’ health assessment, which forms an integral part of the Australian Government’s Closing the Gap commitment. The aim of the Aboriginal and Torres Strait Islander Health Assessment (Medicare Benefits Schedule item 715) is to help ensure Indigenous Australians receive primary health care matched to their needs, by encouraging early detection, diagnosis and intervention for common and treatable conditions that cause morbidity and early death. The health assessment is an annual service and covers the full age spectrum.
However, in 2016-2017 just 27 per cent of Indigenous adults aged 15 to 24 had an annual health assessment, while only 30 per cent of 25-to 54-year-olds, and 41 per cent of Indigenous adults over 55 had one.
Professor Sanson-Fisher said chronic diseases continue to be a major contributor to unhealthy ageing among Aboriginal and Torres Strait Islander people.
“The prevalence of most chronic diseases increases with age and affects not only physical health, but also the broader contributors to the well-being of older Aboriginal people, including participation in family, community and cultural leadership roles and connection with community networks,” Professor Sanson-Fisher said.
Key contributing chronic conditions include cardiovascular diseases (19 per cent of the chronic disease prevalence gap), mental and substance use disorders (14 per cent), cancer (9 per cent), chronic kidney disease, diabetes, vision loss, hearing loss and respiratory, musculoskeletal, neurological and congenital disorders.
Around 37 per cent of the burden of disease in Aboriginal people could be prevented by reducing risk factors. The risk factors causing the most burden are tobacco use (12 per cent of the total burden), alcohol use (8 per cent), high body mass (8 per cent), physical inactivity (6 per cent), high blood pressure (5 per cent) and high blood glucose levels (5 per cent).
“Mainstream general practice is a crucial setting to impact on prevention, timely diagnosis and appropriate management of chronic disease for Aboriginal people, which is imperative to help Close the Gap,” Professor Sanson-Fisher said.
* HMRI is a partnership between the University of Newcastle, Hunter New England Health and the community.
** A Targeted Call for Research (TCR) is a one-time solicitation for grant applications to address a specific health issue. Quality evidence generated from research will allow for better planning, funding and implementation of policies and services to achieve and support healthy ageing for Aboriginal and Torres Strait Islander peoples.
*** Life Tables for Aboriginal and Torres Strait Islander Australians, 2015-2017', Australian Bureau of Statistics 28/11/2018