Access and Society as Determinants of Ischaemic Heart Disease in Indigenous Populations

Curtis, Elana; Harwood, Matire; Riddell, Tania; Robson, Bridget; Harris, Ricci; Mills, Clair; Reid, Papaarangi

doi:10.1016/j.hlc.2010.04.129

Cited by 44 publications

(39 citation statements)

References 11 publications

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“…An exception to this is the work of who suggests that in New Zealand the availability of care is inversely proportional to the need of the population served, where those who need healthcare the most, receive the least; the inverse care law first suggested by Curtis suggest that three key factors must be addressed in order to invoke changes in health equity; a) acknowledging the role of society, b) understanding the policy imperatives, and c) exploring the clinician's role. This approach they conclude is consistent with the human rights of Māori as tangata whenua, the rights of Māori as outlined within the Treaty of Waitangi and New Zealand health policy [33,34]. A recurrent theme in the understanding of health inequities is the way society distributes health resources, of material wealth, housing, education and employment [35].…”

Section: Racial Inequities In Cardiovascular Disease In New Zealandsupporting

confidence: 55%

“…A number of researchers have concluded that the development of an integrated healthcare programme is required to address the increased risks of CVD in rural and urban Māori that is sensitive to their cultural perspective of health [54][55][56]. While interventions that focus upon such risk factors are important they will fail to fully address the ethnic inequities that exist in New Zealand healthcare unless the socioeconomic inequities such as poverty are addressed first [33]. A weakness of interventions developed to improve Māori cardiovascular health suggest lies in their aim to change Māori behaviour rather than the behaviour of society towards Māori.…”

Section: Cultures Apartmentioning

confidence: 99%

“…A weakness of interventions developed to improve Māori cardiovascular health suggest lies in their aim to change Māori behaviour rather than the behaviour of society towards Māori. The fundamental causes of ethnic differences in healthcare are rooted in; culture, biology, racism, economic deprivation and the politics of the dominant culture [9,33].…”

Section: Cultures Apartmentioning

confidence: 99%

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Racial Inequities in Cardiovascular Disease in New Zealand

Miner-Williams¹

2017

Divers Equal Health Care

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The literature is replete with studies pertaining to ethnic inequities in healthcare. A thorny subject that has been described for decades and yet has few remedial solutions. The pattern of ethnic inequities in healthcare is a global phenomenon that is not confined to any specific race or culture. Worldwide, cardiovascular disease (CVD) is the topmost cause of death and a substantial burden on healthcare resources. In New Zealand CVD is the leading cause of death, accounting for 40% of all deaths annually. Diminished life expectancy is one example of racial inequity in healthcare between Māori and Pākehā (the non-indigenous population). This review attempts to clarify the muddy waters of 175 years of post-colonial healthcare inequity in New Zealand and in particular the causes of inequity in the incidence of CVD and mortality in Māori. Such dialogue will hopefully stimulate discussion among policy makers and clinicians to redress the ethnic inequities in healthcare.

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Section: Racial Inequities In Cardiovascular Disease In New Zealandsupporting

confidence: 55%

Section: Cultures Apartmentioning

confidence: 99%

Section: Cultures Apartmentioning

confidence: 99%

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Racial Inequities in Cardiovascular Disease in New Zealand

Miner-Williams¹

2017

Divers Equal Health Care

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“…given the substantially lower rates of intervention experienced by minority groups 4,5,22 . Such inequitable outcomes are the product of a mix of unconscious bias 3 , more explicit racial discrimination 5 and institutional racism 23 within health care systems and structures.…”

Section: Collaboration Between Policy Makers Mainstream Inter-discipmentioning

confidence: 99%

Can my mechanic fix blue cars? A discussion of health clinicians' interactions with Aboriginal Australian clients

Hill

Ewen

Paul

et al. 2016

Aust. J. Rural Health

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We expect our professional mechanics to 'diagnose' and 'treat' our cars irrespective of colour, but are we expecting less from our health professionals? There is an increasing focus in the literature on health practitioner decision-making and its influence on the nature and quality of health care. In this article we explore how the basic diagnostic and therapeutic skills that health care practitioners have should be utilised equitably for all clients and propose ways this might be realised. Could the development of Indigenous specific curricula be teaching our medical students to think that Aboriginal patients are different from the norm? We conclude that despite the gains in introducing more comprehensive Aboriginal health curricula there remains considerable work to be done before we can be confident that we are ensuring that health practitioners are no longer contributing to health disparities. Key words:Aboriginal Health, Indigenous Health, health professional, racism in health, health disparities. 3 Applying ones expertise …Consider the following: if we own a car that is experiencing mechanical problems we usually would seek the advice and services of a mechanic, whose expertise in mechanics as demonstrated by their qualifications. We expect the mechanic to be able to diagnose any known mechanical problems that we, as the car owner, cannot be expected to know. We expect the mechanic to explain to us what is wrong with my car, to investigate and apply the most efficient ways of fixing the car and to be held accountable if she/he misdiagnoses or maltreats the mechanical needs of the car. We, as the owner, cannot be responsible for fixing the mechanical problems that are beyond my particular expertise and knowledge. Despite health professionals only playing a small part in the diverse factors influencing health and health care outcomes, it is useful to ask a range of questions. These questions include, could the continuing poor health of Aboriginal people be partly caused by health practitioners due to the practitioners not receiving the education required for reducing the ongoing health disparities? Could health professional's engagement with individuals and / or community also be a factor? Have practitioners not made the contribution they could or should do in this area?And, do we expect practitioners to be sufficiently skilled to substantially reduce the gap? 4 Just as we would expect a qualified mechanic to be able to repair different cars, regardless of their colour, a qualified doctor or other health professional should be able to effectively treat people from different populations with identified medical problems -regardless of their background. What if a mechanic said they could not work on your car because it is blue and

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“…4 However, the role of health practitioners and health-care services and systems are important, given the differential levels of care and interventions that Indigenous people receive when they attend for health-care advice. 5,6 It should be noted that differential outcomes from clinical contact have also been documented for minority groups in other settings. 7,8 While differential health outcomes from health-care services is a key issue, it becomes even more relevant in the context of the burden of disease in Aboriginal and Torres Strait Islander communities, which are two to three times that of the Australia wide population.…”

Section: Introductionmentioning

confidence: 99%

Creating change: building the capacity of the medical workforce in Aboriginal health

Paul

2012

ANZ Journal of Surgery

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Background: This paper provides an overview of the long-term strategies that have been in place at the University of Western Australia, which aim to build the capacity and preparedness of the health-care workforce in Aboriginal health. In 1996, the Centre for Aboriginal Medical and Dental Health was established within the Faculty of Medicine, Dentistry and Health Sciences to implement a comprehensive approach to Aboriginal health. Methods: The initial focus was on developing recruitment and retention strategies that meaningfully address the significant under-representation of Aboriginal and Torres Strait Islander people in the medical and broader health professions. At the same time, the Centre developed, implemented and evaluated a comprehensive vertically and horizontally integrated Aboriginal health curriculum initially in the Medicine course and subsequently in the Podiatry and Nursing courses within the faculty. Results: The priority has been to ensure that all graduates will be better prepared to work effectively and safely with Aboriginal and Torres Strait Islander people and communities. Without effective alternative entry processes access to tertiary health courses and health careers would not have been an option for the majority of Aboriginal and Torres Strait Islander students and graduates. Conclusion: This paper reflects on the partnerships, structures and approaches that have enabled the achievements to date and on the challenges that confront not only initial implementation but also sustaining the gains already made.

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Access and Society as Determinants of Ischaemic Heart Disease in Indigenous Populations

Cited by 44 publications

References 11 publications

Racial Inequities in Cardiovascular Disease in New Zealand

Racial Inequities in Cardiovascular Disease in New Zealand

Can my mechanic fix blue cars? A discussion of health clinicians' interactions with Aboriginal Australian clients

Creating change: building the capacity of the medical workforce in Aboriginal health

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