A lack of information about the epidemiology of heart disease and the treatment gaps for Indigenous people in Australia has prevented substantial heart disease survival improvements. This research project aims to describe the extent of and reasons for these inequities in order to improve CVD outcomes in Indigenous people.

Heart disease is recognised as a major public health issue in Indigenous people, and is a significant cause of hospitalisation for Indigenous people of both sexes.  Over the last three decades there has been a marked improvement in survival from heart disease in the general Australian population due to advances in medical treatment, use of coronary artery revascularisation procedures (to unblock arteries in the heart) and provision of cardiac rehabilitation services.

However, preliminary evidence suggests that the rates of use and uptake of these services among Indigenous Australians is much less than would be expected for their high rates of heart disease. Furthermore, there is a lack of information about the epidemiology of heart disease and the treatment gaps for Indigenous people in Australia. This research project aims to describe the extent of and likely reasons for these inequities through quantitative and qualitative methods.

Project aims

1. To describe the epidemiology of CVD in Indigenous compared to non-Indigenous Western Australians
   
2. To determine the experiences of Indigenous people in WA admitted with acute cardiac ischaemic events, including barriers to timely presentation, revascularisation procedures and participation in cardiac rehabilitation programs, and
3. To ensure the findings are used for health service and system action to reduce inequalities in CVD outcomes in Indigenous people.

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Funding

This project is funded by a grant from the National Health and Medical Research Council of Australia:
NHMRC - Project grant number 1031057 $950,800 2008-2010

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Publications

Thompson SC, Taylor KP. Are we really committed to making a difference? Reflections on Indigenous health research and dissemination [Editorial].  Aust NZ J Public Health 2009:33(5):403-404.

Thompson SC, Sanfilippo FM, Briffa TG, Hobbs MST. Towards better health research in Australia - a plea for improving the efficiency of Human Research Ethics Committee processes. [letter] Med J Aust 2009; 190(11): 652.

Katzenellenbogen JM, Sanfilippo FM, Hobbs MST, et al. Incidence of and case fatality following acute myocardial infarction in Aboriginal and non-Aboriginal Western Australians (2000-2004): a linked data study. Heart, Lung & Circulation 2010; 19: 717-25.

Katzenellenbogen JM, Sanfilippo FM, Hobbs MST, et al. Variable effects of prevalence-correction of population denominators on differentials in myocardial infarction incidence: a record linkage study in Aboriginal and non-Aboriginal Western Australians. J Clin Epidemiol 2010; doi:10.1016/j.jclinepi.2010.08.008.

Briffa TG, Sanfilippo FM, Hobbs MST, et al. Under-ascertainment of Aboriginality in records of cardiovascular disease in hospital morbidity and mortality data in Western Australia: a record linkage study. BMC Med Res Methodol 2010; 10: 111-116.

Taylor KP , Smith  JS, Dimer L, Ali M, Wilson N, Thomas T, Thompson SC.  “You're always hearing about the stats. Death happens so often": new perspectives on barriers to Aboriginal participation in cardiac rehabilitation [letter].  Med J Aust 2010; 192(10): 602.

Katzenellenbogen JM, Sanfilippo FM, Hobbs MST, et al. Aboriginal to non-Aboriginal differentials in outcomes following non-fatal first-ever acute myocardial infarction persist after adjustment for co-morbidity. Eur J Cardiovasc Prev Rehab 2011. doi: 10.1177/1741826711417925.

Taylor K, Thompson SC, Smith JS, Ali M, Dimer L, Wood M. Exploring the impact of an Aboriginal Health Worker on hospitalised Aboriginal experiences: lessons from cardiology.Australian Health Review 2009; 33(4): 549 – 557.

DiGiacomo M, Davidson PM, Taylor K, et al. ‘I don’t know why they don’t come’: the need for cultural competence in Aboriginal health. Aust Health Rev 2010:34:452-457.

DiGiacomo M, Davidson PM, Taylor K, et al. Health information systems: linkage and coordination are critical for increasing access to cardiac rehabilitation for Indigenous Australians. Quality in Primary Care 2010; 18(1): 17-26.

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