Indigenous Health Flashcards
(21 cards)
Discuss the social and health issues faced by Indigenous Australians. How has this occured?
Compared to non-indigenous Australians Indigenous Australians
- have a higher burden of disease
- Higher levels of grief and trauma
- A more social disadvantage.
These factors lead to greater rates of hospitalisation as well as higher infant and adult mortality.
Causes:
- After european settlement genocide taking place –> loss of culture
- Introduction of alcohol, tobacco and expanded diet
- Stolen generation
- Racism/Discrimination
- Seperation from traditional land (Indigenous Australians have a very strong connection to their lands) - adversely impact health and wellbeing
- Decreased wellbeing of community can **adversely impact the physical and mental wellbeing of an Individual
**
It is important to look at Indigenous health from a holistic point of view as social, emotional and cultural factors play a large bearing role on physical health.
What is “sorry business” and does this affect medication adherance?
- A term used by Indigenous Australians - refers to the death of a family or community member and the mourning process. Patients will travel thousands of kilometres to be with their family at the time of death –> putting needs of family and community above their own health – wont have time to collect or take medications or attend appointments - affects medication adherance
Compare prevalence of health issues in Indigenous and non-indigenous people.
- Smoking rates has decreased
- 37% have obesity - related to food insecurity: supermarkets have limited access to fresh produce and costs are high. People with limited income will tend to buy foods that are cheap (e.g. potatoes and rice). Consistently consuming a high amount carbs and less proteins and fibre - trigger health conditions such as diabetes.
- 30% have high levels of pyschological distress compared to N-I people (11%)
- Suicide rates were twice
- 2.4 x as likely to be hospitalised for respiratory diseases
– 3.3 x as likely to have diabetes
– 1.2 x as likely to report having cardiovascular disease
– 10 x as likely to be hospitalised for chronic kidney disease
– 2 x as likely to have severe or profound disability
Compare the mortality rates in Indigenous Australians and Non-indigenous Australians
In 2010-2012 the life expectancy at birth for Indigenous Australians was
- 69.1 years for Males (10.6 yrs lower compared to.._
- 73.7 years for females (9.5 yrs lower compared to)
- Life expectancy gap has been narrowed by 2.8 yrs for males and 1.8 yrs for females
What is the aim of closing the gap (CTG)
To reduce Indigenous disadvantage with respect to: life expectancy, child mortality, access to early childhood education, educational achievement and employment success
Discuss the role of the government in “closing the gap”
The new national agreement on closing the gap (made by the Council of Australian Governments and the Coalition of Aboriginal and Torres Strait Islander Peak Organisations) has set out priorities for the next 10 yrs
Priorities outline the targets and measures that will help to improve the health and wellbeing - reach their goals.
- What are priority reform outcomes?
- What are socio-economic outcomes?
- four outcomes related to reforming the way that government works to ‘accelerate improvements in the lives of Aboriginal and Torres Strait Islander peoples’
- outcomes important to the rights, wellbeing and quality of life of Aboriginal and Torres Strait Islander peoples. Currently there are 17 socia-economic outcomes identified
How can we “close the gap” successfully
Key to the success of any measure in closing the gap is harnessing the strength of culture as an underlying determinant of good health through identity and belonging, supportive relationships, resilience and wellbeing.
Define cultural awareness
- Raising the awareness and knowledge of individuals about the experiences of cultures which are different from their own
Define cultural respect
Cultural respect acknowledges that the health and cultural
wellbeing of Aboriginal and Torres Strait Islander peoples, within mainstream healthcare settings, warrants special attention
Define cultural competence
- Cultural competence comprises four components:
(a) Awareness of one’s own cultural world view
(b) Attitude towards cultural differences
(c) Knowledge of different cultural practices and world views (d) Cross-cultural skills
By developing CC we are able to understand, communicate with and effectively interact with people across all cultures
Discuss the range of medical services that are targeted for Indigineous Australians
- either government run or Aboriginal Community controlled Health services
- range from large services that are run by several medical practitioners to small services which rely on Aboriginal Health Workers and nurses providing primary healthcare services
- ## Focus on preventative care (e.g. immunisation, approapriate screening, early intervention)
What is the Item 715 health check?
Medicare-funded health assessment specifically designed for Indigenous Australians thats aims to support early detection, diagnosis and referral for chronic conditions thereby improving health outcomes
What is the item 10987?
Indigenous Australians who have recieved an MBS health assessment are eligible to access Medicare rebates for follow-up services that are provided by a practice nurse or Aboriginal and Torres Strait Islander health practitioner. Follow up services can include; education, counselling, advice, examinations and clinical monitoring
Discuss the roles of Aboriginal and Torres Strait Islander health practitioners
- Treats diseases/injuries (e.g. dress wounds)
- Can write prescriptions
- Maintain health records
- they act as communicators/interpretors
- Responsible for case management
- Promotes health education
- Assist clients to navigate the health system
- Can administer vaccinations and draw blood from patient - send it off pathology
Discuss the Remote Area Aboriginal Health Services Program (RAAHS) - Medical Service
- Address the barriers experienced by Indigineous Australians living in remove areas where they have difficulties in accessing medications for PBS
- Community and hospital pharmacies supply the medicine in bulk to Aboriginal health services
- Medications are dispensed by an Aboriginal and Torress Strait Islander Practioner or RN
- Excluded drugs: emergency medicines (Doctor’s bag), highly specialised drugs, schedule 8 medicines and all non-PBS medications.
Discuss the Indigenous Dose Administration Aid (IDAA) Program - Medical Service
“assist patients in the community who identify as Aboriginal and/or Torres Strait Islander to better manage their medicines, with the objective of avoiding medication misadventure and improving medication adherence”
D
Discuss the closing the gap PBS co-payment program.
Reduces the cost of PBS medicines for eligible Indigenous Australians who are living with or at risk of chronic conditions -
1. Eligible general patients - $31. 60 per item ???
2. Concessional patients - $7.70 per item ???
3. Indigenous Aus - sign up for closing the gap - concession card you pay no co-payment ???
4. Medicare card holder - you pay $7.70 ???
Since July 1st 2021 all prescribers are now eligible to prescribe a CTG prescription provided the patient has been registered for the scheme with Services Australia.
Any PBS prescriber or AHPRA registered Aboriginal and Torres Strait Islander Health Practitioner registered with Medicare as a provider can register eligible Indigenous patients for CTG via Health Professional Online Services (HPOS).
Prescribers are no longer required to endorse prescriptions with ‘CTG’ for registered patients as the prescription will be rejected by PBS Online if the CTG code is not entered when being dispensed (rejection code 811)
From October 1st 2021, scripts that are dispensed as CTG for patients not registered for CTG with Services Australia will be rejected (PBS online rejection code 810).
Pharmacists can confirm if an Indigenous patient is registered for the CTG program via HPOS.
CTG benefits are applied based on the date of dispensing **and not **date of prescribing. **. - If the patient registers for CTG after getting the prescription from the doctor - they will still get the discount for the medication - as long as the medication is dispensed after the CTG registraiton date
What medications are listed on the PBS for Indigenous Australians?
- Iron tablets (Ferrous fumarate/Ferrous fumarate + folic acid)
– Chloramphenicoleyedrops
– Thiamine
– Anti-fungal creams,powder, tablets, solution and shampoo
– Mupirocin nasal ointment
– Albendazole tablets
– Ciprofloxacin ear drops
– Magnesium tablets - Aspirin(100mgand300mgstrength)
– Bisacodyl suppositories
– Oral rehydration salts
– Folic acid
– Glucose and ketone indicators for urine
– Paracetamol tablets and liquid
Discuss the role of the pharmacist in improving the health of Indigenous Australians
The pharmacist plays a very important role in providing a culturally competent health experience for Indigenous Australians as they are responsible for providing them with medication and advice/information.
Establishing trust through the building of relationships is essential to the delivery of effective health care.
Personal relationships need to be built with the individual, appropriate family members and the community before a professional or clinical relationship can be established.
Outline the “deadly pharmacists” foundation training
Training delivered by the PSA aimed at improving cultural awareness/respect, communication skills and better understanding health challenges for first nations people. This will significantly improve health outcomes.
