Professor Sandra Eades’ blueprint to Close the Gap

Renowned Australian researcher Professor Sandra Eades has celebrated the contribution 50 years of Aboriginal Community Controlled Primary Care Services has made to Indigenous health, but warned there is still more to be done – and at an earlier stage – to further improve outcomes.
 
Speaking to more than 1000 clinicians during her keynote address at the WONCA World Conference last week, she referenced her own 40-plus-year experience at the Derbarl Yerrigan Health Service in Perth, where she began as a work experience student before working her way up to the board.
 
A Noongar woman from south-Western Australia, Professor Eades noted that Aboriginal Community Controlled Primary Care Services now provide more than three million episodes of care annually to more than 400,000 people, and used it as an example of what First Nations-led care can achieve.
 
‘In the spirit of self-determination and having control over their own futures, the first of these clinics were established,’ she said.
 
‘Indigenous people all over the world face different challenges and here in Australia we do too, but we also have a lot to celebrate.’
 
However, ongoing research collaborations through her role as a head epidemiologist at Melbourne University’s School of Population and Global Health have also exposed lingering areas for improvement.
 
Some of this research has focused on Aboriginal Community Controlled Primary Care Services, which Professor Eades noted offer numerous benefits, including improved patient engagement with specialist clinics and increased cervical screening uptake.

They are also effective at diagnosing and treating infectious diseases such as syphilis and hepatitis C with high rates of cure.
 
After receiving feedback that young Indigenous people were neglected when it comes to research, Professor Eades developed the Next Generation – Aboriginal Youth Wellbeing Study, a longitudinal cohort that assesses the health and wellbeing of Aboriginal and Torres Strait Islander adolescents and youth aged 10–24 years.
 
To Professor Eades’s surprise, the study identified high rates of pre-hypertension and hypertension in Indigenous young people – something she describes as ‘an emerging wicked problem’ that we need a better understanding of.
 
‘High blood pressure is one of the seven leading factors that contribute to the health gap between Indigenous and non-Indigenous Australians,’ she said.
 
‘Five per cent of Aboriginal young people between 18 and 30 actually have high absolute cardiovascular risk when you look at their profile using national data.
 
‘The Australian guidelines for assessing and managing cardiovascular disease risk [now has] a recommendation in the newly published guidelines that First Nations Indigenous people aged 18–29 should have their individual cardiovascular risk factors assessed and treated.
 
‘But it doesn’t say anything about people younger than 18 and the guidelines don’t provide clear advice in terms of managing those individual risk factors in younger people.’
 
As part of the Next Generation study, Professor Eades found that 11% of Aboriginal and Torres Strait Islander young people have pre-hypertension and 19% have hypertension, with prevalence varying according to age and other risk factors such as increased body mass index.
 
‘By the time you get to 20–24 years old, only 46% have normal blood pressure,’ she said.
 
Further research is planned to ensure the accuracy of the results; however, Professor Eades says addressing early risk factors for cardiovascular disease in young people is key to Closing the Gap.
 
‘GPs and primary care services have to be involved in thinking more about young people’s health and thinking more about the importance of having youth friendly health services for their holistic health needs but also for thinking about how to give these young people the same life prospects as other young people,’ she said.
 
‘There’s a need to work with frontline primary healthcare providers and work with Aboriginal communities and make sense of what the options are for coming to grips with emerging chronic disease risk factors occurring at a time when we all expect young people to be in the best health.’
 
Professor Eades’ message coincided with one delivered by Dr Karen Nicholls, Chair of RACGP Aboriginal and Torres Strait Islander Health, who has called for Indigenous voices to be heard in order to achieve better health outcomes.
 
‘The evidence is clear that when Aboriginal and Torres Strait Islander people have a voice in policies and practices that affect them, the outcomes are better, resources are better-used, and we move closer to closing the gap in health equity,’ she said.
 
‘The RACGP has not changed its commitment in Aboriginal and Torres Strait Islander health. The college will continue working closely with and listening to Aboriginal and Torres Strait Islander voices.’
 
For Professor Eades, initiatives like Aboriginal Community Controlled Primary Care Services, along with research, are a part of the solution.
 
‘Aboriginal and Torres Strait Islander people are the world’s longest continuous living culture, and ensuring self-determination in the delivery of general practice care is crucial,’ she said.
 
‘We have made many strides forward, but we still have a long way to go, and that includes an even greater focus on community led research and health service responses to the health inequalities experienced by Aboriginal and Torres Strait Islander people.
 
‘We must get this right if we hope to Close the Gap.’
 
Log in below to join the conversation.

Indigenous health WONCA 2023 WONCA World Conference