Cardiac care - Health priorities
In 2013, the Australian Health Ministers' Advisory Committee made improving the cardiac health of Aboriginal and Torres Strait Islander people a high priority in recognition of the significant impact of cardiac health on closing the gap in life expectancy. While there have been improvements in mortality from cardiovascular disease for Aboriginal and Torres Strait Islander people in Queensland, it remains the second leading cause of mortality and requires ongoing action. Focussing on acute rheumatic fever (ARF) and rheumatic heart disease (RHD) was a key recommendation of both the Queensland Aboriginal and Torres Strait Islander cardiac health strategy 2014–2017 and the 2016 Australian Medical Association Report Card on Indigenous Health - A Call to Action to Prevent New Cases of Rheumatic Heart Disease in Indigenous Australia by 2031.
ARF and RHD are diseases of social injustice with the disease burden borne almost exclusively by the disadvantaged. Unlike ischaemic heart disease, the drivers for onset of ARF and RHD are principally poor social determinants and in many cases the disease is entirely preventable. Rates and incidences of ARF and RHD are unacceptably high in Queensland’s Aboriginal and Torres Strait Islander population with 88 per cent of ARF notifications across the 1999 to 2017 period for Aboriginal and Torres Strait Islander people. In Queensland, the age group at greatest risk for ARF is children aged 5–19 with the median age of onset at 12 years.
In response Queensland Health with key partners has developed an Aboriginal and Torres Strait Islander Rheumatic Heart Disease Action Plan 2018–2021 (1.47 MB). The Action Plan will look to strengthen the connections between the different parts of the health system, increase awareness of best practice care and share information to support better coordinated care for the patient.
The Action Plan identifies targeted actions under the five priority areas to address ARF and RHD among Aboriginal and Torres Strait Islander Queenslanders:
- Promote, prevent, empower
- Improve the patient experience
- Strengthen the approach
- Foster clinical knowledge
- Enhance the Queensland RHD Register and Control Program
This Action Plan is directed towards Aboriginal and Torres Strait Islander people and the care they receive; however it is anticipated that implementation of relevant elements of this Action Plan will have a positive effect on all people impacted by ARF and RHD in Queensland.
The RHD action plan is underpinned by Making Tracks towards closing the gap in health outcomes for Indigenous Queenslanders by 2033 - Queensland's evidence-based Indigenous health policy and accountability framework.