Aboriginal Heart Health @AHPC_VU #HeartHealth: the first step in getting Australia’s health on track

 

” One Australian dies every 12 minutes from CVD including heart attack and stroke – 40 percent prematurely. People with type 2 diabetes are 3-4 times more likely to suffer a heart attack or stroke. People with CVD are also at risk of kidney disease.”

Australia spends more on cardiovascular diseases than on any other disease group (3). The costs of CVD amount to over 12% of all health care expenditure. In 2011, CVD was the second most burdensome disease group in Australia, causing 15% of the total $4.5 million disability-adjusted life years lost (4).

Diseases of the circulatory system are also closely associated with other major chronic health conditions such as diabetes, cancer, chronic obstructive pulmonary disease and arthritis.

This policy paper builds upon the work of the National Vascular Disease Prevention Alliance (NVDPA) and leading Australian health researchers to reinvigorate and reinforce the case for preventing CVD and its risk factors and in turn, to reduce disability, comorbidity and premature death.

These experts agree that the most important next step that the Australian Government should take to prevent and manage CVD is promoting an Absolute Cardiovascular Risk Assessment in primary practice.

The experts called for:

Targeted screening and treatment for absolute risk assessment of cardiovascular disease for adults aged 45–74 years and from 35 years for Aboriginal and Torres Strait Islanders in line with guidelines.”

Heart Health: the first step in getting Australia’s health on track

 ” The National Vascular Disease Prevention Alliance (NVDPA) has today supported calls for heart and stroke disease risk assessments to be embedded alongside type 2 diabetes and kidney disease risk assessment in routine GP visits for everyone over 45.

Australian Health Policy Collaboration (AHPC) released the policy paper Heart Health: the first step in getting Australia’s health on track in Canberra today.”

Download a copy : Heart Health: the first step in getting Australia’s health on track

 

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Read over 30 Aboriginal Heart Health articles HERE

 ” Aboriginal and Torres Strait Islander people are up to three times more likely to suffer a stroke than non-Indigenous Australians and almost twice as likely to die, according to the Australian Bureau of Statistics “

Read over 70 Aboriginal Stroke Health articles HERE

Read over 130 Aboriginal Diabetes Health Articles HERE

The paper recommends a national investment in Absolute Cardiovascular Risk Assessment (ACVR) screening and outlines a national primary care strategy to reduce the impact of cardiovascular disease (CVD) on the community.

This paper builds on the NVDPA proposal for an integrated health check for cardiovascular disease, type 2 diabetes and chronic kidney disease.

NVDPA member and Stroke Foundation Chief Executive Officer Sharon McGowan said regular integrated health checks delivered by GPs will ensure people at high risk were identified and managed.

“Chronic diseases are Australia’s greatest health challenge and leading cause of illness, disability and death. However, much of this burden could be prevented through early detection and early treatment,’’ Ms McGowan said.

“Integrated health checks will help ensure Australians stay alive, stay well longer and stay out of hospital.”

AHPC Director Professor Rosemary Calder said embedding risk assessments into GP visits would be the single most effective strategy for chronic disease prevention.

The NVDPA and AHPC both recommend that integrated risk assessments be supported by the Medicare Benefits Schedule and promoted through the community and Primary Health Networks.

The AHPC Heart Health report was developed in collaboration with leading national clinical and policy experts and in consultation with the Royal Australian College of General Practice and the NVDPA.

The NVDPA includes the Stroke Foundation, the National Heart Foundation, Kidney Health Australia and Diabetes Australia.

The Heart Health report follows the AHPC’s policy roadmap, Getting Australia’s Health on Track, 2016 which aims to significantly reduce preventable illness and disability.

See NACCHO Aboriginal Health Alert #GetonTrack Report : The ten things we need to do to improve our health 

NACCHO #fightstroke Aboriginal Health News : New smartphone APP to treat atrial fibrillation and prevent strokes.”

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“A lot of the time, you’ll get a machine that has a lot of connections and you’re there for about 10 to 15 minutes setting up, whereas the iECG is in a comfortable position in your hands and it’s just two fingers on the back of a probe on the back on a phone,” he said.

“People are quite happy to do it, they’re quite surprised that a screening tool can be so small and so mobile.”

At the heart of the research is community consultation.

The programs and rollout have been designed with local people on the ground because they are more in touch with what the community needed.”

Daniel Kelly is an Aboriginal Health Education Officer at the hospital in Brewarrina in north-west NSW and said it was less daunting for patients who were sometimes scared of hospitals

NACCHO Articles about strokes and recovery

A new smartphone app could revolutionise the way health care is delivered in the outback Brooke Boney from ABCNews Reports

The iECG replaces a traditional ECG machine to detect atrial fibrillation, which is responsible for one third of all strokes in Australia.

A pilot at the University of Sydney is trialling the technology in far western New South Wales to create the first snapshot of atrial fibrillation rates in Aboriginal people.

One of the benefits is that it can be carried out by local healthcare workers with minimal training and effort.

‘Oh go away, it’s only a phone’

One of the Aboriginal health officers, Helen Ferguson, said it was so easy, some of the patients thought they were joking.

The smartphone app iECG

“It was so funny because when we first got the little machine we would say to the people, ‘now we’ve just come to have a little yarn to you, this is a machine that we’ve got and it’s like a little ECG machine and instead of having all the cords on and it’ll give you a reading of either normal or AF [atrial fibrillation]’,”she said.

“And then they’d say ‘oh go away, it’s only a phone’, and they thought we were pretending.”

The patient places their fingers on connectors and holds on for 30 seconds.

The file is processed by an app on the phone which gives results almost immediately.

Once an abnormality is picked up, the patient is referred to a specialist in Sydney or they can book an appointment with visiting specialists who come to the area about once a month.

One of those specialists, Dr John Watson, is a leading neurologist and said that stroke, as a result of atrial fibrillation, could be among the most severe — but it can also be easily treated with anti-coagulant medications.

“A lot of the time, the stroke can be the presenting feature of the atrial fibrillation,” he said.

“One of the worst things is to see someone who’s just had a stroke to find out that they are in atrial fibrillation and that was the cause of the stroke, and then to hear that the chance to detect it earlier was missed or ignored or it was detected and not enough was done to try to treat the atrial fibrillation and prevent the stroke.”

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More info about F.A.S.T. and Stroke Foundation HELP

Telehealth to transform outback care

It is the beginning of a new way of treating people in remote and inaccessible areas.

As a concept, telehealth has been around for a while but new technology is helping to push that along.

Dr Watson said new equipment, which included satellite technology and medical instruments, could send information back to specialists in real time — meaning consultations could take place more frequently and for less cost.

“We may have a cardiologist in Sydney who says, ‘every Thursday morning, for three hours, I’m free, I’m available to help run a clinic anywhere else in the country’,” he said.

Treating Indigenous people in communities rather than sending people to cities for treatment, where possible, could be more successful and more cost effective.

Dr Susannah Tobin  said culturally appropriate health care was not just important, but vital if patients were to see the benefits.

“If we can deliver them where they feel comfortable … then they’re more likely to be able to take advantage of it and to see the benefit,” she said.

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NACCHO Aboriginal health #Stroke Stories : Written by the mob for the mob

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“It’s very important that it belongs to the local community.And the community chose the stories, artwork and analogies that would be best to make it work.

The river is compared to the blood flow through the body,” says Rachel. “If it’s dammed with silt and trees then nothing gets past, like when an artery gets blocked. Or if the river floods it kills the land it goes over, which can be like a bleed in the brain.”

Rachel Peake, Stroke Care Coordinator in from Hunter New England Health.

A book of personal stroke stories from Aboriginal community members is proving effective at getting authentic, relatable information across to others in the community and raising stroke awareness.

All the words in Stroke: Written by the Mob for the Mob come from the Aboriginal people of the Kamilaroi/Gomeroi/Gamilaraay/Gamilaroi nations. The booklet was published by the Hunter New England Local Health District of NSW.

Download Stroke: Written by the Mob for the Mob (PDF, 12 MB)

“It’s very important that it belongs to the local community,” says Rachel Peake, Stroke Care Coordinator in from Hunter New England Health. “And the community chose the stories, artwork and analogies that would be best to make it work.”

The stories were gathered through a series of yarning sessions, which let people direct the conversation themselves. This makes sure that nothing important is missed, and that the authentic voices of the participants come through.

The result is a relaxed mix of humour and art. This includes the painting on the booklet’s cover, a representation of stroke and the brain created by students from the Peel High School. This picture also demonstrates the analogy of the river, which is central to the booklet’s message.

“The river is compared to the blood flow through the body,” says Rachel. “If it’s dammed with silt and trees then nothing gets past, like when an artery gets blocked. Or if the river floods it kills the land it goes over, which can be like a bleed in the brain.”

Since its publication the booklet has taken on a life of its own, with hardly any copies left from the original print run of 2000. This is partly due to people’s pride in their own family members, demonstrating that the booklet is reaching the community it was created for.

As Rachel says, “This is the message the community wanted: if they’re given a voice, they can educate their own people.”

You can find the Stroke: Written by the Mob for the Mob booklet on enableme and InformMe, as well as a series of videos of respected community members telling their own stories.

Download Stroke: Written by the Mob for the Mob (PDF, 12 MB)

Declaration: Colin Cowell editor of NACCHO Aboriginal Health News Alerts is stroke survivor and was recently elected to the board of Stroke Foundation as a Consumer director

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Aunty Pam’s story

Audrey’s story

Bill and Coral’s story

Delphine’s story

Tales from Toomelah

  Declaration of interest: Colin Cowell editor of NACCHO Aboriginal Health News Alerts is stroke survivor and was recently elected to the board of Stroke Foundation as a Consumer director

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NACCHO Health Newspaper : Aboriginal people are up to three times more likely to have a stroke

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We know that Aboriginal and Torres Strait Islander people are up to three times more likely to have a stroke than non-Indigenous Australians, The good news is most strokes are preventable and treatable. However communities need to be empowered to protect themselves from this insidious disease.

In Australia, stroke is the leading cause of long-term disability in adults, accounting for 25 per cent of all chronic disability. The NSF reports that roughly 50,000 strokes occur per year with over 437,000 people living with stroke across the country. While severity varies, two thirds of victims, like Tania, are left with impeding disabilities.

The Stroke Foundation has called on the Federal Government to fund an urgent $44 million campaign to address the gap in stroke care.”

Stroke Foundation Chief Executive Officer Sharon McGowan

For more information on stroke and the campaign, visit strokefoundation.com.au

From page 20 NACCHO Aboriginal Health Newspaper out this week : Free PDF download

The Stroke Foundation is calling for increased stroke awareness initiatives in Aboriginal and Torres Strait Islander communities.

Sharon McGowan said better education about the risks and signs of stroke was crucial to help close the unacceptable health gap which threatens the lives of thousands of people each year.

“Stroke is a serious medical emergency which requires urgent medical attention. However too many Aboriginal and Torres Strait Islanders are unable to recognise the signs of stroke.

“We believe everyone deserves the chance to lead a healthy life. More must be done to educate people about stroke prevention and awareness in the community.

“We are calling on the Federal Government to fund a national campaign to increase awareness of the signs of stroke and how people should respond,” she said.

The Stroke Foundation has a simple acronym to help people remember the signs of stroke:

Face – has their mouth drooped?

Arms – can they raise both of their arms above their head?

Speech – is their speech slurred? Can they understand what you’re saying?

Time – Call triple zero (000) immediately. Do not delay.

Ms McGowan said it was vital that more Aboriginal and Torres Strait Islander people were able to recognise these signs in themselves and their family members.

“Stroke is a sudden interruption of blood flow to the brain. Without the blood to deliver oxygen, the stroke affected parts of the brain start to die. This can lead of death or significant disability for those who survive a large stroke,’’ she said.

“Unfortunately awareness of the signs of stroke in Indigenous communities is low. It is vital that people can recognise the signs of stroke and know to call triple zero immediately

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For Tania Lewis, an Awabakal woman, stroke was something that only happened to older people.

“Never had I ever come across one or heard much about them. I had nothing to do with them,” she tells.

But in 2011, Tania suffered a severe stroke at the age of 39 that would leave her with permanent right-sided hemiplegia – paralysis of one side of the body.

Tania Lewis

Tania with husband Leonard at the Barmedman Mineral Pool in 2007. Barmedman is Len’s home town and where the couple were married in 1989.

“When I woke up, I didn’t know what was going on. I couldn’t communicate. I couldn’t tell anyone I was still here. It was really scary. I’d never seen the effects of a stroke.

“First, I lost my voice, then my vision, my [ability to] swallow and my movement of all my body parts. I lost all my bowel and bladder function. I’ve still got bad sight but I can see again. My speech took about six months.”

In Australia, stroke is the leading cause of long-term disability in adults, accounting for 25 per cent of all chronic disability. The NSF reports that roughly 50,000 strokes occur per year with over 437,000 people living with stroke across the country. While severity varies, two thirds of victims, like Tania, are left with impeding disabilities.

Tania Lewis, an Awabakal woman, and her husband Len, a Wiradjuri man, have been best friends since childhood. Now married 27 years, they live in Bonnels Bay, NSW with their teenage daughter, Faith. In 2011, their relationship faced the ultimate test when a severe stroke left Tania paralysed. This is their story.

The burden of stroke doesn’t just fall on the patient, but can take a significant toll on family and carers.

“The doctor at the hospital tried to take Power of Attorney and Guardianship away from me and give it to the Guardianship Board, because he didn’t believe that [my husband] Len or anyone could look after me,” Tania recalls.

“I was put through hell. I figured life wasn’t worth living anymore because they took everything away from me. I couldn’t go home to my family. So I tried to off myself.

I figured life wasn’t worth living anymore because they took everything away from me. I couldn’t go home to my family.

“Then all of a sudden, one day the doctor said, ‘You can go home. We can’t rehabilitate you anymore’. At home, I was having seizures for a while. My hubby wouldn’t sleep. He and his mum would take shifts looking after me. We tried to get assistance but there was nothing for young people. So one day, my husband collapsed on the lounge room floor from exhaustion. It was just a nightmare. That’s how I ended up in aged care.”

Tania spent the next two and a half years between three aged care facilities.

“I wouldn’t wish it upon nobody,” she says.

It was during her nightly ritual of chatting with her daughter via Facebook that Tania typed “young people in nursing homes” into Google. The search engine’s results would lead to her life-changing encounter with the YPINH.

“With help from the Aboriginal Disability Network, they advocated to get me out and get the right support equipment at home. Whatever I need, physio, OT – they’ve got my back. I can’t thank them enough for what they’ve done for me.”

Today, Tania is working with the Aboriginal Disability Network, helping Indigenous Australians navigate their way through the National Healthcare System.

It has long been recognised that Aboriginal and Torres Strait Islander people have a life expectancy that is approximately 20 years less than non-Indigenous Australians (Australian Bureau of Statistics). Recent data from the ABS shows that up to 80 per cent of the mortality gap can be attributed to chronic diseases such as heart disease, stroke, diabetes and kidney disease.

For many Aboriginal communities, especially those in remote regions, socio-economic factors play an important role. Kerin O’Dea from Darwin’s Menzies School of Health Research cites unemployment, poor education outcomes and limited access to fresh foods as key factors in her paper, Preventable chronic diseases among Indigenous Australians.

Lifestyle related risks such as smoking, alcohol misuse, stress, poor diet, and inadequate physical activity also need to be addressed, according to the Australian Institute of Health and Welfare .

But the first step, McGowan says, is for indigenous stroke sufferers to recognise the signs of a stroke in themselves and their family members. The NSF recommends the F.A.S.T. test as the most effective way to remember the most common signs of a stroke.

Face: Check their face. Has their mouth drooped?
Arms: Can they lift both arms?
Speech: Is their speech slurred? Do they understand you?
Time: Is critical. If you see any of these signs call 000 straight away.

“If I had known that because I’d lost my vision I had suffered a stroke, I could’ve put two and two together and got help, but I didn’t know anything,” Tania says.

“I was a heavy smoker, but not anymore – no way. Life’s too important. I didn’t ever know anything about a stroke – I was more thinking when you smoke, you can have lung problems and lose your fingers, like on the packets. But they don’t say anything about a stroke – they don’t advertise that stuff.”

The Stroke Foundation has called on the Federal Government to fund an urgent $44 million campaign to address the gap in stroke care. For more information on stroke and the campaign, visit strokefoundation.com.au.

Declaration of Interest : Colin Cowell Editor of NACCHO NEWSPAPER is a recent #stokesurvivor , following this advice he was in hospital within 15 minutes avoiding serious damage

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NACCHO Stroke Resources News :Indigenous stroke survivor campaigns for culture to aid in stroke recovery

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“It can happen to anyone — stroke doesn’t discriminate against colour, it doesn’t discriminate against age.

Maths isn’t a good way to see if someone with a cultural background is improving in recovery.

Seith Fourmile, Indigenous stroke survivor

Seith Fourmile says testing Indigenous stroke survivors recognition of native plants and seasonal changes is better suited than testing them with more traditional methods of stroke rehabilitation.

ABC Far North: Mark Rigby

 

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In what can only be described as a cruel twist of fate, Cairns Indigenous elder Seith Fourmile (Gudju Gudju) suffered a major stroke while working as a cultural advisor to a far north Queensland brain injury association.

“I actually had a blood vessel burst in my brain so, I became one of those people,” Mr Fourmile said.

“I went into method acting where I was actually in the hospital bed going through what people with acquired brain injuries go through.

“I spent quite a few months not being able to walk at all, just bed ridden.”

It was during this time Mr Fourmile realised the challenges traditional means of recovery presented to Indigenous stroke survivors.

As a qualified electrician, he had no problems dealing with the mathematical equations medical staff asked him, to measure the effect the stroke had had on his brain, but they got him thinking.

“If somebody didn’t go to school, they’d find it hard and if they couldn’t do those types of maths equations they’d be seen as not improving,” he said.

“[Indigenous Australians] are used to plants and animals and could probably name all the different seasons as we know them in our culture and let people know what’s around at that time.

“Maths isn’t a good way to see if someone with a cultural background is improving in recovery.”

In conjunction with Synapse, the brain injury association he still works with, Mr Fourmile is developing a seasonal calendar which can be used to measure the recovery of Indigenous stroke survivors.

“As soon as [they see] the wattle is flowering, they’ll know what’s out in the ocean, whether the mullet is fat, whether the shellfish are fat,” he said.

“A lot of Indigenous people can relate to those seasons and it’ll trigger that memory.”

For the work he has done, Mr Fourmile has been nominated for an award in the ‘Improving Life After Stroke’ category in the 2015 National Stroke Foundation Awards.

“I’m overwhelmed that I’ve been nominated for an award … I’ve never been nominated for any award, ever,” he said.

The best part of being nominated however was the opportunity it gave him to spread awareness of stroke in the wider community.

“It can happen to anyone — stroke doesn’t discriminate against colour, it doesn’t discriminate against age,” Mr Fourmile said.

“If the nomination means I get to educate more people about stroke, then so be it; that’s great.”

Facts and figures about stroke

  1. Stroke is one of Australia’s biggest killers and a leading cause of disability.
  2. 1 in 6 people will have a stroke in their lifetime. These people are someone’s sister, brother, wife, husband, daughter, son, partner, mother, father… friend. Behind the numbers are real lives.
  3. In 2015 there will be more than 50,000 new and recurrent strokes – that is 1000 strokes every week or one stroke every 10 minutes.
  4. In 2012 there were nearly130,000 or 30% of stroke survivors under the age of 65 in the community. [In 2012 there were over 420,000 people living with the effects of stroke and 30% of these people were of working age.]
  5. In 2015 there will be almost 440,000 people living with the effects of stroke. This is predicted to increase to 709,000 in 2032.
  6. Stroke kills more women than breast cancer and more men than prostate cancer.
  7. 65% of those living with stroke also suffer a disability that impedes their ability to carry out daily living activities unassisted.
  8. In 2012, the total financial costs of stroke in Australia were estimated to be $5 billion.
  9. The estimate of $49.3 billion in burden of disease costs for stroke is comparable to the $41 billion burden of disease costs that Deloitte Access Economics estimated for anxiety and depression in 2010.
  10. The FAST test is an easy way to recognise and remember the signs of stroke. Using the FAST test involves asking these simple questions:

Face Check their face. Has their mouth drooped?

Arm Can they lift both arms?

Speech Is their speech slurred? Do they understand you?

Time Time is critical. If you see any of these signs, call 000 straight away

Stroke recovery information

My Stroke Journey has all the information you need immediately after a stroke. It explains the different types of stroke, and provides details about stroke treatment and care. My Stroke Journey also provides information about leaving hospital and the services and support available.

Our fact sheets provide more detail on a range of topics, including:

Post Stroke Checklist

This Post-Stroke Checklist has been developed to help you talk to your healthcare team, acting as a prompt for common problems experienced by people post-stroke. Fill it out and take it with you to each visit and raise relevant questions with your team.

Post Stroke CHECKLIST

Call StrokeLine for more information on 1800 787 6531800 787 653 FREE or email strokeline@strokefoundation.com.au

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Editors Note : On World Stroke Day 29 October the editor of NACCHO Communique Colin Cowell had a stroke and was admitted in “15 minutes ” to Calvary Hospital Canberra where he had extensive treatment and support over 7 days from the stroke team lead by Dr Ramesh Sahathevan : Now on the long road to recovery : PS Agree with Seith Fourmile about those tests