This study provides a new perspective from Aboriginal Health Workers (AHWs) working in the area of heart health in the Aboriginal community of western Sydney.
AHWs are well placed and keen to be a part of the team that assesses cardiovascular risk. However, lack of recognition of the AHWs’ skills and lack of access to formal training are current barriers to enhancing their role in the heart health team.
Cardiovascular disease (CVD) is a major health concern in the Aboriginal population and contributes to the significant life expectancy gap between Aboriginal and non-Aboriginal Australians. Conventional risk factors alone do not account for the excess CVD mortality, which has foundations in the economic, social, physiological, psychological and educational disadvantage of the Aboriginal population. There is a lack of progress in reducing the disparities in health outcomes between Aboriginal and non-Aboriginal Australians. This may be because of a focus, to date, on acute care and patient responsibility rather than addressing underlying determinants of health such as living conditions and socioeconomic factors.
In Aboriginal communities, Aboriginal Health Workers (AHWs) fulfil a variety of roles, depending on personal interests and the needs of the community. Unfortunately, a lack of understanding of the diverse expertise of AHWs persists. A universal role is that of a cultural broker through which communication between Aboriginal people and non-Aboriginal healthcare providers are enhanced, thereby increasing the effectiveness of their interaction. Recognition of AHWs as an important part of the healthcare team has been suggested as a means of delivering improved healthcare to the Aboriginal population.
The aim of this study was to study the perspectives of Aboriginal health professionals (nurses and AHWs) regarding cardiovascular risk and heart health, including their understanding of cardiovascular risk assessment. Qualitative research methods can improve the understanding of perceptions of health across cultures and lead to improved health outcomes.
This study was undertaken with AHWs and Aboriginal nurses from the Aboriginal Medical Service Western Sydney (AMSWS) and Western Sydney Local Health District, all of whom are working in the area of chronic disease management or heart health. AMSWS is a large Aboriginal community controlled health organisation that provides multidisciplinary primary healthcare, including cardiovascular screening, healthy lifestyle education and case management to clients with heart disease.