Identifying Indigenous patients a health priority
Why is it relevant to identify a patient as being Aboriginal or Torres Strait Islander? Researchers working on a project aimed at doing just that often encountered this question, and both health professionals and indigenous communities raised it.
However, strong goodwill for the project was generated once the link between identifying Indigenous Australians and providing them with better health care was understood, says one of its lead researchers, Associate Professor Margaret Kelaher, Deputy Director of CHPPE (Centre for Health Policy, Programs and Economics) at the Melbourne School of Population and Global Health. “As part of the Commonwealth Government’s ‘Closing the Gap’ initiative, new measures were introduced to improve Indigenous people’s access to medical services,” she says. “One of the major barriers to having people take up some of those services was the problem of identifying who is Indigenous and therefore eligible for them.”
In simple terms, the project’s aim was to make it easier for health professionals to ask patients another question, one that could help improve their lifelong health: Are you of Aboriginal or Torres Strait Islander descent? This could lead to preventative health measures, such as immunisations, and/or earlier diagnosis and treatment for chronic diseases like diabetes, for which Indigenous people are at higher risk.
CHPPE’s involvement was as a member of the Cooperative Research Centre for Aboriginal Health. The project, Improving the Identification of Aboriginal and Torres Strait Islander People in Mainstream General Practice, produced a series of recommendations (see link below) to apply at practice level, community and regional level, and national level.
The project’s report emphasised that for identification strategies to be effective, they had to be relevant to both health professionals and Indigenous people, attractive to introduce, achievable and necessary. Recommendations for the latter included tightening accreditation to require GPs to do cultural competency training to ensure their practices were safe places for patients to identify themselves as being Indigenous.
Consultations with Indigenous leaders had confirmed that the option to do so had to be voluntary. “From the outset of the project we explored with community leaders what they thought best practice was and they rejected some options, such as putting a permanent marker on your Medicare card,” Associate Professor Kelaher says. “This was seen as negative because people don’t get to choose under what circumstances they get to identify and it could make them potentially vulnerable to discrimination.”
The researchers identified attitudinal, administrative and organisational barriers to better identification. An organisational barrier at a health clinic, for example, might include poor communication between reception staff and health professionals about a patient’s Indigenous status.
The project’s recommendations have been well received by GPs attending General Practice Network workshops. “People have been very positive and there have been a whole lot of new Aboriginal health care workers employed as part of the Government’s indigenous chronic disease initiative,” Associate Professor Kelaher says. “They say they’ve found the research we did very useful in guiding their activities.”
For a full list of the recommendations, visit the Indigenous health link at: http://www.anu.edu.au/aphcri/
Caption: Associate Professor Margaret Kelaher