Group F14 Executive Summary
Members:
Andrea Lee (z5179993)
Cheng Ratsamy (z5164499)
Xin Yi Lin (z5160413)
Nay Win Pyo (z5176361
Social Issue
In the Indigenous community of Kimberley, WA, there are high rates of Type II Diabetes
with chronic health complications due to diabetes being the leading cause of avoidable
hospitalisations between 2008-2012 (WACHS, 2015). Indigenous youth in Kimberley also
experience a younger age of onset and higher mortality from Type II Diabetes (Maple-Brown
and Hamptom, 2020). Therefore, the high burden of disease and intergenerational effects on
Indigenous youth demands change.
SDG
3. Good health and well being
4. Quality Education
10. Reduced Inequalities
SMART Goals and Indicators
1. Improving residents blood sugar levels through food security and nutrition literacy
•
Long term: Increase in Life expectancy
•
Medium term: Decrease in rate of diabetes
•
Short term/Immediate: Decrease in Diet, rate of fast food consumption.
2. Setting up Cardiovascular Exercise Program for residents in the area
•
Long term: Obvious rise in Physical activity participation
•
Medium term: Decrease in Rate of obesity
•
Short term: Increase in average physical activity levels
3. Setting up Diabetes awareness among the community with educational programs
•
Long term: State-wide drop of average blood glucose levels among Type 2 Diabetes
patients.
•
Medium term: High demand in diabetes-related health care services and products.
•
Short term: Increase in purchase of diabetes test kits
Who we are?
We are a non for-profit organisation, aiming to reduce Type 2 Diabetes within the Kimberly
community through the utilisation of resources and the collaboration of established
organisations and stakeholders who are actively exploring similar goals within Kimberly.
Why the problem is complex
The root causes and setbacks in Kimberley are due to lack of infrastructure, health care
access and food insecurity (WACHS, 2015). As diabetes is a chronic disease that requires
periodic tests and check-ups, residents in rural areas like Kimberley find it difficult to travel
to medical centres and remain compliant to long-term diabetes treatment and modify lifestyle
risk factors such as diet and physical inactivity (Hallberg et al., 2019). Indigenous Australians
also experience co-existing issues of marginalisation and the traumatic history of racism that
make it difficult to break cycles of socioeconomic disadvantage, which contributes to poor
health outcomes (AIHW, 2020).
Strategy and theory of change
Three main strategies are implemented targeting diet, exercise and education creating
awareness and ensuring progressive change towards a positive social impact. Community
stores with locally sourced fresh produce aids in the incorporation of healthier food choices
into the diet of local residents. Exercise programs rolled out to increase physical activity and
promote cardiovascular health of participants is another example of progressive approach to
improve general physical wellbeing. Youth educational programs that aim for transformative
change educates knowledge on measuring techniques for diabetes. Increased collaboration
with bodies such as diabetes Australia, local sports clubs and Kimberly aboriginal medical
services ensures sustainability and maximise social impact effects.
References
AIHW, 2020, Diabetes Overview, Australian Government, Canberra [accessed 8 November
2020, from < https://www.aihw.gov.au/reports/diabetes/diabetes/contents/what-is-diabetes>]
CRANAplus, 2020, Indigenous Affairs Committee Inquiry into Food Prices and Food
Security in Remote Indigenous Communities, June 2020, Submission 63.
Hallberg et al., 2019, Reversing Type 2 Diabetes: A Narrative Review of the Evidence,
Nutrients, 11(4) pp: 766 [accessed 8 November 2020, from <
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6520897/>]
WACHS, 2015, Kimberley – population and health snapshot, Rural Health West: Outreach,
Government of Western Australia, Perth, available online [accessed 8 November, from <
https://ruralhealthwest01.blob.core.windows.net/www-production/docs/defaultsource/outreach/outreach-regional-profiles/kimberley-population-and-healthsnapshot_0417.pdf?sfvrsn=2>]
Stage 2: Blueprint for Change
Aboriginal Australians are susceptible to several chronic diseases in Western
Australia. The diseases can easily be avoidable with a healthy lifestyle, good education,
awareness and access to medical services. “Chronic conditions like respiratory diseases
(including asthma), heart and circulatory diseases, high blood pressure, diabetes, kidney
diseases and some cancers are more common among Aboriginal and Torres Strait Islander
people than among non-Indigenous people in WA(Chronic Diseases, 2020).”
Diabetes WA established that about 1 in 3 Aboriginal Strait Islanders will develop
diabetes in their lifetime. Diabetes is an important contributor to the considerably higher
circulatory disease mortality rate among Indigenous Australians at young ages (9–10 times
higher in Indigenous men aged 25–44 years, and 12–13 times higher in Indigenous women
aged 35–54 years) (O’Dea, Rowley and Brown, 2007). Type 2 diabetes is the main type of
diabetes that is devastating Aboriginal’s health.
It is impossible to fully prevent diabetes from occurring. there are certain measures
and pre-emptive actions we can take to reduce the rate of Diabetes occurring in the
Aboriginal Populations in Western Australia. The main root causes of Diabetes among
Aboriginal Australians in WA include but not limited to
1. High Blood Pressure and Cholesterol
2. Tobacco Smoking
3. Low Level of Physical Activity and Poor diet
4. Obesity
5. Genetics
The more the person has root causes, the more likely he or she is susceptible to
developing type 2 diabetes. Even though some root causes such as genetics cannot be
prevented, precautionary measures can be taken to prevent habitual root causes. Obesity,
High Blood Pressure and Cholesterol can be taken care of by checking the diet plan,
increasing physical activity, and having usual medical checks. According to the report,
Aboriginal and Torres Strait Islander people with high blood pressure were nearly three times
as likely as those without high blood pressure to have diabetes (24% compared with 9%)
(Burrow & Ride, 2016).
Kimberley, Western Australia
According to (Australian Bureau of Statistics, 2020), There were 34,364 people in
Kimberley by 2016. Aboriginal people make up 41.6% of the population. That makes up to
14089 of the total population. Therefore, even though Kimberley has a low population,
Australian Aboriginals make up a big portion of the population. In Kimberley, Median
Weekly Household income is 920$ while median monthly mortgage payment is 2167$.
Western Australia’s average income is $1210 while the average monthly mortgage payment
is $1660. Therefore, we can conclude Aboriginal community households in Kimberley are
held back on income compared to the average Australian household. The income situation
and rising rates of diabetes hold hand in hand.
Social Development Goals
To tackle the diabetes problem in Aboriginals, 3 Social Development Goals (SDG) as
developed by the United Nations are set to help the Kimberley Aboriginal Community. SDGs
are as mentioned below.
1. Good Health and Well Being
Good Health and Well Being should be one of the main goals to succeed in tackling
type 2 Diabetes problem in aboriginal Australians located in Kimberley, WA. Type 2
diabetes is a disease that is known to connect to bad health habits. The disease occurs
subsequently connecting to other chronic diseases such as High Blood Pressure and obesity.
It is a chronic disease that can be treated mainly by diet, exercise, medication, and insulin
therapy. Therefore, if the communities do not start engaging and following in optimal diet
plans and exercise programs, things will still look dire.
2. Quality Education
Main root problems for the rising levels of diabetes are the habits and day to day food
consumption choices. The 2 problems can only be countered by receiving quality education
regarding health and wellbeing since young age. Aboriginal Communities in Kimberley are
held back by infrastructure, basic income, health education and other factors. That contributes
to the rising levels of diabetes occurrence in the community. Even though organisations such
as Diabetes Western Australia and Aboriginal Community Controlled Health Services
(ACCHS) try to reduce the rate by setting up educational programs and transportation
programs for rural communities to have better health access. Things are still looking dire due
to the distrust in the health system due to historical events such as the stolen generation,
unwillingness to obtain medical advice and lack of policies that target marginalisation.
3. Reduced Inequalities
Residents in Kimberley suffer from diabetes not only because of knowledge but also
the lack of infrastructure and inequalities set up by location remoteness. The lack of
accessible, effective, and comprehensive service delivery to rural-remote West Australians,
both compounds the problems and renders a solution more difficult, as cycles of poverty and
disconnectedness become entrenched over time and generations(Davis K, 2018). Greater
levels of remoteness often correlate with smaller populations which results in ‘market failure’
due to scalability and private sector service provision, further creating inequalities and
inequities for rural and remote communities (Davos K, 2018). Western Australian State
government has taken necessary actions to reduce inequalities by starting a project back in
2012. The project involved costing and planning for the delivery of services to Aboriginal
communities in WA and reflects the intent of the Bilateral Agreement. However, Councils
affected by the Bilateral Agreement were unable to obtain agreement from governments to
provide adequate resources to take over responsibility for municipal services in Indigenous
communities (Davos K, 2018). Therefore, reducing inequalities is a substantial goal to reduce
diabetes among Kimberley Aboriginal residents. The residents need access to health care and
services to combat the chronic disease effectively.
3 SMART GOALS
We can take necessary actions and set up the goals to make sure the social development goals
will be achieved soon. The goals will have to be measurable and achievable over a period. 3
SMART GOALS necessary to achieve the SDGs are as below:
1. Improving residents blood sugar levels through food security and nutrition
literacy
It is common for middle-aged, and elderly people to get Type 2 Diabetes. These days,
we are seeing growing numbers in children, teens, and adolescents among Kimberley
Aboriginal Society. The key to reducing blood sugar level is in diet control. It is much easier
to control and shape the mindset of the residential youth and children compared to adults.
There have been organisations set up to control the diet problem, but it has been ineffective
due to infrastructure and logistical reasons. Therefore, to control the diet, we need to
understand the importance of community stores where Aboriginal communities have main
access to food in Kimberley.
Due to low income, Aboriginal communities are denied access from eating fresh and
healthy food, having to depend a lot on community stores. The importance of community
stores within remote Aboriginal communities is demonstrated by the fact that as much as
95% of all the food that is eaten within the community is purchased from the community
store (Bussey C,2012). Especially in rural communities such as Kimberley, Community
stores are the solution for most of the problems that Aboriginals are facing. Community
stores not only give jobs and training to the community, but essential knowledge regarding
diet and health. Community stores are not only the main socio economic enterprise in the
community, but should also be regarded as having an essential role in long term employment,
education and training and provide a priority setting for achieving goals in educating about
food, nutrition issues; particularly food security and promoting general and physical
wellbeing (Bussey C,2012).
We need to work together with state government and community stores in the area.
We can gravely reduce fast food, junk food and processed food consumption. The only
possible way to achieve it is by importing local fresh food sourced locally. BOAB Health
services set up health programs for residents in Kimberley.Their programs reduce the health
inequalities for Aboriginal people in the Kimberley. This includes recognition of the unique
health care needs for Aboriginal people and advocating for Aboriginal people to stay in the
country or minimising the length of stay away from the country, when accessing specialist
care (BOAB, 2020). They also have projects working on the development of localised
resources to support health literacy and education (BOAB,2020).
The main goal should be to work together with BOAB, use the connections and
establish the relationship between stakeholders such as the State Government, Educational
Board and Community markets.
To track the progress of the project, we can work with Health, WA and Australia
Bureau of statistics to track diet and rate of fast-food consumption to check our progress in
short term goals. For medium term goals, we can contact the national diabetes strategy
advisory group and Diabetes Western Australia (DiabetesWA) to track the reduction in the
rate of diabetes. We can work together with Aboriginal controlled health services and Health,
WA to track the increase in life expectancy of Kimberley Aboriginal residents.
2. Setting up Cardiovascular Exercise Program for residents in the area.
Cardiovascular diseases are the leading cause of death among people with type 2
diabetes and the implementation of regular cardiovascular exercise is an important factor in
controlling the negative effects of type 2 diabetes. Research has shown that regular exercise
has significantly improved the key indicators directly related to type 2 diabetes. We need to
work together with the state government for the Establishment of low-cost cardiovascular
exercise equipment and community access to recreational centers. This will not only increase
the standard of living in the Aborignial community, but also improve the community’s
diabetes symptoms. In addition, implementation of various sporting activities hosted by the
government for the community will not only improve the quality of life for the community,
but also serve as a benchmark for future relationships between the Aboriginals and the
government. Studies have shown that combining aerobic and resistance exercises yielded the
best results in improving the key indicators and symptoms for type 2 diabetes.
For short term goals, we will see the rise in average physical activity levels among the
recreational centres set up by the government. We should be able to see reduction in rate of
obesity if the physical activity levels rate remain constant. For the long term, we will be
seeing the obvious rise in physical activity participation and included in the day to day plans
of Australian Aboriginals located in Kimberley, WA.
3. Setting up diabetes awareness among the community with the educational
programs.
There are three main healthcare services provided in Kimberly, WA: Aboriginal
Community Controlled Health Services, Primary and Allied Health Services, and Hospital
Services.
It would be best to begin the awareness of the issue of prevailing cases of diabetes
among the Aboriginals with the children in school. The implementation of proper nutritious
diet in school canteens as well as physical education classes in the primary and secondary
schools in WA along with health classes designed to promote healthy lifestyles outside of
school. This policy will ensure that the children are taking the knowledge and awareness back
to their communities and promote diabetes awareness within their communities. This method
is effective as the root cause of the problem will be addressed. The future generations of the
WA residents will have the awareness regarding the negative effects related with type 2
diabetes. Thus, the Aboriginal community’s view towards their sedentary lifestyle will shift
into a more active and healthy way of life.
In order to address the growing concerns regarding the diabetes rate in youth, it is
vital to address them while they are still in school. Aboriginal Health Council of Western
Australia has set up a youth program to target the issue. The AHCWA Youth Committee
members are also regularly provided with opportunities to contribute to and provide feedback
on relevant policy and program development both on community level and government level
(AHWCA,2020). Health education regarding Diabetes is already well researched and readily
available for Australians. The problem is for the organisation to make sure it is readily
accessed by the Kimberley Aboriginal Communities. Even though several organisations set
up awareness meetings and conferences among Western Australian cities, Kimberley is
looked over due to low population density. Therefore, schools are the most vital institutions
for the educational programs to reach the communities to make an impact and change.
For short term goals, we can work together with health, WA and hospital services to
increase the diabetes test kits readily available in the community. For medium term, we need
to set up programs for community wide diabetes checks and diabetes medication. We can see
progress by measuring the rise in community’s participation each year. In the long term, we
will start to see a state-wide drop of average blood glucose levels regarding the effectiveness
of the educational programs.
References
Australian Institute of Health and Welfare (2017). Aboriginal and Torres Strait Islander health
performance framework 2017 report: Western Australia. Canberra: Australian Institute of Health and
Welfare.
Burrow S, Ride K (2016) Review of diabetes among Aboriginal and Torres Strait Islander people.
Australian Indigenous HealthInfoNet
Australian Bureau of Statistics (2020). Kimberley 2016 Census Quick Stats,
https://quickstats.censusdata.abs.gov.au/census_services/getproduct/census/2016/quickstat/51001#:~:t
ext=In%20the%202016%20Census%2C%20there,up%2041.6%25%20of%20the%20population.
Bussey C (2012) Community stores influence the health of Aboriginal people living in the Fitzroy
Valley region of the Kimberley. Australian Indigenous HealthBulletin 12(1). Retrieved [access date]
from http://healthbulletin.org.au/articles/community-stores-influence-the-health-of-aboriginal-peopleliving-in-the-fitzroy-valley-region-of-the-kimberley/
Davis K (2018) Rural and Regional Inequality in WA: Economic Senate Submission. Retrieved from
www.walga.asn.com.au
AHWCA (2020) MAPPA Retrieved from https://www.ahcwa.org.au/mappa
Kerin O'Dea, Kevin G Rowley and Alex Brown (2007) Diabetes in Indigenous Australians: possible
ways forward. Retrieved from https://www.mja.com.au/journal/2007/186/10/diabetes-indigenousaustralians-possible-ways-forward