Commentary: Improving access to cardiac rehabilitation (Heart: Road for health) for Aboriginal and Torres Strait Islander peoples in rural and remote areas of North Queensland

• Published in: The Australian journal of rural health 2023-02, Vol.31 (1), p.152-158
• Main Authors: Field, Patricia, Franklin, Richard C., Barker, Ruth, Ring, Ian, Leggat, Peter, Canuto, Karla
• Format: Article
• Language: English
• Subjects: Aboriginal Health; Access; access issues; Australasian cultural groups; Australian Aboriginal and Torres Strait Islander Peoples; Brokerage; Cardiac Rehabilitation; Cardiovascular diseases; Colonialism; communication; community based rehabilitation; Cultural sensitivity; Development policy; Disadvantaged; Health Promotion; Health Services, Indigenous; Health status; Heart Diseases; Humans; Indigenous peoples; Medical personnel; Native peoples; policy; Queensland; Rehabilitation; Remote areas; Rural areas; Rural communities; Rural roads; Skills; Social factors; System effectiveness
• ISSN: 1038-5282; 1440-1584
• DOI: 10.1111/ajr.12932

Aims To focus on the needs, challenges and opportunities to improve access to cardiac rehabilitation (CR) (Heart: Road to health [HRH]) for Aboriginal and Torres Strait Islander peoples in rural and remote (R&R) areas of North Queensland. Context It is known that there is insufficient access to HRH for Aboriginal and Torres Strait Islander peoples in R&R areas of NQ, who have the highest rates of heart disease and socioeconomic disadvantage mainly due to poor social determinants of health. However, at least in part due to the impact of colonialism and predominantly western medicalised approach to health care, few gains have been made. Approach This commentary draws on recent research and literature and reflects on cultural issues that impact on improving access to an HRH for Aboriginal and Torres Strait Islander peoples in R&R areas. The underutilisation of the skills of Aboriginal and Torres Strait Islander Health Workers (ATSIHW) and a lack of a defined process to ensure access to culturally responsive HRH are discussed. Finally, a way forward is proposed that includes the development of policies, pathways and guidelines to ensure that appropriate support is available in the client's home community. Conclusion It is proposed that culturally responsive, accessible and effective HRH is achievable through the reorientation of current health systems that include a continuous client‐centred pathway from hospital to home. In this model, ATSIHW will take a lead or partnership role in which their clinical, cultural brokerage and health promotion skills are fully utilised.