Lung health care for Aboriginal and Torres Strait Islander Queenslanders: breathing easy is not so easy

Abstract

Objectives. In Aboriginal and Torres Strait Islander peoples in Queensland, to (a) determine the disease burden of common chronic lung diseases and (b) identify areas of need with respect to lung health services. Methods. Literature reviews and analyses of hospitalisation and mortality data were used to describe disease epidemiology and available programs and services. Key stakeholder interviews and an online survey of health professionals were used to evaluate lung health services across the state and to identify services, needs and gaps. Results. Morbidity and mortality from respiratory diseases in the Indigenous population is substantially higher than the non-Indigenous population across all age groups and regions. There are inadequate clinical services and resources to address disease prevention, detection, intervention and management in an evidence-based and culturally acceptable fashion. There is a lack of culturally appropriate educational resources and management programs, insufficient access to appropriately engaged Indigenous health professionals, a lack of multi-disciplinary specialist outreach teams, fragmented information systems and inadequate coordination of care. Conclusions. Major initiatives are required at all levels of the healthcare system to adequately address service provision for Indigenous Queenslanders with lung diseases, including high quality research to investigate the causes for poor lung health, which are likely to be multifactorial. What is known about the topic? Chronic diseases, including lung disease contribute to, and influence outcomes of, the well-known health and socioeconomic disadvantage among Aboriginal and Torres Strait Islander Australians. Nationwide, the most common reason for hospitalisation of Indigenous Australians is for lung diseases (after renal dialysis). What does this paper add? There is currently no state- or nation-wide comprehensive review of chronic lung disease burden and the health services available to prevent, treat and manage lung disease. This review fills this gap in Queensland and has found that chronic lung disease burden is not homogenous. There are substantial gaps in, and barriers to, the provision of high quality, evidence based services and a paucity of well-designed research to inform policy and health service delivery. What are the implications for practitioners? Evidence-based strategies are needed at the primary, secondary and tertiary levels of the healthcare system. Fourteen recommendations relevant to practitioners and policy makers were formulated.

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