Rheumatic Heart Disease Naidoc 2021

Time to ‘Heal Country’ and End Rheumatic Heart Disease

Talking Rheumatic Heart Disease - the greatest cause of disparity in cardiovascular health between First Nations people and non-Indigenous people in Australia

7 July 2021

To mark NAIDOC Week, the Victor Chang Cardiac Research Institute spoke with Western Australian Cardiovascular Research Alliance (WACRA) board member Dr Lee Nedkoff about rheumatic heart disease – a disease First Nations peoples are committed to defeating alongside health professionals, infectious disease specialists and community leaders.

This year’s NAIDOC week theme, Heal Country, calls on all Australians to embrace Aboriginal and Torres Strait Islander people’s culture and heritage. It also calls for greater management, involvement, and empowerment of First Nation’s peoples – a plea that is central to the mission of researchers Associate Professor Judith Katzenellenbogen, Dr Lee Nedkoff and colleagues.

Over the past three years, this team of researchers has studied the incidence of rheumatic heart disease (RHD), which can cause atrial fibrillation, heart failure, stroke, death, and disability. The auto-immune disease is a result of a throat or skin infection caused by Strep A bacteria and can be prevented if the original infection is treated with antibiotics.

In research from the End RHD in Australia: Study of Epidemiology (ERASE) project, published in the Journal of the American Heart Association, they discovered:

Aboriginal and Torres Strait Islander peoples aged under 45 years old are 64 times more likely to suffer from RHD than non-Aboriginal people in Australia.

This disproportionate burden of disease means that RHD is the greatest cause of disparity in cardiovascular health between Aboriginal and Torres Strait Islander and non-Indigenous people in Australia.

Dr Nedkoff says it was essential to document the true extent of RHD in Australia to provide the Federal Government with accurate data on the RHD burden.

“Our work involved bringing together data from all over the country. Health data in Australia is often fragmented so it took two years to gather all the data from health authorities from different states,” says Dr Nedkoff.

Why is rheumatic heart disease so prevalent in Aboriginal communities?

There there are several reasons why RHD is so prevalent in Aboriginal communities, including poor environmental conditions - particularly in remote areas, inadequate housing, underdiagnosis of acute rheumatic fever, and access to primary healthcare and resources.

Overcoming these challenges will require systemic change according to fellow WA researcher Dr Emma Haynes. Dr Hayes says: “Indigenous strengths, knowledges and worldviews need to be integrated into the way RHD, and health generally, is approached.

“We need to harness these strengths to build towards solutions to these health challenges.”

Solutions to eliminate RHD in Australia by 2031 have been laid out in a blueprint called the RHD Endgame strategy, which was five years in the making.

Associate Professor Katzenellenbogen adds: “Health specialists and health organisations, including the National Aboriginal Community Controlled Health Organisation, have all worked tirelessly to deliver this Endgame strategy. There is clear evidence for a new approach with a focus on healthcare, housing and environmental health initiatives led by Aboriginal and Torres Strait Islander peoples.

“Our research was just one of the pillars that will bring the end of RHD to fruition. We also need funding and political priorities to recognise how indefensible the current gulf is between Aboriginal and non-Aboriginal Australians when it comes to rheumatic heart disease.”

The Victor Chang Cardiac Research Institute's Professor Livia Hool, who is chair of the Western Australian Cardiovascular Research Alliance (WACRA), adds: “The END RHD coalition is a fantastic example of a partnership working across research disciplines and with communities, and is one WACRA is proud to support and highlight.”

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Acknowledgement of Country

The Victor Chang Cardiac Research Institute acknowledges Traditional Owners of Country throughout Australia and recognises the continuing connection to lands, waters and communities. We pay our respect to Aboriginal and Torres Strait Islander cultures; and to Elders past and present.

Victor Chang Cardiac Research Institute - The Home of Heart Research for 30 Years