Indigenous Populations Review: Brazilian vs Australian Indigenous Health States in local communities

The diet of indigenous Australians has changed since the 1800’s with a shift that has happened more recently in the mid 20-th century. Originally indigenous traditional diets consisted of fish, insects, plants and non-domesticated animals, a diet seen to protect from the indigenous from disease (Brimblecombe et al. 2014). A healthy mix of proteins, good fats and fibre were consumed, today we are seeing high intake of salt, fat and sugars, flour and sugar being the main staple due to social disadvantages, this diet is now being linked to diseases such as kidney failure, type 2 Diabetes and vascular disease (Brimblecombe et al. 2014).

 

There is a divide that still exists between the health of indigenous Australians and non-aboriginal Australians (Keast 2015, p.18). Indigenous Australians have poorer health outcomes and at a younger age than those that are of non-aboriginal background, there is increased risk of chronic diseases and mental health conditions that are associated with disability, alcohol and drug use (Keast 2015, p.18).

Closing the gap reports show only a minor improvement in health and education within indigenous Australian groups, the report showed increased mortality rates for Aboriginals due to the lack of funds and resources for primary healthcare, the campaign concluded that the only way to improve health equality would be   continued investment surrounding health in all aspects including mental health, emotional wellbeing and health as a whole (Keast 2015, p.19).

Budget cuts have a lot to do with programs being adhered to and without engagement from the community and representative organisations the programs can be seen to fail just weeks after they are initiated (Keast 2015, p .19).

 

 

Case studies within Brazil showed their indigenous people suffering more from morbidity and mortality rates than the rest of the population (Coimbra 2013, p.52).  A national survey was conducted in 2008-2009 to obtain information regarding the characterization of nutritional status in indigenous women and children from all four major regions of Brazil (Coimbra 2013, p.52). Clinical measurements, interviews and data were collected regarding nutritional status, prevalence of disease such as hypertension & diabetes (Coimbra 2013, p. 52). Access to health services, programs and general characteristics of diet and economic status were also considered (Coimbra 2013, p. 52).

 

 

 

113 villages were studied which included over 5000 Brazilian households.

Obesity was the common thread with lower socioeconomic status in the North when compared to other regions (Coimbra 2013, p. 52).  Obesity was seen to be near 20% for the overall study with 15% of those having hypertension and a shocking 40% of people presenting with anaemia across the board (Coimbra 2013, p. 52). Disparities in health concluded to basic healthcare and sanitation services not being as widely available within Brazils indigenous communities as they are with the rest of the population as well as socioeconomic status and financial struggle (Coimbra 2013, p. 52).

 

With Brazils ongoing changes in the public health profile and increasing rates of malnutrition and obesity amongst indigenous Brazilians, a nutritional program was put in place in 2013 (Da Silva 2013, p.1200).  The program ran for 28 weeks involving 238 Indigenous patients (Da Silva 2013, p.1200). Patients participated in activities involving nutrition education included was a seminar for 50 minutes once a week and physical activity of 1 hour, 2 times per week (Da Silva 2013, p.1200). Changes were recorded using body mass index, the effect then evaluated using models to generally estimate basic body changes throughout the participants (Da Silva 2013, p.1200).

It was seen among the obese patients a reduction in BMI of 64% among the group had made at least a 3% improvement. 26% improved their nutritional intake, with most increasing their physical activity. Three physical fitness tests showed significant improvements in performance (Da Silva 2013, p.1200).

 

The intervention program for indigenous Brazilians was seen to be successful having an effect on those who were overweight, with a significant improvement in nutritional status and physical fitness overall (Da Silva 2013, p.1200).

 

A healthy lifestyle program began in 1993 named the Looma healthy lifestyle program amongst Indigenous Australians from WA (Monash University 2015). The program was put in place due to the fact that 42% of adults were overweight or obese, 25% had diabetes (Monash University 2015). The program was originally targeted to those with diabetes but later the program was extended to the whole community. Food education, cooking classes and food shopping to teach healthier eating habits, traditional cooking practices, education surrounding diabetes and regular exercise and hunting groups were introduced (Monash University 2015).

The aim of the program was to reduce CVD disease risk by educating indigenous groups about the importance of increasing fruit and vegetable consumption and the reduction of saturated fats (Monash University 2015). Activities included informal education sessions to increase the awareness of diabetes, sport and walking groups which included hunting trips, the promotion of traditional cooking methods such as cooking on an open fire and cooking classes to promote healthy eating (Monash University 2015).

 

After four years the evaluation proved to have succeeded with the reduction of cardiovascular risk factors, but there was little to no change in those with diabetes or obesity (Monash University 2015). In 1997 the program extended to encourage and promote health to children. School breakfast programs were introduced and changes to what was sold in the school canteen were seen. Weekly education classes on health were also implemented (Monash University 2015).

While the Looma healthy lifestyle program is a part of the WA country service for health and the school breakfast program still runs from a collaborative effort with Foodbank WA. Health assessments of Looma were recorded in 2009 showing there was no increase in the incidence of diabetes since 2003 and BMI ranges within the community also were remaining stable. In addition 84% of children were in a stable weight range compared to the 77% in the broader Australian community (Monash University 2015). The Looma program proved to be successful in that its aim to target all age ranges from children to adults in particular who were at risk of obesity and diabetes worked and there was a general improvement in health overall.

 

 

Traditionally Aboriginals had the skills and means to access and hunt for the food they needed (Brimblecombe et al. 2014).  Barriers to health were found to be similar in both Australian indigenous groups and Brazilian. Participants to the programs both had low incomes and financial security, making the contemporary diet out of reach for most which was the number one thing contributing to their health. With priorities for money not being food foremost, more-so money for phone credit, basic household items, and within most groups, elicit substances (Brimblecombe et al. 2014).

Participants agreed that long life foods were cheaper and sustained their stomachs and cupboards greater than the healthier options. With Flour and sugar the cheaper option for such communities this is seen as a barrier toward their long-term health, with education being the key enabler to real change here (Brimblecombe et al. 2014).

 

To compare and contrast Australian indigenous groups versus Brazilian indigenous groups there was a major disconnect within the community understanding of the native background of Aboriginals in terms of the ways they find, hunt and gather foods and its social importance. While the program coordinators seemed to be aware of the background and traditional heritage, more consideration was needed when implementing the programs to factor this in.  Whereas Brazilian groups were more accepting of change as it wasn’t imbedded socially as deeply as with Australian Indigenous.

 

 

In conclusion it is apparent that for indigenous health programs to work a number of factors are involved, government funding, community participation, awareness, financial freedom, education from an early age, to name a few. Not one factor would fix the health concerns of our indigenous people today, all factors need to be considered, respected and thought about in order for a program to truly succeed.

 

References

 

Australian Indigenous Health Info Net, 2015, Looma Healthy Lifestyle Program, viewed 10th October 2015, http://www.healthinfonet.ecu.edu.au/key-resources/programs-projects?pid=614

 

Australian Institute of Health and Welfare, 2015, What works to overcome Indigenous disadvantage, viewed 13th October 2015, www.aihw.gov.au/closingthegap/what-works/

 

Brimblecombe, J, Maypilma, E, Colles, S, Scarlett, M, Garnggulkpuy, D, Ritchie, J, O’Dea, K, 2014, ‘Factors Influencing Food Choice in an Australian Aboriginal Community’, Qualitative Health Research, Vol. 24(3), pp. 387-400

 

Coimbra, C, Santos, R, Welch, J, Cardoso, A, De Souza, M, Garnelo, L, Rassi, E, Foller, M, Horta, B, 2013, ‘The First National Survey of Indigenous People’s health and Nutrition in Brazil, rationale, methodology and overview of results’, BMC Public Health, vol. 13, p. 52, viewed 27 October 2015 <www.ebscohost.com>

 

Da Silva, L, Fisberg, M, Pires, M, Nassar, S, Sottovia, C, 2013, ‘The effectiveness of physical activity and nutrition education program in the prevention of overweight in school children in Criciuma Brazil’, European Journal of Clinical Nutrition, Vol. 11, p.1200, viewed 20 October 2015 <www.ebscohost.com>

 

 

Keast, K, Dragon, N, ‘Stepping into the gap, Australian Nursing and Midwidery Journal, March 2015, vol. 22, no. 8, p. 18-22., viewed 20 October 2015, <www.ebscohost.com>