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Chronic disease care in remote Aboriginal Australia has been transformed

BMJ 2013; 347 doi: (Published 18 October 2013) Cite this as: BMJ 2013;347:f6127
  1. Wendy E Hoy, professor of medicine, Centre for Chronic Disease, School of Medicine, University of Queensland, Brisbane, Australia
  1. w.hoy{at}

Programmes to recognise and manage the prevalence of chronic disease represent a sea change in healthcare for Indigenous Australians, writes Wendy Hoy

Since the late 1980s chronic non-communicable disease (hypertension, type 2 diabetes, kidney disease, cardiovascular disease, and chronic lung disease) has appeared among Aboriginal people living in remote areas of Australia in proportions sometimes described as “epidemic.”1 Transitional and minority populations worldwide are experiencing the same phenomenon, said to represent the major global health challenge of the 21st century.

In Aborigines, these conditions have arisen because of rapid changes in epidemiology and health services. Sharp reductions in infant and childhood deaths in the past 45 years mean more Aboriginal people are surviving to adult life2 and adult life expectancy has, more recently, also been increasing as preventable and treatable problems such as infections and malnutrition are mitigated. Regrettably, a background of pervasive disadvantage persists, characterised by poverty, poor diet, lack of exercise, poor housing, poor education, lack of training and employment opportunities, along with high rates of cigarette smoking, and misuse of alcohol and other substances.

However, awareness and management of these chronic diseases in Aboriginal people in remote areas have been transformed since the late 1990s. This is not so easily seen in less remote areas where determination of Aboriginal status is sometimes uncertain, health …

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