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stewartm0205 t1_ix5jtpm wrote

You have to get follow up care. If you don’t there is a good chance you will die.


ihateusednames t1_ix6d34m wrote

Question is then what's keeping them from getting follow-up care.

Socioeconomic factors? Medical system abuse / lack of trust?


candlesandfish t1_ix6kgsk wrote

A bit of all of those, and distance. Aboriginal communities tend to be a long way from the cities where the hospitals are, and it makes follow up hard. This is improving with things like dialysis clinics in the communities or a hub local to a few communities, because kidney disease is very prevalent in the indigenous population.

It’s also likely that they miss out on preventative medicine before they end up in the ICU too, again due to distance/mistrust so the condition is likely to be more severe than if it was caught earlier.


ihateusednames t1_ix78hme wrote

Great bit about the distance, so lack of infrastructure as well. I wasn't satisfied with what I had suggested so I do appreciate your thoughts into this.

Found a pretty good journal article about it pretty easily they seem to think it's about distance as well

Aboriginal and non-aboriginal people had similar 365-day rates going to the same long-distance hospitals. Conclusion: They need better hospitals.


sonyka t1_ix7m3gj wrote

Exactly, all signs to point to indigenous communities needing more local healthcare providers/facilities than they've got. Not an expert but I'm gonna go out on a limb and guess their HCPs-per-mile rate is a lot lower than in non-indigenous areas. Per the link they're coming sicker and younger than non-indigenous patients. Apparently follow up care compliance isn't great. Add in a cultural reluctance to travel… it almost explains itself. If they don't have clinics within their radius they don't go.

What to do? Maybe a program to incentivize HCPs to set up shop in or near rural areas (the US does this; it helps… some). Even better, one to assist/encourage more indigenous community members to become HCPs.


ihateusednames t1_ix7n4io wrote

Encouraging growth of HCPs in indigenous communities is an interesting idea, might take some time to pull off because they are far from other forms of infrastructure there is also the issue of medical education.

I completely understand why follow-up care compliance is low, I'd have a difficult time arranging that much travel / time spent doing this and I have a flexible schedule + a working car / efficient highway system.

First step is convincing people that this is an "everyone" problem.


IAMCRUNT t1_ixa19ar wrote

The reason that state governments pour money into development in capital cities and deny applications for commercial developments in country towns is because there is more instant profit to be made for their mates. This not only leaves people outside capital cities with less opportunities, low population growth and attracts less medical professionals, it also makes city living unaffordable for healthcare workers. It is lose lose for all the people they are supposed to represent except for the money..


yoda_jedi_council t1_ix8u7sz wrote

> kidney disease is prevalent in indigenous population.

Now I'm curious.


stewartm0205 t1_ixb3zgs wrote

I would guess dietary and lack of preventative care. Too much salt and starch. And no regular blood pressure and blood sugar check.


wotmate t1_ix7z0j4 wrote

>While the risk of death a year after their admission was similar for Indigenous and non-Indigenous patients, the researchers say the risk became higher for Indigenous people once factors including age, illness severity, socio-economic status and remoteness were taken into account.


chesterbennediction t1_ix8b22k wrote

Physical distance probably.


swiftcleaner t1_ixfipj9 wrote

I don’t know if I interpreted your comment wrong but what do you mean by physical distance. Like, indigenous people are very common throughout cities and all over the world, they usually just fall under the latino community.


chesterbennediction t1_ixg36i8 wrote

in Australia half of the people that live in very remote areas and 18 percent in semi remote areas are aboriginal which is high considering they only make up 3 percent of the total population. this means that many aboriginals live in remote areas and are less likely to follow up with healthcare needs since the hospital is further away or has less specialized resources.


Debbiesatramp t1_ix6dj1x wrote

Considering how racist Australians are, probably bad treatment. These studies replicate themselves all over the West. People of colour die or receive far more negative consequences from hospital stays because of racism


JJisTheDarkOne t1_ix6kucr wrote

Not true at all. Our health system doesn't discriminate. Actually, it does. It does in the way that Aboriginal People have their own specific health system on top of the normal public system.

Apart from that straight up discrimination based on race, the health system treats everyone the same, regardless of race.

Most of the Aboriginal health problems are caused directly because of Aboriginal people causing the issues themselves.


VVllCCAA t1_ix6yq6a wrote

You're having a laugh mate if you think level of care doesn't differ depending on a variety of factors, whether that be race, gender etc. Even if it's not an actively conscious bias, there's still unconscious bias at play in everyone's day to day life


Debbiesatramp t1_ix79emy wrote

A lot of white people just cannot stand when you point out institutional racism and unconscious bias. Rather than humble themselves and listen, they cover their ears and scream, IT’S NOT TRUE! WHITE PEOPLE ARE NOT RACIST! The ego and superiority complex behind it all!

It’s very funny that this is the science sub and it is full of emotionally immature people refusing to follow basic scientific principles of logic and rationality.


KarizmuH t1_ix7qk72 wrote

I would say based on your logic and generalization you sound racist yourself. That's some real unconscious bias there eh. Some scientist you must be.


dr_Octag0n t1_ix7tlfw wrote

Isn't making broad generalisation based on skin color rasist?


Haquestions4 t1_ix7ex02 wrote

TIL that Australians are white.


hiddenstar13 t1_ix7k20x wrote

… yes? Is this is a real TIL or a sarcastic one? I believe white people are a majority in Australia.


ihateusednames t1_ix78198 wrote

It might not directly. I can't get too much into it without getting anecdotal / sifting through databases but even the best medical systems in the world discriminate, it's kind just something people do. Even if they addressed race, you could go to a hundred trainings to not discriminate against aboriginal people, unless the program had a wide scope you might see someone obviously poor walk into the ER in pain and be more inclined to mark them down as drug-seeking.

That doesn't even get into what r/candlesandfish brought up, you could consider not building enough capable hospitals in areas where aboriginals tend to live a form of discrimination.

Discrimination by race is craftier than a sign painted "No Aboriginals", very often it is subconscious, and even if there is a special health system designed to bridge the gap (happy they're trying at least) without infrastructure and funding to back it up it's a band-aid solution.


Frontrunner453 t1_ix7nd9v wrote

>Most of the Aboriginal health problems are caused directly because of Aboriginal people causing the issues themselves

Couldn't even wait a full paragraph before saying something racist, eh?


dr_Octag0n t1_ix8emmk wrote

Alcohol abuse is a huge problem facing many indigenous Australians. Depression and self harm behaviours also play a huge role. The number one cause of death for indigenous Australians aged 5 to 17 is suicide according to this report. A very sad state of affairs.


Frontrunner453 t1_ix9kwnk wrote

Sure is! Deaths of despair, which all of these fit into, are also very common in marginalized communities in the US, and I'd wager around the world, and none of them are solely due to individual choices.


dr_Octag0n t1_ix9l5hj wrote

More due to lack of choices in many cases.


JJisTheDarkOne t1_ixamfs6 wrote

What one of the major issues here is: It's a generational issue.

Aboriginals abusing drugs and alcohol, not caring about the environment where they live. No pride in anything etc. Then they have kids.

The kids are left to their own devices and end up running amok. Since the parents aren't looking after them and guiding them in life they hang around, get into trouble and ultimately end up abusing drugs or alcohol and acting the same way their parents did... and the circle completes and continues on.

It doesn't matter what I say, people are going to just pull the "racist card" on me. It's not all Aboriginals, and it's a higher percentage than any other ethnic group. The ones why break that cycle are normal people just like everyone else.


dr_Octag0n t1_ixbyahz wrote

You are totally right unfortunately. I was trying to give the individual who called someone rasist more information. Online, knee-jerk reactions are all to common. The individual calling someone out is an American and unfortunately many individuals there equate criticism with racism. I've seen groups of aboriginal kids at servos sniffing petrol at Moree. Many under the age of 10.


JJisTheDarkOne t1_ixalv66 wrote

It's not racist to call out things exactly as they are. Just because you personally get upset over it doesn't mean it's racist.

If you want to forgo pulling out the "racist card" and want some debate and facts on the situation then I'm happy to discuss.


mini_z t1_ix6gwci wrote

The general average life expectancy of indigenous Australian’s is unfortunately lower due to higher genetic predispositions to chronic conditions such as heart disease and diabetes. So I think it might be a combination of different aspects, awareness of follow up care necessity (maybe this is an area worth improving), living in remote communities (lower access to health care), genetic predispositions and potentially lifestyle factors


Hemingwavy t1_ix7pnep wrote

Also indigenous people are the most incarcerated minority on earth, 1/6 indigenous men above the are of 14 has alcohol dependancy, a greater proportion of indigenous Australians live rurally which reduces life expendancy.


stewartm0205 t1_ixb4uqi wrote

Not used to the amount of salt and calories in the modern diet. Take salt for instance. After thousands of years living in a low salt environment, they evolved a strong desire for it couple with it having an enhanced effect on them.


jimb2 t1_ix6zs8l wrote

They are also likely to have worse health before the intervention, for many reasons. A big one is that they typically don't have the same culture of health maximisation that is common in the white middle-class. It's a tough problem.


stewartm0205 t1_ixbiq9f wrote

They never needed to. Modern living is dangerous to them.


TwelveUggaDuggas t1_ix7pghi wrote

Turboing unleaded has a few adverse side effects too haha


Strazdas1 t1_ixd5fqa wrote

the indigenouse australians didnt run unleaded cars though.


DrSeuss19 t1_ix6ftpu wrote

Because they don’t follow up, their medical pre dispositions, and they often underestimate the importance of what they’re being told. I work in medicine and this is a related issue with indigenous people I see.


BigCyanDinosaur t1_ix7i4tk wrote

Culture and upbringing has a lot to do with it too, when you've heard your entire life that all non-aboriginals hate you or want you dead, then you start to believe it and distrust any non aboriginal teachings which includes "western" medicine and Healthcare. Same happens in the US with aboriginals and black people, and I'm sure any country that has a currently or previously oppressed minority has the same problem.


itspodly t1_ix7nxhb wrote

To be fair in australia it was only 40-50 years ago that authorities were stealing children off aboriginal communities and giving them to white families as a matter of governmental "assimilation".


Strazdas1 t1_ixd5ksq wrote

Yes. A lot of "Racism" and "dicriminations" problems arent actually racism, but cultural problems.


rampas_inhumanas t1_ix5u0kr wrote

If the conditions they live in are similar to a lot of the reserves in Canada (I imagine they are, same brand of long-standing racism), then there’s your problem.


Digital_Wampum t1_ix5ugjz wrote

Yep, and when most communities are fly in and there's one doctor things like weather and mother nature don't always go to our wishes or plans.


BigCyanDinosaur t1_ix7i77k wrote

Most communities aren't fly in only Canada, and tend to be close to other population centres. Source: did their banking.


candlesandfish t1_ix9n3nc wrote

In Australia they are the opposite. Fly in only and a long way from anything.


Digital_Wampum t1_ix7swv5 wrote

I do books for a fly in doctor.

Thats not the point.

Thanks for contributing.


BigCyanDinosaur t1_ix7zou9 wrote

"When most communities are fly ins" - You

Yes that seems to indeed be the point.


dogecoin_pleasures t1_ix5w2ve wrote

A key factor in this (that might be a difference between Australian and Canadian indigenous) is that it goes against Aboriginal culture to leave one's own land and go into the land of a different first nation. This makes flying to an ICU located in a different city culturally traumatic.


hidden-shadow t1_ix73imb wrote

Around 80% of Aboriginal and Torres Strait Islanders live in urban areas (i.e. connected to local medical services). Not all aboriginal cultures (or people) share this belief, nor do a significant number of aboriginals have the actual knowledge of their culture as a ramification of the Stolen Generations.


dogecoin_pleasures t1_ix75wr9 wrote

For urban indigenous populations, distrust of authorities and therefore unwillingness for follow up care is probably a bigger factor, as well as healthcare bureaucracy being harder to navigate for those who aren't a part of the dominant culture (white, middle class).


hidden-shadow t1_ix76d7l wrote

My point being, I don't think there is any evidence to suggest the issue of crossing borders is a key factor whatsoever. I suggest that the distrust surrounding government associated programs is far more relevant.


dogecoin_pleasures t1_ix771hs wrote

I did a bit of work in the area of aboriginal healthcare and border crossings between nations did come up as an issue as a way in which western healthcare was insensitive to indigenous needs. It probably doesn't affect the most assimilated but might screw regional mortality rates


hidden-shadow t1_ix78bgf wrote

Perhaps, but to call it a key factor in a trend discussing Aboriginal peoples across the country is hard to justify.


Wigglepus t1_ix9s80c wrote

Is there research that shows markedly different health outcomes for Aboriginal people living in urban areas vs those living in rural areas? Are these trends markedly different for Aboriginal people than for the general population?

I don't know anything about Australian health care but in most places rural people tend to have worse health outcomes due to limited access to care. So we should expect to see worse outcomes for rural Aboriginal population as well. However, if boarder crossing is a significant issue health outcomes should be disproportionately worse for rural Aboriginal people vs urban Aboriginal people when compared to the overall urban/rural populations. I.e. difference in outcomes for urban Aboriginal Australian and rural Aboriginal Australian is greater than difference in outcomes for urban non-Aboriginal Australian and rural non-Aboriginal Australian.


hidden-shadow t1_ixlcnij wrote

Yes, though the remoteness itself is only one factor in the gap. And it is drastically different to the non-Indigenous population. Difference in life expectancy between the two groups is ~8 years but widens in remote to very remote regions to ~14 years. Almost no decrease in non-Indigenous life expectancy across various levels of remoteness.

The 'very remote' indigenous populations tend to 'live on land', in isolated communities separate from the general population. So unlike in urban and regional areas, where facilities are readily available, it often requires even further travel to return to urban hubs for treatment.

So the difference is not a positive indication that crossing cultural borders is a key factor. Whereas historic distrust of government services is well documented.


theweightoflostlove t1_ix5ys9k wrote

I agree with you, but if you’re requiring ICU care at the risk of imminent death you’re probably going to make an exception or likely tubed and sedated.

Healthcare facilities, especially in large capital cities feel sterile (pardon the pun) have little indigenous art or design in recognition of indigenous culture to provide First Nations people a little comfort.

Then there’s the challenge of access to pharmacy, follow up appointments, cost and relatively poor health literacy.


vicious_snek t1_ix7cpuj wrote

And when they do have art, its the fake* new dot stuff, not the true stuff. Not that they could have a lot of the true stuff, because its secret. Hence the dots, what happened was the western desert nation (IIRC) was doing art with an anthropologist or sociologist in the 70s, and invented the dots to hide the actual painting from him and white viewers. It's not ancient, and it's not the history for any of the other nations

You'll find some aboriginal folks with some very strong anti dot art opinions, and it wouldn't provide them with all that much comfort.


ScrunchieEnthusiast t1_ix679jm wrote

I’m not indigenous, but this is not the case in Canada. Moving from place to place is par for the course in my province.


BetterLivingThru t1_ix6a151 wrote

I'm a Canadian who is familiar with many of our first nations and has read much professional anthropological literature about Australian Aboriginal people, so I feel I can comment on this. While both types of groups are connected to their land, Australian Aboriginal mythological relation to the land is way more intense. I imagine separation is way more traumatic, whereas for Canadian First Nations, it's more about separation from the community itself, then specifically about the land, and personal connection to the stories about the land, which are often "owned" by specific individuals in Australia and closely kept.


crazyjkass t1_ix6vgxg wrote

Indigenous peoples of North America moved around a lot and were really economically, technologically, and socially sophisticated. Pretty much every tribal nation is less than 300 years old and is descended from people from a totally different region. But the aboriginal Australians believe their ancestors lived on the exact same piece of land continuously for 40,000 years with no change in lifestyle or culture. It was punishable by death (spearing) to trespass on another tribes land unless you can prove you're not a trespasser by singing the songline that tells the story of your ancestor totem passing through the country in the dreamtime. They're fundamentally opposed to humans taking advantage of natural resources and building things because people grow out of the land like plants. People migrating is like uprooting a tree.

From the perspective of an American/Canadian, the things aboriginal Australians say about their own culture sounds like the racist myths told in North America about the natives. They also have the one drop rule in Australia, but they get mad if you call it that.


CinnamonBlue t1_ix7noyv wrote

It sounds cruel to inflict Western Medicine on these people. They have their own medicine that has served them for thousands of years. Wouldn’t it be kinder to help them revive/use that instead?


dogecoin_pleasures t1_ix7peoo wrote

The valorisation of traditional medicine has positive cultural benefits but, unfortunately, had some unintended effects of vaccine hesitation. So I think the challenge is combining the two in a way that bests serves peoples needs


Strazdas1 t1_ixd5py2 wrote

Refusing to live like civilized people in self-imposed reserves hardly the fault if anyone but themselves.


The_Salami_Arms t1_ix6h9wz wrote

Having grown up and worked In the communities up north it doesn’t surprise me at all. The article is click bait however it does highlight the disparity in education, and living standards in our rural communities. Remember working in the NT and hearing about a young girl (f23) in the community who died because she stopped going to her dialysis treatments. IMO education and location play a massive part in this… most places are isolated.


ImReflexess t1_ix6274r wrote

Correlation /= causation?? Is it really their ethnicity causing it or something else?


triciann t1_ix6j7ig wrote

I would imagine it’s more related to their reason for being admitted to the ICU. Probably something like they don’t seek help from a hospital unless it’s really bad


marcblank t1_ix6pg6s wrote

This. It’s likely they come in sicker. And then don’t get follow up care.


Pechumes t1_ix9xx93 wrote

Agreed. I HATE studies like this that make it seem like it’s their race/ethnicity that’s the factor, and not other things at play.


biebiedoep t1_ix61bvn wrote

They're also less likely to survive after not having an ICU admission. This is the most pointless research ever.


triciann t1_ix6lazg wrote

It’s not pointless. Both of these things seem to point to them being less likely to obtain medical help sooner rather than later. It can help to direct the government to find out why they aren’t seeking the care they need so they can help get them it.


TwelveUggaDuggas t1_ix7pv7h wrote

I'm sure a lower rate of seeking help is a factor but surely poorer health across the board also effect this poorer progrnosis? That's something you'd expect to show up in people of lower socio-economic background regardless of race.


potatoaster t1_ix76875 wrote

"It is likely that the difference is less directly attributable to the ICU admission than to a complex interplay between pre- and post-hospitalisation factors, socio-economic disadvantage, remoteness, and chronic disease trajectory. Primary and public health interventions for preventing and managing chronic disease could reduce the incidence of early death... Possible explanations include more rapid disease progression and restricted access to pre- and post-ICU care in public and primary health care."


choomtown t1_ix7fufw wrote

most indigenous people i know have had terrible experiences and treatment from healthcare providers - often in the form of their pain not being believed, being distrusted, being assumed to be there to be lying to get medicine, and being treated like test subjects or animals rather than humans. I know plenty who straight up refuse to go because their health problems are easier to deal with than the condescending and sometimes prison like treatment they receive.

add that to affordability, isolation, as very, very significant factors. if you were treated like a bug or thief each time you went to a doctor, would you keep going?


swiftcleaner t1_ixfj2yw wrote

I’m a bit surprised by the amount of people who deny that there is a racial prejudice going on. It’s subtle, like when your doctor immediately denies your blatant pain, but those tiny things add up, and it becomes generational, where indigenous people don’t trust their doctors. I’m sure it’s way more factors obviously, but it is definitely one.


argmax t1_ix71rws wrote

Admitted to ICU for what?


pregnantsmoker t1_ix77cef wrote

Are indigenous people going to the ICU at an older age? Are they more likely to suffer from alcoholism or smoking? Do they go different ICUs than white Australians? Do the white Australians go to the same ICUs as indigenous people also have poor recovery outcomes?


SenorBeef t1_ix7c29q wrote

Could it be that access to hospitals is harder for them, so they only admit themselves when things are more serious than average (and therefore more likely to be fatal later)? Seems like a ton of confounds here.


svefnugr t1_ix7drwa wrote

I wouldn't be surprised if any Aboriginal is more likely to die the next year, regardless of visiting the ICU.


kingp43x t1_ix8pbjq wrote

Is it only bots that post content to this sub? wagamaga bot has 10 million karma, this one has over 4 million, and the others are up to nearly half a million. The bots post the article and the initial comment.


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AEternal1 t1_ix7wcgu wrote

Can an Australian chime in and answer this: is the cost for an aboriginal to go to college a barrier to entry? Im assuming their target clientel would be poor, so would that even be economically feasible to begin with? ................. Otherwise, it looks like capitalism wont solve it, and if humans were inclined towards altruism this wouldnt be a problem in the first place. .............. It seems like they are too far removed both socially and physically to meaningfully contribute to nearby metropolises, so why would taxing those citizens to pay for aboriginal care inspire those citizens to vote for those politicians? ( we've already covered that people arent altruistic by nature ) in america at least, we dont take care of homeless problems until it annoys the wealthy enough for them to clear up the eye sore. Out of sight, out of mind. So, what would be the most likely way to successfully tackle this problem?


carcinoma_kid t1_ix8m3gv wrote

How does that compare with indigenous people who have not been to the ICU?


Big-Mathematician540 t1_ix8qnor wrote

Just all indigenous people, or just Australian?

The research is Australian so I assume the latter, but...


KingVargeras t1_ix9g0l9 wrote

So this makes sense. I went and worked at a hospital on a reservation in the states for awhile. And I will tell you it was one of the most obese populations I’ve ever worked on very unhealthy even the children were unhealthy didn’t exercise and overall health in the community was very poor. The months I was there I saw less skinny natives then I have fingers. They admitted to me there was a lot of genetic issues also because of in-breading. It was honestly very sad. They had all this beautiful land and their elders wouldn’t approve improvements and kept all the young held hostage to progress.


swiftcleaner t1_ixfjio2 wrote

I’m confused by the people who equate “Indigenous” with “reservations.” I don’t know if the study is specifically saying “indigenous people from reservations,” but there are millions of indigenous people living normal everyday, modern lives in major cities in the US.


Grai0black t1_ix9hhwh wrote

I am indigenous to my country and am doing pretty good compared to newcomers


Pechumes t1_ix9xqnb wrote

Why are articles/studies like this focused on RACE, and implying that their race is the factor for them having higher mortality?? I’ve seen a lot with Covid as well, people saying race has something to do with it vs other factors.


xeneks t1_ix67bby wrote

This is heartbreaking.


ThickD_4_thickThighs t1_ix75rlr wrote

A settler colonial society’s healthcare system has worse outcomes for indigenous people? Pikachu is flabbergasted.


noogai131 t1_ix7lly9 wrote

I'm sorry, is the purely indigenous societal based healthcare system miraculously better than modern technology?


ThickD_4_thickThighs t1_ix88gsu wrote

Are we comparing indigenous healthcare in 1780s to European healthcare in 1780s when life expectancy in UK was 39 years?

We don’t know what outcome were for the indigenous because someone killed most of them before we could ask.

The fact you assume the subpar healthcare of “modern technology”(read: settler-colonial) is better with no evidence is what [insert your favorite adjective]-supremacist looks like.

A society run on that way of thinking is exactly why indigenous peoples have worse outcomes.


noogai131 t1_ix88phy wrote

That's a lot of babble for what essentially amounts to calling me a racist, failing to elaborate on what an alternative system of healthcare without "settler colonial" technology would look like, and leaving. Gigachad move, but you still look more stupid than I do, and that's saying something.


Pechumes t1_ix9y2xj wrote

Is it due to their ethnicity, or other factors like “distance from hospital and other healthcare facilities”?


ThickD_4_thickThighs t1_ixa7gp5 wrote

Paper adjusts for > age, admission diagnosis, illness severity, hospital type, jurisdiction, remoteness and socio-economic status


spudkensington t1_ix5rfql wrote

Well this is the most obvious thing I've ever read in r/science


[deleted] t1_ix687wh wrote



spidersnake t1_ix69mfg wrote

Why did you bring this up on a study about indigenous people of another nation?


kickbut101 t1_ix6clpr wrote

Because they read and interpreted what they wanted out of the title instead of actually reading it.


PMzyox t1_ix5vv79 wrote

Damn foreigners, coming in here taking all the good healthcares