Adrian Chernyk: Health & Indigenous Australians

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Stay Safe This Thanksgiving Season

Thanksgiving is usually one of the busiest travel times each year. This year makes it more complicated. With the COVID-19 pandemic, it has altered how we approach our holidays and put a significant strain on families as they must decide to keep themselves and others safe.

The Centers for Disease Control and Prevention (CDC) recommended against traveling this Thanksgiving season. Before making the decisions to travel, they say each person should ask themselves a few important questions:

Are you or someone in your household at increased risk of getting seriously ill from COVID-19?
Are cases high at your destination?
Are hospitals in your community or destination overwhelmed or at capacity with COVID-19 patients? You can find out here.
Does the state you’re potentially traveling to have their own specific travel restrictions for visitors?
In the 14 days before your travel plans, have you or anyone around you had close contact with individuals you don’t live with?
Do you plan on traveling by bus, airplane, or a train? This makes social distancing hard. It might be something you should consider avoiding.
Are you also heading to your destination with people you don’t live with?

Read my Medium article on this topic for more insights.

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DNA, The discovery that changed science forever

The structure of deoxyribonucleic acid or DNA was discovered by James Watson and Francis Crick in 1953. This discovery changed science forever as the DNA molecule was proven to be the genetic material used in the development and functioning of all organisms. Discovering the double helical structure of DNA explained how the anti-parallel base pairing of the nucleotides allow for the copying of the genetic code that is responsible for heredity, development, and evolution- in short finally understanding the secret of life. It almost seems unimaginable how these two scientists could have made such an important and long lasting discovery that has contributed numerous additional breakthroughs in science and medicine, such as the mapping of the human genome, none of which would have been possible without Watson and Crick, who shared the Nobel prize in 1962 for their work.

My article on Medium, The Discovery of DNA, explores this achievement in more depth.

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Pain and Prejudice: Musculoskeletal Conditions and the Fight to be Validated

Lack Of Treatment For Musculoskeletal Pain Can Be An Unfair Burden

A not often discussed health burden facing Aboriginal and Torres Strait Islander Australians is musculoskeletal pain (MSP). In addition to the painful physical symptoms, many Indigenous Australians who feel unwelcome and unacknowledged by mainstream medical services feel no choice but to suffer in silence.

Statistics

Musculoskeletal pain refers to pain felt in the musculoskeletal system, such as in joints, ligaments, tendons, and muscles. Arthritis and osteoarthritis are the most common causes of MSP. Indigenous people are 1.6 times more likely to suffer from osteoarthritis than non-Indigenous people. 20% of Indigenous people suffer long-term MSP. While pain doesn’t directly shorten life expectancy, it can greatly reduce quality of life and hinder management of other conditions (such as staying active to fight high blood pressure).

Myth-busting

It is a misconception that Indigenous Australians don’t want to receive care. Their lower presentation at health facilities is more often attributed to negative experiences and associations with the staff and surroundings. Poor communication and language barriers are frequently cited as reasons for poor attendance. The attitude of medical professionals is also important. Patients do not want to seek care if they feel they are being stereotyped or stigmatized.

Alarmingly, Indigenous Australians were 2.2 times more likely to be prescribed opioids for pain by GP trainees than non-Aboriginal patients. This can be due in part to the inconvenient distance of non-opioid pain treatment, but could also be evidence of inadequate communication with patients, leading to blanket prescribing.

Why this matters

We cannot abandon the needs of Indigenous Australians simply because of language and cultural barriers. Indigenous Australians bear a huge burden of disease that needs special attention and resources to address. Left without proper medical attention, MSP will persist for Indigenous Australians, worsening many of their preexisting conditions and potentially encouraging opioid addiction.

By: Adrian Chernyk, 2020

Sources

The Conversation: Myths about musculoskeletal pain and Aboriginal Australians prevent high quality care

https://theconversation.com/myths-about-musculoskeletal-pain-and-aboriginal-australians-prevent-high-quality-care-76390

BioMed Central: The overall health and risk factor profile of Australian Aboriginal and Torres Strait Islander participants from the 45 and up study

Click to access 1471-2458-13-661.pdf

ANZ Journal of Surgery: Variation in rates of hip and knee joint replacement in Australia based on socio-economic status, geographical locality, birthplace and indigenous status https://www.ncbi.nlm.nih.gov/pubmed/21299795

Australian Journal of Rural Health: Quiet about pain: Experiences of Aboriginal people in two rural communities

https://onlinelibrary.wiley.com/doi/full/10.1111/ajr.12185

Pain Medicine: The Pattern of Opioid Management by Australian General Practice Trainees.

https://www.ncbi.nlm.nih.gov/pubmed/26118466

Written by: Adrian Chernyk

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Health of Aboriginal Mothers Neglected in the Australian Prison System

Though Aboriginal and Torres Strait Islander (ATSI) women make up only 3% of Australia’s female population, they account for over one-third of Australia’s female prison population.

80% of Indigenous female prisoners are mothers. Research released in May based on interviews with 43 Aboriginal mothers across six prisons found that the overwhelming majority of them don’t have access to culturally appropriate care for their physical and mental health.

Cause and Effect

Socioeconomic disadvantage and intergenerational trauma stemming from colonization and Australia’s former child separation policies are largely responsible for the surge in female ATSI incarcerations. Post Traumatic Stress Disorder, anxiety disorders, depressive disorders, psychotic disorders, and substance abuse are widespread.

Since many Indigenous mothers turn to illegal substances to cope with their trauma, they are more likely to be repeatedly incarcerated. 80% of incarcerated mothers in New South Wales were imprisoned on drug-related charges.

Mental Stressors

The interviews revealed that long distances between prison and the mothers’ homes made it difficult for families to visit. If the mother doesn’t have the money, she can’t make a phone call. Visits from their children who were taken in by the government are rare. Mothers who were taking effective medication for mental health disorders before being in prison often can’t access the same medication while incarcerated.

Poor Physical Health

Some mothers have sustained serious injuries from domestic violence, such as head pain and memory loss, making it physically difficult for them to access treatment on their own. They also reported higher instances of endometriosis, ovarian cysts, and cervical cancer.

Long-Term Strategies

Improvement to the alarming rates of Indigenous female incarceration is to keep them from entering the system in the first place. Providing culturally appropriate trauma-informed counseling, substance abuse rehabilitation, and long-term housing can be the difference between a life caught in the prison system and a life safe from it.

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Indigenous Infant Deaths Alarmingly High

New research recently published by the University of Sunshine Coast Nursing and Midwifery has found the rate of Sudden and Unexpected Death in Infants (SUDI) was more than 3.5 times higher for Indigenous Australian infants than non-Indigenous infants from 2010-2014. The Australian government’s Closing the Gap campaign had reported SUDI rates as only two times higher for Indigenous infants—far lower than reality.

Why So Different?

Indigenous Australian SUDI rates jumped because of under-identification of Indigenous status in infant death records. This is concerning because flawed statistics can lead to insufficient funding for programs aimed at Closing the Gap. Under-identification also hinders the ability to determine the genuine progress of Closing the Gap.

What’s Being Done

The government has yet to take action toward under-identification of Indigenous infants as this report was just released. Public health initiatives educating parents on safe sleep habits have proven effective in reducing instances of SUDI. Charities like Red Nose are aimed at providing educational materials and resources to parents with the goal of eradicating SUDI.

Read USC’s report here: https://onlinelibrary.wiley.com/doi/full/10.1111/1753-6405.12951

Visit Red Nose here: https://rednose.org.au/

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Good News for Indigenous Australian Health: A Summary of Progress

The annual Report Card for the Implementation Plan for the National Aboriginal and Torres Strait Islander (ATSI) Health Plan 2013-2023 was released this October. It found that 12 out of 20 health goals are on track to be met by 2023. This is good news for Indigenous Australians, who for generations have suffered poor health stemming from the traumas of colonization.

Progress Highlights: Children’s Health

As of December 31, 2018, 97% of ATSI 5-year-olds were fully immunized. The goal for 88% of ATSI 1-year-olds to be fully immunized by 2023 is on track.

All three goals in the maternal health and parenting domain are on track to be achieved by 2023. Although the target to decrease child mortality by 50% was not on track as of 2017, this will likely help the child morality gap begin to close.

Where We’re Behind: Preventive Checks and Screenings

The goals relating to health checks and screenings are not on track. However, the health check usage rate across all age groups increased to nearly 29% in 2016-17, up from 11% in 2010-2011.

The cancer mortality rate for ATSI people increased by 25% from 1998-2017, but increased usage of cancer screenings may bring about decreases in cancer mortality rates.

Thinking Positive

An opinion piece by Dr. Katie Thurber, a Research Fellow in the ATSI Health Program at Australian National University, highlighted the importance of framing health statistics positively. It is more likely to elicit a better emotional response than when statistics are framed negatively, she says. This can help Indigenous Australians be more invested in their own health—one of he biggest hurdles in ATSI engagement with medical resources.

Read the Australian Government Department of Health summary of the Report Card here:

https://www1.health.gov.au/internet/main/publishing.nsf/Content/indigenous-implementation-plan

Read the full Report Card here: https://www1.health.gov.au/internet/main/publishing.nsf/Content/AC51639D3C8CD4ECCA257E8B00007AC5/$File/Report-Card-Accessibility-version.pdf

Read Dr. Katie Thurber’s op-ed here:

https://science.anu.edu.au/news-events/news/indigenous-health-and-gap-would-be-better-served-focusing-positives-not-negatives

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Hearing Loss Affecting Indigenous Australian Children

Over 6,000 Aboriginal and Torres Strait Islander (ATSI) children in Australia’s Northern Territory (NT) are at risk for hearing loss, according to the Australian Institute of Health and Welfare’s (AIHW) NT hearing health report released last week.

According to the report:

“While a number of hearing health services have been provided to Indigenous children and
young people in the Northern Territory, there are still high numbers of outstanding referrals.
At December 2018, there were 3,098 children and young people on the waiting list for
outreach audiology services and 3,918 children and young people on the waiting list for
ENT teleotology services. In 2017, there were 4,037 children and young people on the
waiting list for ENT teleotology services. A comparison of the number of referrals for ENT
teleotology between 2017 and 2018 can be found in Table S4.6.

The high number of outstanding referrals can largely be explained by a shortage of
available specialists.”

On the positive side, the numbers of youth with hearing loss decreased by 8% from 2012-2018. Although hearing loss and ear disease are still considered a public health emergency by the World Health Organization, progress is being made.

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Australia’s Assisted Dying Bill and its Ethical Concerns for Indigenous Australians

On October 14, 2019, a campaign to urge Western Australian Legislative Counselors to vote “no” on a Voluntary Assisted Dying Bill was launched. The proposed laws would give terminally ill adults living in WA who are in pain and likely have less than six months to live (or one year if they have a neurodegenerative condition) access to life-ending drugs.

The bill has reignited heated debate over the ethics of euthanasia and has raised special concerns for Aboriginal and Torres Strait Islander (ATSI) people. Some believe that offering the option of assisted suicide is not acceptable when quality of treatment for these terminal illnesses is already subpar for ATSI people.

Referencing disproportionately high cancer rates among Indigenous Australians, ENT specialist Dr. Kelvin Kong of the Aboriginal Worimi people believes the bill “jump[s] to an end-stage conversation when we haven’t got all the pathways in cancer management leading up to palliative care.” He believes the priority should be improving healthcare access to Indigenous Australians.

In a survey of 1,500 doctors, 90% wanted access to palliative care for patients concurrent with the offer of voluntary assisted dying. 79% believed a specialist in the patient’s disease should be involved in the euthanasia process.

Indigenous Senator Pat Dodson stated the bill does not consider Indigenous Australians’ conception of life and death. Aboriginal life is as much about the community as it is about the individual, he said, and an individual ending their own life ignores the emotional and cultural wellbeing of the whole community.

The Sydney Morning Herald reports, “Debate on the proposed legislation is due to commence in the Legislative Council on [October 15] and is expected to take the rest of the year before a decision is made.”

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Diabetes at Crisis Levels for Indigenous Australians

Diabetes is one of the biggest health epidemics in the Aboriginal and Torres Strait Islander (ATSI) community today. It is estimated that 3 million Australians will be affected by Type 2 diabetes by 2025. ATSI people are 3 times more likely to have Type 2 diabetes (formerly known as adult-onset diabetes) than non-ATSI people. The ATSI death rate for diabetes is 17 times higher for Indigenous Australians than for non-ATSI people.

Historical Origins

Before the European colonization of Australia, Indigenous Australians were hunter-gatherers. They were very physically active as they searched for food and resources. As colonizers seized their land, however, this lifestyle was disrupted. Many ATSI people were relocated to missions or towns where they were forced to rely on food handouts. Their level of physical activity sharply decreased.

Diabetes Today

Poverty is a major risk factor for diabetes. Often, the only affordable food has poor nutritional value. Diabetes is twice as common among those people living in remote areas. Community grocery stores can jack up prices in these areas, which can hinder efforts to make better food choices.

What can be done?

We must first recognize that ATSI people living in poverty have less time and fewer resources to make all recommended lifestyle changes to manage diabetes. If we really want to fight this epidemic, larger health initiatives must be introduced.

Preventive measures are key, as there is no cure for Type 2 diabetes once it develops. Setting simple and attainable goals such as cutting back on sugary drinks and getting lots of exercise is a good start.

Resources

Explore more diabetes statistics here:

Diabetes Australia Official Website

Diabetes information for Aboriginal and Torres Strait Islanders:

National Diabetes Services Scheme (NDSS) Official Website

National Diabetes Services Scheme (NDSS) Hotline

(+61) 1300 136 538

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Coordinating Medical Treatment for Aboriginal and Torres Strait Islander Patients

Aboriginal and Torres Strait Islanders make up 3% of Australia’s population, or just over 760,000 people. There are about 500 different Aboriginal peoples in Australia today, each with their own territory, language, customs, and beliefs. This rich diversity is what makes the Aboriginal and Torres Strait Islander culture so special—and what makes coordinating medical treatment more challenging than with non-aboriginal Australians. No two peoples are alike, and medical treatment is not one size fits all.

Nonetheless, many Indigenous people cite a lack of understanding of their culture by non-Indigenous healthcare professionals as one reason for not accessing healthcare services. One way Australia is circumventing these challenges is with the help of Aboriginal cultural liaison officers. There is also a big push for more Aboriginal and Torres Strait Islanders to enter the medical field.

Appropriate care is one of the best ways to bridge the cultural gap between Aboriginal/Torres Strait Islander patients and non-Indigenous healthcare professionals. My new article on Medium, The Value of Culturally Appropriate Care when Treating Aboriginal and Torres Strait Islander Patients, addresses this issue.

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Australia May Recognize Indigenous People in the Country’s Constitution

CNN has reported that “two years after the Australian government rejected a landmark plan to officially recognize indigenous people in the country’s Constitution, a top official said he will move forward with a national referendum on the issue.”

Australia’s Aboriginal and Torres Islander peoples have long campaigned to be formally recognized in the Constitution, according to CNN. Indigenous Affairs Minister Ken Wyatt, the first indigenous Australian to hold his position, believes it will pass, though it could take an estimated three years.

“Indigenous people continue to suffer from severe discrepancies in terms of health, education and employment outcomes compared to white Australians,” said CNN.

Read the complete article here.

A Stylometric Analysis: Writing in the Bipolar Individual

Adrian Chernyk
LED Image of brain
Photo by Tayla Jeffs on Unsplash

We can extrapolate that bipolar individuals are more emotionally reactive and sensitive to the world around them

While there is undoubtedly a link between bipolarity and the artistic temperament, this study raises more questions than answers yet is still an important step in taking this research in a new direction. In fact, highly accomplished people are probably under-diagnosed with this disease because of their extreme productivity that might mask any pathology. Since individuals suffering from general depression are often unproductive, we may wonder why bipolar individuals might be creative in a depressed state; based on our study we can extrapolate that bipolar individuals are more emotionally reactive and sensitive to the world around them. They are less inhibited and therefore more likely to take risks, not just with substances and gambling but also creative risks. They are more likely to express themselves freely. Bipolar disorder’s extreme mood changes from one end of the spectrum to the other permits the writer to possibly see a more beautiful truth in humanity and nature due to the contradictory processes always inherent in his or her thinking. Further research should compare general depression to bipolar depression to examine the reasons for this dichotomy of creative ability. The question remains: how many of our great thinkers and writers were bipolar, and if treatment had been available at the time would we be culturally and intellectually depressed today without their outstanding works? How does the answer to this reflect how aggressively we would like to treat this disease in the future?

Read full article at: https://issuu.com/adrianchernyk/docs/ac_a_stylometric_analysis_of_writing_in_the_bipola