RELATIONSHIPS KEY TO BETTER INDIGENOUS HEALTH – AND THE 715 HEALTH CHECK IS PAVING THE WAY

Dr Mark Wenitong is one of a kind. Descending from the Kabi Kabi tribal group of South Queensland, Mark is one of the first Aboriginal men to graduate as a Doctor and is now a powerful advocate for improving Indigenous health outcomes.

Mark says he was inspired to become a Doctor by his mother who was one of the first Aboriginal Health Workers to be trained in Queensland. Her work with the Cape York community, in particular tackling the surge of sexually transmitted diseases in the region at the time, inspired a passion for better health within the family.

“Mum’s legacy was what really made me want to become a Doctor. I wanted to be able to help our mob to look after their own health, to provide a cultural lens. For me, that’s why it’s so important that Aboriginal Doctors are part of our service system, we can translate research, evidence and even program work into real practice” says Mark.

“With more Aboriginal Doctors, we can relate to our people, overcome barriers and build cultural resonance.”

After studying and graduating from the University of Newcastle in 1995, Mark is now based in Cairns at Apunipima Health Service, working with the local Aboriginal and Torres Strait communities up north, both in the clinic and out in communities.

Mark says, the annual health check for Aboriginal and Torres Strait Islander people, item 715 under the Medicare Benefits Schedule, provides enormous opportunities for GPs to engage with Indigenous communities about their health needs.

“The importance of 715s can’t be overstated – it’s one of the most important innovations that Medicare, and the Government, has brought in. We needed to do it, because we needed to get an understanding of what people’s health profile was before they were unwell. Why wait until patients come to us with a chronic disease? Let’s start screening early,” says Mark.

With Aboriginal and Torres Strait Islander people 2.3 times more likely to suffer a chronic condition, the annual health check is designed to provide early detection and prevention. Mark says the assessment is critically important in improving Indigenous health outcomes.

“There’s a couple of aspects to a 715 that are really important. The first is the screening – there are lots of people that are asymptomatic – meaning they aren’t showing symptoms yet –  that could have early disease like diabetes, hypertension. These patients may not come in until they get symptoms because people still think they have to be sick to come to a clinic. It’s an important way to engage the community, so they know they can come to a clinic whenever they need do,” says Mark.

“The other important aspect is that it’s a comprehensive assessment – a complete head to toe. By screening a broad array of physical, social and emotional factors, we get a really good picture of individual and community level health. Because we can identify problems early, we can also start early treatment.

“At a community level, we get really great data from undertaking the 715. We work with the local Elders groups to deliver 715 health check days out in the community, and screen people that otherwise wouldn’t come to the clinic. It gives us an idea of what the issues are at a really local level. We can then look at broader issues that affect the whole community, like immunisation, dementia, mental health and social well-being and can work to develop appropriate programs that tackle the specific issue a community might be experiencing.”

The annual health check is available for Aboriginal and Torres Strait Islander people of all ages, however nationally less than 30 per cent of patients are accessing the check.

Mark says it’s important to engage young patients with getting a 715 early as part of educating people about how to stay healthy.

“I see young people come in for their 715 and they’re very well. But I talk to them about health maintenance, talk to them about what they could end up like. Their uncle whose overweight, with no teeth and smoking outside. Our young people want to look deadly and fit, so we can help them with information and tips to stay in good health.

But with Aboriginal and Torres Strait Islander Doctors representing less than 1% of the general practitioner workforce it’s important that all GPs understand the benefits of a 715 for Aboriginal and Torres Strait Islander patients.

Mark says the key to improving mainstream health services for Aboriginal and Torres Strait Islander patients is to encourage practices to engage with their local community to build cultural competency.

“If Aboriginal people walk into a service and don’t feel welcome, they won’t come back. Access is a big issue – creating a safe space for people to feel welcome is important,” says Mark.

“You really have to engage with the local Aboriginal community, so they feel comfortable to come in and get their 715. You need to understand cultural sensitivities to get a proper medical history – you can’t diagnose if you don’t know what’s really going on with a patient, so building that trust is really critical.

“Most GPs can do this fairly well with most people, so it’s just a matter of then learning a little bit more about Aboriginal social and cultural issues to be able to relate to these patients in the right way. If you do, you’ll make a big difference.

“Some mainstream practices I’ve worked with have done really simple things, like putting Aboriginal health posters up in the waiting room or hiring and Aboriginal Health Worker or Aboriginal receptionist to help people feel welcome.”

Mark’s message to health professionals is simple – help your Aboriginal and Torres Strait Islander patients in the same way you help any others.

“Aboriginal and Torres Strait Islander people have the worst health outcomes of any community in Australia. We have a responsibility as health professionals to take care of this community, the same way that we take care of any part of our community.  Our people can actually take care of themselves if they have the education and the information in their hands.”

The 715 health check is available annually to Aboriginal and Torres Strait Islander people of all ages. Further information, including resources for patients and health practitioners is available at www.health.gov.au/715-health-check.