Vascular health risks in the Aboriginal community. A cultural approach.

BACKGROUND: Diabetes, heart disease and other vascular diseases are a great problem in Aboriginal communities and there are many reasons for this. As a health professional it is easy to feel overwhelmed by both the magnitude of the problem and the feeling that it is just too hard when patients don't seem to take charge of their own health. OBJECTIVE: This article aims to outline the increased vascular disease and vascular risk factors in the Aboriginal community and explore some of the historical, socio-economic, cultural and genetic reasons for this. The barriers to health care and self management are discussed and some positive developments in the area of Aboriginal vascular health are noted. DISCUSSION: To improve health outcomes we need to focus on two parts of the same problem. First, we need to tackle the vascular diseases at their roots--the vascular risk factors. Second, we need to look at ways to promote self management so that our patients can identify personal barriers to self care and be partners in their health care. There is evidence that better organised systems of care, such as recall systems and improved screening systems, are very beneficial. The most successful interventions are culturally appropriate and developed and implemented with Aboriginal community control.