Cardiovascular disease and type 2 diabetes: an exploration amongst South Asians and Anglo-Australians living in Victoria, Australia
Aim: The body of work presented in this dissertation aimed to address the patterns of CVD presentation amongst Anglo-Australians (AA) and Australian dwelling SAs and to examine and explore the perceptions and experiences of SAs and AAs living with T2D and/or CVD.
Methods: This study was divided into two phases. Phase
1 was a retrospective hospital clinical case audit to determine patterns of CVD
presentation. The study population included SA and AA patients hospitalised for ischaemic heart disease. Baseline characteristics,
evidence of diabetes and other CVD risk factors were compared. Angiographic
data were also compared to determine severity and these were assessed using a modified Gensini score. In phase 2,
semi-structured indepth interviews were conducted with 57 participants (41 SAs
and 16 AAs) with either T2D and/or CVD.
Results: Phase 1 confirmed the SA pattern of CVD presentation in other western
nations, i.e. high rates of cardiovascular disease at younger ages, with greater severity, higher
rates of T2D and low BMI measurements (a conventional risk factor). Findings from phase 2 indicated
key similarities and differences between the perceptions and experiences of the participants
drawn from the two ethnic groups. These pertained to their engagement with health professionals and
the health system, their self-management practices such as physical activity
and dietary patterns, as well as the bidirectional effects of migration on
their health related behaviours.
Conclusions and future direction: The findings presented in this thesis have made an original contribution in an area where there is a strong need for an evidence base to inform health service delivery and public health action to alleviate the increasing burden of CVD and T2D among SAs. This group should be targeted for more aggressive screening for these diseases at younger ages with more intensive treatment strategies. Prevention and management strategies need to be individually and communally tailored as well as culturally appropriate. Health professionals should bear this in mind when providing clinical advice. Similarly, those responsible for the development and implementation of health promotion interventions for prevention and management of these diseases will need to consider culturally sensitive approaches.