Turning cultural bias around to improve kidney health for Aboriginal and Torres Strait Islander people

New recommendations aimed at redressing the cultural bias at play for Aboriginal people receiving kidney care have been released during National Kidney month.

The full report prepared for the National Indigenous Kidney Transplantation Taskforce (NIKTT) by researchers at the Lowitja Institute and the University of Adelaide details ways to improve kidney transplantation rates and care for Aboriginal and Torres Strait Islander people, by addressing the issues that lead to culturally biased care.

At the heart of the report are the voices of Aboriginal and Torres Strait Islander people with lived experience of kidney disease, making their knowledge and understandings a central guide the recommendations.

“Institutional racism and systemic bias are barriers to kidney transplantation and affect Aboriginal and Torres Strait Islander peoples across the health system,” kidney transplant recipient, health researcher, and proud Narungga, and Ngarrindjeri woman, Kelli Owen says.

“Despite being diagnosed at earlier ages than other Australians, Aboriginal and Torres Strait Islander people are significantly more likely to experience kidney failure, and are, four times less likely to receive a kidney transplant when they need it."Associate Professor Janet Kelly

“We have the answers to help keep our mob healthy and provide culturally safe kidney care. We just need them to be applied.”

University of Adelaide Associate Professor of Nursing Janet Kelly says bias in the system has serious consequences for Aboriginal and Torres Strait Islander people.

“Despite being diagnosed at earlier ages than other Australians, Aboriginal and Torres Strait Islander people are significantly more likely to experience kidney failure, and are, four times less likely to receive a kidney transplant when they need it,” Associate Professor Kelly says.

“Our efforts have been focussed on investigating why that happens - what aspects of the health care environment need to change and improve and how more comprehensive and respectful cultural engagement will help to redress the huge gap in health outcomes between Aboriginal people with kidney disease and other Australians with the disease.”

The report gathered information from across Australia, from the Kimberley to Goulburn Valley, collecting the experiences of Aboriginal and Torres Strait Islander patients, families, health professionals, and community members.

That input has shaped the report findings in four key areas:

• Inclusion of Aboriginal and Torres Strait Islander people at all levels of kidney care.
• Creating a culturally safe workforce and valuing the Aboriginal and Torres Strait Islander workforce.
• Enhancing service delivery and models of care.
• Improving structures and policies in kidney care.

The report recommends the establishment of Indigenous Reference Groups in every transplantation unit across Australia, as well as building the Aboriginal and Torres Strait Islander kidney health workforce to include specialised clinical roles, including Aboriginal regional transplant care coordinators and sustainable kidney patient navigator/peer support roles.

The full report is available online