'Culturally safe' healthcare needed to end RHD by 2031

With more than 40 million cases worldwide, rheumatic heart disease (RHD) is an acquired but preventable heart disease. Its cause is complex, but linked to Streptococcus A (Strep A), a type of bacteria that can infect the throat or skin. If untreated, these infections can lead to acute rheumatic fever (ARF), which can then cause RHD that can lead to major health problems like heart failure and stroke.

With Australia having one of the world’s highest incidences of ARF and RHD, and with a disproportionate disease burden on Aboriginal and Torres Strait Islander communities, the RHD Endgame Strategy seeks to eliminate the disease in Australia by 2031. Following a systematic review exploring the effectiveness of programs to prevent, reduce and control RHD, researchers from the University of Queensland (UQ) are calling for an urgent prioritising of Indigenous-led RHD programs and a ‘culturally safe’ approach.

“Culturally safe healthcare that respects Aboriginal and Torres Strait Islander cultures and perspectives is essential,” said Lorelle Holland from UQ’s Child Health Research Centre. “By understanding and tackling RHD in this way, we can help reduce the number of people affected and dying from this condition and empower self-determined health care and prevention programs for Indigenous communities.”

Holland said the UQ research reinforced that programs should address health inequities and the cultural, political and social factors that contribute to the disease. Lead author on this recently published research, Yumeng Cai — a senior research assistant from UQ’s School of Nursing, Midwifery and Social Work — said RHD, which is common in poorer countries but almost unknown in urban and well-resourced settings within Australia, is preventable with the right health care and research.

“We need to address why people do not feel safe going to their local health clinic or hospital for essential treatment,” Cai said. “We need to prioritise increased funding for improved living conditions, Strep A vaccination, culturally responsive health education and have Aboriginal and Torres Strait Islander peoples and communities at the table concerning the best way to implement ARF and RHD prevention programs.”

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‘Ending rheumatic heart disease in Aboriginal and Torres Strait Islander communities: a systematic review of prevention programs in Australia’, a 2025 paper on this research, has been published open access in First Nations Health and Wellbeing — The Lowitja Journal and you can read it at doi.org/10.1016/j.fnhli.2024.100040.

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Image credit: iStock.com/JohnnyGreig