The Centre of Research Excellence (CRE) to Reduce Inequality in Heart Disease focuses on improving the heart health and outcomes of groups and communities i.e. Regional Australians, Indigenous Australians and International Health

Implementing cardiovascular standards to improve Indigenous cardiovascular care and outcomes

Research Stream: Indigenous Australians


Cardiovascularstanda1.jpg - largeThis project will develop a framework for the implementation of cardiovascular standards, utilising the ESSENCE Standards, to improve cardiovascular care and outcomes for Aboriginal and Torres Strait Islander people.


The ESSENCE (Essential Service Standards for Equitable National Cardiovascular CarE) Standards were established to guide the development of cardiovascular policy and practice. The ESSENCE Project was funded by the National Aboriginal and Torres Strait Islander Health Equality Council (NATSIHEC) under agreement with the Department of Health and Ageing. The ESSENCE Standards provide a framework for provision of care utilising the best available evidence and expert opinion. They define elements of care and service delivery that should be accessible to all Australians regardless of their location, ethnicity, economic circumstances or gender.


Utilising the ESSENCE Standards, this project will form a basis on which to implement effective systems reform within national health policy and practice to close the gap in life expectancy between Aboriginal and Torres Strait Islander peoples and other Australians.


Full Study Title

Developing a framework for implementing cardiovascular standards to improve Indigenous cardiovascular care and outcomes


Funding Source

CRE to Reduce Inequality in Heart Disease


Rationale for the project

Cardiovascular diseases (CVD) constitute the biggest single cause of death for Aboriginal and Torres Strait Islander people and remain the primary contributor to life expectancy differentials between Indigenous and non‐Indigenous Australians. Importantly, the incidence and mortality pattern of CVD experienced by Indigenous Australians is characterised by early onset and significant differentials, most notable at young ages. CVD is the most critical target for reducing the life expectancy gap between Indigenous and non-Indigenous Australians.


The development of a framework for CVD standards implementation will address the critical elements of care which are necessary to reduce disparity in access and outcomes for five major cardiovascular conditions: Coronary Heart Disease (CHD); Chronic Heart Failure (CHF); Stroke; Rheumatic Heart Disease (RHD); and Hypertension.


Project Aims

Following on from the development and publication of the ESSENCE Standards, the aim is to develop a framework for implementation of cardiovascular standards to improve care and outcomes.


Project Design

The project supports the development of an implementation plan for the ESSENCE Standards into national health policy and practice. Specific projects will develop the various components of the plan, with a view to developing a full implementation framework. The ESSENCE Project concluded that the implementation of ESSENCE Standards would require consideration of the following points to enable reform of policy:

  • Alignment of cardiovascular policy with existing national health reforms.
  • High quality data is required to reduce disparities in cardiovascular disease for Indigenous Australians.
  • There should be a comprehensive approach developed to cardiovascular disease, which includes, prevention and management extending across the continuum of care and range of service providers.
  • There is a need to move towards a more structured approach to ‘Closing the Gap’, including data analysis, evidence, and health system performance.
  • Many of the standards are likely to be best achieved through developing regional CVD Networks.
  • A national gap analysis of existing available cardiovascular services according to the essential service standards should guide the development of critical policy and health care.
  • Cost and cost effectiveness modelling should be undertaken to model the costs and ‘best buys’ in delivering the standards.
  • The ESSENCE Standards should be developed into essential cardiovascular care Key Performance Indicators.


This project will be shaped by addressing the key conclusions of the ESSENCE Project to support the development of a framework for implementation.


Key Collaborators

  • Professor Alex Brown: Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute
  • Professor Garry Jennings: Baker IDI Heart and Diabetes Institute, Director

Key References

1. Brown AD, Jennings J, Mott K, O'Shea R, Lawson T, Pekarsky B, Mott K, on behalf of the ESSENCE steering committee. Essential Sevice Standards for Equittable National Cardiovasciular carE for (ESSENCE) Aboriginal and Torres Strait Islander people. Adelaide, SA: Baker IDI Heart and Diabetes Institute; 2012.


Study Publications