Paving the path to accessible health care for Indigenous adolescents: Understanding the health priorities and needs of Indigenous adolescents, and how these needs can be met by primary health care

Adolescents (aged 10 -24 years)1 represent a third of the Australian Aboriginal and Torres Strait Islander (Indigenous) population. Their health is central to the Closing the Gap agenda and disrupting intergenerational cycles of disadvantage in health and wellbeing.2,3 And yet, their needs have been at the margins of policy and program (including health service delivery) to date.

Our recent publication in the Lancet documented the substantial health needs, early onset of risk and vast inequities in the sociocultural determinants that arise during this developmental phase for Indigenous adolescents.4 Indigenous adolescents have twice the mortality rate of their non-Indigenous counterparts, but more than 80% of this mortality preventable with currently available interventions: There is a huge potential for health gain through the health system. It is this finding in particular that has led to a series of discussions around ensuring that health care is optimised
for Indigenous adolescents. This remains a desperately under-researched area.5 Little is known around how well health services currently cater for the needs of Indigenous adolescents, or how health services can be made more adolescent friendly. This information is fundamental to planning interventions through the health sector and optimising existing platforms (such as the MBS 715
health check).

This project has three key aims. The first is to understand the health needs and priorities from the perspective of Indigenous adolescents. This information will build on our existing understandings of the burden of disease for Indigenous adolescents,4 and is critical to informing the appropriate orientation and points of engagement for health services. The second aim is to understand how can health care needs for Indigenous adolescents be better met through primary health care. It will examine current care seeking behaviours and enablers/ barriers to existing services. The third aim will use the data gathered to codevelop (with young people and service providers) a model of adolescent friendly health care specific to the needs of Indigenous adolescents.

The data generated in this project will provide the basis for a NHMRC project grant that will formally trial and evaluate the model of care.

References:
1. Sawyer S, Azzopardi P, Wickremarathne D, Patton G. The Age of Adolescence. Lancet Child and Adolescent Health 2018; 2(3): 223.
2. Patton GC, Olsson CA, Skirbekk V,.. Azzopardi P, et al. Adolescence and the next generation. Nature 2018; 554(7693): 458-66.
3. Patton GC, Sawyer SM, Santelli JS,.. Azzopardi P, et al. Our future: a Lancet commission on adolescent health and wellbeing. Lancet 2016; 387(10036): 2423-78.
4. Azzopardi PS, Sawyer SM, Carlin JB.. Brown AD. Health and wellbeing of Indigenous adolescents in Australia: a systematic synthesis of population data. Lancet 2017.