Depression, Cardiovascular Disease and Indigenous Australians

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Cardiovascular disease (CVD) is the major cause of premature death and disability experienced by Indigenous Australians and a key contributor to the life expectancy “gap” between Indigenous and non-Indigenous Australians. Because CVD strikes Indigenous Australians between 10 and 20 years earlier than other Australians, the emotional, societal and economic consequences for this population are far greater. Indigenous Australians are also at a particularly high risk of developing psychological illness, given their experience of colonisation, socioeconomic disadvantage, discrimination and racism. It is well-established that depression is an independent risk factor for developing CVD and for poorer outcomes after a CVD event. There is also increasing evidence of causal relationships between psychological distress, depression and CVD in Indigenous communities. These relationships may best be understood within the broader more holistic framework of social and emotional well-being, rather than a biomedical-centred framework that focuses on negative concepts of poor mental health. This chapter explores the complex bidirectional relationship between CVD and depression which is likely to be cyclical in nature and exacerbate the life expectancy gap. Positive approaches to ending this vicious cycle may involve appropriate holistic approaches to measuring and monitoring social and emotional well-being, and acknowledgement of the contribution of intergenerational trauma and discrimination as important determinants of well-being.