Medicine and Health Sciences Commons^™

Quality Indicators Of Diabetes Care: An Example Of Remote-Area Aboriginal Primary Health Care Over 10 Years, Julia V. Marley, Carmel Nelson, Vicki O'Donnell, David Atkinson

Aboriginal Policy Research Consortium International (APRCi)

To describe service characteristics of Derby Aboriginal Health Service (DAHS) and document diabetes management activities and intermediate clinical outcomes for Aboriginal patients with type 2 diabetes.

Kerin O’Dea: Improving The Health Of Indigenous Australians, Tony Kirby

Aboriginal Policy Research Consortium International (APRCi)

No abstract provided.

Cannabis Use In Cape York Indigenous Communities: High Prevalence, Mental Health Impacts And The Desire To Quit, India Bohanna, Alan R. Clough

Aboriginal Policy Research Consortium International (APRCi)

Anecdotal reports suggest that high rates of cannabis use and dependence are significant issues in Indigenous communities in north Queensland; however, there is little scientific evidence to support or refute this.The Cape York Cannabis Project seeks to investigate cannabis use rates, cannabis dependence and mental health impacts for the first time in three Cape York Indigenous communities.

The First Year Counts: Cancer Survival Among Indigenous And Non-Indigenous Queenslanders, 1997–2006, Susanna M. Cramb, Gall Garvey, Patricia C. Valery, John D. Williamson, Peter D. Baade

Aboriginal Policy Research Consortium International (APRCi)

Objective: To examine the differential in cancer survival between Indigenous and non-Indigenous people in Queensland in relation to time after diagnosis, remoteness and area-socioeconomic disadvantage.

Design, setting and participants: Descriptive study of population-based data on all 150 059 Queensland residents of known Indigenous status aged 15 years and over who were diagnosed with a primary invasive cancer during 1997–2006.

Main outcome measures: Hazard ratios for the categories of area- socioeconomic disadvantage, remoteness and Indigenous status, as well as conditional 5-year survival estimates.

Results: Five-year survival was lower for Indigenous people diagnosed with cancer (50.3%; 95% CI, 47.8%–52.8%) compared with non-Indigenous …

A Bibliometric Analysis Of Research On Indigenous Health In Australia, 1972-2008, Gemma E. Derrick, Andrew Hayen, Simon Chapman, Abby S. Haynes, Berenika M. Webster, Ian Anderson

Aboriginal Policy Research Consortium International (APRCi)

Objective: To determine the growth patterns and citation volume of research publications referring to Indigenous health in Australia from 1972 to 2008 compared to seven selected health fields. Methods: Web of Science was used to identify all publications (n=820) referring to the health of Indigenous Australians authored by Australian researchers, 1972 to 2008. Citations for each publication were also captured. Growth was compared with selected health fields as well as with overall Australian research publications. Results: Research publications referring to Indigenous health, while remaining relatively small in number, grew at an average annual rate of 14.1%, compared with 8.2% across …

Area-Based Differentials In Childhood Cancer Incidence In Australia, 1996–2006, Danny R. Youlden, Peter D. Baade, Patricia C. Valery, Timothy E. Hassall, Leisa J. Ward, Adele C. Green, Joanne F. Aitken

Aboriginal Policy Research Consortium International (APRCi)

Background. International studies examining the association between the incidence of childhood cancer and characteristics of the area in which the patient lives have generally reported inconsistent patterns. Area-based differentials in childhood cancer throughout Australia have not been previously published at a national level. Procedure. Population-based information from the Australian Paediatric Cancer Registry was used to identify all children aged 0- to 14-years old diagnosed with invasive cancer or intracranial and intraspinal tumors of benign or uncertain behavior between 1996 and 2006. Age-standardized incidence rates per million children per year and the corresponding incidence rate ratios were calculated, categorized by remoteness …

‘It Had To Be My Choice’ Indigenous Smoking Cessation And Negotiations Of Risk, Resistance And Resilience, Chelsea Bond, Mark Brough, Geoffrey Spurling, Noel Hayman

Aboriginal Policy Research Consortium International (APRCi)

While Australia is considered a world leader in tobacco control, smoking rates within the Aboriginal and Torres Strait Islander population have not declined at the same rate. This failure highlights an obvious shortcoming of mainstream anti- smoking efforts to effectively understand and engage with the socio-cultural context of Indigenous smoking and smoking cessation experiences. The purpose of this article is to explore the narrative accounts of 20 Indigenous ex-smokers within an urban community and determine the motivators and enablers for successful smoking cessation. Our findings indicated that health risk narratives and the associated social stigma produced through anti-smoking campaigns formed …

Poor Food And Nutrient Intake Among Indigenous And Non-Indigenous Rural Australian Children, Josephine D. Gwynn, Victoria M. Flood, Catherine A. D'Este, John R. Attia, Nicole Turner, Janine Cochrane, Jimmy Chun-Yu Louie, John H. Wiggers

Aboriginal Policy Research Consortium International (APRCi)

Background: The purpose of this study was to describe the food and nutrient intake of a population of rural Australian children particularly Indigenous children. Participants were aged 10 to 12 years, and living in areas of relative socio-economic disadvantage on the north coast of New South Wales.

Methods: In this descriptive cross-sectional study 215 children with a mean age of 11.30 (SD 0.04) years (including 82 Indigenous children and 93 boys) completed three 24-hour food recalls (including 1 weekend day), over an average of two weeks in the Australian summer of late 2005.

Results: A high proportion of children consumed …

Social And Emotional Outcomes Of Australian Children From Indigenous And Culturally And Linguistically Diverse Backgrounds, Naomi Priest, Jennifer Baxter, Linda Hayes

Aboriginal Policy Research Consortium International (APRCi)

Objectives: 1) profile the living environments and 2) examine the social and emotional outcomes of Australian children from Indigenous and cultural and linguistically diverse (CALD) backgrounds at school entry. Method: Secondary analysis of cross- sectional data collected in Wave 1 of the Longitudinal Study of Australian Children (n=4,735). Child mental-health outcomes were measured using parent report of the Strengths and Difficulties Questionnaire (SDQ). Results: Significant differences in family and neighbourhood characteristics, including parental income, maternal education, maternal parenting quality and neighbourhood safety, were found in children of Indigenous and CALD backgrounds compared to the reference group of Australian-born, English-speaking children. …

Socioeconomic Disparities In Physical Health Among Aboriginal And Torres Strait Islander Children In Western Australia, Carrington C.J. Sheperd, Jianghong Li, Stephen R. Zubrick

Aboriginal Policy Research Consortium International (APRCi)

Objective. Few empirical studies have specifically examined the relationship between socio-economic status (SES) and health in Indigenous populations of Australia. We sought to provide insights into the nature of this relationship by examining socio-economic disparities in physical health outcomes among Aboriginal and Torres Strait Islander children in Western Australia.

Design. We used a diverse set of health and SES indicators from a representative survey conducted in 2000􏰣2002 on the health and development of 5289 Indigenous children aged 0􏰣17 years in Western Australia. Analysis was conducted using multivariate logistic regression within a multilevel framework. Results. After controlling for age and sex, …

Do Indigenous Australians Age Prematurely? The Implications Of Life Expectancy And Health Conditions Of Older Indigenous People For Health And Aged Care Policy, Philippa R. Cotter, John R. Condon, Tony Barnes, Ian P.S. Anderson, Leonard R. Smith, Teresa Cunningham

Aboriginal Policy Research Consortium International (APRCi)

Objective. To assess whether Indigenous Australians age prematurely compared with other Australians, as implied by Australian Government aged care policy, which uses age 50 years and over for population-based planning for Indigenous people compared with 70 years for non-indigenous people.

Methods. Cross-sectional analysis of aged care assessment, hospital and health survey data comparing Indigenous and non-indigenous age-specific prevalence of health conditions. Analysis of life tables for Indigenous and non-indigenous populations comparing life expectancy at different ages.

Results. At age 63 for women and age 65 for men, Indigenous people had the same life expectancy as non-indigenous people at age 70. …

Healthy Lifestyle Programs For Physical Activity And Nutrition, N.A.

Aboriginal Policy Research Consortium International (APRCi)

No abstract provided.

New Zealand’S Bold Strategy For Reducing Health Disparities, N.A.

Aboriginal Policy Research Consortium International (APRCi)

No abstract provided.

Indigenous Beliefs About Biomedical And Bush Medicine Treatment Efficacy For Indigenous Cancer Patients: A Review Of The Literature, K. D. Schaik, S. C. Thompson

Aboriginal Policy Research Consortium International (APRCi)

Background: Australia’s Indigenous people suffer from higher cancer mortality than non-Indigenous Australians, a discrepancy partly caused by differences in beliefs about treatment efficacy between Indigenous patients and their non-Indigenous healthcare providers. This paper critically reviews the literature associated with Indigenous beliefs about cancer treatment, both ‘bush medicine’ and biomedical, in order to provide recommendations to healthcare providers about accommodating Indigenous beliefs when treating cancer.

Methods: A search was undertaken of peer-reviewed journal papers using electronic databases and citation snowballing. Papers were selected for inclusion based upon relevance to themes that addressed the research questions. Results: Literature suggests that Indigenous beliefs …

Counting The Cost: Estimating The Number Of Deaths Among Recently Released Prisoners In Australia, Stuart A. Kinner, David B. Preen, Azar Kariminia, Tony Butler, Jessica Y. Andrews, Mark Stoové, Matthew Law

Aboriginal Policy Research Consortium International (APRCi)

Objective: To estimate the number of deaths among people released from prison in Australia in the 2007–08 financial year, within 4 weeks and 1 year of release. Design, participants and setting: Application of crude mortality rates for ex-prisoners (obtained from two independent, state-based record-linkage studies [New South Wales and Western Australia]) to a national estimate of the number and characteristics of people released from prison in 2007–08. Main outcome measures: Estimated number of deaths among adults released from Australian prisons in 2007–08, within 4 weeks and 1 year of release, classified by age, sex, Indigenous status and cause of death. …

Health Initiatives By Indigenous People In Australia, Stephanie Clark

Aboriginal Policy Research Consortium International (APRCi)

No abstract provided.

Health Conditions And Health-Policy Innovations In Brazil: The Way Forward, Cesar G. Victoria, Mauricio L. Barreto, Maria Do Carmo, Carlos A. Monteiro, Maria Ines Schmidt, Jairnilson Paim, Francisco I. Bastos, Celia Almeida, Ligia Bahia, Claudia Travassos, Michael Reichenheim, Fernando C. Barros

Aboriginal Policy Research Consortium International (APRCi)

No abstract provided.

Using The Commons To Facilitate Health Communication, Anna Liebzeit, Karen Adams, Mat Jakobi

Aboriginal Policy Research Consortium International (APRCi)

No abstract provided.

Cancer Incidence And Mortality In Indigenous Australians In Queensland, 1997–2006, Suzanne P. Moore, Peter K. O'Rourke, Kylie-Ann Mallitt, Gail Garvey, Adèle C. Green, Michael D. Coory, Patricia C. Valery

Aboriginal Policy Research Consortium International (APRCi)

Objective: To examine cancer incidence and mortality in Indigenous Queenslanders. Design, setting and patients: Assessment of indirectly standardised incidence and mortality ratios for Indigenous Australians in Queensland diagnosed with cancer from 1997 to 2006, compared with the total Queensland population. Main outcome measures: Standardised incidence and mortality ratios. Results: Compared with the total Queensland population, Indigenous Queenslanders had a lower overall incidence of cancer (standardised incidence ratio, 0.79; 95% CI, 0.75–0.82), but a higher incidence of some of the more fatal cancer types. Overall cancer mortality was higher (standardised mortality ratio, 1.36; 95% CI, 1.28–1.45) and similar to rates for …

The Prevalence And Causes Of Vision Loss In Indigenous Australians: The National Indigenous Eye Health Survey, Hugh R. Taylor, Jing Xie, Sarah Fox, Ross A. Dunn, Anna-Lena Arnold, Jill E. Keeffe

Aboriginal Policy Research Consortium International (APRCi)

Aim: To determine the prevalence and causes of vision loss in Indigenous Australians. Design, setting and participants: A national, stratified, random cluster sample was drawn from 30 communities across Australia that each included about 300 Indigenous people of all ages. A sample of non-Indigenous adults aged 􏱄 40 years was also tested at several remote sites for comparison. Participants were examined using a standardised protocol that included a questionnaire (self-administered or completed with the help of field staff), visual acuity (VA) testing on presentation and after correction, visual field testing, trachoma grading, and fundus and lens photography. The data were …

Birthweight And Natural Deaths In A Remote Australian Aboriginal Community, Wendy E. Hoy, Jennifer L. Nicol

Aboriginal Policy Research Consortium International (APRCi)

Objectives: To describe associations between birthweight and infant, child and early adult mortality from natural causes in a remote Australian Aboriginal community against a background of rapidly changing mortality due to better health services. Design, participants and setting: Cohort study of 995 people with recorded birthweights who were born between 1956 and 1985 to an Aboriginal mother in a remote Australian Aboriginal community. Participants were followed through to the end of 2006. Main outcome measures: Rates of natural deaths of infants (aged 0 to < 1 year), children (aged 1 to < 15 years) and adults (aged 15 to < 37 years), compared by birth intervals (1956–1965, 1966–1975 and 1976–1985 for infants and children, and 1956–1962 and 1963–1969 for adults) and by birthweight. Results: Birthweights were low, but increased over time. Deaths among infants and children decreased dramatically over time, but deaths among adults did not. Lower birthweights were associated with higher mortality. Adjusted for birth interval, hazard ratios for deaths among infants, children and adults born at weights below their group birthweight medians were 2.30 (95% CI, 1.13–4.70) ), 1.78 (95% CI, 1.03–3.07) and 3.49 (95% CI, 1.50–8.09), respectively. The associations were significant individually for deaths associated with diarrhoea in infants, with cardiovascular and renal disease in adults, and marginally significant for deaths from pulmonary causes in children and adults. Conclusion: The striking improvements in infant and child survival over time must be applauded. We confirmed a predisposing effect of lower birthweights on deaths in infants and children, and showed, for the first time, an association between lower birthweights and deaths in adults. Together, these factors are probably contributing to the current epidemic of chronic disease in Aboriginal people, an effect that will persist for decades. Similar phenomena are probably operating in developing countries.

Victims Of Violence Among Indigenous Mothers Living With Dependent Children, Kyllie Cripps, Catherine M. Bennett, Lyle C. Gurrin, David M. Studdert

Aboriginal Policy Research Consortium International (APRCi)

Objective: Toidentifyindividualandhouseholdfactorsassociatedwithviolenceamong Australian Indigenous women with dependent children. Design and participants: Univariate and multivariable analysis of data from the 2002 National Aboriginal and Torres Strait Islander Social Survey, stratified by area.

Main outcome measure: Self-reported experience of being a victim of violence in the previous year. Results: OneinfourIndigenouswomenlivingwithdependentchildrenyoungerthan 15 years reported being victims of violence in the previous year; this corresponds to an estimated 24 221 Indigenous mothers (95% CI, 21 507–26 935) nationwide. Violence was more prevalent in regional areas and cities than remote areas. In remote areas, mothers who had been removed from their natural families during childhood …

The Determinants Of First Nation And Inuit Health: A Critical Population Health Approach, Chantelle A.M. Richmond, Nancy A. Ross

Aboriginal Policy Research Consortium International (APRCi)

Environmental dispossession disproportionately affects the health of Canada’s Aboriginal population, yet little is known about how its effects are sustained over time. We use a critical population health approach to explore the determinants of health in rural and remote First Nation and Inuit communities, and to conceptualize the pathways by which environmental dispossession affects these health determinants. We draw from narrative analysis of interviews with 26 Community Health Representa- tives (CHRs) from First Nation and Inuit communities across Canada. CHRs identified six health determinants: balance, life control, education, material resources, social resources, and environmental/ cultural connections. CHRs articulated the role …

The Great Divide In Cancer Care Continues To Fail Aborigines, Georgina Kenyon

Aboriginal Policy Research Consortium International (APRCi)

No abstract provided.

Sustainable Antenatal Care Services In An Urban Indigenous Community: The Townsville Experience, Kathryn S. Panaretto, Melvina R. Mitchell, Lynette Anderson, Sarah L. Larkins, Vivienne Manessis, Petra G. Buettner, David Watson

Aboriginal Policy Research Consortium International (APRCi)

Objective: To evaluate the impact of a sustained, community-based collaborative approach to antenatal care services for Indigenous women.

Design: Prospective quality improvement intervention, the Mums and Babies program, in a cohort of women attending Townsville Aboriginal and Islanders Health Service, 1 January 2000 – 31 December 2005 (MB group), compared with a historical control group (PreMB group), 1 January 1998 – 30 June 1999.

Main outcome measures: Proportion of women having inadequate antenatal care and

screening; perinatal indicators. Results: Thenumberofantenatalvisitsperpregnancyincreasedfromthree

(interquartilerange[IQR],twotosix)inthePreMBgrouptosix(IQR,fourtoten)inthe MB group (P < 0.001). There were significant improvements in care planning, completion of cycle-of-care, and antenatal education activities throughout the study period. About 90% of all women attending for antenatal care were screened for sexually transmitted diseases, 89% had measurement of haemoglobin level, and serological tests for hepatitis B and syphilis (minimum antenatal screening). There was increased attendance for dating and morphology scans. In the MB group compared with the PreMB group, there was a significant reduction in perinatal mortality (14 v 60 per 1000 births; P=0.014). Conclusion: Sustained access to a community-based, integrated, shared antenatal service has improved perinatal outcomes among Indigenous women in Townsville.

Social Support And Thriving Health: A New Approach To Understanding The Health Of Indigenous Canadians, Chantelle A.M. Richmond, Nancy A. Ross, Grace E. Egeland

Aboriginal Policy Research Consortium International (APRCi)

Objectives. We examined the importance of social support in promoting thriv- ing health among indigenous Canadians, a disadvantaged population.

Methods. We categorized the self-reported health status of 31 625 adult indig- enous Canadians as thriving (excellent, very good) or nonthriving (good, fair, poor). We measured social support with indices of positive interaction, emotional support, tangible support, and affection and intimacy. We used multivariable lo- gistic regression analyses to estimate odds of reporting thriving health, using social support as the key independent variable, and we controlled for educational attainment and labor force status.

Results. Compared with women reporting low levels of …

Long-Term Trends In Indigenous Deaths From Chronic Diseases In The Northern Territory: A Foot On The Brake, A Foot On The Accelerator, David P. Thomas, John R. Condon, Ian P. Anderson, Shu Q. Li, Stephen Halpin, Joan Cunningham, Steven L. Guthridge

Aboriginal Policy Research Consortium International (APRCi)

Objective: To examine trends in Northern Territory Indigenous mortality from chronic diseases other than cancer. Design: A comparison of trends in rates of mortality from six chronic diseases (ischaemic heart disease [IHD], chronic obstructive pulmonary disease [COPD], cerebrovascular disease [CVD], diabetes mellitus [DM], renal failure [RF] and rheumatic heart disease [RHD]) in the NT Indigenous population with those of the total Australian population.

Participants: NT Indigenous and total Australian populations, 1977–2001. Main outcome measures: Estimated average annual change in chronic disease mortality rates and in mortality rate ratios. Results: DeathratesfromIHDandDMamongNTIndigenouspeoplesincreased between 1977 and 2001, but this increase slowed after 1990. …

Epilepsy In Indigenous And Non-Indigenous People In Far North Queensland, John Archer, Ruth Bunby

Aboriginal Policy Research Consortium International (APRCi)

Objective: To compare patterns of epilepsy in Indigenous and non-Indigenous people presenting to hospital. Study design: Retrospective cross-sectional survey of individuals admitted to hospital with a diagnosis of epilepsy (1 January 2001 – 31 December 2004); presenting to the emergency department with a seizure (2004); or presenting to the epilepsy clinic (1 September 2002 – 31 March 2005). Setting: Cairns Base Hospital, the major referral centre for Far North Queensland, including Cape York and the Torres Strait, with a population of 230 000 (13% Indigenous). Main outcome measures: Proportion of Indigenous patients presenting for epilepsy; proportion of Indigenous and non-Indigenous …

Injury Profiles Of Indigenous And Non-Indigenous People In New South Wales, Kathleen F. Clapham, Mark R. Stevenson, Sing Kai Lo

Aboriginal Policy Research Consortium International (APRCi)

Objectives: To compare the injury profiles of the Indigenous population in New South Wales with that of the non-Indigenous population.

Design and setting: Descriptive analysis of NSW Health data obtained from the Health Outcomes Information and Statistical Toolkit (HOIST) database. Hospitalisation data were collected for the period 1 July 1999 to 30 June 2003. Mortality data were collected for the period 1 January 1999 to 31 December 2002.

Main outcome measures: Hospitalisation and death rates due to injury by age, sex, injury mechanism and Indigenous status. Rate ratios for comparison between Indigenous and non-Indigenous populations. Results: Rates of death from …

Stage At Diagnosis And Cancer Survival For Indigenous Australians In The Northern Territory, John R. Condon, Tony Barnes, Bruce K. Armstrong, Sid Selva-Nayagam, J. Mark Elwood

Aboriginal Policy Research Consortium International (APRCi)

Objective: To investigate whether Indigenous Australians with cancer have more advanced disease at diagnosis than other Australians, and whether late diagnosis explains lower Indigenous cancer survival rates. Design: Retrospective cohort study.

Setting and participants: Indigenous and non-Indigenous people diagnosed with cancers of the colon and rectum, lung, breast or cervix and non-Hodgkin lymphoma in the Northern Territory of Australia in 1991–2000. Main outcome measures: SEER summary stage of cancer at diagnosis (local, regional or distant spread), cause-specific cancer survival rates and relative risk of cancer death.

Results: Diagnosis with advanced disease (regional or distant spread) was more common for Indigenous …