Patterns of Health and Illness in Indigenous Australian Communities Dr Ross Bailie Associate...
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Patterns of Health and Illness in Indigenous Australian Communities Dr Ross Bailie Associate Professor in Public Health Flinders NT Clinical School Menzies School of Health Research Ph 08-89228835 or 08-89228196 Fax 08-89275187 email: [email protected]
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Transcript of Patterns of Health and Illness in Indigenous Australian Communities Dr Ross Bailie Associate...
Patterns of Healthand Illness in Indigenous Australian Communities
Patterns of Healthand Illness in Indigenous Australian Communities
Dr Ross BailieAssociate Professor in Public
Health
Dr Ross BailieAssociate Professor in Public
HealthFlindersNT Clinical School
FlindersNT Clinical School
Menzies Schoolof Health Research
Menzies Schoolof Health Research
Ph 08-89228835 or 08-89228196Fax 08-89275187
email: [email protected]
Learning ObjectivesLearning Objectives
Patterns of morbidity and mortality
Underlying determinants
Patterns of morbidity and mortality
Underlying determinants
Performance ObjectivesPerformance Objectives
To use your understanding of
patterns and determinants of health
and illness in your everyday practice with
Indigenous people
To use your understanding of
patterns and determinants of health
and illness in your everyday practice with
Indigenous people
Sources of Information and AcknowledgementsSources of Information and Acknowledgements
• Australian Indigenous Health Infonet web site
• Australian Indigenous Health Infonet web site
Definition of Indigenous status
Definition of Indigenous status
• An Aboriginal or Torres Strait Islander is a person of Aboriginal or Torres Strait Islander descent who identifies as Aboriginal or Torres Strait islander and is accepted as such by the community in which he or she is associated.
• An Aboriginal or Torres Strait Islander is a person of Aboriginal or Torres Strait Islander descent who identifies as Aboriginal or Torres Strait islander and is accepted as such by the community in which he or she is associated.
http://www.healthinfonet.ecu.edu.au/html/html_keyfacts/keyfacts_faq.htmhttp://www.healthinfonet.ecu.edu.au/html/html_keyfacts/keyfacts_faq.htm
(Barnes, White, & Ross 1997)(Barnes, White, & Ross 1997)
Population distributionPopulation distribution
• Total estimated Indigenous population~418,800-476,900(projection for June 2000 based on the 1996 census)
• 2.2-2.5% of the total Australian population
• Total estimated Indigenous population~418,800-476,900(projection for June 2000 based on the 1996 census)
• 2.2-2.5% of the total Australian population
http://www.healthinfonet.ecu.edu.au/html/html_keyfacts/keyfacts_faq.htmhttp://www.healthinfonet.ecu.edu.au/html/html_keyfacts/keyfacts_faq.htm
Indigenous Non-Indigenous
Age group
Percentage of population
Population distribution (continued)
Population distribution (continued)
• Age distribution related to patterns of health and illness
• Age distribution typical of a developing country population
• Chronic diseases occur at a relatively young age
• Age distribution related to patterns of health and illness
• Age distribution typical of a developing country population
• Chronic diseases occur at a relatively young age
Standardised Mortality Ratios for selected causes of death, WA,
SA, NT (1995-97)
Standardised Mortality Ratios for selected causes of death, WA,
SA, NT (1995-97)
CAUSE OF DEATH Males Females
Circulatory 2.9 2.5 Injuries 3.2 3.5 Respiratory 5.2 6.0 Cancer 1.4 1.4 Endocrine 6.1 12.0 Digestive 5.1 5.5
All causes 3.0 3.0
CAUSE OF DEATH Males Females
Circulatory 2.9 2.5 Injuries 3.2 3.5 Respiratory 5.2 6.0 Cancer 1.4 1.4 Endocrine 6.1 12.0 Digestive 5.1 5.5
All causes 3.0 3.0
State/ TotalTerritory Indigenous Population Ratio
WA 24.1 6.5 3.7
SA 12.6 4.9 2.6
NT 19.4 11.5 1.7
State/ TotalTerritory Indigenous Population Ratio
WA 24.1 6.5 3.7
SA 12.6 4.9 2.6
NT 19.4 11.5 1.7
Infant mortality rates for the Indigenous and total populations,
WA, SA, and the NT, 1996(infant deaths per 1000 live births)
Infant mortality rates for the Indigenous and total populations,
WA, SA, and the NT, 1996(infant deaths per 1000 live births)
MorbidityMorbidity
• Respiratory disease
• Injury
• Cardiovascular disease
• Diabetes
• Renal disease
• Respiratory disease
• Injury
• Cardiovascular disease
• Diabetes
• Renal disease
Morbidity (continued)Morbidity (continued)
• Metabolic syndrome
• Communicable disease
• Cancer
• Metabolic syndrome
• Communicable disease
• Cancer
Births and pregnancy outcome
Births and pregnancy outcome
• Fertility rates
• Low birth weight
• Fertility rates
• Low birth weight
TrendsTrends
• Widening disparity
• Contrast with other countries
• Widening disparity
• Contrast with other countries
Determinants of Health Status
Determinants of Health Status
• Colonial history
• Education
• Employment
• Income
• Housing
• Colonial history
• Education
• Employment
• Income
• Housing
Determinants of Health Status (continued)
Determinants of Health Status (continued)
• Relative and absolute disadvantage
• Control
• Relative and absolute disadvantage
• Control
EducationEducation
• Poor attendance, retention, and outcomes
• Geographic variability
• Poor attendance, retention, and outcomes
• Geographic variability
Percentage of NT students achieving national reading benchmarks in 1998
(from Learning lessons - An independent review of Indigenous education in the
Northern Territory)
Percentage of NT students achieving national reading benchmarks in 1998
(from Learning lessons - An independent review of Indigenous education in the
Northern Territory)
NT StudentGroup Year 3 Year 5
Non-Indigenous,Urban 82% 78%
All students,Urban 78% 71%
Indigenous,Urban 54% 36%
Indigenous,Non-Urban 6% 4%
NT StudentGroup Year 3 Year 5
Non-Indigenous,Urban 82% 78%
All students,Urban 78% 71%
Indigenous,Urban 54% 36%
Indigenous,Non-Urban 6% 4%
Links between health, education and
socio-economic status
Links between health, education and
socio-economic status
• Vicious cycle• Vicious cycle
EmploymentEmployment
• Unemployment > 2 x higher
• Pastoral industry
• Racism
• Education
• Unemployment > 2 x higher
• Pastoral industry
• Racism
• Education
Employment (continued)Employment (continued)
• Unskilled labour
• CDEP
• Unskilled labour
• CDEP
IncomeIncome
• Low paid jobs
• Government payments
• Low paid jobs
• Government payments
Housing and physical environment
Housing and physical environment
• Infrastructure
• Urban/rural/remote disparity
• Infrastructure
• Urban/rural/remote disparity
ConclusionConclusion
• Marked disparities in health status
• Underlying determinants
• Strategies
• Marked disparities in health status
• Underlying determinants
• Strategies
