patterns of health and illness in indigenous australian communities

Patterns of Healthand Illness in Indigenous Australian Communities

Dr Ross BailieAssociate Professor in Public

HealthFlindersNT Clinical School

Menzies Schoolof Health Research

Ph 08-89228835 or 08-89228196Fax 08-89275187

email: ross.bailie@menzies.edu.au

Learning Objectives

Patterns of morbidity and mortality

Underlying determinants

Performance Objectives

To use your understanding of

patterns and determinants of health

and illness in your everyday practice with

Indigenous people

Sources of Information and Acknowledgements

• Australian Indigenous Health Infonet web site

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.

http://www.healthinfonet.ecu.edu.au/html/html_keyfacts/keyfacts_faq.htm

(Barnes, White, & Ross 1997)

Population 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

http://www.healthinfonet.ecu.edu.au/html/html_keyfacts/keyfacts_faq.htm

Indigenous Non-Indigenous

Age group

Percentage of population

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

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

State/ TotalTerritory Indigenous Population Ratio

WA 24.1 6.5 3.7SA 12.6 4.9 2.6NT 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)

Morbidity

• Respiratory disease• Injury• Cardiovascular disease• Diabetes• Renal disease

Morbidity (continued)

• Metabolic syndrome

• Communicable disease

• Cancer

Births and pregnancy outcome

• Fertility rates

• Low birth weight

Trends

• Widening disparity

• Contrast with other countries

Determinants of Health Status

• Colonial history• Education• Employment• Income• Housing

Determinants of Health Status (continued)

• Relative and absolute disadvantage

• Control

Education

• 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)

NT StudentGroup Year 3 Year 5Non-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

• Vicious cycle

Employment

• Unemployment > 2 x higher

• Pastoral industry

• Racism

• Education

Employment (continued)

• Unskilled labour

• CDEP

Income

• Low paid jobs

• Government payments

Housing and physical environment

• Infrastructure

• Urban/rural/remote disparity

Conclusion

• Marked disparities in health status

• Underlying determinants

• Strategies