Patterns of Healthand Illness in Indigenous Australian Communities: 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: ross.bailie@menzies.edu.au
Learning Objectives: Learning Objectives Patterns of morbidity and mortality Underlying determinants
Performance Objectives: 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: Sources of Information and Acknowledgements 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. http://www.healthinfonet.ecu.edu.au/html/html_keyfacts/keyfacts_faq.htm (Barnes, White, & Ross 1997)
Population distribution: 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
Slide7: 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
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
Infant mortality rates for the Indigenous and total populations, WA, SA, and the NT, 1996(infant deaths per 1000 live births): State/ Total
Territory 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)
Morbidity: Morbidity Respiratory disease
Injury
Cardiovascular disease
Diabetes
Renal disease
Morbidity (continued): Morbidity (continued) Metabolic syndrome
Communicable disease
Cancer
Births and pregnancy outcome: Births and pregnancy outcome Fertility rates
Low birth weight
Trends: Trends Widening disparity
Contrast with other countries
Determinants of Health Status: Determinants of Health Status Colonial history
Education
Employment
Income
Housing
Determinants of Health Status (continued): Determinants of Health Status (continued) Relative and absolute disadvantage
Control
Education: 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): Percentage of NT students achieving national reading benchmarks in 1998 (from Learning lessons - An independent review of Indigenous education in the Northern Territory) NT Student Group 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 andsocio-economic status: Links between health, education and socio-economic status Vicious cycle
Employment: Employment Unemployment > 2 x higher
Pastoral industry
Racism
Education
Employment (continued): Employment (continued) Unskilled labour
CDEP
Income: Income Low paid jobs
Government payments
Housing and physical environment: Housing and physical environment Infrastructure
Urban/rural/remote disparity
Conclusion: Conclusion Marked disparities in health status
Underlying determinants
Strategies