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Indigenous Australians (indigenous + australian)
Selected AbstractsPROSPECTS FOR ,CLOSING THE GAP' IN SOCIOECONOMIC OUTCOMES FOR INDIGENOUS AUSTRALIANS?AUSTRALIAN ECONOMIC HISTORY REVIEW, Issue 3 2009Jon C. Altman Australia; aborigines; closing the gap; long-run social and economic change; Torres Strait islanders Practical reconciliation' and more recently ,closing the gap' have been put forward as frameworks on which to base and evaluate policies to address Indigenous disadvantage. This paper analyses national-level census-based data to examine trends in Indigenous wellbeing since 1971. There has been steady improvement in most socioeconomic outcomes in the last 35 years; a finding at odds with the current discourse of failure. Evidence of convergence between Indigenous and non-Indigenous outcomes, however, is not consistent. For some outcomes, relatively rapid convergence is predicted (within 25 years), but for the majority of outcomes, convergence is unlikely to occur within a generation, if at all. [source] Other people, other drugs: the policy response to petrol sniffing among Indigenous AustraliansDRUG AND ALCOHOL REVIEW, Issue 3 2004Dr PETER H. D'ABBS Abstract This paper examines the policy response of Australian governments to petrol sniffing in Indigenous communities from the 1980s until the present. During this period, despite the formation of numerous inquiries, working parties and intergovernmental committees, there has been little accumulation of knowledge about the nature and causes of sniffing, or about the effectiveness of interventions. Policies are fragmentary; programmes are rarely evaluated, and most rely on short-term funding. The paper sets out to explain why this should be so. It draws upon a conceptual framework known as ,analytics of government' to examine the ways in which petrol sniffing comes to the attention of government agencies and is perceived as an issue; the mechanisms deployed by governments to address petrol sniffing; ways in which knowledge about sniffing is generated; and the underlying assumptions about people that inform policy-making. Drawing upon case studies of policy responses, the paper argues that a number of structural factors combine to marginalize petrol sniffing as an issue, and to encourage reliance on short-term, one-off interventions in place of a sustained policy commitment. Four recommendations are advanced to help overcome these factors: (1) agreements should be reached within and between levels of government on steps to be taken to reduce risk factors before the eruption of petrol-sniffing crises; (2) the evidence base relevant to petrol sniffing (and other inhalants) should be improved by funding and directing one or more existing national drug research centres to collate data on inhalant-caused mortality and morbidity, and to conduct or commission research into prevalence patterns, effectiveness of interventions and other gaps in knowledge; (3) the current pattern of short-term, pilot and project funding should be replaced with longer-term, evidence-based interventions that address the multiple risk and protective factors present in communities; and (4) insistence by governments that communities must take ,ownership' of the problem should be replaced by a commitment to genuine partnerships involving governments, non-government and community sectors. [source] ARGUING OVER [THE] REMOTE CONTROL: WHY INDIGENOUS POLICY NEEDS TO BE BASED ON EVIDENCE AND NOT HYPERBOLEECONOMIC PAPERS: A JOURNAL OF APPLIED ECONOMICS AND POLICY, Issue 1 2007BOYD H. HUNTER Recent public debate on Indigenous issues has been provoked, inter alia, by a 2005 Centre for Independent Studies paper by Helen Hughes and Jenness Warin, who focused on the extent to which policies have been effective in improving the living conditions of Indigenous Australians since the era of self-determination commenced. Unfortunately, the quality of historical data is questionable, and hence we need an appreciation of the reliability of estimates. The 2002 National Aboriginal and Torres Strait Islander Social Survey allows a detailed interrogation of the reliability of estimates. This paper critically analyses socioeconomic changes between 1994 and 2002 for remote and other areas by comparing the recent data with analogous data collected in 1994. Changes in health status and a range of socio-economic indicators are documented to provide a more balanced assessment of the level of economic and social development in the respective areas. [source] Adolescent emergency department presentations with alcohol- or other drug-related problems in Perth, Western AustraliaADDICTION, Issue 7 2001Gary K. Hulse Aims. To identify the morbidity, type of substance used and the pattern of presentation by adolescents with problems related to alcohol or other drug (AOD) use. Design. A 4-week retrospective review of hospital records. Setting. Four metropolitan hospitals in Perth, Australia. Participants. There were 1064 presentations by people aged 12-19 years of which 160 (15%) were related to AOD use. The median age of the AOD cases was 17 (interquartile range 16-19) of whom 97 (61%) were male and 19 (12%) were Indigenous Australians. Findings. Alcohol was the most frequent precursor to presentation (66, 41%) followed by heroin (24, 15%) and prescription/over-the-counter drugs (24, 15%). Injury was the most common diagnosis at presentation (50, 31%), followed by overdose/drug use (47, 29%). A diagnosis of injury was significantly more likely following the use of alcohol than other categories of substances (,2 = 42.07, df = 3, p < 0.001). Deliberate self-harm (DSH) occurred in more female than male cases (,2 = 7.4, df = 1, p < 0.01). Presentations were more frequent over the weekend (102, 64%) than on weekdays, and the length of stay was significantly shorter for weekend cases (Mann-Whitney U 2132, p < 0.05). Conclusions. Given the small window of opportunity to provide AOD treatment to youth following hospital presentation, a number of suggestions are made. From a harm-minimization perspective the focus of interventions should be on alcohol use by male youth and DSH associated with prescription/over-the-counter drug use by female adolescents. In addition, Indigenous youth are over-represented in hospital presentations, but there is currently a lack of evaluated interventions designed for them. [source] Indigenous Australians and liquor licensing restrictionsADDICTION, Issue 10 2000Dennis Gray First page of article [source] Attitudes toward Out-groups and the perception of consensus: All feet do not wear one shoeJOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY, Issue 6 2008Anne Pedersen Abstract Although social perception research has been carried out across a number of diverse domains, to the best of our knowledge, studies have not directly assessed the relationship between attitudes toward the out-group and perceptions of community support for those attitudes. In the present research, we report the findings of a study conducted in Western Australia using data collected from 653 participants from three different locations. The main thrust of our study was the accuracy of beliefs about consensus as it related to attitudes toward two marginalized groups: Indigenous Australians and asylum seekers. With respect to their attitudes toward these two groups, our respondents were placed in seven categories corresponding to their responses to our seven point attitude scales. Three main findings emerged. First, respondents at all seven levels overestimated community support for their views with respect to both Indigenous Australians and asylum seekers. Second, as respondents in both groups became more rejecting, their estimates of community support progressively increased in a linear fashion. Third, respondents in the more negative categories were significantly less accurate in their estimates than those in the more positive categories. How these findings might contribute to programmes designed to reduce prejudice is discussed. Copyright © 2008 John Wiley & Sons, Ltd. [source] Reflections on practice: Ethics, race, and worldviewsJOURNAL OF COMMUNITY PSYCHOLOGY, Issue 6 2002Brian J. Bishop Two case studies involving Indigenous Australians are described, which pose ethical and conceptual problems. Over two decades ago Sarason (1972) gave the warning that we are socialized into a culture so well that our interventions can be ineffective or misguided unless we attempt to come to grips with history and the broader social context. Understanding worldviews of both the targeted community and ourselves is imperative if we are going to do more good than harm. The two case studies involve White practitioners working with Indigenous people, and as such, bring into sharp relief the ethical issues and worldviews of those involved. Reflection on the process of intervention provides a mechanism for insight into informed practice and the development of professional knowledge and theory. © 2002 Wiley Periodicals, Inc. [source] Joining the dots: The links between education and health and implications for Indigenous childrenJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 12 2009Vanessa Johnston Abstract This paper provides a general overview of the literature investigating the nexus between education and health; discussing the relationship between these domains at individual, family and community levels. We then briefly examine the programme and research implications of such a framework for interventions aimed at improving education and health, with specific reference to young Indigenous Australians. We find that while education and health are inextricably linked, throughout the life course and at different levels of influence, there is less empirical work exploring this relationship in an Indigenous context. Given the gravity of literacy and numeracy failure rates in school-based education and its potential impact on Indigenous health, we assert an urgent case for rigorous research into interventions that address the barriers to effectiveness in implementing quality educational experiences and opportunities for Indigenous children. [source] Interpreting incidence trends for treated end-stage renal disease: Implications for evaluating disease control in AustraliaNEPHROLOGY, Issue 4 2004JOHN H STEWART SUMMARY: Background: Five sources of change modify trends in incidence of treated end-stage renal disease (ESRD): (i) demography; (ii) disease control, comprising prevention and treatment of progressive kidney disease; (iii) competing risks, which encompass dying from untreated uraemia or non-renal comorbidity; (iv) lead-time bias; and (v) classification bias. Thus, rising crude incidence of treated ESRD may conceal effective disease control when there has been demographic change, lessening competing risks, or the introduction of bias. Methods: Age-specific incidences of treated ESRD in Australia were calculated from Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry data by indigenous/non-indigenous status (all causes) and by primary renal disease (non-indigenous only) for two successive decades, 1982,1991 and 1992,2001. Results: We postulate that less competing risks explained much of the increase in treated ESRD in the elderly and Indigenous Australians. The increase in glomerulonephritic ESRD in non-indigenous Australians could be ascribed mainly to immigration from non-European countries. There was no significant change in incidence of treated ESRD in Indigenous or non-indigenous persons aged less than 25 years, in non-indigenous persons aged 25,64 years for ESRD caused by hereditary polycystic disease or hypertension, or in type 1 diabetics aged over 55 years. End-stage renal disease from analgesic nephropathy had declined. The increase in treated ESRD caused by type 2 diabetic nephropathy appeared to be multifactorial. Lead-time/length bias and less competing risks may have concealed a small favourable trend in other primary renal diseases. Conclusion: Whether recent disease control measures have had an impact on incidence of treated ESRD is not yet certain, but seems more likely than implied by previous reports. [source] Ontologies of the image and economies of exchangeAMERICAN ETHNOLOGIST, Issue 1 2004Fred Myers ABSTRACT In the early 1970s, the Aboriginal artist and activist Wandjuk Marika asked the Australian government to investigate the unauthorized use of Yolngu clan designs on a variety of commodity forms, inaugurating a process of recognizing Indigenous ownership of "copyright" in such designs. This treatment of design,and of culture,as a form of property involves understandings and practices of materiality and subjectivity that differ from those informing indigenous, Aboriginal relationships to cultural production and circulation. In this article I explore the significance for material culture theory of recent work on and events in the development of notions of cultural property. One of my main concerns is the relevance of local understandings of objectification, or objectness, and human action,as embedded in object-ideologies. I discuss the limited capacity of legal discourses of cultural property to capture and reflect the concerns of Indigenous Australians about their own relation to culture, to creativity, and to expression. [source] Discourse Resistance And Negotiation By Indigenous AustraliansPEACE & CHANGE, Issue 2 2003John Synott In the context of intercultural relations, the boundaries between dominant and subordinated communities are constructed in a variety of ways. Language frames, or discourses, understood from a sociological rather than a linguistic perspective can be considered to constitute one of the main processes for determining the character of intercultural boundaries. Using this theoretical perspective, this article examines a number of discourses that have contributed to the construction of social relations between Australian Aborigines and the dominant nonindigenous cultural groups in Australia. Examples from the colonial period show the way in which indigenous people were oppressed along racial boundaries, even as they resisted, while more recent instances chart the process of indigenous people in renegotiating social relations and in asserting the process of self-determination and cultural celebration. [source] Surveying Mobile Populations: Lessons from Recent Longitudinal Surveys of Indigenous AustraliansTHE AUSTRALIAN ECONOMIC REVIEW, Issue 3 2002B. H. Hunter Geographically mobile populations are notoriously difficult to survey, especially in a cross,cultural context. In broad terms, it is difficult to ensure that respondents are representative of the underlying population, can be relocated, and that data obtained are relevant to them. At a practical level, the problem can be as basic as not having any well,formed notion of what defines a household. Consequently, the resulting analysis of households is at best imprecise and, at worst, conceptually confused. This article documents the lessons for the design and conduct of longitudinal data collection from three recent surveys of an exceptionally mobile population, Indigenous Australians. There appears to be a trade,off between cultural relevance, data quality, response rates and survey costs. The use of Indigenous interviewers does not, in itself, guarantee that response rates will be acceptable. [source] The Effectiveness of Indigenous Job Search StrategiesTHE ECONOMIC RECORD, Issue 256 2006BOYD H. HUNTER This analysis uses the only existing large-scale longitudinal survey of Indigenous Australians to examine the effects of job search behaviour over an 18-month period starting from March 1996. Job search methods were not generally related to the probability of finding and retaining employment when a range of other personal and regional factors are taken into account. Search intensity (as measured by the number of jobs applied for) had a significant effect on the prospect of finding employment, but was unrelated to the probability of job retention. [source] An Analysis of Occupational Outcomes for Indigenous and Asian Employees in AustraliaTHE ECONOMIC RECORD, Issue 240 2002Vani K. Borooah This paper examines occupational performance in Australia across three racial groups in Australia: Indigenous Australians; Asian people, defined as all those whose language spoken at home was either Chinese, Vietnamese or other forms of a South-east or East Asian language; and white people, defined as the residual category. The paper has as its starting point, observed differences in occupational attainment among the three groups in Australia and sets out to account for these observed differences on the basis of both race and non-racial attributes such as, age, education and area of residence. [source] Older Indigenous Australians: their integral role in culture and communityAUSTRALASIAN JOURNAL ON AGEING, Issue 1 2007Jeni Warburton This review explores the social and cultural roles played by older Indigenous Australians within their communities. In the absence of a body of conventional academic literature on this topic, we used a broad range of sources including stories, articles, videos, and other narratives to present the lived experiences of older Indigenous Australians illustrated in their own words. The intention is to move beyond the usual negative focus of reporting the significant health and social problems experienced by older Indigenous Australians, whilst still recognising that their present-day roles within the society have to be understood against a backdrop of such lifetime disadvantage. The major underlying theme of this review is the crucial roles played by older Indigenous people and how these roles have adapted over time to contemporary circumstances. Roles include kinship relationships, support for the young, transmission of cultural knowledge, as well as the key concept of respect for older people as ,survivors'. [source] Pregnancy and neonatal characteristics of opioid-dependent Indigenous Australians: A rural and metropolitan comparisonAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 3 2009Emma TETSTALL Aims: To identify maternal, obstetric and neonatal characteristics of opioid-dependent Indigenous Australians in rural and metropolitan settings. Methods: Retrospective cohort study of 232 metropolitan and 67 rural infants born to mothers maintained on methadone throughout pregnancy for the treatment of opiate dependency, between January 2000 and December 2006. Medical records of identified mother/infant dyads were reviewed by evaluating 20 different maternal, obstetric and neonatal parameters. Results: The number of infants of opiate-dependent mothers (IODMs) identified to be of Aboriginal ethnicity was 47 in the rural and 50 in the metropolitan setting. This reflected a significantly higher proportion in the rural versus metropolitan areas (70.1% vs 21.6%, P < 0.05). The effect of rurality was independent of ethnicity with significantly lower rates of neonatal withdrawal requiring treatment (P < 0.001), antenatal consultations (P < 0.01), department of community services (DoCS) involvement (P < 0.001) and shorter infant lengths of stay (P < 0.001). There was a non-significant trend towards more intrauterine growth restriction in Aboriginal infants. There were no significant differences in parameters in rural Indigenous versus rural non-Indigenous infants. Conclusions: Significant differences exist between rural and metropolitan IODMs in terms of less attendance at antenatal consultations, less neonatal withdrawal requiring treatment, shorter average length of hospital stay for the infant and less documented DoCS involvement. These differences maybe a reflection of a different diagnostic and management approach. Ethnicity had no major clinical impact in either the rural or the metropolitan settings. Future research comparing the long-term outcomes would be of interest. [source] Socio-economic gradients in self-reported diabetes for Indigenous and non-Indigenous Australians aged 18,64AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 2010Joan Cunningham Abstract Objective: To examine and compare socio-economic gradients in diabetes among Indigenous and non-Indigenous Australians. Methods: I analysed weighted data on self-reported diabetes and a range of socio-economic status (SES) measures for 5,417 Indigenous and 15,432 non-Indigenous adults aged 18,64 years from two nationally representative surveys conducted in parallel by the Australian Bureau of Statistics in 2004,05. Results: After adjusting for age, diabetes prevalence was significantly higher among those of lower SES in both Indigenous and non-Indigenous populations. The age- and sex-adjusted odds ratios (OR) for diabetes for the lowest versus the highest SES group were similar for the two populations on many variables. For example, the OR for the lowest quintile of equivalised household income (compared with quintiles 3,5 combined) was 2.3 (95% CI 1.6,3.4) for the Indigenous population and 2.0 (95% CI 1.5,2.8) for the non-Indigenous population. However, Indigenous people of high SES had greater diabetes prevalence than low SES non-Indigenous people on every SES measure examined. Conclusion: Socio-economic status explains some but not all of the difference in diabetes prevalence between Indigenous and non-Indigenous Australians. Other factors that may operate across the socio-economic spectrum, such as racism, stress, loss and grief, may also be relevant and warrant further examination. Implications: Indigenous Australians do not constitute a homogeneous group with respect to socio-economic status or diabetes prevalence, and this diversity must be recognised in developing measures to redress Indigenous health disadvantage. [source] Managing alcohol-related problems among Indigenous Australians: what the literature tells usAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 2010Dennis Gray Abstract Objective: To contextualise and provide an overview of two review papers , prepared as part of a larger research program , dealing with different aspects of the treatment of Indigenous Australians with alcohol-related problems. Method: The papers were reviewed thematically and compared to identify key issues raised in them. Findings: Together, the papers highlight the paucity of the evidence base for the provision of treatment for Indigenous Australians with alcohol-related problems. Among the key issues identified are: the need to engage with clients in culturally safe ways; practitioner, organisational and client barriers to engagement; the contexts in which Indigenous drinking and treatment take place; the need to develop rigorous methods of evaluation more appropriate to Indigenous cultural and service provision settings; and the importance of effective partnerships in the provision of services. Conclusion: For those working in the field, the reviews direct attention to the need to review and interrogate our current practice. They also provide clear directions for future research. [source] Delivering culturally appropriate residential rehabilitation for urban Indigenous Australians: a review of the challenges and opportunitiesAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 2010Kate Taylor Abstract Objective: To review the challenges facing Indigenous and mainstream services in delivering residential rehabilitation services to Indigenous Australians, and explore opportunities to enhance outcomes. Methods: A literature review was conducted using keyword searches of databases, on-line journals, articles, national papers, conference proceedings and reports from different organisations, with snowball follow-up of relevant citations. Each article was assessed for quality using recognised criteria. Results: Despite debate about the effectiveness of mainstream residential alcohol rehabilitation treatment, most Indigenous Australians with harmful alcohol consumption who seek help have a strong preference for residential treatment. While there is a significant gap in the cultural appropriateness of mainstream services for Indigenous clients, Indigenous-controlled residential organisations also face issues in service delivery. Limitations and inherent difficulties in rigorous evaluation processes further plague both areas of service provision. Conclusion: With inadequate evidence surrounding what constitutes ,best practice' for Indigenous clients in residential settings, more research is needed to investigate, evaluate and contribute to the further development of culturally appropriate models of best practice. In urban settings, a key area for innovation involves improving the capacity and quality of service delivery through effective inter-agency partnerships between Indigenous and mainstream service providers. [source] Reducing alcohol related harm experienced by Indigenous Australians: identifying opportunities for Indigenous primary health care servicesAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 2010Anthony Shakeshaft Abstract Objective: Identify key issues and opportunities relating to the dissemination of cost-effective interventions for alcohol in Indigenous-specific settings. Methods: Update previous reviews of the Indigenous alcohol literature, particularly in relation to intervention and dissemination studies aimed at identifying and integrating into routine clinical care those strategies that are most cost-effective in reducing alcohol-related harm. Results: The harmful use of alcohol has been identified as a major public health issue, which has a disproportionately high negative impact on Indigenous Australians. While the disproportionately high burden of harm borne by Indigenous Australian communities is well documented in descriptive studies, attempts to redress this imbalance through well controlled intervention and dissemination studies appear to have been inadequate to date. There is compelling evidence from the non-Indigenous community that brief intervention is an effective treatment for harmful alcohol use, compared to the relatively lower levels of evidence for primary and tertiary level interventions. The effectiveness of brief intervention for alcohol in Indigenous Australian communities should, therefore, be examined. Conclusions and Implications: An opportunity exists to implement brief intervention into Indigenous primary health care settings, as an evidence-based strategy using established resources. There is the possibility that such Indigenous-specific health services research will lead the dissemination field in demonstrating how the implementation process can be successfully tailored to specific and defined clinical settings. [source] Epidemiology of alcohol-related burden of disease among Indigenous AustraliansAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 2010Bianca Calabria Abstract Objective: To compare the burden of alcohol-related harm and underlying factors of this harm, by age and sex, for Indigenous and general population Australians. Methods: Population attributable fractions are used to estimate the disability adjusted life years (DALYs) for alcohol-related disease and injury. The DALYs were converted to rates per 1,000 by age and sex for the Indigenous and general populations. Results: Homicide and violence rates were much higher for Indigenous males: greatest population difference was for 30,44 years, Indigenous rate 8.9 times higher. Rates of suicide were also greater: the largest population difference was for 15,29 years, Indigenous rate 3.9 times higher. Similarly, for Indigenous females, homicide and violence rates were much higher: greatest population difference was for 30,44 years, Indigenous rate 18.1 times higher. Rates of suicide were also greater: the largest population difference was for 15,29 years, Indigenous rate 5.0 times higher. Conclusions: Alcohol consumption and associated harms are of great concern for Indigenous Australians across all ages. Violent alcohol-related harms have been highlighted as a major concern. Implications: To reduce the disproportionate burden of alcohol-related harm experienced by Indigenous Australians, targeted interventions should include the impact on families and communities and not just the individual. [source] Brief intervention resource kits for Indigenous Australians: generally evidence-based, but missing important componentsAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 2010Anton Clifford Abstract Objective: Little is known about the content and quality of brief intervention kits specifically targeting SNAP risk factors (smoking, poor nutrition, alcohol misuse or physical inactivity) among Indigenous Australians. This paper reviews the type and quality of these kits. Methods: Brief intervention kits were primarily identified by contacting 74 health-related organisations in Australia between 1 February 2007 and 4 March 2007. Results: Ten brief intervention kits met inclusion criteria: four targeted smoking; three targeted alcohol; one targeted alcohol, smoking and other drugs; one targeted alcohol, other drugs and mental health; and one targeted all SNAP risk factors. Brief intervention kits were reviewed using criteria developed from clinical guidelines for SNAP risk factors and guidelines for evaluating health promotion resources. Three kits met all review criteria. Five kits were consistent with evidence-based guidelines, but lacked a training package, patient education materials and/or behavioural change strategies. All kits used images and language identifiable with Indigenous Australia, however, their cultural appropriateness for Indigenous Australians remains unclear. Conclusions and implications: The specific content of the missing components should be guided by the best-available evidence, such as established mechanisms for health care provider feedback to patients as a behaviour change strategy, as well as the needs and preferences of health care providers and patients. [source] Living longer with a greater health burden , changes in the burden of disease and injury in the Northern Territory Indigenous population between 1994,1998 and 1999,2003AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 2010Yuejen Zhao Abstract Objective: To measure changes over time in the burden of disease for Northern Territory (NT) Indigenous and non-Indigenous population. Methods: The numbers, and crude and age-adjusted rates of disability adjusted life years (DALY) were calculated for periods 1994,1998 and 1999,2003. A measure of information bias was developed to adjust for the tendency of years lost to disability (a component of DALY) to increase over time because of increasing data availability. The jackknife method was used for DALY uncertainty assessment. Results: The all-cause DALY rate was stable for the non-Indigenous population, but increased for the Indigenous population. For both populations, the burden of premature death decreased while the burden of disability increased. For the Indigenous population, there were substantial increases in DALY rates for type 2 diabetes, depression, nephritis/nephrosis, suicide and sense organ disorders. Conclusions: The burden of disease for Indigenous people increased over the study periods, with improvement in the burden of fatal outcomes more than offset by substantial increase in the prevalence and severity of non-fatal conditions. Implications: The paradoxical shift of living longer with a greater health burden has not been previously reported for Indigenous Australians, and highlights the critical importance of prevention for sustaining life expectancy improvement and managing escalation of health costs. This study also demonstrated the usefulness of the DALY to monitor population health. [source] End-stage kidney failure in Indigenous AustraliansAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 4 2008John Mathews No abstract is available for this article. [source] Can human rights discourse improve the health of Indigenous Australians?AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 5 2006Natalie Gray Objective:Recognition of the poor health outcomes of Indigenous Australians has led to an interest in using human rights discourse as a framework for arguing that the Australian Government has an international obligation to improve Indigenous health. Method:This paper explores two potential directions for human rights discourse in this context. The first is the development and elaboration of an asserted ,human right to health'. The second focuses on developing an understanding of the interactions between health and human rights, particularly the underlying social determinants of health, and thereby creating an advocacy framework that could be used to promote the inclusion of human rights considerations into the policy-making agenda. Results:This paper argues that despite the symbolic force of human rights discourse, its capacity to improve the health of Indigenous Australians through international law is limited. This is so irrespective of whether recourse is made to a legal or moral imperative. Conclusion and Implications:The ,human right to health' is limited primarily by several barriers to its implementation, some of which are perpetuated by the current Australian Government itself. Although the potential advocacy capacity of human rights discourse is similarly limited by the hostility of the Government towards the notion of incorporating human rights considerations into its public policy decision making, it does provide a sustainable intellectual framework in which to consider the social and structural determinants of health and maintain these issues on the political agenda. [source] Comparing Indigenous health status across regions: a numerical example of uncertaintyAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 6 2002Joan Cunningham Objective: To illustrate how regional variation in data quality could explain some or all of the apparent regional differences in the health status of Indigenous Australians. Methods: A series of simple hypothetical numerical examples is provided, with varying assumptions regarding the accuracy of identification of Indigenous deaths. Results: The apparent difference in Indigenous mortality in remote compared with urban areas is of a magnitude that could be explained by relatively modest regional differences in data quality. Conclusion and implications: Determinations of relative health status within the Indigenous population must take into account the impact of variability in data quality. Accepted: October 2002 [source] Oral health-related quality of life among rural-dwelling Indigenous AustraliansAUSTRALIAN DENTAL JOURNAL, Issue 2 2010SD Williams Abstract Background:, There is limited information on the impact of poor oral health on Indigenous Australian quality of life. This study aimed to determine the prevalence, extent and severity of, and to calculate risk indicators for, poor oral health-related quality of life among a convenience sample of rural-dwelling Indigenous Australians. Methods:, Participants (n = 468) completed a questionnaire that included socio-demographic, lifestyle, dental service utilization, dental self-care and oral health-related quality of life (OHIP-14) factors. Results:, The prevalence of having experienced one or more of OHIP-14 items ,fairly often' or ,very often' was 34.8%. The extent of OHIP-14 scores was 1.88, while the severity was 15.0. Risk indicators for having experienced one or more of OHIP-14 items ,fairly often' or ,very often' included problem-based dental attendance, avoiding dental care because of cost, difficulty paying a $100 dental bill and non-ownership of a toothbrush. An additional risk indicator for OHIP-14 extent was healthcare card ownership, while additional indicators for OHIP-14 severity were healthcare card ownership and having had 5+ teeth extracted. Conclusions:, Risk indicators for poor oral health-related quality of life among this marginalized population included socio-economic factors, dentate status factors, dental service utilization patterns, financial factors and dental self-care factors. [source] A HISTORICAL PERSPECTIVE ON INDIGENOUS SOCIOECONOMIC OUTCOMES IN AUSTRALIA, 1971,2001AUSTRALIAN ECONOMIC HISTORY REVIEW, Issue 3 2005Jon C. Altman aborigines; Australia; population census; social change; economic change Current debate in Indigenous affairs in Australia often involves the assertion that the last 30 years has been a period of policy failure. This article examines trends across a number of socioeconomic outcomes for Indigenous Australians from the 1967 referendum to the present, using census data. Overall, there has been steady, although not spectacular improvement in outcomes over time. These improvements are especially marked for education, which was coming from an exceptionally low base. This finding is somewhat at odds with the common perception of the ,failure' of Indigenous policy. [source] Learning from the past, looking to the future: Exploring our place with Indigenous AustraliansAUSTRALIAN OCCUPATIONAL THERAPY JOURNAL, Issue 2 2009Alison Nelson This paper aims to explore ways in which we as occupational therapists in Australia can participate in enabling a different and better future for all Australians. In doing so, it is necessary to explore our history and our cultures, both individually and collectively as a profession, and to understand the ways in which these shape who we are and what we do. As occupational therapists, we have valuable knowledge and skills that have the potential to contribute in a positive way to the health and educational outcomes of Indigenous Australians. As a profession operating in Australia, we also have a responsibility to reach this potential. This paper aims to present some of these contributions and to provide examples of practical and culturally safe ways in which we can take action. [source] Associations between tobacco and cannabis use in remote indigenous populations in Northern AustraliaADDICTION, Issue 3 2005Alan R. Clough ABSTRACT Aims To assess whether cannabis use, recently taken up by many indigenous Australians in remote communities, has reinforced tobacco use. Design Cross-sectional study. Setting Three eastern Arnhem Land communities (Northern Territory, NT); total population = 3384, in 2001. Participants From 1247 people aged 17,36 years, 190 (120 males, 70 females) were opportunistically recruited. Measurements Self-reported life-time and current tobacco, cannabis and other substance use were confirmed by local health workers and using clinic records. Participants reported level of substance use, frequency and duration (years used). Associations with tobacco use were calculated (odds ratios: OR) using logistic regression with age, sex, alcohol use and a history of petrol sniffing as confounders. Findings In univariate analyses current tobacco users were more likely than non-users to be using cannabis (OR = 3.1, 1.5,6.2, P = 0.002) and this association remained in multivariate analyses (OR = 3.0, 1.4,6.8, P = 0.006). Tobacco use was associated with the number of years of cannabis use (P = 0.035). The likelihood that tobacco users were also cannabis users increased as quantity of cannabis used increased (P = 0.008). Current tobacco use was no more likely in those who initiated cannabis from 1998 onwards than in those who initiated cannabis before 1998 (OR = 1.1, 0.4,3.2, P = 0.881). One-third of life-time users of both tobacco and cannabis initiated their use at or near the same time, and very few of these (12%) had discontinued either cannabis or tobacco. Conclusions Cannabis appears to have influenced the continued use of tobacco in these populations with possible additional burdens for cardiovascular and respiratory diseases and challenges for interventions. [source] | |||||||||||||||||||