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Indigenous Status (indigenous + status)
Selected AbstractsPost-neonatal mortality by rurality and Indigenous status in QueenslandJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 7-8 2006Michael Coory Aim: To compare post-neonatal mortality among urban and rural Indigenous babies in Queensland. Methods: Registrations of deaths at ages 28 days to 12 months were linked to routine data from the Queensland Perinatal Data Collection. Results: Indigenous babies were 2.52 times more likely to die during the post-neonatal period than non-Indigenous babies (95% confidence interval: 1.99, 3.20). The differential remained when urban and rural areas were examined separately: the differential was 2.53 (1.81, 3.54) in urban areas and 2.26 (1.58, 3.23) in rural areas. Conclusion: The key demographic variable that determines post-neonatal mortality in Queensland is Indigenous status, not rurality. This has important policy implications because it means that interventions to reduce the disparity in mortality between Indigenous and non-Indigenous babies should be delivered in urban as well as rural areas. Better routine data are needed and in particular clinical classification of deaths, so that interventions can be monitored and avoidable factors identified. [source] What is the impact of missing Indigenous status on mortality estimates?AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 4 2009An assessment using record linkage in Western Australia Abstract Background: The analysis aimed to assess the Indigenous status of an increasing number of deaths not coded with a useable Indigenous status from 1997 to 2002 and its impact on reported recent gains in Indigenous mortality. Methods: The Indigenous status of WA death records with a missing Indigenous status was determined based upon data linkage to three other data sources (Hospital Morbidity Database System, Mental Health Information System and Midwives Notification System). Results: Overall, the majority of un-coded cases were assigned an Indigenous status, with 5.9% identified as Indigenous from the M1 series and 7.5% from the M2 series. The significant increase in Indigenous male LE of 5.4 years from 1997 to 2002 decreased to 4.0 and 3.6 years using the M1 and M2 series, respectively, but remained significant. For Indigenous females, the non-significant increase in LE of 1.8 years from 1997 to 2002 decreased to 1.0 and 0.6 years. Furthermore, annual all-cause mortality rates were higher than in the original data for both genders, but the significant decline for males remained. Conclusion: Through data linkage, the increasing proportion of deaths not coded with a useable Indigenous status was shown to impact on Indigenous mortality statistics in Western Australia leading to an overestimate of improvements in life expectancy. Greater attention needs to be given to better identification and recording of Indigenous identifiers if real improvements in health status are to be demonstrated. A system that captures an individual's Indigenous status once and is reflected in all health and administrative data systems needs consideration within Australia. [source] Measuring the gap: accuracy of the Western Australian hospital morbidity data in the identification of adult urban Aboriginal and Torres Strait Islander peopleAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 3 2009Pamela J. Bradshaw Abstract Objective: To assess the sensitivity of the recording of Aboriginality in the Western Australia Linked Data. Methods: This was a follow-up study using record linkage. Demographic data was obtained from 993 adult, urban-dwelling Aboriginal Australian participants in the Perth Aboriginal Atherosclerosis Risk study (PAARS). These were linked to the Western Australian Linked Data (State-wide hospital admissions and discharges, and deaths) to provide the number of admissions and Indigenous status coding from 1980 to 2006. Results: There were 14,413 admissions for PAARS participants in the study period. The sensitivity of coding of Indigenous status in hospital admissions data significantly improved over time, exceeding 0.9 in every year since 2002. Prior to 2002 sensitivity was around 0.8, but poorer for males, with some anomalous years. Conclusions: The coding of Indigenous status in the Western Australia Hospital Morbidity Database since 2002 has improved. The data from earlier decades must be approached with more caution. Implications: The improved accuracy of identification of Indigenous status in the Western Australia Hospital Morbidity Database allows comparative studies of adult Aboriginal and non-Aboriginal population health outcomes to be undertaken with confidence. [source] Exploring the epidemiological characteristics of cancers of unknown primary site in an Australian population: implications for research and clinical careAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 4 2008Colin Luke Abstract Objectives: To investigate incidence, mortality and case survival trends for cancer of unknown primary site (CUP) and consider clinical implications. Method: South Australian Cancer Registry data were used to calculate age-standardised incidence and mortality rates from 1977 to 2004. Disease-specific survivals, socio-demographic, histological and secular predictors of CUP, compared with cancers of known primary site, and of CUP histological types, using multivariable logistic regression were investigated. Results: Incidence and mortality rates increased approximately 60% between 1977-80 and 1981-84. Rates peaked in 1993-96. Male to female incidence and mortality rate ratios approximated 1.3:1. Incidence and mortality rates increased with age. The odds of unspecified histological type, compared with the more common adenocarcinomas, were higher for males than females, non-metropolitan residents, low socio-economic areas, and for 1977-88 than subsequent diagnostic periods. CUP represented a higher proportion of cancers in Indigenous patients. Case survival was 7% at 10 years from diagnosis. Factors predictive of lower case survival included older age, male sex, Indigenous status, lower socio-economic status, and unspecified histology type. Conclusion: Results point to poor CUP outcomes, but with a modest improvement in survival. The study identifies socio-demographic groups at elevated risk of CUP and of worse treatment outcomes where increased research and clinical attention are required. [source] Cancer mortality in Aboriginal people in New South Wales, Australia, 1994,2002AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 5 2006Rajah Supramaniam Objective:To describe, for the first time, mortality from cancer for Aboriginal residents of New South Wales (NSW). Methods:These are the results of a descriptive study of cancer deaths from the NSW Central Cancer Registry for 1994 to 2002. Standardised mortality ratios were calculated with Poisson confidence intervals to compare the relative rates in the Indigenous and non-Indigenous populations. Results:The overall standardised mortality rates were 66% higher for males and 59% higher for females for Aboriginal people compared with non-Indigenous people. Mortality from lung cancer was 50% and 100% higher than for NSW non-Indigenous males and females respectively. The high mortality rate from cervical cancer in Aboriginal females is contrary to the trends in the general population since the introduction of free population-based screening. Conclusions:For the first time, data are available for cancer mortality for Aboriginal people in NSW. Mortality for all cancers combined was higher than that of the non-Indiaenous population. This suggests that a combination of later diagnoses and perhaps poorer treatment outcomes as well as being diagnosed with poorer prognosis cancers is occurring in Aboriginal people of NSW. Implications:It was possible to increase the rate of identification in a population register using routinely collected data, but the completeness and accuracy of Indigenous status should, and can, be improved in all notifying data collections. Public health planners in NSW can now begin to address the issues of prevention, treatment and palliation of cancer in Aboriginal people with local, rather than imputed, evidence. [source] Social Inequality: Utilisation of general practitioner services by socio-economic disadvantage and geographic remotenessAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 2 2004Gavin Turrell Objective: To examine the association between socio-economic status (SES) and GP utilisation across Statistical Local Areas (SLAs) that differed in their geographic remoteness, and to assess whether Indigenous status and GP availability modified the association. Design: Retrospective analysis of Medicare data for all unreferred GP consultations (1996/97) for 952 SLAs comprising the six Australian States. Geographic remoteness was ascertained using the Area Remoteness Index of Australia (ARIA), and SES was measured by grouping SLAs into tertiles based on their Index of Relative Socioeconomic Disadvantage score. Main outcome measure: Age/sex standardised rates of GP utilisation for each SLA. Main results: In SLAs classified as ,highly accessible', rates of GP use were 10.8% higher (95% CI 5.7,16.0) in the most socio-economically disadvantaged tertile after adjustment for Indigenous status and GP availability. A very different pattern of GP utilsation was found in ,remote/very remote' SLAs. After adjustment, rates of GP use in the most socio-economically disadvantaged tertile were 25.3% lower (95% CI 5.9,40.7) than in the most advantaged tertile. Conclusions: People in socio-economically disadvantaged metropolitan SLAs have higher rates of GP utilisation, as would be expected due to their poorer health. This is not true for people living in disadvantaged remote/very remote SLAs: in these areas, those most in need of GP services are least likely to receive them. Australia may lay claim to having a primary health care system that provides universal coverage, but we are still some way from having a system that is economically and geographically accessible to all. [source] Evaluation of immunisation coverage for Aboriginal and Torres Strait Islander children using the Australian Childhood Immunisation RegisterAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 1 2004Brynley P. Hull Objective: To estimate immunisation coverage for routinely administered vaccines among children using receipt of a particular Hib vaccine (PRP-OMP) as a proxy for Indigenous status. Methods: Until May 2000, PRP-OMP was provided only for Indigenous children in all jurisdictions except the Northern Territory. In three one-year ACIR-derived birth cohorts, any child recorded on the ACIR as receiving one or more doses of PRP-OMP as the only Hib vaccine was presumed to be Aboriginal and Torres Strait Islander. Using this proxy, estimated numbers of Indigenous children were compared with Australian Bureau of Statistics estimates, and immunisation status for recommended vaccines was estimated at 12 and 24 months by jurisdiction and remoteness compared with children who received other Hib vaccines (presumed non-Indigenous). Results: The numbers of Aboriginal and Torres Strait Islander children estimated using this ,proxy method' are approximately 42% of those estimated by the ABS. Immunisation coverage (among proxy Indigenous children) at 12 months (72,76%) and 24 months (64,73%) was considerably lower than others (90,94% and 81,88%, respectively). These children had significantly lower coverage when living in accessible areas than remote areas. Conclusions and Implications: These data provide the first national measure of immunisation status and are likely to be a valid measure among those identified. Aboriginal and Torres Strait Islander immunisation coverage is 17% lower with the biggest gaps in urban areas, indicating the need for better quality data informing appropriate interventions. [source] Results from the 4th National Clients of Treatment Service Agencies census: changes in clients' substance use and other characteristicsAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 4 2002Fiona Shand Objective: The 2001 Clients of Treatment Service Agencies (COTSA) census, the fourth since 1990, was conducted to enable a comparison of the drug and alcohol-related problems being treated over an 11-year period. Method The 24-hour census was conducted on Wednesday 2 May 2001 in all Australian States and Territories. All agencies providing treatment for drug and alcohol problems in Australia were asked to provide demographic, treatment and substance use information about all clients treated on census day. The data were analysed with frequencies and basic descriptive statistics. Results: Of the agencies surveyed, 90.3% responded. The census suggests that, among the treatment population, the mean age of substance users has decreased and the proportion of clients who are women has increased. Treatment for opiate, cannabis and amphetamine problems increased; treatment for alcohol problems decreased. Substance use patterns differed according to sex, age, size of the population centre, and Indigenous status. Conclusions and implications: Changes among the treatment population reflect changes in demographics and substance use among the broader drug-using community, with the exception of the presentation of alcohol problems for treatment. The reasons for the apparent decline in treatment for alcohol problems are not clear, although a number of factors, such as changes in treatment strategies and facilities and relative increases in other substance use problems, are considered. Any decrease in treatment for a significant health problem such as alcohol use disorder will have considerable public health implications. [source] Lip cancer in Western Australia, 1982,2006: a 25-year retrospective epidemiological studyAUSTRALIAN DENTAL JOURNAL, Issue 2 2009L Abreu Abstract Background:, The aim of this study was to report on the epidemiological trends in incidence and mortality rates of lip cancer in Western Australia from 1982,2006. Methods:, Incidence and mortality data were provided by the Western Australian Cancer Registry. Analysis of demographic distribution by gender, age, metro-rural residence and Indigenous status and by sub-site of lip cancer was undertaken. Percentages, crude, age-specific and direct age-standardized rates were computed with 95% confidence intervals. Results:, In Western Australia, lip cancer represents 49 per cent of all oral cancer cases. A total of 2152 new cases and 31 deaths due to lip cancer were reported. Eighty-one per cent of new cases occurred on the lower lip. The incidence rate ratio of males to females was 2.5-3:1, with non-Indigenous people suffering 98 per cent of lip cancer. Rural dwellers have higher standardized incidence rates when compared to people living in metropolitan areas. An increasing trend with older age is consistent throughout the study period. Conclusions:, Over the 25 years, on average 90,100 people are diagnosed with lip cancer but only 1,2 people die each year. These mortality rates are very low indeed and are the reason for its good prognosis. [source] Indigenous children and receipt of hospital dental care in AustraliaINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 5 2006L. M. JAMIESON Summary., Objective., The aim of this study was to investigate dental procedures received under hospital general anaesthetic by indigenous and non-indigenous Australian children in 2002,2003. Methods., Separation data from 1297 public and private hospitals were obtained from the Australian Institute of Health and Welfare National Hospital Morbidity Database for 2002,2003. The dependant variable was the admission rate of children receiving four categories of dental care (i.e. extraction, pulpal, restoration or other). The explanatory variables included sex, age group, indigenous status and location (i.e. major city, regional or remote). Rates were calculated using estimated resident population counts. Results., The sample included 24 874 children aged from 2 to 14 years. Some 4·3% were indigenous (n = 1062). Admission rates for indigenous and non-indigenous children were similar, with indigenous males having 1·2 times the admission rate of indigenous females (P < 0·05). Indigenous children aged < 5 years had 1·4 times the admission rate of similarly aged non-indigenous children (P < 0·001) and 5·0 times the admission rate of 10,14-year-old indigenous children (P < 0·001). Remote-living indigenous children had 1·5 times the admission rate of their counterparts in major cities or regional areas (P < 0·001), and 1·4 times the admission rate of remote-living non-indigenous children (P < 0·01). The extraction rate of indigenous males was 1·3 times that of non-indigenous males (P < 0·01), and 1·2 times that of indigenous females (P < 0·05). Pre-school indigenous children had 2·2 times the extraction rate of similarly aged non-indigenous children (P < 0·001), and 5·3 times that of indigenous 10,14-year-olds (P < 0·001). The extraction rate of remotely located indigenous children was 1·5 times that of indigenous children in major cities (P < 0·01), and 1·8 times that of remote-living non-indigenous children (P < 0·001). Conclusions., In certain strata , particularly males, the very young and those in remote locations , indigenous children experienced higher rates of extractions than non-indigenous children when undergoing care in a hospital dental general anaesthetic setting. [source] Low genetic variability of the white-clawed crayfish in the Iberian Peninsula: its origin and management implicationsAQUATIC CONSERVATION: MARINE AND FRESHWATER ECOSYSTEMS, Issue 1 2008Javier Diéguez-Uribeondo Abstract 1.A study on the genetic variability of the white-clawed crayfish was carried out based on mitochondrial cytochrome oxidase subunit I gene sequences. The sequences applied were more informative regarding white-clawed crayfish genetic variability than others previously used. 2.Two haplotypes were found to exist in the Iberian Peninsula. The haplotypes exhibit a strong geographic subdivision (,ST=0.83). One of the Iberian haplotypes was similar to north Italian haplotypes and the second differed in only one mutation. This pattern of genetic variability contrasts with those found in glacial refugial areas of France, Italy and the Balkan Peninsula. 3.Two hypotheses on the origin of the white-clawed crayfish in the Iberian Peninsula are discussed: (i) one based on an anthropogenic origin, and (ii) a second based on a successive number of postglacial ancient and recent bottlenecks, i.e. the disjunction between Iberian and Italian populations of white-clawed crayfish species is due to competition between A. italicus and A. pallipes, in addition to the impact of crayfish plague and human translocations. 4.New references for the white-clawed crayfish in the Iberian Peninsula were found in medieval and Arabic texts. The results show that this species has been thriving in this peninsula since ancient periods and that its indigenous status should not be questioned. 5.Conservation action and plans should consider the low genetic diversity as a limitation for farm-raising specimens more adapted and resistant to changing environments and diseases. Copyright © 2007 John Wiley & Sons, Ltd. [source] Chlamydia trachomatis in Tasmania 2001,2007: rising notification trendsAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 2 2010Nicola Stephens Abstract Objectives: To investigate trends in notification rates of Chlamydia trachomatis in Tasmania, Australia, by population sub-groups, from 1 January 2001 to 31 December 2007. Methods: An enhanced surveillance dataset was used to supplement case notifications. Rates based on age group were analysed by sex, geographic region, indigenous status, sexual exposure, reason for testing and healthcare provider. Results: In all age groups, the notification rate increased steeply. The highest rates were seen in the ages 15,24 years; this age group represented 15% of the population but accounted for 74% of the chlamydial notifications. The increased rates in females aged 15,24 years and males 15,19 years in Tasmania were larger than the increases observed nationally. Rates were consistently higher in urban areas. Females were more likely to have been tested as a result of screening, and males were more likely to have been tested when presenting with symptoms or as a result of contact tracing. The majority of cases reported sexual exposure with opposite sex partners only. Conclusions: This study highlights the increasing significance of chlamydial infection as a public health issue, the gender differences in health-seeking behaviour, and the discrepancies in testing patterns. These findings will assist with the design of health promotion programs. [source] Influence of socioeconomic and cultural factors on rural healthAUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 1 2009John R. Beard Abstract Objective:,To provide a framework for investigating the influence of socioeconomic and cultural factors on rural health. Design:,Discussion paper. Results:,Socioeconomic and cultural factors have long been thought to influence an individual's health. We suggest a framework for characterising these factors that comprises individual-level (e.g. individual socioeconomic status, sex, race) and neighbourhood-level dimensions (population composition, social environment, physical environment) operating both independently and through interaction. Recent spatial research suggests that in rural communities, socioeconomic disadvantage and indigenous status are two of the greatest underlying influences on health status. However, rural communities also face additional challenges associated with access to, and utilisation of, health care. The example is given of procedural angiography for individuals with an acute coronary event. Conclusions:,Socioeconomic and cultural factors specific to rural Australia are key influences on the health of residents. These range from individual-level factors, such as rural stoicism, poverty and substance use norms, to neighbourhood-level social characteristics, such as lack of services, migration out of rural areas of younger community members weakening traditionally high levels of social cohesion, and to environmental factors, such as climate change and access to services. [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] | ||||||||||