Lower than expected morbidity and mortality for an Australian Aboriginal population: 10-year follow-up in a decentralised community

Rowley, Kevin G., O'Dea, Kerin, Anderson, Ian, McDermott, Robyn, Saraswati, Karmananda, Tilmouth, Ricky, Roberts, Iris, Fitz, Joseph, Wang, Zaimin, Jenkins, Alicia, Best, James D., Wang, Zhiqiang, and Brown, Alex (2008) Lower than expected morbidity and mortality for an Australian Aboriginal population: 10-year follow-up in a decentralised community. Medical Journal of Australia, 188 (5). pp. 283-287.

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Abstract

Objective: To examine mortality from all causes and from cardiovascular disease (CVD), and CVD hospitalisation rate for a decentralised Aboriginal community in the Northern Territory.

Design and participants: For a community-based cohort of 296 people aged 15 years or older screened in 1995, we reviewed hospital and primary health care records and death certificates for the period up to December 2004 (2800 person-years of follow-up).

Main outcome measures: Mortality from all causes and CVD, and hospitalisation with CVD coded as a primary cause of admission; comparison with prior trends (1988 to 1995) in CVD risk factor prevalence for the community, and with NT-specific Indigenous mortality and hospitalisation rates.

Results: Mortality in the cohort was 964/100 000 person-years, significantly lower than that of the NT Indigenous population (standardised mortality ratio [SMR], 0.62; 95% CI, 0.42–0.89). CVD mortality was 358/100 000 person-years for people aged 25 years or older (SMR, 0.52; 95% CI, 0.23–1.02). Hospitalisation with CVD as a primary cause was 13/1000 person-years for the cohort, compared with 33/1000 person-years for the NT Indigenous population.

Conclusion: Contributors to lower than expected morbidity and mortality are likely to include the nature of primary health care services, which provide regular outreach to outstation communities, as well as the decentralised mode of outstation living (with its attendant benefits for physical activity, diet and limited access to alcohol), and social factors, including connectedness to culture, family and land, and opportunities for self-determination.

Item ID: 36808
Item Type: Article (Research - C1)
ISSN: 1326-5377
Funders: National Health and Medical Research Council (NHMRC), VicHealth, Australian Government Department of Health and Ageing
Date Deposited: 18 Dec 2014 02:38
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111706 Epidemiology @ 100%
SEO Codes: 92 HEALTH > 9203 Indigenous Health > 920301 Aboriginal and Torres Strait Islander Health - Determinants of Health @ 100%
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