The risk status, screening history and health concerns of Aboriginal and Torres Strait Islander people attending an Aboriginal Community Controlled Health Service

Background Gonorrhoea occurs at high levels in young Aboriginal and Torres Strait Islander people living in remote communities, but there are limited data on urban and regional settings. An analysis was undertaken of gonorrhoea testing and positivity at four non-remote Aboriginal Community Controlled Health Services participating in a collaborative research network. Methods: This was a retrospective analysis of clinical encounter data derived from electronic medical records at participating services. Data were extracted using the GRHANITE program for all patients aged 15–54 years from 2009 to 2013. Demographic characteristics and testing and positivity for gonorrhoea were calculated for each year. Results: A total of 2971 patients (2571 Aboriginal and/or Torres Strait Islander) were tested for gonorrhoea during the study period. Among Aboriginal and/or Torres Strait Islander patients, 40 (1.6%) tested positive. Gonorrhoea positivity was associated with clinic location (higher in the regional clinic) and having had a positive chlamydia test. By year, the proportion of patients aged 15–29 years tested for gonorrhoea increased in both men (7.4% in 2009 to 15.9% in 2013) and women (14.8% in 2009 to 25.3% in 2013). Concurrent testing for chlamydia was performed on 86.3% of testing occasions, increasing from 75% in 2009 to 92% in 2013. Factors related to concurrent testing were sex and year of test. Conclusions: The prevalence of gonorrhoea among young Aboriginal and/or Torres Strait Islander people in non-remote settings suggests that the current approach of duplex testing for chlamydia and gonorrhoea simultaneously is justified, particularly for women.

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(Murradambirra Dhangaang - Make Food Secure) Aboriginal Community and Stakeholder Perspectives on Food Insecurity in Urban and Regional Australia: A Qualitative Study

10.21203/rs.3.rs-463149/v1 ◽

2021 ◽

Author(s):

Simone Sherriff ◽

Deanna Kalucy ◽

Allison Tong ◽

Nawazish Naqvi ◽

Janice Nixon ◽

...

Keyword(s):

Food Insecurity ◽

Torres Strait Islander ◽

Local Food ◽

System Level ◽

Torres Strait Islander People ◽

Aboriginal Communities ◽

Aboriginal Community ◽

Stakeholder Perspectives ◽

Torres Strait ◽

Regional Australia

Abstract Background: Food insecurity affects one in five Aboriginal and Torres Strait Islander people residing in non-remote environments. Inequalities in diet contribute to the differential impact on diet-sensitive chronic diseases and the related burden of disease among Aboriginal and Torres Strait Islander people. This study aimed to describe Aboriginal community and stakeholder perspectives on food insecurity to get a better understanding of the key factors driving this issue and recommendations for potential solutions in urban and regional Aboriginal communities in Australia. Methods: Semi-structured interviews were conducted with 44 participants who were purposively selected. This included Aboriginal people in two communities and both Aboriginal and non-Aboriginal stakeholders from local food relief agencies, food suppliers, schools, and government. A conceptual framework was developed from food insecurity literature and we used the sensitizing concepts of availability, affordability, accessibility and acceptability or the lack thereof of healthy food to elicit interview responses. Interview transcripts were analysed thematically. Results: All participants felt strongly that food insecurity was a major problem experienced in the local Aboriginal communities. Five core areas impacting on food security identified: trapped in financial disadvantage; gaps in the local food system; limitations of non-Aboriginal food relief services; on-going impacts of colonization; and maintaining family, cultural and community commitments and responsibilities. Conclusions: This study found Aboriginal families in urban and regional Australia are experiencing food insecurity on a regular basis, which is impacted by a range of socio-economic, environmental, systemic and cultural factors, as reported by the participants. Our findings highlight the need to address system level changes in the food environment and acknowledge Aboriginal culture and food preferences while considering the development of programs to alleviate food insecurity among urban and regional communities.

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Disparity in Physical and Mental Multimorbidity Between Aboriginal and Torres Strait Islander people and non-Indigenous Australians: implications for Equity in Health Service use and Work Productivity

10.21203/rs.3.rs-127839/v1 ◽

2020 ◽

Author(s):

William Carman ◽

Marie Ishida ◽

Justin S Trounson ◽

Kanya Anindya ◽

Grace Sum ◽

...

Keyword(s):

Mental Health ◽

Health Service ◽

Torres Strait Islander ◽

Service Use ◽

Work Productivity ◽

Health Service Use ◽

Indigenous Australians ◽

Torres Strait Islander People ◽

Torres Strait ◽

Care Costs

Abstract Background: Multimorbidity, the presence of ≥2 chronic conditions, is a major contributor to health inequalities, with significant impact on health care costs. This study aims to examine the differences in chronic physical and mental health multimorbidity between Aboriginal and Torres Strait Islander people and non-Indigenous Australians, and the effect of multimorbidity on health service use and work productivity amongst Aboriginal and non-Indigenous Australians.Methods: This study conducted cross-sectional analyses of the Household, Income, and Labour Dynamics in Australia Wave 17, examining a nationally representative sample of 16,749 respondents aged 18 years and above. We applied multivariable linear and logistic regressions to examine the association between multimorbidity and self-reported health, health service use, and employment productivity.Results: Aboriginal respondents reported a higher prevalence of multimorbidity (24.2%) compared to non-Indigenous Australians (20.7%), and the prevalence of co-existing mental and physical multimorbidity was almost twice as high (16.1% vs 8.1%). Multimorbidity was associated with higher health service use (any overnight admission: AOR 1.52), reduced employment productivity (days sick leave: coef. 0.25), and lower perceived health status (SF6D score: coef. -0.04). These associations are similar in both Aboriginal and non-Indigenous populations.Conclusions: Multimorbidity prevalence was greater among Aboriginal and Torres Strait Islanders compared to the non-Indigenous population, likely driven by the greater prevalence of mental health conditions reported by the Aboriginal sample. Strategies for better management of mental and physical multimorbidity would not only reduce health care costs among those affected but may contribute to a reduction in health inequalities in Australia.

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Cardiovascular disease risk assessment in an Aboriginal community-controlled health service: comparing algorithms

Australian Journal of Primary Health ◽

10.1071/py19216 ◽

2020 ◽

Vol 26 (4) ◽

pp. 281 ◽

Cited By ~ 1

Author(s):

Xavier Fitzgerald ◽

Ana Herceg ◽

Kirsty Douglas ◽

Nadeem Siddiqui

Keyword(s):

Cardiovascular Disease ◽

Risk Assessment ◽

High Risk ◽

Health Service ◽

Torres Strait Islander ◽

Lipid Lowering ◽

Risk Scores ◽

Cvd Risk ◽

Aboriginal Community ◽

Torres Strait

Aboriginal and Torres Strait Islander people have high rates of cardiovascular disease (CVD). The National Vascular Disease Prevention Alliance (NVDPA) CVD risk assessment algorithm is used for all Australians. The Central Australian Rural Practitioners Association (CARPA) algorithm used in the Northern Territory adds five percentage points to all NVDPA risk scores for Indigenous Australians. Information was extracted from an Aboriginal Community-Controlled Health Service for all Aboriginal and Torres Strait Islander regular clients aged 35–74 years without known CVD (n=1057). CVD risk scores were calculated using both algorithms. Prescription of lipid-lowering medications was assessed. Clients with high-risk scores were reviewed and recalled if required. CVD risk scores were calculated for 362 (34.4%) clients. Clients with high CVD risk comprised 17.7% (NVDPA) or 23.8% (CARPA), with most determined clinically. Clients with low CVD risk comprised 73.7% (NVDPA) or 47.2% (CARPA). More than 30% of those with high risk were not on lipid-lowering medications. Significant health and social issues affected treatment uptake. It is unclear which algorithm is most applicable; however, this service has decided to continue to use the NVDPA algorithm. Use of CVD risk assessment and management of high-risk clients could be increased in primary care.

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The impact of Aboriginal community controlled health service advocacy on Aboriginal health policy

Australian Journal of Primary Health ◽

10.1071/py05022 ◽

2005 ◽

Vol 11 (2) ◽

pp. 53 ◽

Cited By ~ 10

Author(s):

Ben Bartlett ◽

John Boffa

Keyword(s):

Health Policy ◽

Health Service ◽

Health Services ◽

Torres Strait Islander ◽

Aboriginal Health ◽

Aboriginal Community ◽

Implementation Phase ◽

Torres Strait ◽

Strategic Relationships ◽

The Impact

This paper reviews the advocacy role of Aboriginal community controlled health services (ACCHSs) in the development of Aboriginal health policy over the past 30 years, with a specific focus on the recent changes in Commonwealth funding and administrative responsibility - the transfer of Aboriginal health service funding from the Aboriginal and Torres Strait Islander Commission (ATSIC) to the Office of Aboriginal and Torres Strait Islander Health Services (OATSIHS) within the Commonwealth Department of Health and Ageing (DoHA), and the development of policies aimed at Aboriginal health services accessing mainstream (Medical Benefits Scheme [MBS]) funds. The outcomes of this policy change include a significant increase in funding to Aboriginal primary health care (PHC), the inclusion of ACCHSs in collaborative strategic relationships, and the development of new arrangements involving regional planning and access to per capita funds based on MBS equivalents. However, the community sector remains significantly disadvantaged in participating in this collaborative effort, and imposed bureaucratic processes have resulted in serious delays in releasing funds for actual services in communities. Government agencies need to take greater heed of community advocacy, and provide appropriate resourcing to enable community organisations to better direct government effort, especially at the implementation phase. These remain major concerns and should be considered by non-health sectors in the development of new funding and program development mechanisms in the wake of the abolition of ATSIC.

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Engaging with Aboriginal Shire Councils in remote Cape York communities to address smoke-free environments

Australian Journal of Primary Health ◽

10.1071/py19023 ◽

2019 ◽

Vol 25 (5) ◽

pp. 419

Author(s):

Kiarah E. Cuthbert ◽

Clare Brown ◽

Melinda Hammond ◽

Tiffany A. Williams ◽

Desmond Tayley ◽

...

Keyword(s):

Health Services ◽

Tobacco Smoking ◽

Torres Strait Islander ◽

Service Providers ◽

Critical Role ◽

Torres Strait Islander People ◽

Aboriginal Community ◽

Health Council ◽

Cape York ◽

Torres Strait

The high prevalence and health effect of tobacco smoking and secondhand smoke exposure among Aboriginal and Torres Strait Islander people is well known. Due to its significance, the responsibility of tackling smoking among Aboriginal and Torres Strait Islander people should not remain solely with health service providers. The creation of supportive environments and collaboration beyond the health sector are critical elements of comprehensive primary health care practised by Aboriginal Community Controlled Health Services. This paper discusses how Apunipima Cape York Health Council worked with three Aboriginal Shire Councils to create more smoke-free places, using local working groups, information sessions and community-based health promotion. The flexibility and the time allocated to the engagement process with councils, community leaders, organisations and community members were important. All three communities acknowledged the benefits of role modelling and working together to improve health, with addressing tobacco smoking seen as ‘everyone’s business’ and ‘not just service providers’. Aboriginal Shire Councils can play a critical role, in partnership with Aboriginal Community Controlled Health Services, in creating healthy places that enable healthy choices.

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