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

Author(s):  
Simone Sherriff ◽  
Deanna Kalucy ◽  
Allison Tong ◽  
Nawazish Naqvi ◽  
Janice Nixon ◽  
...  

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.

Sexual Health ◽  
2017 ◽  
Vol 14 (4) ◽  
pp. 320 ◽  
Author(s):  
Mary Ellen Harrod ◽  
Sophia Couzos ◽  
James Ward ◽  
Mark Saunders ◽  
Basil Donovan ◽  
...  

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.


2020 ◽  
pp. 108-114 ◽  
Author(s):  
Jennifer Chynoweth ◽  
Meaghan M. McCambridge ◽  
Helen M. Zorbas ◽  
Jacinta K. Elston ◽  
Robert J.S. Thomas ◽  
...  

PURPOSE To improve cancer outcomes for Aboriginal and Torres Strait Islander people through the development and national endorsement of the first population-specific optimal care pathway (OCP) to guide the delivery of high-quality, culturally appropriate, and evidence-based cancer care. METHODS An iterative methodology was undertaken over a 2-year period, and more than 70 organizations and individuals from diverse cultural, geographic, and sectorial backgrounds provided input. Cancer Australia reviewed experiences of care and the evidence base and undertook national public consultation with the Indigenous health sector and community, health professionals, and professional colleges. Critical to the OCP development was the leadership of Aboriginal and Torres Strait Islander health experts and consumers. RESULTS The OCP received unanimous endorsement by all federal, state, and territory health ministers. Key elements of the OCP include attention to the cultural appropriateness of the health care environment; improvement in cross-cultural communication; relationship building with local community; optimization of health literacy; recognition of men’s and women’s business; and the need to use culturally appropriate resources. The OCP can be used as a tool for health services and health professionals to identify gaps in current cancer services and to inform quality improvement initiatives across all aspects of the care pathway. CONCLUSION The development of the OCP identified a number of areas that require prioritization. Ensuring culturally safe and accessible health services is essential to support early presentation and diagnosis. Multidisciplinary treatment planning and patient-centered care are required for all Aboriginal and Torres Strait Islander people, irrespective of location. Health planners and governments acknowledge the imperative for change and have expressed strong commitment to work with Indigenous Australians to improve the accessibility, cultural appropriateness, and quality of cancer care.


Author(s):  
Fiona H McKay ◽  
Stephanie L Godrich

Food insecurity disproportionately impacts Aboriginal and Torres Strait Islander Australians. This review sought to investigate research and evaluations of programs and interventions implemented to address food insecurity among Aboriginal and Torres Strait Islander communities. A rapid review was conducted to collate the available research from six databases. The search was conducted in May 2020. Search constructs related to food insecurity, Aboriginal and Torres Strait Islander people, and Australia. 25 publications were included in this review, 24 reported on an intervention, while nine were evaluations of an intervention. Interventions included behaviour change projects, including projects that sought to change purchasing and cooking behaviours, school-based education programs, and gardening programs. In general, the studies included in this sample were small, and lacked a systematic consideration of the factors that shape the experience of food insecurity among Aboriginal and Torres Strait Islander people specifically. Based on the findings of this review, authors suggest greater consideration to the systematic determinants of food insecurity among Aboriginal and Torres Strait Islander communities to have lasting and sustainable impact on food insecurity. This review has been registered with the international prospective register of systematic reviews (PROSPERO: CRD42020183709). Novelty bullets • Food insecurity among Aboriginal and Torres Strait Islander people poses significant risk to health and wellbeing. • Small scale food security interventions may not provide ongoing and sustained impact. • Any intervention to promote food security will need to involve Aboriginal and Torres Strait Islander people and be sustained once external parties have left.


2017 ◽  
Vol 23 (5) ◽  
pp. 415 ◽  
Author(s):  
Leigh Bramwell ◽  
Wendy Foley ◽  
Tanya Shaw

Food insecurity adversely affects diet quality, physical, mental and social wellbeing and the capacity to act on health advice recommended by primary healthcare providers. In this article, an overview of the neglected issue of food insecurity in urban Aboriginal and Torres Strait Islander communities is provided. Policy and action on food security for urban Aboriginal and Torres Strait Islander people is reviewed, and it is argued that for primary health care to better address food insecurity, an evidence base is needed to understand the experiences of individuals and households and how to work effectively to support food insecure clients.


2019 ◽  
Vol 25 (5) ◽  
pp. 419
Author(s):  
Kiarah E. Cuthbert ◽  
Clare Brown ◽  
Melinda Hammond ◽  
Tiffany A. Williams ◽  
Desmond Tayley ◽  
...  

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.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jamie Bryant ◽  
Natasha Noble ◽  
Megan Freund ◽  
Jennifer Rumbel ◽  
Sandra Eades ◽  
...  

Abstract Background Aboriginal and/or Torres Strait Islander people experience dementia at a rate three to five times higher than the general Australian population. Aboriginal Community Controlled Health Services (ACCHSs) have a critical role to play in recognising symptoms of cognitive impairment, facilitating timely diagnosis of dementia, and managing the impacts of dementia. Little is known about the barriers and enablers to Aboriginal people receiving a timely dementia diagnosis and appropriate care once diagnosed. This study aims to explore, from the perspective of healthcare providers in the ACCHS sector across urban, regional and remote communities, the barriers and enablers to the provision of dementia diagnosis and care. Methods A qualitative study involving semi-structured interviews with staff members working in the ACCHS sector. Aboriginal Health Workers, General Practitioners, nurses, practice or program managers, and Chief Executive Officers were eligible to participate. Consenting ACCHS staff completed a telephone interview administered by a trained interviewer. Interviews were audio-recorded, transcribed, and analysed using qualitative content analysis. Results Sixteen staff from 10 ACCHSs participated. Most participants perceived their communities had a limited understanding of dementia. Symptoms of dementia were usually noticed by the GP or another healthcare worker at the ACCHS who had an ongoing relationship with the person. Most participants reported that their service had established referral pathways with either hospital-based geriatricians, geriatricians located with aged care assessment teams, or specialists who visited communities periodically. Key enablers to high quality dementia care included the use of routine health assessments as a mechanism for diagnosis; relationships within communities to support diagnosis and care; community and family relationships; comprehensive and holistic care models; and the use of tailored visual resources to support care. Key barriers to high quality care included: denial and stigma; dementia being perceived as a low priority health condition; limited community awareness and understanding of dementia; lack of staff education and training about dementia; and numerous gaps in service delivery. Conclusions Substantially increased investments in supporting best-practice diagnosis and management of dementia in Aboriginal communities are required. ACCHSs have key strengths that should be drawn upon in developing solutions to identified barriers to care.


Author(s):  
Amanda Lee ◽  
Meron Lewis

Aboriginal and Torres Strait Islander peoples suffer higher rates of food insecurity and diet-related disease than other Australians. However, assessment of food insecurity in specific population groups is sub-optimal, as in many developed countries. This study tailors the Healthy Diets ASAP (Australian Standardised Affordability and Pricing) methods protocol to be more relevant to Indigenous groups in assessing one important component of food security. The resultant Aboriginal and Torres Strait Islander Healthy Diets ASAP methods were used to assess the price, price differential, and affordability of healthy (recommended) and current (unhealthy) diets in five remote Aboriginal communities. The results show that the tailored approach is more sensitive than the original protocol in revealing the high degree of food insecurity in these communities, where the current diet costs nearly 50% of disposable household income compared to the international benchmark of 30%. Sixty-two percent of the current food budget appears to be spent on discretionary foods and drinks. Aided by community store pricing policies, healthy (recommended) diets are around 20% more affordable than current diets in these communities, but at 38.7% of disposable household income still unaffordable for most households. Further studies in urban communities, and on other socioeconomic, political and commercial determinants of food security in Aboriginal and Torres Strait Islander communities appear warranted. The development of the tailored method provides an example of how national tools can be adapted to better inform policy actions to improve food security and help reduce rates of diet-related chronic disease more equitably in developed countries.


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