scholarly journals Built Environments and Cardiometabolic Morbidity and Mortality in Remote Indigenous Communities in the Northern Territory, Australia

2020 ◽  
Vol 17 (3) ◽  
pp. 769 ◽  
Author(s):  
Camille Le Gal ◽  
Michael J. Dale ◽  
Margaret Cargo ◽  
Mark Daniel
Keyword(s):  
Built Environment ◽  
Indigenous Health ◽  
Health Behaviours ◽  
Indigenous Communities ◽  
Morbidity And Mortality ◽  
Cumulative Exposure ◽  
Indigenous Australians ◽  
Mortality And Morbidity ◽  
Individual Level ◽  
Community Buildings

The health of Indigenous Australians is dramatically poorer than that of the non-Indigenous population. Amelioration of these differences has proven difficult. In part, this is attributable to a conceptualisation which approaches health disparities from the perspective of individual-level health behaviours, less so the environmental conditions that shape collective health behaviours. This ecological study investigated associations between the built environment and cardiometabolic mortality and morbidity in 123 remote Indigenous communities representing 104 Indigenous locations (ILOC) as defined by the Australian Bureau of Statistics. The presence of infrastructure and/or community buildings was used to create a cumulative exposure score (CES). Records of cardiometabolic-related deaths and health service interactions for the period 2010–2015 were sourced from government department records. A quasi-Poisson regression model was used to assess the associations between built environment “healthfulness” (CES, dichotomised) and cardiometabolic-related outcomes. Low relative to high CES was associated with greater rates of cardiometabolic-related morbidity for two of three morbidity measures (relative risk (RR) 2.41–2.54). Cardiometabolic-related mortality was markedly greater (RR 4.56, 95% confidence interval (CI), 1.74–11.93) for low-CES ILOCs. A lesser extent of “healthful” building types and infrastructure is associated with greater cardiometabolic-related morbidity and mortality in remote Indigenous locations. Attention to environments stands to improve remote Indigenous health.

scholarly journals The role of the oral microbiota in chronic non-communicable disease and its relevance to the Indigenous health gap in Australia

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Matilda Handsley-Davis ◽  
Lisa Jamieson ◽  
Kostas Kapellas ◽  
Joanne Hedges ◽  
Laura S. Weyrich
Keyword(s):  
Oral Health ◽  
Indigenous Health ◽  
Communicable Disease ◽  
Indigenous Communities ◽  
Indigenous Australians ◽  
Oral Microbiota ◽  
Oral Diseases ◽  
Emotional Wellbeing ◽  
Health Gap ◽  
Systemic Health

Abstract Background Aboriginal Australians and Torres Strait Islanders (hereafter respectfully referred to as Indigenous Australians) experience disproportionately poor health and low life expectancy compared to non-Indigenous Australians. Poor oral health is a critical, but understudied, contributor to this health gap. A considerable body of evidence links poor oral health to increased risks of other chronic non-communicable conditions, such as diabetes, cardiovascular disease, chronic kidney disease, and poor emotional wellbeing.  Main The oral microbiota is indisputably associated with several oral diseases that disproportionately affect Indigenous Australians. Furthermore, a growing literature suggests direct and indirect links between the oral microbiota and systemic chronic non-communicable diseases that underpin much of the Indigenous health gap in Australia. Recent research indicates that oral microbial communities are shaped by a combination of cultural and lifestyle factors and are inherited from caregivers to children. Systematic differences in oral microbiota diversity and composition have been identified between Indigenous and non-Indigenous individuals in Australia and elsewhere, suggesting that microbiota-related diseases may be distinct in Indigenous Australians.  Conclusion Oral microbiota research involving Indigenous Australians is a promising new area that could benefit Indigenous communities in numerous ways. These potential benefits include: (1) ensuring equity and access for Indigenous Australians in microbiota-related therapies; (2) opportunities for knowledge-sharing and collaborative research between scientists and Indigenous communities; and (3) using knowledge about the oral microbiota and chronic disease to help close the gaps in Indigenous oral and systemic health.

scholarly journals Science, research and social change in Indigenous health — evolving ways of knowing

2009 ◽  
Vol 33 (4) ◽  
pp. 628 ◽  
Author(s):  
Peter W Harvey
Keyword(s):  
Clinical Research ◽  
Indigenous Health ◽  
Ways Of Knowing ◽  
Science Research ◽  
Indigenous Communities ◽  
Indigenous Australians ◽  
Dominant Culture ◽  
Effect Change ◽  
Traditional Approaches ◽  
Epistemological Framework

History tells us of the overwhelming destructive influence of exotic culture, politics and knowledge forms upon the worldview and wellbeing of Indigenous Australians. The power of dominant culture to oppress, control and dominate traditional Indigenous ways of knowing and being has been identified as a being a crucial influence on the health status, future hopes and aspirations of Indigenous Australians. Fundamental to this assertion is that the alienating effect of the belief in and application of the scientific method in relation to learning and knowing is a phenomenon that is incompatible with the law and cultural ways of traditional Indigenous people. The establishment of the Centre of Clinical Research Excellence (CCRE) is predicated upon and responds to a deep need in our community today to synthesise the ideological and epistemological premises of an increasing range of cultures and world views. It recognises that clinical research, for example, is important to the health of Aboriginal and Torres Strait Islander peoples, but also that the way such research is designed and carried out is also crucial to its potential to effect change in and improve the state of Indigenous health in Australia. This paper examines knowledge principles and processes associated with research in Indigenous communities, explores emerging research trends in science and proposes an epistemological framework for synthesis of traditional approaches with those of the scientific paradigm.

Support for Indigenous wildlife management in Australia to enable sustainable use

2010 ◽  
Vol 37 (3) ◽  
pp. 255 ◽  
Author(s):  
George R. Wilson ◽  
Melanie J. Edwards ◽  
Jennifer K. Smits
Keyword(s):  
Indigenous People ◽  
Wildlife Management ◽  
Rural Areas ◽  
Management Practices ◽  
Indigenous Health ◽  
Minor Component ◽  
Indigenous Communities ◽  
Customary Law ◽  
Indigenous Australians ◽  
Wildlife Harvesting

Wildlife managers could play a greater role in ensuring that Indigenous wildlife harvesting is sustainable and helping to address community health and employment challenges facing Indigenous Australians in remote and rural areas. Wildlife managers need to listen more to what Indigenous people say they want from their country and for their people, such as increased game to supplement their diet and security for totemic species, to maintain culture. In pre-colonial Australia, adherence to customary law maintained wildlife species Indigenous Australians wanted. Today the long-term sustainability of Indigenous wildlife harvesting is threatened. Where Indigenous communities lack leadership and other social problems exist, their capacity to apply customary land-and sea-management practices and to operate cultural constraints on wildlife use is reduced. The Indigenous right to hunt should coexist with responsible management. Improved wildlife management that combines science and traditional knowledge has implications for Indigenous people worldwide. Western science can support Indigenous passion for caring for the land. It can draw on traditional Indigenous practice and, through reciprocal learning, help reinstate Indigenous law and culture in communities. In Australia, wildlife managers could be more engaged in supporting Indigenous Australians in activities such as surveying populations and estimating sustainable yields, identifying refuge areas, maximising habitat diversity, controlling weeds and feral animals, and exchanging information across regions. Although support for Indigenous land and wildlife management has risen in recent years, it remains a minor component of current Australian Government resource allocation for addressing Indigenous need. Wildlife management could be a stronger focus in education, training and employment programs. Proactive wildlife management conforms to both the western concept of conserving biodiversity and Indigenous wildlife management; it can support sustainable harvesting, provide employment and income, create learning and training opportunities and improve Indigenous health. If greater expenditure were directed to Indigenous wildlife management, wildlife managers, especially Indigenous wildlife managers, could become more engaged in cultural initiatives across traditional and scientific practices and so contribute to programs that address the health and motivational challenges facing Indigenous communities.

scholarly journals Arts-Based Compassion Skills Training (ABCST): Channelling Compassion Focused Therapy Through Visual Arts for Australia’s Indigenous Peoples

2020 ◽  
Vol 11 ◽  
Author(s):  
James Bennett-Levy ◽  
Natalie Roxburgh ◽  
Lia Hibner ◽  
Sunita Bala ◽  
Stacey Edwards ◽  
...  
Keyword(s):  
Indigenous Peoples ◽  
Visual Arts ◽  
Health Professionals ◽  
Cultural Context ◽  
Indigenous Health ◽  
Group Processes ◽  
Indigenous Communities ◽  
Skills Training ◽  
Indigenous Australians ◽  
Compassion Focused Therapy

The last 20 years have seen the development of a new form of therapy, compassion focused therapy (CFT). Although CFT has a growing evidence base, there have been few studies of CFT outside of an Anglo-European cultural context. In this paper, we ask: Might a CFT-based approach be of value for Indigenous Australians? If so, what kind of cultural adaptations might be needed? We report the findings from a pilot study of an arts-based compassion skills training (ABCST) group, in which usual CFT group processes were significantly adapted to meet the needs of Indigenous Australians. At face value, CFT appeared to be a promising approach to enhancing the social and emotional wellbeing of Australia’s Indigenous peoples. However, despite initial consultations with Indigenous health professionals, the first attempts to offer a more conventional group-based CFT to Indigenous clients were largely unsuccessful. Following a review and advice from two Indigenous clients, we combined elements of CFT with visual arts to develop a new approach, “arts-based compassion skills training” (ABCST). This paper reports an evaluation of this pilot ABCST group. The group had 6 × 4 h sessions of ABCST, facilitated by two psychologists (1 Indigenous, 1 non-Indigenous) and two artists (1 Indigenous, 1 non-Indigenous). There were 10 participants, who attended between 2 and 6 sessions: five were clients, five were health professionals. Between 1 and 3 months later, six of the participants (2 clients, 4 health professionals) were interviewed. Qualitative analysis of interview data identified that two key processes—creating a positive group atmosphere and channeling compassion skills training through the medium of visual arts—led to four positive outcomes for participants: planting the seeds of new understandings, embodying the skills of compassion, strengthening relationships with others, and evolving a more self-compassionate relationship. We suggest that the preliminary results are sufficiently encouraging to warrant further development of ABCST in Indigenous communities.

Non-Fatal Deliberate Self-Harm in Three Remote Indigenous Communities in Far North Queensland, Australia

Crisis ◽  
2019 ◽  
Vol 40 (6) ◽  
pp. 422-428 ◽  
Author(s):  
Chris Rouen ◽  
Alan R. Clough ◽  
Caryn West
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Care Center ◽  
Indigenous Communities ◽  
Indigenous Australians ◽  
Deliberate Self Harm ◽  
Health Care Center ◽  
Far North ◽  
Primary Health ◽  
Self Harm

Abstract. Background: Indigenous Australians experience a suicide rate over twice that of the general population. With nonfatal deliberate self-harm (DSH) being the single most important risk factor for suicide, characterizing the incidence and repetition of DSH in this population is essential. Aims: To investigate the incidence and repetition of DSH in three remote Indigenous communities in Far North Queensland, Australia. Method: DSH presentation data at a primary health-care center in each community were analyzed over a 6-year period from January 1, 2006 to December 31, 2011. Results: A DSH presentation rate of 1,638 per 100,000 population was found within the communities. Rates were higher in age groups 15–24 and 25–34, varied between communities, and were not significantly different between genders; 60% of DSH repetitions occurred within 6 months of an earlier episode. Of the 227 DSH presentations, 32% involved hanging. Limitations: This study was based on a subset of a larger dataset not specifically designed for DSH data collection and assesses the subset of the communities that presented to the primary health-care centers. Conclusion: A dedicated DSH monitoring study is required to provide a better understanding of DSH in these communities and to inform early intervention strategies.

scholarly journals Review of Associations between Built Environment Characteristics and Severe Acute Respiratory Syndrome Coronavirus 2 Infection Risk

2021 ◽  
Vol 18 (14) ◽  
pp. 7561
Author(s):  
Jingjing Wang ◽  
Xueying Wu ◽  
Ruoyu Wang ◽  
Dongsheng He ◽  
Dongying Li ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Built Environment ◽  
Longitudinal Research ◽  
Empirical Studies ◽  
Infection Risk ◽  
Design Guidelines ◽  
Individual Level ◽  
Transit Accessibility ◽  
Level Data ◽  
Transmission Pathways

The coronavirus disease 2019 pandemic has stimulated intensive research interest in its transmission pathways and infection factors, e.g., socioeconomic and demographic characteristics, climatology, baseline health conditions or pre-existing diseases, and government policies. Meanwhile, some empirical studies suggested that built environment attributes may be associated with the transmission mechanism and infection risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, no review has been conducted to explore the effect of built environment characteristics on the infection risk. This research gap prevents government officials and urban planners from creating effective urban design guidelines to contain SARS-CoV-2 infections and face future pandemic challenges. This review summarizes evidence from 25 empirical studies and provides an overview of the effect of built environment on SARS-CoV-2 infection risk. Virus infection risk was positively associated with the density of commercial facilities, roads, and schools and with public transit accessibility, whereas it was negatively associated with the availability of green spaces. This review recommends several directions for future studies, namely using longitudinal research design and individual-level data, considering multilevel factors and extending to diversified geographic areas.

Reproductive Healthcare Beliefs and Behaviours Among Displaced Tribal Communities in Odisha and Chhattisgarh: An Analysis Using Health Belief Model

2021 ◽  
pp. 2277436X2110059
Author(s):  
Madhulika Sahoo ◽  
Jalandhar Pradhan
Keyword(s):  
Health Belief Model ◽  
Cultural Distance ◽  
Indigenous Health ◽  
Belief Systems ◽  
Health Belief ◽  
Indigenous Communities ◽  
Tribal Communities ◽  
Traditional Health ◽  
Belief Model ◽  
Reproductive Healthcare

The modern healthcare system often experiences difficulties in understanding and providing care to indigenous communities. This is mainly because of the cultural distance between mainstream healing methods and indigenous health belief systems. The Lancet series (2006) on indigenous health discussed the integration of Western and traditional health practices and identified the importance of this integration for betterment of the human world. To understand what health and health care signify to tribal communities in India, it is necessary to examine the whole social system and the beliefs and behaviours related to their culture that provides meaning to people. This study examines the traditional medicinal practices and socio-cultural healthcare beliefs and behaviours of diplaced tribal communities in Odisha and Chattisgarh. The current study has used the health belief model (HBM) to examine the perceived susceptibility and severity of diseases among tribal communities, pertaining to their reproductive healthcare beliefs and practices.

scholarly journals Blood Pressure Trajectories Across the Life Course

2021 ◽  
Vol 34 (3) ◽  
pp. 234-241
Author(s):  
Norrina B Allen ◽  
Sadiya S Khan
Keyword(s):  
Blood Pressure ◽  
Measurement Errors ◽  
Clinical Care ◽  
Population Level ◽  
Cumulative Exposure ◽  
Older Adulthood ◽  
Individual Level ◽  
The Life Course ◽  
Level Group ◽  
Improve Health

Abstract High blood pressure (BP) is a strong modifiable risk factor for cardiovascular disease (CVD). Longitudinal BP patterns themselves may reflect the burden of risk and vascular damage due to prolonged cumulative exposure to high BP levels. Current studies have begun to characterize BP patterns as a trajectory over an individual’s lifetime. These BP trajectories take into account the absolute BP levels as well as the slope of BP changes throughout the lifetime thus incorporating longitudinal BP patterns into a single metric. Methodologic issues that need to be considered when examining BP trajectories include individual-level vs. population-level group-based modeling, use of distinct but complementary BP metrics (systolic, diastolic, mean arterial, mid, and pulse pressure), and potential for measurement errors related to varied settings, devices, and number of readings utilized. There appear to be very specific developmental periods during which divergent BP trajectories may emerge, specifically adolescence, the pregnancy period, and older adulthood. Lifetime BP trajectories are impacted by both individual-level and community-level factors and have been associated with incident hypertension, multimorbidity (CVD, renal disease, cognitive impairment), and overall life expectancy. Key unanswered questions remain around the additive predictive value of BP trajectories, intergenerational contributions to BP patterns (in utero BP exposure), and potential genetic drivers of BP patterns. The next phase in understanding BP trajectories needs to focus on how best to incorporate this knowledge into clinical care to reduce the burden of hypertensive-related outcomes and improve health equity.

Transforming a global order in New Zealand to reduce health inequities in service provision

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Rawson
Keyword(s):  
Public Health ◽  
New Zealand ◽  
Indigenous Knowledge ◽  
Best Practice ◽  
Indigenous Health ◽  
Indigenous Communities ◽  
Health Inequities ◽  
Medical Emergency ◽  
Major Work ◽  
Health Initiatives

Abstract St John has been providing service in New Zealand for nearly 140 years since its arrival. It has now close to 4000 staff and nearly 20000 Members and over 8500 volunteers. In New Zealand the major work of St John is its Ambulance service providing front line first responders to crash, medical emergency and other life-threatening situations. St John New Zealand also provides a number of 'Community Health' initiatives focused on strengthening communities and prevention. In recent years St John has recognised that they have not engaged well with Indigenous communities and that their organisation in New Zealand must become skilled and relevant in addressing the needs of the Indigenous people of New Zealand, as they suffer the greater burden of disease and illness than any other population in the country. St John NZ Community and Health Services are embarking on a process of transformation through re-orienting its culture and practice by adopting Public Health approaches and an equity lens over all its programmes. They also have committed to understanding and using Indigenous knowledge to support this re-orientation to most effectively engage and implement programmes that will reduce Indigenous health inequities. This presentation will describe the process by which they will be implementing their strategy for change and highlight best practice for working with Indigenous communities. Key messages Indigenous Knowledge is key to addressing Indigenous Health inequities. Mainstream Public Health can learn from Indigenous Public Health approaches.

scholarly journals The school environment and sugar-sweetened beverage consumption among Guatemalan adolescents

2017 ◽  
Vol 20 (16) ◽  
pp. 2980-2987 ◽  
Author(s):  
Katelyn M Godin ◽  
Violeta Chacón ◽  
Joaquin Barnoya ◽  
Scott T Leatherdale
Keyword(s):  
Public Schools ◽  
Built Environment ◽  
School Environment ◽  
School Type ◽  
School Food ◽  
Sugar Sweetened Beverage ◽  
Individual Level ◽  
Vending Machines ◽  
Sweetened Beverages ◽  
Behavioural Characteristics

AbstractObjectiveThe current study sought to examine Guatemalan adolescents’ consumption of sugar-sweetened beverages (SSB), identify which individual-level characteristics are associated with SSB consumption and describe school characteristics that may influence students’ SSB consumption.DesignWithin this observational pilot study, a questionnaire was used to assess students’ consumption of three varieties of SSB (soft drinks, energy drinks, sweetened coffees/teas), as well as a variety of sociodemographic and behavioural characteristics. We collected built environment data to examine aspects of the school food environment. We developed Poisson regression models for each SSB variety and used descriptive analyses to characterize the sample.SettingGuatemala City, Guatemala.SubjectsGuatemalan adolescents (n1042) from four (two public, two private) secondary schools.ResultsBuilt environment data revealed that students from the two public schools lacked access to water fountains/coolers. The SSB industry had a presence in the schools through advertisements, sponsored food kiosks and products available for sale. Common correlates of SSB consumption included school type, sedentary behaviour, frequency of purchasing lunch in the cafeteria, and frequency of purchasing snacks from vending machines in school and off school property.ConclusionsGuatemalan adolescents frequently consume SSB, which may be encouraged by aspects of the school environment. Schools represent a viable setting for equitable population health interventions designed to reduce SSB consumption, including increasing access to clean drinking-water, reducing access to SSB, restricting SSB marketing and greater enforcement of existing food policies.

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