Australian Indigenous

Australian Indigenous HealthBulletin
An electronic journal from the Australian Indigenous HealthInfoNet
Vol.1 No.1 July 2001 - September 2001: ISSN 1445-7253

Journal articles

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Ah-Tye PJ (2001)
Pancreatitis in remote Australia: an Indigenous perspective.
Australian Journal of Rural Health;9:134-137.
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Capp K, Deane FP, Lambert G (2001)
Suicide prevention in Aboriginal communities: application of community gatekeeper training.
Australian and New Zealand Journal of Public Health;25(4):315-21.
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Cass A, Cunningham J, Wang Z, Hoy W (2001)
Regional variation in the incidence of end-stage renal disease in Indigenous Australians.
Medical Journal of Australia;175:24-27.
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Chang A, Shannon C, O'Neil MC, Tiemann AM, Valery PC, Craig D, Fa'afoi E, Masters IB (2000)
Asthma management in Indigenous children of a remote community using an Indigenous health model.
Journal of Paediatric Child Health;36:249-251.

This article describes the management of asthma for children living in Thursday Island, Queensland. Fifty four children who were referred by Indigenous health-care workers were evaluated by paediatric respiratory physicians. Forty of the 54 children referred with a provisional diagnosis of asthma did have asthma. Only 59% of parents knew the dose of the medication prescribed and 80% had minimal knowledge of the medications. The management of children with asthma can be improved substantially by the use of age-appropriate delivery devices and medications, and improving knowledge of asthma. Specialist delivery service to remote Indigenous communities can be effectively delivered in partnership with the Indigenous health service.
Australian Indigenous HealthInfoNet abstract

Clough AR, Burns CB, Mununggurr N (2000)
Kava in Arnhem Land: a review of consumption and its social correlates.
Drug and Alcohol Review;19(3):319-328.

Anecdotes and comments have promoted the perception that dosage levels of kava among Aboriginal people are much greater than in Pacific Island societies. This paper reviews published data about kava consumption and evaluates it against information collected from observation in one Aboriginal community in the Northern Territory. Lone drinkers appear to be the heaviest users while lowest consumption takes place in private domestic situations, where people enjoy kava as part of family group activities.
Australian Indigenous HealthInfoNet abstract

d'Abbs P, Togni S (2000)
Liquor licensing and community action in regional and remote Australia: a review of recent initiatives.
Australian and New Zealand Journal of Public Health;24(1):45-53.

This article describes a review undertaken in remote and regional locations in Australia to determine the effectiveness of community-based initiatives involving restrictions on alcohol availability. Findings from evaluations of community initiatives in Tennant Creek (NT), Derby (WA), Halls Creek (WA), Elliott (NT) and Curtin Springs (NT) were compared with respect to impact on alcohol consumption, and on indicators of alcohol-related harm relating to public order, health and wellbeing and economic activities. Results found that restrictions were likely to have a modest but real impact on alcohol consumption, and a significant impact on indicators of alcohol-related harm, especially violence. Restrictions on availability are an effective means of reducing alcohol-related harm at a local level and, depending upon the processes involved in their introduction, are likely to have strong community support provided that other measures are also pursued.
Australian Indigenous HealthInfoNet abstract

Downs SH, Marks GB, Sporik R, Belosouva EG, Car NG, Peak JK (2001)
Continued increase in the prevalence of asthma and atopy.
Archives of Disease in Childhood;84(1):20-23.

This article describes a study that was conducted in Wagga Wagga, NSW to determine the change in the prevalence of wheeze, diagnosed asthma and atopy in schoolchildren aged 8-11 years between 1992 and 1997. Five per cent of the children were Indigenous.These results were compared with the reported increase in prevalence between 1982 and 1992.

Between 1992 and 1997, the prevalence of wheeze increased by 5.1%, asthma diagnosis by 8.1% and atopy by 6.7%. Similar increases in prevalence had been found between 1982 and 1992.
Australian Indigenous HealthInfoNet abstract

Dugdale A, Watlemaro I (2001)
Aboriginal health: a sick minority skews statistics.
Australian Journal of Rural Health;9:111-115.
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Gracey M (2000)
Infant feeding and weaning practices in an urbanizing traditional, hunter-gatherer society.
Pediatrics;106(5):1276-1277.

This paper describes recent changes in breastfeeding patterns for Aboriginal people. In traditional Aboriginal society, infants were breastfed for at least two years. In the early 1980s in Perth, 82% of Aboriginal mothers initiated breastfeeding. Half of these women were still breastfeeding when the baby was 12 weeks old and 20% at 12 months. In Melbourne, 98% of Aboriginal mothers began breastfeeding, but only 50% were doing so at three months and 32% at 6 months. A survey in 1994 showed that breastfeeding was more prevalent among non-urban Aboriginal people and that women of higher socioeconomic status tended to breastfeed for longer. Urbanisation, changing lifestyles and the adoption of Western diets are all discussed as influential factors in breastfeeding patterns.
Australian Indigenous HealthInfoNet abstract

Gray D (2000)
Indigenous Australians and liquor licensing restrictions.
Addiction;95(10):1469-1472.

Recent research has shown that the proportion of Indigenous Australians who consume alcohol on an occasional or frequent basis is lower than that among the non-Indigenous population. However, in aggregate, Indigenous Australians who do consume alcohol do so at levels greatly in excess of levels among non-Indigenous people, resulting in a variety of harm at both the individual and community level. This editorial describes factors influencing consumption of alcohol at excessive levels among Indigenous Australians. The effectiveness of liquor licensing restrictions and barriers to the effectiveness of additional restrictions are also analysed. Liquor licensing restrictions can be an effective part of a broader strategy to reduce alcohol consumption and related harm in some areas of rural and remote Australia.
Australian Indigenous HealthInfoNet abstract

Gray D, Saggers S, Atkinson D, Sputore B, Bourbon D (2000)
Beating the grog: an evaluation of the Tennant Creek liquor licensing restrictions.
Australian and New Zealand Journal of Public Health;24(1):39-44.

This article describes a review undertaken in Tennant Creek (NT) of the 'Beat the Grog' campaign. This project was initiated more than a decade ago to trial increased restrictions on the availability of alcohol in the town. Estimates of quarterly per capita consumption of pure alcohol by persons older than 15 years, admissions data from the local hospital, women's refuge and sobering up shelter, and police data on detentions in custody and common offences were compared for the 12 months prior and 24 months subsequent to the introduction of the restrictions. A random sample survey of residents older than 18 years was conducted to ascertain attitudes towards the restrictions. The restrictions were effective in reducing alcohol consumption and acute related harm and had the support of the majority of people in Tennant Creek. Alcohol restrictions can be an effective part of a broad public health strategy to deal with problems associated with excessive alcohol consumption.
Australian Indigenous HealthInfoNet abstract

Hayman N, Kanhutu J, Bond S, Marks GC (2000)
Breast-feeding and weaning practices of an urban community of Indigenous Australians.
Asia Pacific Journal of Clinical Nutrition;9(3):232-234.

This article describes a survey conducted to determine current breast-feeding and infant-feeding practices among Indigenous mothers in Brisbane. Breast-feeding had been initiated by 59% of the mothers with infants up to the age of two years in mid 1998. However, by four months after birth only 25% of the mothers were breast-feeding. Only 20% of the infants were solely breast-fed during their first four months of life. This survey indicates the need to appropriately promote breast-feeding as the best source of nutrition for babies.
Australian Indigenous HealthInfoNet abstract

Hunter P (2001)
Editorial.
Australian Journal of Rural Health;9:103-104.

Disadvantage in determinants of health such as, living conditions, education, past injustices and socioeconomic circumstances impacts on life expectancy for Aboriginal people. This article examines deficiencies in responsibility for providing appropriate services to prevent and manage health conditions. There is a need for more partnerships with Aboriginal people as demonstrated by The National Aboriginal Community Controlled Health Organisation, a national body that draws on the expertise of its membership to provide relevant information.
Australian Indigenous HealthInfoNet abstract

Macintosh DJ, Pearson B (2001)
Fractures of the femoral neck in Australian Aboriginals and Torres Strait Islanders.
Australian Journal of Rural Health;9:127-133.
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Mackerras D (2001)
Birthweight changes in the pilot phase of the Strong Women, Strong Babies, Strong Culture Program in the Northern Territory.
Australian and New Zealand Journal of Public Health;25(1):34-40.

There is little variation in mean birthweight across the Northern Territory for non-Indigenous people, but mean birthweight varies by nearly 300 grams for Aboriginal people. The Strong Women, Strong Babies, Strong Culture Program commenced in August 1993 with the specific goals of increasing infant birthweights by earlier attendance for antenatal care and improving maternal weight status. Aboriginal women in three pilot communities worked with pregnant women in a program that emphasised both traditional practices and Western medicine.

Data from the Northern Territory Midwives Collection showed that the mean birthweight of infants of Aboriginal women increased by 171 grams between 1990-1991 and 1994-1995 in the pilot communities and by 92 grams in the surrounding three rural regions. Ongoing evaluation of the program will determine the extent to which the change in birthweight can be attributed to the program and whether the effects can be replicated elsewhere.
Australian Indigenous HealthInfoNet abstract

Mackerras D (2000)
Size for gestation in Aboriginal babies: a comparison of two papers.
Australian and New Zealand Journal of Public Health;24(3):287-290.

This article compares two recent papers which examined low birthweight in Aboriginal infants and came to different conclusions about the role of size for gestation and preterm delivery in influencing the proportion of low birthweight. The two studies used different methods to estimate the infants' gestational ages and to analyse the data, so the results could not be compared directly. This paper analysed data collected in six Top End communities to calculate the proportion of infants who were small for gestational age. The analysis incorporated the methods of both earlier studies. Despite the high overall prevalence of preterm delivery, the majority of these infants were not of low birthweight. Intervention programs to improve birth weights in Aboriginal infants need to address both conditions - small size for gestational age and preterm delivery and target the whole population.
Australian Indigenous HealthInfoNet abstract

McMichael C, Kirk M, Manderson L, Hoban E, Potts H (2000)
Indigenous women's perceptions of breast cancer diagnosis and treatment in Queensland.
Australian and New Zealand Journal of Public Health;24(5):515-519.

There is little evidence related to the incidence of breast cancer among Aboriginal women and Torres Strait Islander women. It would appear that although the incidence is slightly lower, mortality rates are similar to or higher than for other Australians. This paper reports the findings of research conducted to identify social, structural and personal factors among Indigenous women in Queensland associated with the detection of breast cancer, and the treatment and post-treatment care and support of cancer. The study was conducted among 101 Indigenous women and 85 service providers in Queensland in 1998-1999. Personal history of health services, provision of information about mammography, the cost of treatment and care, and availability of personal support, all influenced women's willingness to access services and maintain treatment. Indigenous women's knowledge and practice relating to the early diagnosis and prevention of breast cancer may improve through outreach work, to encourage their confidence in preventive health. Women's commitment to preventive health will also be enhanced by improved quality and access to health care, and improved relationships between practitioners and patients.
Australian Indigenous HealthInfoNet abstract

Miller PJ, Law M, Torzillo PJ, Kaldor J (2001)
Incident sexually transmitted infections and their risk factors in an Aboriginal community in Australia: a population based cohort study.
The Journal of Sexual Health & HIV;77(1):21-25.

This paper reports the findings of a study undertaken by the Nganampa Health Council to determine risk factors for incident sexually transmitted infections in the Anangu Pitjantjatjara Lands in central Australia. Participants were 1,034 Aboriginal people aged 12-40 years who were resident in the study region and seen for STI diagnosis during the period 1 January 1996 to 30 June 1998.

Three predictors of incident STI were identified: age (15-29 years), substance use and a history of previous STI. Particularly vulnerable were people aged 15-19 years and females with a history of regular petrol sniffing.
Australian Indigenous HealthInfoNet abstract

O'Connor ML, Parker E, Meiklejohn B, Oldenburg B, Alati R (2000)
Knowledge of heart health by Aboriginal and Torres Strait Islander health workers in Queensland.
Health Promotion Journal of Australia;10(3):213-216.

Cardiovascular disease, including heart attack and stroke, is the major cause of death among Australian Indigenous populations, who have death rates that are more than twice those of the non-Indigenous population. This paper reports the findings of a study undertaken in Queensland between 1996 and 1997 to identify Aboriginal and Torres Strait Islander health workers' educational needs, knowledge and current practices in the area of heart health. Phase one of the study involved an audit of existing heart health education resources available to health workers throughout Australia. The second phase involved the administration of a mailed questionnaire to 206 health workers in Queensland. Results showed that health workers consider culturally specific promotional resources the more effective, irrespective of the fact that mainstream resources might be more complete. The survey also highlighted that there is a lack of specific education and training in heart health for Aboriginal and Torres Strait Islander health workers. Current practices were found to be limited by time, money, lack of education and training, and lack of appropriate resources.
Australian Indigenous HealthInfoNet abstract

Ong MA, Weeramanthri TS (2000)
Delay times and management of acute myocardial infarction in Indigenous and non-Indigenous people in the Northern Territory.
Medical Journal of Australia;173(4):201-204.

In the Northern Territory, Indigenous people are more likely than non-Indigenous people to die from ischaemic heart disease at a younger age. The mortality might be reduced by ensuring prompt presentation, diagnosis and treatment of Indigenous people with acute myocardial infarction (AMI). A study was conducted in the Top End of the Northern Territory to investigate differences in presentation and management of Indigenous and non-Indigenous patients hospitalised with AMI. Participants were 122 patients with definite or possible AMI admitted to hospitals in the Top End of the Northern Territory. There were significant delays from onset of chest pain to first presentation to health services for both Indigenous and non-Indigenous patients. Concerted efforts are needed to improve health service access in rural areas and to encourage Indigenous people with persistent chest pain to present earlier.
Australian Indigenous HealthInfoNet abstract

Pacza T, Steele L, Tennant M (2001)
Development of oral health training for rural and remote Aboriginal health workers.
Australian Journal of Rural Health;9(3):105-110.
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Shannon C, Young E, Haswell-Elkins M, Hutchins C, Craig D, Canuto C, Kenny G, McClure R (2001)
Injury prevention in Indigenous communities: policy to practice.
Health Promotion Journal of Australia;11(1):61-66.

The excessive injury rate in Aboriginal and Torres Strait Islander communities is a major contributor to the dramatic health differential that exists between Indigenous and non-Indigenous Australians. This paper reports the establishment of an injury prevention program in a remote rural community in Queensland. The project was initiated through collaboration with key members of the Aboriginal community and the Indigenous Health Program, University of Queensland. Interviews, focus groups, household census and environmental audits were held to determine the frequency and distribution of non-hospitalised injuries. There would appear to be urgent need to encourage widespread implementation of injury prevention programs to reduce the excess injury rate now experienced in Aboriginal and Torres Strait Islander communities.
Australian Indigenous HealthInfoNet abstract

Sinnott MJ, Wittmann B (2001)
An introduction to Indigenous health and culture: the first tier of the three tiered plan.
Australian Journal of Rural Health;9(3):116-120.
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Tsey K, Every A (2000)
Evaluating Aboriginal empowerment programs: the case of family wellbeing.
Australian and New Zealand Journal of Public Health;24(5):509-514.

Increased numbers of suicides and attempted suicides by young Aboriginal people in Alice Springs and the surrounding region in the latter half of 1997, led to the formation of a coalition of organisations to address the problem. In 1998, the group received funding to run a Family Wellbeing empowerment course for:

The course was developed by a group of Adelaide-based survivors of the 'stolen generation' and was premised on the idea that all humans have basic physical, emotional, mental and spiritual needs. This paper reports the findings from the evaluation of the Family Wellbeing empowerment course. Participation in the course resulted in high levels of personal empowerment. There was no evidence of organisational and community empowerment, such as stronger social networks and systems-level change. The effectiveness of the Family Wellbeing course highlights the importance of resourcing Aboriginal people to develop their own programs that address trauma and other issues resulting from colonisation.
Australian Indigenous HealthInfoNet abstract

Watson J, Obersteller EA, Rennie L, Whitbread C (2001)
Diabetic foot care: developing culturally appropriate educational tools for Aboriginal and Torres Strait Islander peoples in the Northern Territory, Australia.
Australian Journal of Rural Health;9:121-126.
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Wilson J (2001)
Remote area Aboriginal health services managers: key practice challenges.
Australian Journal of Rural Health;9(3):138-140.
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