Australian Indigenous

Australian Indigenous HealthBulletin
Vol 5 No 3 July 2005 - September 2005: ISSN 1445-7253

A peer-reviewed electronic journal from the Australian Indigenous HealthInfoNet

Journal articles

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Angeles GA (2005)
Winning essay: Fish traps — a significant part of our health and wellbeing.
Medical Journal of Australia;182(10):541-543
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Armstrong RM (2005)
Dr Ross Ingram Memorial Essay Competition: award presentation.
Medical Journal of Australia;183(1):39
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Armstrong RM, Van Der Weyden MB (2005)
Fishing, health and stirring stories. The Dr Ross Ingram Memorial Essay Competition 2005.
Medical Journal of Australia;182(10):541
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Bookallil M, Chalmers E, Bell A (2005)
Challenges in preventing pyelonephritis in pregnant women in Indigenous communities.
Rural and Remote Health;5(online):395. Retrieved from: http://rrh.deakin.edu.au
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Bond CJ (2005)
A culture of ill health: public health or Aboriginality? [essay finalist].
Medical Journal of Australia;183(1):39-41
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Bowden FJ (2005)
Controlling HIV in Indigenous Australians [editorial].
Medical Journal of Australia;183(3):116-117
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Burgess CP, Johnston FH, Bowman DMJS, Whitehead PJ (2005)
Healthy country: healthy people?: exploring the health benefits of Indigenous natural resource management.
Australian and New Zealand Journal of Public Health;29(2):117-122

Objective: Decades of health-related research have produced a large body of knowledge describing alarming rates of morbidity, mortality and social/cultural disruption among Indigenous Australians, but have failed to deliver sustainable interventions to arrest the deepening spiral of ill-health. This paper explores the potential of Indigenous natural resource management (NRM) activities to promote and preserve Indigenous health in remote areas of northern Australia.

Method: A literature review of the health, social science and ecology peer-reviewed journals and secondary literature.

Conclusions and Implications: Effective interventions in Indigenous health will require trans-disciplinary, holistic approaches that explicitly incorporate Indigenous health beliefs and engage with the social and cultural drivers of health. Aboriginal peoples maintain a strong belief that continued association with and caring for ancestral lands is a key determinant of health. Individual engagement with 'country' provides opportunities for physical activity and improved diet as well as boosting individual autonomy and self-esteem. Internationally, such culturally congruent health promotion activities have been successful in programs targeting substance abuse and chronic diseases.

NRM is fundamental to the maintenance of biodiversity of northern Australia. Increased support for Indigenous involvement in land and sea NRM programs would also deliver concrete social benefits for communities including opportunities for sustainable and culturally apt regional employment, applied education and economic development. NRM may also reinvigorate societal/cultural constructs, increasing collective esteem and social cohesion.

Abstract reproduced with permission of the Australian and New Zealand Journal of Public Health (view website)

Calver J, Wiltshire A, D'Arcy C, Holman J, Hunter E, et al. (2005)
Does health assessment improve health outcomes in Indigenous people?: an RCT with 13 years of follow-up.
Australian and New Zealand Journal of Public Health;29(2):107-111

Objective: To examine the impact of a multi-component health assessment on mortality and morbidity in Kimberley Aboriginal residents during a 13-year follow-up.

Method: A population-based randomised controlled trial using linked hospital, cancer and death records to evaluate outcomes in 620 intervention and 6,736 control subjects.

Results: The intervention group had a higher rate of first-time hospitalisation for any reason (IRR=1.37; 95% CI 1.25-1.50), a higher rate of injury-related hospital episodes (IRR=1.31; 95% CI 1.15-1.48) and a higher notification rate of alcohol-related cancers. There was a smaller difference in the rates of multiple hospitalisations (IRR=1.14; 95% CI 0.75-1.74) and no improvement in overall mortality compared with controls (IRR=1.08; 95% CI 0.91-1.29).

Conclusions: There was no overall mortality benefit despite increased health service contact associated with the intervention.

Implications: Although not influencing mortality rates, multi-component health assessment may result in a period of increased health service use in Aboriginal and Torres Strait Islander populations, thus constituting an 'intervention'. However, this should not be confused with systematic and sustained interventions and investment in community development to achieve better health outcomes.

Abstract reproduced with permission of the Australian and New Zealand Journal of Public Health (view website)

Clough PR, d'Abbs P, Cairney S, Gray D, Maruff P, et al. (2005)
Adverse mental health effects of cannabis use in two Indigenous communities in Arnhem Land, Northern Territory, Australia: exploratory study.
Australian and New Zealand Journal of Psychiatry;39(7):612-620

This study investigates adverse mental health effects of cannabis use among Indigenous cannabis users in remote communities in the Northern Territory. Twenty-eight criteria describing mental illness were developed by local Indigenous health workers and key informants. Through analysis of data from interviews with cannabis users, these symptoms were clustered into five groups: ‘anxiety’, ‘dependency’, ‘mood’, ‘vegetative’ and ‘psychosis’. The association of these clusters with self-reported cannabis use were assessed. Associations were found between the number of ‘cones’ usually smoked per week and the cluster combinations ‘anxiety-dependency’ and ‘mood-vegetative’.

Australian Indigenous HealthInfoNet abstract

Hanna JN, Smith GA, McCulloch BG, Taylor CT, Pyke AT, et al. (2005)
An assessment of the interval between booster doses of Japanese encephalitis vaccine in the Torres Strait.
Australian and New Zealand Journal of Public Health;29(1):44-47

Objective: Japanese encephalitis (JE) emerged for the first time in the Torres Strait, north Australia, in 1995. The inactivated mouse-brain derived JE vaccine was offered to all residents of the outer Torres Strait Islands prior to the 1996 wet season. This study was undertaken to determine the appropriateness of the recommended three-year interval between booster doses of the vaccine.

Methods: JE neutralising antibody was measured in residents of Badu Island for whom 30-36 months had passed since either a previous booster or the completion of the primary immunisation series.

Results: Only 70 (32%) of 219 eligible individuals had protective antibodies; 50 (37%) of the adults were immune, compared with 20 (24%) of the children (odds ratio (OR) 1.93; 95% confidence interval (CI) 1.01-3.74).

Conclusions: This low level of immunity suggests that there is little in the way of natural boosting from either JE or other closely related viruses. Given the apparent low level of risk of exposure to the JE virus in the Torres Strait, and the logistical complexities involved in delivering the booster doses, the current recommendation of a three-year interval is not inappropriate.

Implications: It would be advantageous to have a JE vaccine that is not only safer but also more immunogenic, so that it might be possible to further increase the booster dose interval.

Abstract reproduced with permission of the Australian and New Zealand Journal of Public Health (view website)

Howitt R, McCracken K, Curson P (2005)
Australian Indigenous health - what issues contribute to a national crisis and scandal?
GeoDate;(March):8-15

This article examines the nature and consequences of the health status of Indigenous Australians, with particular focus on leading causes of death, and historical and geographical aspects of Indigenous health. While the article identifies the basic needs for accessible and relevant health services and infrastructure, it also acknowledges that increased funding, services, and 'practical reconciliation' will not address the upstream and midstream factors that produce poor health outcomes and consequences. The article concludes that changes in behaviours and attitudes, greater social acceptance of diverse values, and a more responsive policy framework are needed in order to improve the future of Indigenous health.

Australian Indigenous HealthInfoNet abstract

Hoy WE, Kondalsamy-Chennakesavan SN, Nicol JL (2005)
Clinical outcomes associated with changes in a chronic disease treatment program in an Australian Aboriginal community.
Medical Journal of Australia;183(6):305-309
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Leonard H, Petterson B, De Klerk N, et al. (2005)
Association of sociodemographic characteristics of children with intellectual disability in Western Australia.
Social Science and Medicine;60(7):1499-1513

This article looks at the social determinants of intellectual disability for children born in Western Australia, and examines the differences between Aboriginal and non-Aboriginal children. The results indicate that socioeconomic disadvantage, Aboriginality, being a single mother, and being a teenage mother, increase the risk of having a child with an intellectual disability. The findings have implications for primary prevention opportunities.

Australian Indigenous HealthInfoNet abstract

McCabe M, Ricciardelli L, Mellor D, Ball K (2005)
Media influences on body image and disordered eating among Indigenous adolescent Australians.
Adolescence;40(157):115-127

This study explores body satisfaction, body change strategies, and perceptions of media messages about body change strategies among Indigenous and non-Indigenous Australian adolescents. Despite perceiving fewer media messages about weight loss, Indigenous adolescents engaged in more body change strategies (losing weight, increasing weight and increasing muscle) than non-Indigenous adolescents. Possible explanations for these differences are discussed and the need for further research is stressed.

Australian Indigenous HealthInfoNet abstract

McNeill PM, Macklin R, Wasunna A, Komesaroff PA (2005)
An expanding vista: bioethics from public health, Indigenous and feminist perspectives.
Medical Journal of Australia;183(1):8-9
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Thomas M (2004)
Antecedents of renal disease in Aborigines.
Nephrology;9(Supplement 4):s113-s116

This article examines the increasing rates of end-stage renal disease in the Australian Indigenous population, particularly for those living in northern and more remote areas and especially in disadvantaged communities. Risk factors such as proteinuria, low birthweight, skin infections, adult obesity, diabetes or its precursors, smoking, excessive alcohol intake, and family history of renal disease are considered in terms of loss of renal function. It is explained that following detection of renal disease, active medical intervention is effective in reducing the progression of kidney disease and is also cost-effective. The need for addressing the underlying social causes contributing to the epidemic of end-stage renal disease is stressed.

Australian Indigenous HealthInfoNet abstract

Tsey K, Whiteside M, Daly S, Deemal A, Gibson T, et al. (2005)
Adapting the 'family wellbeing' empowerment program to the needs of remote Indigenous school children.
Australian and New Zealand Journal of Public Health;29(2):112-116

Objective: To adapt the Family Wellbeing empowerment program, which was initially designed to support adults to take greater control and responsibility for their decisions and lives, to the needs of Indigenous school children living in remote communities.

Method: At the request of two schools in remote Indigenous communities in far north Queensland, a pilot personal development and empowerment program based on the adult Family Wellbeing principles was developed, conducted and evaluated in the schools. The main aims of the program were to build personal identity and to encourage students to recognise their future potential and be more aware of their place in the community and wider society.

Results: Participation in the program resulted in significant social and emotional growth for the students. Outcomes described by participating students and teachers included increased analytical and reflective skills, greater ability to think for oneself and set goals, less teasing and bullying in the school environment, and an enhanced sense of identity, friendship and 'social relatedness'.

Conclusion: This pilot implementation of the Family Wellbeing Program adapted for schools demonstrated the program's potential to enhance Indigenous young people's personal growth and development. Challenges remain in increasing parental/family involvement and ensuring the program's sustainability and transferability. The team has been working with relevant stakeholders to further develop and package the School-based Family Wellbeing program for Education Queensland's New Basics curriculum framework.

Abstract reproduced with permission of the Australian and New Zealand Journal of Public Health (view website)

Wright MR, Giele CM, Dance PR, Thompson SC (2005)
Fulfilling prophecy? Sexually transmitted infections and HIV in Indigenous people in Western Australia.
Medical Journal of Australia;183(3):124-128
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