Australian Indigenous

Journal articles

Anonymous. (2000).
Nurses back professional recognition for ATSI health workers.
Australian Nurses Journal, 7(6), 8.

The Australian Nursing Federation (ANF) has backed calls for Aboriginal and Torres Strait Islander (ATSI) health workers to be recognised as a profession and called for the introduction of a system of professional licensing.
Australian Nurses Journal abstract

Ariotti, L. (1999).
Social construction of Anangu disability.
Australian Journal of Rural Health, 7, 216-222.

Bashford, A. (2000).
'Is White Australia possible?' Race, colonialism and tropical medicine.
Ethnic and Racial Studies, 23(2), 248-271.

Broom, A.K., Wallace, M.J., Mackenzie, J.S., Smith, D.W., & Hall, R.A. (2000).
Immunisation with gamma globulin to Murray Valley encephalitis virus and with an inactivated Japanese encephalitis virus vaccine as prophylaxis against Australian encephalitis: evaluation in a mouse model.
Journal of Medical Virology, 61(2), 259-265.

In northwestern Australia, the flavivirus Murray Valley encephalitis (MVE) poses a significant health risk to infants in some Aboriginal communities, particularly during each wet season. While there are too few cases to warrant the development of a vaccine against MVE, a safe, effective prophylaxis for these children is still urgently required, The use of passive transfer of human gamma globulin to MVE or immunisation with a vaccine to the closely related Japanese encephalitis (JE) virus were investigated as potential strategies. When 40 mg of IgG was purified from MVE-immune human sera and transferred to 3-week-old mice, the animals were protected from lethal IP inoculation with MVE virus while still producing a detectable immune response to the virus. Similarly, sera from adult mice infected sublethally with MVE or JE virus provided significant protection against MVE infection. However, sera from mice sublethally infected with the related Kunjin or immunised with the inactivated JE vaccine (Biken) provided no protection against MVE challenge. In fact, mice immunised passively with the latter appeared to succumb to MVE challenge more rapidly than mice that received serum from unimmunised animals, suggesting that antibody to the vaccine had accelerated the progression of disease. These preliminary trials in mice indicate that passive immunisation with human gamma globulin has the greatest potential as a strategy for MVE prophylaxis, whilst the apparent enhancement of MVE by antibodies to the JE vaccine requires further investigation, with particular reference to current vaccination programs in areas of Australia and Papua New Guinea, where both JE and MVE occur.
Journal of Medical Virology abstract

Coory, M. (2000).
Is birthweight an appropriate health outcome measure for Torres Strait Islander babies?
Australian and New Zealand Journal of Public Health, 24(1), 60-63.

Although Torres Strait Islanders (TSIs) are often combined with Aborigines, they are a distinct group and would prefer to be considered separately The Queensland Perinatal Data Collection (QPDC) has been the only population-based, perinatal collection in Australia that has distinguished between Aboriginal and TSI mothers. It provided a unique opportunity to compare outcome measures based on birthweight in the TSI, Aboriginal and white populations. TSIs were of particular interest because recent research from overseas suggests that, in groups with high rates of obesity and diabetes, birthweight is not a valid outcome measure. This is of concern because outcome measures based on birthweight have been proposed as a way of monitoring the neonatal health of Indigenous Australians. Results from a retrospective analysis of 10 years of routine data from the QPDC indicated that TSIs had a birthweight distribution similar to that of whites, but mortality rates similar to those of Aborigines. For birthweights between 2500g and 4000g, TSIs had mortality rates that were 2.5 times higher than those for whites. In conclusion, although birthweight is widely used, it is not necessarily a valid outcome measure in all populations. For TSIs, maternal conditions such as obesity and diabetes might cause changes in the uterine environment that produce heavier, but not healthier, babies.
Australian and New Zealand Journal of Public Health abstract

Currie, B.J., & Carapetis, J.R. (2000).
Skin infections and infestations in Aboriginal communities in northern Australia. Australasian Journal of Dermatology, 41(3), 139-145.

This article provides a review of skin infections in Aboriginal communities in central and northern Australia. The importance of scabies, pyoderma, fungal and other skin infections is discussed as is the development of guidelines and community preventive programs. The authors conclude that the control and management of skin infections will depend on improvements in social and economic conditions, particularly living conditions and overcrowding.
Australian Indigenous HealthInfoNet abstract

Eades, S. (2000).
Reconciliation, social equity and Indigenous health - a call for symbolic and material change.
Medical Journal of Australia, 172, 468-469.

This article discusses the importance of the reconciliation process in bringing about social equity among Australians and ultimately improving the health status of Indigenous people. It acknowledges the evidence of the sub-standard health of Indigenous Australians and its ties with socioeconomic factors, racism and prejudice. Notable efforts made by Australians to deal with Indigenous health and equity issues are mentioned, but it is highlighted that these do not address the attitudes in Australian society that continue to marginalise and disempower Indigenous people. Recognition of Indigenous people's prior ownership is noted as central to achieving social and economic equity in Australia, with important challenges including the reconciliation process and the willingness of Australians to take actions that bring symbolic and material change.
Australian Indigenous HealthInfoNet abstract

Ewald, D., Franks, C., Thompson, S., & Patel, M.S. (2000).
Possible community immunity to small round structured virus gastroenteritis in a rural aboriginal community.
Communicable Disease Intelligence, 24(3), 48-50.

The process, results and consequences of an investigation into an outbreak of gastroenteritis are discussed. The outbreak affected visitors to a rural Aboriginal community in central Australia, but none of the community residents were similarly affected. It is suggested that past exposure to the small round structured virus (SRSV) implicated in the outbreak may have resulted in immunity among community residents.
Australian Indigenous HealthInfoNet abstract

Field, P., & Gregory, G. (2000).
Non-governmental organisations to combine for work on chronic disease in Aboriginal peoples, Torres Strait Islanders and rural and remote populations.
Australian Journal of Rural Health, 8(4), 239.

This article describes the background and motivation behind a proposed alliance of non-government organisations to develop a chronic disease strategy for Indigenous peoples and rural and remote populations. The strategy would address heart disease and other chronic preventable diseases in the target populations. It is hoped that the initiative would become a facet of a broader 'national chronic disease prevention and management strategy'.
Austrlaian Indigenous HealthInfoNet abstract

Gracey, M., Williams, P., & Smith, P. (2000).
Aboriginal deaths in Western Australia: 1985-89 and 1990-94.
Australian and New Zealand Journal of Public Health, 24(2), 145.

A study examined death data for Aboriginal and non-Aboriginal persons in Western Australia in 1985-89 and 1990-94. Main causes of death among Aboriginal males in 1990-94 were circulatory conditions, respiratory diseases, injury and poisoning, neoplasms and endocrine diseases; in Aboriginal females they were circulatory conditions, neoplasms, endocrine diseases, respiratory diseases, and injury and poisoning. The Aboriginal male all-cause age-standardised death rate fell 3%, while the non-Aboriginal male rate fell 11%. The Aboriginal female all-cause death rate rose 11%, while the non-Aboriginal rate fell 5%. Over the study period, Aboriginal health standards, as reflected by death rates, apparently worsened relative to non-Aboriginal standards.
Australian and New Zealand Journal of Public Health abstract

Gray, D., Saggers, S., Sputore, B., & Bourbon, D. (2000).
What works? A review of evaluated alcohol misuse interventions among Aboriginal Australians.
Addiction, 95(1), 11-22.

Aims:To identify which intervention strategies have been effective in reducing excessive consumption of alcohol, and related harm, among some segments of Australia's Aboriginal population.
Design: Items dealing with 'alcohol' and 'evaluation' were identified from the comprehensive electronic database on Aboriginal alcohol and other drug issues, maintained by Australia's National Drug Research Institute (formerly the National Centre for Research into the Prevention of Drug Abuse). From these were selected all reports dealing specifically with evaluation of particular intervention projects. These were grouped and systematically reviewed under the broad categories of treatment, health promotion education, acute interventions and supply reduction.
Findings:A broad range of intervention strategies has been employed. Few systematic evaluations have been undertaken, however, and the methodologies employed have been generally insufficient to allow robust generalisation. The impact of most interventions appears limited but, in part, this may be a function of inadequate resourcing and programme support.
Conclusions: Despite the limitations of the evaluation reports, several conclusions can be tentatively drawn. It appears there is a need to employ a broader range of treatment models and complementary intervention strategies. Interventions are generally inadequately resourced. There is a suggestion that supply reduction interventions may be effective. Most importantly, there is a pressing need for more rigorous evaluation studies in cooperation with Aboriginal community organisations.
Addiction abstract

Guthrie, J.A., Dore, G.J., McDonald, A.M., & Kaldor, J.M. (2000).
HIV and AIDS in Aboriginal and Torres Strait Islander Australians: 1992-1998.
Medical Journal of Australia, 172, 266-269.

Health Promotion Journal of Australia. (2000).
South Australia: reconciliation statement signed by the South Australian Department of Human Services.
Health Promotion Journal of Australia, 10(1), 56.

Henderson, S. (2000).
Focus on psychiatry in Australia.
British Journal of Psychiatry, 176, 97-101.

Humankind has been present on the Australian continent for at least 40,000 - some say 60,000 - years, remarkably adapted to the environment and having a cultural tradition appreciated by few Caucasians. Non-Indigenous people have been here for only 200 years; and psychiatry for about half of that. We know nothing about the mental health of pre-contact Indigenous peoples; but we now know a little about the ways in which mental disorders are explained and treated by traditional methods. In two centuries, the Aboriginal and Torres Strait Islands communities, which are very diverse, have been steadily reduced to become only 1.5% of the population. From settlement in 1788 until the 1950s, most non-Indigenous Australians were of Anglo-Saxon or Celtic origin. Since the Second World War, the pattern of immigration has greatly enriched Australian life, first through large numbers of people from the Mediterranean littoral, Western Europe and the Balkans, and more recently from south-east Asia. Ethnic diversity is now evident in most peoples' daily lives - whom you see in the street, whom you work alongside, who your friends are, what you eat and who you have as patients. So the present Australian population of 18 million has undergone a marked change in demography and lifestyle within only two generations. Like the people, psychiatry is also changing rapidly. Where are the changes taking place? What is it like to be a psychiatrist here at present? Where has there been success and where has there been failure? Where is there lots of action?
British Journal of Psychiatry abstract

Hoy, W.E., Baker, P.R., Kelly, A.M., & Wang, Z. (2000).
Reducing premature death and renal failure in Australian Aboriginals: a community-based cardiovascular and renal protective program.
Medical Journal of Australia, 172, 473-478.

Hunter, E. (1999).
Considering the changing environment of Indigenous child development.
Australasian Psychiatry, 7(3), 137-140.

The author portrays Indigenous youth suicide as a result of past and present factors. Focussing on past issues, he identifies five historic periods - pre-contact, frontier conflict, institutional control, deregulation and contemporary - through which he describes the lives of Indigenous people in terms of authority, economy, family structure and function, sustenance, and nurturance. This construction of past events is used as a basis to explain Indigenous youth suicide, pointing out that the social and childhood development of young males is a function of the social circumstances of Indigenous communities in the past. The author points out the need for health professionals to be aware of relevant historical, cultural and political forces that have impacted on Indigenous social practices.
Australian Indigenous HealthInfoNet abstract

Laming, A.C., Currie, B.J., DiFrancesco, M., Taylor, H.R., & Mathews, J.D. (2000).
A targeted, single-dose azithromycin strategy for trachoma.
Medical Journal of Australia, 172, 163-166.

Objective:To evaluate the impact of treating children with acute trachoma and their contacts with oral azithromycin.
Design:Open, uncontrolled, prospective evaluation of a community-based treatment strategy.
Setting:Central Australian semi-desert Aboriginal community (1995-1996).
Participants:216 school and pre-school children aged 6 months and up to 15 years.
Intervention:All children with acute trachoma and their contacts (co-resident siblings aged between 6 months and 15 years) received single-dose oral azithromycin suspension (20 mg/kg, to a maximum of l000 mg).
Main outcome measure: Prevalence of acute trachoma (World Health Organization trachoma diagnostic criteria).
Results:Trachoma prevalence at baseline was 42% (71/169) and 55% (18/33) for schoolchildren and pre-schoolchildren, respectively; 103 schoolchildren and 21 pre-schoolchildren, comprising 77 with follicular trachoma and their 47 contacts, were treated with azithromycin over an 8-week period. Acute trachoma prevalence in schoolchildren fell to 22% at 6-8 months (P<0.0001) and was 31% at 12 months (P<0.05 compared with baseline). Pre-school children were followed up for 6 months after treatment, and their trachoma prevalence fell from 55% to 25% (P<0.05). Further treatment was given to children with trachoma at 12 months, and the point prevalence of trachoma for schoolchildren at 24 months was 34%.
Conclusions:In contrast to mass-treatment strategies, significant reductions in trachoma prevalence at 6 months were achieved by screening 35% of community members (216) and treating 20% (124). The subsequent prevalence increases support the need for more comprehensive treatment programs, including health promotion and efforts to improve living conditions.
Medical Journal of Australia abstract

Maher, P. (1999).
A review of traditional Aboriginal health beliefs.
Australian Journal of Rural Health, 7, 229-236.

Main, D., Nichol, R., & Fennell, R. (2000).
Reconciling pedagogy and health sciences to promote Indigenous health.
Australian and New Zealand Journal of Public Health, 24(2), 211-213.

This article describes an ethnographic study of Indigenous learning styles that gives consideration to the fields of education, public health and Indigenous cultural perspectives. The study focuses on health and human science courses and highlights the cultural constraints that Indigenous students face in mainstream tertiary education. Strategies are suggested that account for differences in Indigenous learning styles and assist both tertiary students and lecturers to facilitate learning capacity. The authors conclude that culturally appropriate education strategies for Indigenous public health students should enhance their capacities in future public health roles.
Australian Indigenous HealthInfoNet abstract

McDermott, R., Rowley, K. G., Lee, A. J., Knight, S., & O'Dea, K. (2000).
Increase in prevalence of obesity and diabetes and decrease in plasma cholesterol in a Central Australian Aboriginal community.
Medical Journal of Australia, 172, 480-484.

McGrath, C. (2000).
Issues influencing the provision of palliative care services to remote Aboriginal communities in the Northern Territory.
Australian Journal of Rural Health, 8(1), 47.

Palliative care is a service available to many Australians subject to location and varying criteria. This paper seeks to identify some of the issues that hamper the provision of this sophisticated service to Aborigines living in remote parts of the Northern Territory. The paucity of literary sources of information demonstrates the need for research to be carried out in this field.
Australian Journal of Rural Health abstract

Oldenburg, B., McGuffog., & Turrell, G (2000).
Socioeconomic determinants of health in Australia: policy responses and intervention options.
Medical Journal of Australia, 172, 489-492

Tackling socioeconomic health inequalities represents one of Australia's most challenging public health issues.
Research has demonstrated that the role of physicians and other health professionals, as advocates for change in the delivery of health services, public health policy and other community-wide initiatives, is extemely important in reducing mortality and improving health outcomes.
Multilevel actions to reduce health inequalities should include changes to macrolevel social and economic policies; improving living and working conditions; strengthening communities for health; improving behavioural risk factors; empowering individuals and strengthening their social networks; and improving responses from the healthcare system and associated treatment services.
Australia has yet to develop a coordinated and integrated approach to addressing health disparities; however, previously successful public health interventions addressing other health issues are good starting points.
Medical Journal of Australia abstract

Pocock, J. (1999).
Wanted: better services: a look at the Victorian government's Improving human services for Victorian Kooris: Koori services improvement strategy.
Youth Issues Forum, Winter 1999, 4-8.

This article discusses a document released by the Victorian Government which was promoted as a comprehensive attempt to deliver better outcomes to Victoria's Koori community. Author Julian Pocock questions the principles and strategies of the report, in particular, claiming it is unclear whether many of the improvements are towards Koori services or human services in general. The importance of Koori people having control of services is highlighted, and contestability and tendering are seen as a threat to this control.
Australian Indigenous HealthInfoNet abstract

Roberts, C., & Crofts, N. (2000).
Hitting up in the Top End: characteristics of needle exchange clients in Darwin.
Australian and New Zealand Journal of Public Health, 24(1), 82-85.

Repeat cross-sectional studies were conducted on injecting drug use (IDU) and blood-borne viral (BBV) infection in rural Australia during a two-week period in July and October-November 1998 at the Darwin needle exchange, with 129 and 121 respondents respectively. The results indicated the commonest drug of choice was heroin, but the commonest drug injected was morphine. Self-reported sharing of needles and syringes was uncommon. Self-reported serostatus for HIV was high (8% and 11.4% respectively), but seemingly mostly associated with sexual rather than IDU risk; for hepatitis C (HCV) status, these were 54% and 37%. Among IDUs of Aboriginal or Torres Strait Islander (ATSI) background, who made up 14% of the first round respondents, patterns of IDU and of BBV infection were the same as among non-ATSI respondents. These surveys reveal patterns of IDU in Darwin that have both similarities and differences with those in the major urban centres in Australia.
Australian and New Zealand Journal of Public Health abstract

Rowley, K. G., Daniel, M., Skinner, K., Skinner, M., White, G. A., & O'Dea, K. (2000).
Effectiveness of a community-directed 'healthy lifestyle' program in a remote Australian Aboriginal community.
Australian and New Zealand Journal of Public Health, 24(2), 136-144.

Objective:To assess the sustainability and effectiveness of a community-directed program for primary and secondary prevention of obesity, diabetes and cardiovascular disease in an Aboriginal community in north-west Western Australia.
Method: Evaluation of health outcomes (body mass index, glucose tolerance, and plasma insulin and triglyceride concentrations) in a cohort of high-risk individuals (n=49, followed over two years) and cross-sectional community samples (n=200 at baseline, 185 at two-year and 132 at four-year follow-ups), process (interventions and their implementation) and impact (diet and exercise behaviour).
Results: For the high-risk cohort, involvement in diet and/or exercise strategies was associated with protection from increases in plasma glucose and triglycerides seen in a comparison group; however, sustained weight loss was not achieved. At the community level, significant reductions were observed in fasting insulin concentration but no change in prevalence of diabetes, overweight or obesity. Weight gain remained a problem among younger people. Sustainable improvements were observed for dietary intake and level of physical activity. These changes were related to supportive policies implemented by the community council and store management.
Conclusions: Community control and ownership enabled embedding and sustainability of program, in association with social environmental policy changes and long-term improvements in important risk factors for chronic disease.
Implications:Developmental initiatives facilitating planning, implementation and ownership of interventions by community members and organisations can be a feasible and effective way to achieve sustainable improvements in health behaviours and selected health outcomes among Aboriginal people.
Australian and New Zealand Journal of Public Health abstract

Smith, R.M., Smith, P.A., McKinnon, M., & Gracey, M. (2000).
Birthweights and growth of infants in five Aboriginal communities.
Australian and New Zealand Journal of Public Health, 24(2), 124-135.

Objectives: To improve, by culturally appropriate means, birthweights and growth of children up to three years of age over 14 months in five Aboriginal communities in north-western Australia.
Methods: Frequent individual nutritional assessment of infants and children with counselling of mothers and carers and of pregnant women and the introduction of the Aboriginal-controlled Strong Women, Strong Babies, Strong Culture maternal support program. Outcomes compared with those in the same communities for the five years preceding intervention.
Results:By international standards, pre-intervention birthweights of full-term infants (37-42 weeks) were only moderately depressed and recovered to exceed standard weight-for-age within two weeks of birth. Growth of full-term infants slowed abruptly after six months. Prevalence and duration of breastfeeding were very high. Prevailing low average birthweight was chiefly attributable to a prevalence of pre-term birth approaching 20%. Intervention was not accompanied by any change in full-term birth weight but was associated with increased weight gain after six months. From 12 to 36 months growth rose by 30 g per month (p=0.001 ). Average birthweights of pre-term infants were <2,500 g and average weight-for-age did not improve during intervention.
Conclusions:Both low birthweight and a disproportionate part of intransigent failure to grow by Aboriginal infants were associated with pre-term birth. Depressed average growth of full-term infants appeared to respond to nutritional counselling accompanied by a community support program.
Implications: Investigation of the causes of the exceptionally high rate of Aboriginal pre-term birth in the region is urgently required.
Australian and New Zealand Journal of Public Health abstract

Swift, H. (2000).
Nurses in front line against influenza in Indigenous communities.
Australian Nursing Journal, 7(8), 13.

According to the Department of Health and Aged Care, nurses in community health settings working with Aboriginal and Torres Strait Islander communities can make an invaluable contribution to the pre-winter immunisation campaign against influenza.
Australian Nursing Journal abstract

Van Haaren, M., & Williams, G. (2000).
Central Australian nurse management model (CAN model): a strategic approach to the recruitment and retention of remote-area nurses.
Australian Journal of Rural Health, 8(1), 1-5.

This paper outlines a new management model for the recruitment and retention of remote area nurses in central Australia. Implemented in 1997, the Central Australian Remote Nursing Services Management Model (CAN Model) has stabilised the remote area nursing workforce and improved remote health service delivery. The Model incorporates three key initiatives that focus on improvements in the work environment, delivery of a work-based professional development program and ready access to relief staff. The authors recommend that similar systematic approaches be introduced across rural Australia. They conclude 'that only when the nursing workforce is stabilised will the quality, continuity and appropriateness of health care to Indigenous populations in remote areas be fully realised.'
Australian Indigenous HealthInfoNet abstract

Last updated: 13 February, 2003