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Predicting heart disease in Aboriginal and Torres Strait Islander people
This study is a follow up of cardiovascular disease (CVD) outcomes for a cohort of Indigenous people in the Northern Territory (NT) who participated in a health screening program Heart health in the 1990s. It aimed to identify what clinical measures best predict the risk of heart attack and stroke in Indigenous communities in central Australia.
The first community for whom data collection and analysis was complete was Utopia. Findings from Utopia include:
- adult mortality rates from all causes during the period 1995-2004 were about 40% lower at Utopia compared to those for Indigenous people in the NT generally.
- hospitalisation with CVD as the primary cause of admission occurred at a much lower rate for Utopia residents than for other Indigenous people in the NT
- obesity and diabetes occured at lower rates for Utopia residents than for other Indigenous people in the NT.
It is thought that the benefits of a traditional lifestyle, enabled by the decentralized nature of the community and including regular exercise and intake of bush tucker, is one reason why Utopia residents have achieved these good outcomes. Lower rates of smoking, strong culture, and the community-directed nature of primary health care services provided by Urapuntja Health Service, are also attributed to these better outcomes.
In 2011 the Onemda VicHealth Koori Health Unit at the University of Melbourne commenced a further study of three of the original participating communities that seeks to investigate the social determinants of health.
In particular the study aims to identify early markers of cardiovascular risk that may be useful in clinical screening programs, with the aim of reassessing and amending current clinical guidelines. This study is due for completion in 2014.
Abstract adapted from the Lowitja Institute and the University of Melbourne
179 Grattan Street
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Senior Research Fellow
Onemda VicHealth Koori Health Unit
Melbourne School of Population and Global Health
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The University of Melbourne
Melbourne Vic 3010
Ph: (03) 8344 0814
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O'Neal DN, Piers LS, Iser DM, Rowley KG, Jenkins AJ, Best JD, O'Dea K (2008)
Australian Aboriginal people and Torres Strait Islanders have an atherogenic lipid profile that is characterised by low HDL-cholesterol level and small LDL particles.
Journal of Atherosclerosis Research; 201(2): 368-377
Cooperative Research Centre for Aboriginal Health (2008)
Good health outcomes over two decades for a decentralised NT Aboriginal community - Utopia [policy brief].
: Cooperative Research Centre for Aboriginal Health
Shemesh T, Rowley KG, Piers LS, Best JD, O'Dea K (2008)
Low high-density lipoprotein-cholesterol is the most prevalent metabolic abnormality for Australian Aboriginal men and women when lean.
European Journal of Cardiovascular Prevention & Rehabilitation; 15(1): 49-51
Rowley KG, O'Dea K, Anderson I, McDermott R, Saraswati K, Tilmouth R, Roberts I, Fitz J, Wang Z, Best JD, Wang Z, Brown A (2008)
Lower than expected morbidity and mortality for an Australian Aboriginal population: 10-year follow-up in a decentralised community.
Medical Journal of Australia; 188(5): 283-287
Schutte AE, Shemesh T, Rowley K, Best JD, McDermott R, O'Dea K (2005)
The metabolic syndrome and changing relationship between blood pressure and insulin with age, as observed in Aboriginal and Torres Strait Islander peoples.
Diabetic Medicine; 22(11): 1589-1597