Journal articles on the topic 'Australia's indigenous health policy'
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1
Walker, Judi, and Grant Lennox. "Duelling Band-aids: Debating and Debunking Issues Affecting Primary Health Care to Achieve Deliverance for Australia's Health." Australian Journal of Primary Health 6, no. 4 (2000): 147. http://dx.doi.org/10.1071/py00048.
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The constant pressure for growth on all areas of health spending is not matched by the country's capacity to pay. Despite a progressive shift to a primary health care approach that promotes health and wellbeing, illness prevention, healthy lifestyles, early detection, rehabilitation and public health strategies, not all segments of Australian society enjoy good health. In this paper, general indications of the health and wellbeing of Australians are described, and the health and wellbeing of two important population groups: rural and remote and Indigenous populations are discussed, providing a review of Australia's health system. Anomalies in the status of the health of Australians are apparent. Models of primary healthcare, individual health and urban health are compared with models of acute and institutional care, population health and rural health.
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FISHER, MATTHEW, SAMANTHA BATTAMS, DENNIS MCDERMOTT, FRAN BAUM, and COLIN MACDOUGALL. "How the Social Determinants of Indigenous Health became Policy Reality for Australia's National Aboriginal and Torres Strait Islander Health Plan." Journal of Social Policy 48, no. 1 (May 28, 2018): 169–89. http://dx.doi.org/10.1017/s0047279418000338.
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AbstractThe paper analyses the policy process which enabled the successful adoption of Australia's National Aboriginal and Torres Strait Islander Health Plan 2013–2023 (NATSIHP), which is grounded in an understanding of the Social Determinants of Indigenous Health (SDIH). Ten interviews were conducted with key policy actors directly involved in its development. The theories we used to analyse qualitative data were the Advocacy Coalition Framework, the Multiple Streams Approach, policy framing and critical constructionism. We used a complementary approach to policy analysis. The NATSIHP acknowledges the importance of Aboriginal and Torres Strait Islander (hereafter, Aboriginal) culture and the health effects of racism, and explicitly adopts a human-rights-based approach. This was enabled by a coalition campaigning to ‘Close the Gap’ (CTG) in health status between Aboriginal and non-Aboriginal Australians. The CTG campaign, and key Aboriginal health networks associated with it, operated as an effective advocacy coalition, and policy entrepreneurs emerged to lead the policy agenda. Thus, Aboriginal health networks were able to successfully contest conventional problem conceptions and policy framings offered by government policy actors and drive a paradigm shift for Aboriginal health to place SDIH at the centre of the NATSIHP policy. Implications of this research for policy theory and for other policy environments are considered along with suggestions for future research.
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Donato, Ronald, and Leonie Segal. "Does Australia have the appropriate health reform agenda to close the gap in Indigenous health?" Australian Health Review 37, no. 2 (2013): 232. http://dx.doi.org/10.1071/ah12186.
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This paper provides an analysis of the national Indigenous reform strategy – known as Closing the Gap – in the context of broader health system reforms underway to assess whether current attempts at addressing Indigenous disadvantage are likely to be successful. Drawing upon economic theory and empirical evidence, the paper analyses key structural features necessary for securing system performance gains capable of reducing health disparities. Conceptual and empirical attention is given to the features of comprehensive primary healthcare, which encompasses the social determinants impacting on Indigenous health. An important structural prerequisite for securing genuine improvements in health outcomes is the unifying of all funding and policy responsibilities for comprehensive primary healthcare for Indigenous Australians within a single jurisdictional framework. This would provide the basis for implementing several key mutually reinforcing components necessary for enhancing primary healthcare system performance. The announcement to introduce a long-term health equality plan in partnership with Aboriginal people represents a promising development and may provide the window of opportunity needed for implementing structural reforms to primary healthcare. What is known about the topic? Notwithstanding the intention of previous policies, considerable health disparity exists between Indigenous and non-Indigenous Australians. Australia has now embarked on its most ambitious national Indigenous health reform strategy, but there has been little academic analysis of whether such reforms are capable of eliminating health disadvantage for Aboriginal people. What does the paper add? This paper provides a critical analysis of Indigenous health reforms to assess whether such policy initiatives are likely to be successful and outlines key structural changes to primary healthcare system arrangements that are necessary to secure genuine system performance gains and improve health outcomes for Indigenous Australians. What are the implications for practitioners? For policymakers, the need to establish genuine partnership and engagement between Aboriginal people and the Australian government in pursuing a national Indigenous reform agenda is of critical importance. The establishment of the National Congress of Australia’s First Peoples provides the opportunity for policymakers to give special status to Indigenous Australians in health policy development and create the institutional breakthrough necessary for effecting primary healthcare system change.
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Olsen, Anna, Jack Wallace, and Lisa Maher. "Responding to Australia's National Hepatitis B Strategy 2010–13: gaps in knowledge and practice in relation to Indigenous Australians." Australian Journal of Primary Health 20, no. 2 (2014): 134. http://dx.doi.org/10.1071/py12162.
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The Australian National Hepatitis B Strategy 2010–13 outlines five priority areas for developing a comprehensive response to the hepatitis B virus (HBV): building partnerships and strengthening community action; preventing HBV transmission; optimising diagnosis and screening; clinical management of people with chronic hepatitis B (CHB); and developing health maintenance, care and support for people with HBV. A scoping study was used to map the main sources and types of evidence available on the epidemiology and natural history of HBV among Indigenous Australians as well as public health responses published since 2001 (January 2001–May 2013). Gaps in current knowledge were identified. While the literature documents the success of universal infant immunisation and indicates the potential for screening initiatives to identify infected and susceptible individuals, prevalence of CHB and hepatocellular cancer remain high in Indigenous Australians. Significant gaps in knowledge and practice were identified in relation to each of the five National Hepatitis B Strategy priority action areas. Successful implementation of the strategy in Indigenous communities and reducing the burden of HBV and hepatocellular cancer in Indigenous Australians will require increased investment in research and knowledge transfer across all priority areas.
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Firebrace, Sharon. "Issues in Service Delivery for Women Statewide: Koori Context." Australian Journal of Primary Health 4, no. 3 (1998): 89. http://dx.doi.org/10.1071/py98034.
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For introduction, let me state what most of us will readily acknowledge as fact: the Koori health profile contains the greatest challenge for health providers on all levels today. This has been the case for decades and current indicators confirm the relatively stagnant health outcomes of Australia's indigenous population. Similarly challenged indigenous populations throughout the world -especially in New Zealand, Canada and USA - have improved their indigenous health profiles while we, in Australia, lag behind. Despite the best intentions of government and indigenous agencies, the state of indigenous health remains a damning indictment of our society's human rights conscience.
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Turner, Lyle, Tim Albers, Adrian Carson, Carmel Nelson, Renee Brown, and Marianna Serghi. "Building a regional health ecosystem: a case study of the Institute for Urban Indigenous Health and its System of Care." Australian Journal of Primary Health 25, no. 5 (2019): 424. http://dx.doi.org/10.1071/py19038.
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Efforts to address Indigenous health disadvantage require a refocus on urban settings, where a rapidly increasing majority (79%) of Indigenous Australians live. Proximity to mainstream primary care has not translated into health equity, with the majority of the Indigenous burden of disease (73%) remaining in urban areas and urban Indigenous people continuing to face significant barriers in accessing comprehensive and culturally appropriate care. This paper presents a case study of how the Institute for Urban Indigenous Health (IUIH) has strategically responded to these challenges in South East Queensland – home to Australia’s largest and equal fastest growing Indigenous population. The IUIH has developed a new regional and systematised model – a regional health ‘ecosystem’ – for how primary care is delivered and intersects with the broader health system. Through intentional action, which strengthens the self-efficacy of community, the IUIH System of Care has delivered real gains for the Indigenous population of the region and has the capacity to deliver similar improvements in health access and outcomes in other regions.
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Matthews, Anna, Lisa R. Jackson Pulver, and Ian T. Ring. "Strengthening the link between policy formulation and implementation of Indigenous health policy directions." Australian Health Review 32, no. 4 (2008): 613. http://dx.doi.org/10.1071/ah080613.
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This study aimed to understand the problems within the Indigenous health policy process in Australia and how weaknesses in the process impact on policy implementation. Using semistructured questions, 23 key stakeholders in the policy-making process were interviewed. Three main themes dominated; a need for increased Indigenous involvement in policy formulation at the senior Australian Government level, increased participation of Indigenous community-controlled health organisations in the policy-making process and, most importantly, ensuring that policies have the necessary resources for their implementation. The emergence of these specific themes demonstrated weaknesses in policy process from the formulation stage onward. Tackling these would, according to our informants, significantly enhance the effectiveness of the policy process and contribute to further improvement of the health of Indigenous Australians.
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Chynoweth, J., B. Daveson, M. McCambridge, J. Coutts, H. Zorbas, and K. Whitfield. "A National Priority: Improving Outcomes for Aboriginal and Torres Strait Islander People With Cancer Through an Optimal Care Pathway." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 243s. http://dx.doi.org/10.1200/jgo.18.97700.
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Background and context: Cancer survival rates in Australia are among the best in the world, yet Aboriginal and Torres Strait Islander (indigenous) people continue to experience disparities in the distribution and burden of cancer, and unwarranted variations in outcomes. Indigenous Australians are 40% more likely to die of cancer than non-Indigenous Australians. Cancer Australia developed the National Aboriginal and Torres Strait Islander Cancer Framework (the framework), which identified 7 national priorities to address disparities in cancer outcomes experienced by indigenous Australians. An ongoing collaboration with indigenous Australians was integral to developing this shared agenda. Priority 5 in the framework highlights the need to ensure indigenous Australians affected by cancer receive optimal and culturally appropriate treatment, services, and supportive and palliative care. Aim: To improve cancer outcomes for indigenous Australians through the development and national endorsement of a population-specific Optimal Care Pathway (OCP) to guide the delivery of consistent, safe, high-quality, culturally appropriate and evidence-based care. Strategy/Tactics: Cancer Australia formed a partnership with the Victorian Department of Health and Human Services (DHHS) to address Priority 5 and develop the OCP. The approach to development was underpinned by Cancer Australia's Model of Engagement for Aboriginal and Torres Strait Islander People and guided by the national Leadership Group on Aboriginal and Torres Strait Islander Cancer Control (Leadership Group). Program/Policy process: Cancer Australia, in collaboration with DHHS: • reviewed experiences of care and the framework's comprehensive evidence base • developed a draft OCP to complement tumor-specific pathways • facilitated an Expert Working Group, comprising indigenous health sector leaders and consumers to refine and validate the draft OCP • undertook national public consultation, including with the indigenous health sector and community, health professionals and professional colleges • received an indication of support to proceed to endorsement from the Leadership Group. Outcomes: The first population-specific OCP for Aboriginal and Torres Strait Islander people with cancer received national endorsement. It will guide the delivery of consistent, safe, high-quality, culturally appropriate and evidence-based care. What was learned: Key elements of optimal care include: addressing the cultural appropriateness of the healthcare environment; improving cross-cultural communication; relationship building with local community; optimizing health literacy; recognition of men's and women's business; and the need to use culturally appropriate resources. The national priority in the framework informed and unified high-level direction, which was integral to effective OCP development and endorsement. The evidence-based, step-wise development approach contributed to its relevance, utility and quality.
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Cotter, Philippa R., John R. Condon, Tony Barnes, Ian P. S. Anderson, Leonard R. Smith, and Teresa Cunningham. "Do Indigenous Australians age prematurely? The implications of life expectancy and health conditions of older Indigenous people for health and aged care policy." Australian Health Review 36, no. 1 (2012): 68. http://dx.doi.org/10.1071/ah11996.
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Objective. To assess whether Indigenous Australians age prematurely compared with other Australians, as implied by Australian Government aged care policy, which uses age 50 years and over for population-based planning for Indigenous people compared with 70 years for non-indigenous people. Methods. Cross-sectional analysis of aged care assessment, hospital and health survey data comparing Indigenous and non-indigenous age-specific prevalence of health conditions. Analysis of life tables for Indigenous and non-indigenous populations comparing life expectancy at different ages. Results. At age 63 for women and age 65 for men, Indigenous people had the same life expectancy as non-indigenous people at age 70. There is no consistent pattern of a 20-year lead in age-specific prevalence of age-associated conditions for Indigenous compared with other Australians. There is high prevalence from middle-age onwards of some conditions, particularly diabetes (type unspecified), but there is little or no lead for others. Conclusion. The idea that Indigenous people age prematurely is not well supported by this study of a series of discrete conditions. The current focus and type of services provided by the aged care sector may not be the best way to respond to the excessive burden of chronic disease and disability of middle-aged Indigenous people. What is known about the topic? The empirical basis for the Australian Government’s use of age 50 for Indigenous aged care planning, compared to age 70 for the non-indigenous population, is not well established. It is not clear whether Indigenous people’s poorer health outcomes and lower life expectancy are associated with premature ageing. What does this paper add? This paper compares Indigenous and non-indigenous life expectancy and prevalence of health conditions. Only some conditions associated with ageing appear to affect Indigenous people earlier than other Australians. The proposition of premature ageing based on this explanatory framework is uncertain. The estimated gap between Indigenous and non-indigenous life expectancy in later life is ~6 years. What are the implications for practitioners? The current rationale for using a lower Indigenous planning age is problematic; however, further research is required to assess the effectiveness of this policy measure. The much higher prevalence of preventable chronic conditions among Indigenous Australians in middle-age groups is clear. The ‘early ageing’ frame can imply irremediable disability and disease. The aged care sector may be filling gaps in other services. The community care services for this group require a more tailored approach than simply lowering the planning age for aged care services.
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Leggat, Sandra G. "Improving Aboriginal health." Australian Health Review 32, no. 4 (2008): 587. http://dx.doi.org/10.1071/ah080587.
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In recognition of the recent achievements of the Close the Gap campaign, this issue of AHR contains a set of papers focusing on Aboriginal health. At the national Indigenous Health Equality Summit in Canberra in March 2008, the Close the Gap Statement of Intent was signed. This Statement of Intent requires the government, health and social service agencies and the Aboriginal communities to work together to achieve equality in health status and life expectancy between Indigenous and non-Indigenous Australians by the year 2030. (See http:// www.hreoc.gov.au/Social_Justice/health/statement_ intent.html) The first three papers present important policy lessons. Matthews and her colleagues stress the need to strengthen the link between policy formulation and implementation (page 613). Their study found that the lack of progress in improving Aboriginal health may be the result of lack of Indigenous involvement in policy formulation at the senior Australian Government level, limited participation of Indigenous community controlled health organisations in the policy making process and insufficient resources for implementation. Anderson, Anderson and Smylie outline the achievements of the National Indigenous Health Performance Measurement System (page 626), and change management lessons from Aboriginal community controlled health organisations are discussed by Leanne Coombe from the Apunipima Cape York Health Council (page 639). Other papers with a focus on Aboriginal health include a review of emergency department access (page 648), overseas-trained doctors working in rural and remote Aboriginal health settings (page 655) and eye health programs within remote Aboriginal communities (page 664).
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Gray, Marion A., and Florin I. Oprescu. "Role of non-Indigenous researchers in Indigenous health research in Australia: a review of the literature." Australian Health Review 40, no. 4 (2016): 459. http://dx.doi.org/10.1071/ah15103.
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Objective This paper explores the body of knowledge around Indigenous health research and aims to outline what roles are appropriate for non-Indigenous researchers within Indigenous health research in Australia. Methods A literature review was conducted using CINAHL, PubMed and Scopus in May 2015. The search terms were ‘non-Indigenous researchers’ AND ‘Indigenous health research’ and other combinations of these terms. Additional documents were sourced by hand using the reference lists of key articles. Results Seven thematic categories were identified: (1) Closing the Gap: implications for research; (2) history of Indigenous research; (3) developing Indigenous research using a capacity-building approach; (4) the cultural interface between Western paradigms and Indigenous knowledge; (5) ethical Indigenous research; (6) culturally safe Indigenous research; and (7) positive roles for non-Indigenous researchers in Indigenous research. Conclusion It is important that non-Indigenous researchers become more aware of culturally appropriate ways in which to undertake Indigenous research and to ensure that the research undertaken is safe, ethical and useful for participants. Fostering partnerships between non-Indigenous academic organisations and researchers and Indigenous health researchers is an important development that can promote and enhance the emerging field of Indigenous inquiry. Actively contributing to capacity building with Indigenous researchers and research initiatives is a key role that non-Indigenous researchers and academic institutions can have in improving Indigenous health. Self-determination through health research capacity building and evidence-based advocacy may provide the most useful outcomes for Indigenous people. What is known about the topic? The health status of Indigenous Australians is well below that of other Australians. Historically, research about Indigenous health has been undertaken by non-Indigenous researchers using Western research paradigms. There is a need to identify appropriate roles for non-Indigenous researchers supportive of culturally safe and ethical research. What does this paper add? This paper synthesises available knowledge about the role of non-Indigenous researchers with Indigenous health research and provides suggestions for their contribution to Indigenous research practice. What are the implications for practitioners? Non-Indigenous researchers need to: (1) focus on culturally safe research practices; (2) be willing to address power imbalances within the research process; and (3) advocate for change within academic institutions to support culturally safe research practices.
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Ishak, Maged. "Indigenous health: Patterns of variation in terms of disease categories." Australian Health Review 21, no. 4 (1998): 54. http://dx.doi.org/10.1071/ah980054.
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While many studies investigated the higher morbidity and mortality levels ofindigenous Australians in the high-density indigenous areas in the Northern Territory,Western Australia and South Australia, few examined the situation in New SouthWales, where more than 28% of the indigenous population lives. Admissions to acutepublic and private hospitals in New South Wales for 1989?1995 are used in the studyreported here to examine indigenous health and its differential patterns by diseasecategories. The study allowed for the monitoring of disease groups with particularlyhigh indigenous admissions and, accordingly, pinpointed areas for improvement. Age-standardisedestimates for the indigenous population are provided. Age compositionof admissions for each disease category and admissions by residential area are alsoestimated.
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Cosh, Suzanne, Lauren Maksimovic, Kerry Ettridge, David Copley, and Jacqueline A. Bowden. "Aboriginal and Torres Strait Islander utilisation of the Quitline service for smoking cessation in South Australia." Australian Journal of Primary Health 19, no. 2 (2013): 113. http://dx.doi.org/10.1071/py11152.
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Smoking prevalence among Indigenous Australians far exceeds that of non-Indigenous Australians and is considered the greatest contributor to burden of disease for Indigenous Australians. The Quitline is a primary intervention for facilitating smoking cessation and, given the health implications of tobacco use, maximising its effectiveness for Indigenous Australians is imperative. However, the utilisation and effectiveness of this service within the Indigenous Australian population has not been examined. This study explores the utilisation of the South Australian Quitline by smokers identifying as Indigenous Australian. Quitline counsellors collected data regarding demographic characteristics, and smoking and quitting behaviour from Quitline callers in 2010. Results indicated that the proportion of Indigenous and non-Indigenous smokers who registered for the service was comparable. Demographic variables and smoking addiction at time of registration with the Quitline were similar for Indigenous and non-Indigenous callers. However, results indicated that Indigenous callers received significantly fewer callbacks than non-Indigenous callers and were significantly less likely to set a quit date. Significantly fewer Indigenous callers reported that they were still successfully quit at 3 months. Thus, Indigenous Australian callers may be less engaged with the Quitline and further research is required exploring whether the service could be tailored to make it more engaging for Indigenous Australians who smoke.
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Craven, Rhonda G., and Gawain Bodkin-Andrews. "New Solutions for Addressing Indigenous Mental Health: A Call to Counsellors to Introduce the New Positive Psychology of Success." Australian Journal of Guidance and Counselling 16, no. 1 (July 1, 2006): 41–54. http://dx.doi.org/10.1375/ajgc.16.1.41.
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AbstractAustralia's ‘black’ history has had and continues to have a pervasive and adverse impact on Indigenous Australians. In fact, Indigenous Australians are the most disadvantaged Australians based on all socioeconomic indicators that serve to drive life potential. There is also a dearth of scholarly research available, particularly in relation to Indigenous children in the schooling sector and mental health. However, recent research with both Indigenous and non-Indigenous populations offers new, potentially potent, solutions. In this article we provide (a) a rationale for Indigenous mental health being a significant social issue of our time, (b) a summary of some recent research findings pertaining to mental health of young Indigenous Australians, (c) outline why a positive psychology approach offers a new solution for intervention with specific reference to the importance of the self-concept construct for Indigenous students, and (d) call upon counsellors, practitioners, and policy makers to implement and evaluate the latter approach.
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Thomas, David P., Ian P. Anderson, and Margaret A. Kelaher. "Accessibility and quality of care received in emergency departments by Aboriginal and Torres Strait Islander people." Australian Health Review 32, no. 4 (2008): 648. http://dx.doi.org/10.1071/ah080648.
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Objectives: To examine the accessibility and quality of care received in emergency departments by Aboriginal and Torres Strait Islander people compared with other Australians. Methods: We examined 2004?05 data from the National Non-admitted Patient Emergency Department Care database from the Northern Territory and Western Australia, the only jurisdictions where Indigenous identification in the database was considered acceptable. Results: In the NT, Indigenous people were 1.7 times as likely to present to an emergency department as non-Indigenous people. Indigenous patients in the NT and WA do not appear to use EDs for ?primary care? problems more than non- Indigenous patients. More NT Indigenous patients walked out before being seen or before their treatment was completed. However, Indigenous patients generally waited a similar time, and often slightly shorter, to be seen as similar non-Indigenous patients in WA and the NT. Conclusions: We recommend the regular monitoring of equity in the accessibility and quality of ED care for Indigenous people compared with other Australians. Indigenous identification in the database needs to improve so monitoring of ED performance can extend beyond WA and the NT.
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Shahid, Shaouli, Kerri R. Beckmann, and Sandra C. Thompson. "Supporting cancer control for Indigenous Australians: initiatives and challenges for cancer councils." Australian Health Review 32, no. 1 (2008): 56. http://dx.doi.org/10.1071/ah080056.
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As in other developed countries, the Australian population is ageing, and cancer rates increase with age. Despite their substantially lower life expectancy, Indigenous Australians are also experiencing concerning cancer statistics, characterised by increasing rates, later diagnosis, higher mortality, and lower participation in screening than the non-Indigenous population. Eighteen months after the first national Indigenous Cancer Control Forum, this environmental scan within the statebased Cancer Councils was undertaken to map activities in service provision in Indigenous cancer control with a view to sharing the lessons learned. The findings show that although most of the organisations had tried to work with Indigenous communities on cancer issues, there have been difficulties in building and sustaining relationships with Indigenous organisations. Lack of having Indigenous staff internally, few Indigenous-specific resources, and few planned, long-term commitments were some of the major impediments. Some of these limitations can easily be overcome by building and improving regional or local partnerships, providing cultural awareness training to internal staff, and by building the capacity of Indigenous organisations. Health promotion projects of the Cancer Councils directed at Indigenous people could be more effectively implemented with such considerations.
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Harvey, Peter W. "Science, research and social change in Indigenous health — evolving ways of knowing." Australian Health Review 33, no. 4 (2009): 628. http://dx.doi.org/10.1071/ah090628.
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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.
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Dalton, Vicki. "Death and Dying in Prison in Australia: National Overview, 1980–1998." Journal of Law, Medicine & Ethics 27, no. 3 (1999): 269–74. http://dx.doi.org/10.1111/j.1748-720x.1999.tb01461.x.
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This paper discusses the role of the Australian Institute of Criminology (AIC) in monitoring inmate deaths in custody on a national basis. It also provides a descriptive overview of Australian Indigenous and non-Indigenous inmate deaths in custody during the eighteen-year period between 1980 and 1998.In October 1987, the Royal Commission into Aboriginal Deaths in Custody (RCIADIC) commenced investigating the deaths of Australia's Indigenous people in custody throughout Australia between January 1, 1980 and May 31, 1989. RCIADIC's task was to examine the circumstances of the deaths; the actions taken by authorities; and the underlying causes of Indigenous deaths in custody, including social, cultural, and legal factors. The investigation found that the major factor contributing to the high number of Indigenous deaths in custody was the disproportionately higher rates at which Indigenous people come into contact with the criminal justice system. RCIADIC concluded that the most significant reason for this contact was the severely disadvantaged social, economic, and cultural position of many Indigenous people.
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Krichauff, Skye, Joanne Hedges, and Lisa Jamieson. "‘There’s a Wall There—And That Wall Is Higher from Our Side’: Drawing on Qualitative Interviews to Improve Indigenous Australians’ Experiences of Dental Health Services." International Journal of Environmental Research and Public Health 17, no. 18 (September 7, 2020): 6496. http://dx.doi.org/10.3390/ijerph17186496.
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Indigenous Australians experience high levels of untreated dental disease compared to non-Indigenous Australians. We sought to gain insight into barriers that prevent Indigenous Australians from seeking timely and preventive dental care. A qualitative study design was implemented, using face-to-face interviews conducted December 2019 to February 2020. Participants were 20 Indigenous Australians (10 women and 10 men) representing six South Australian Indigenous groups; Ngarrindjeri, Narungga, Kaurna, Ngadjuri, Wiramu, and Adnyamathanha. Age range was middle-aged to elderly. The setting was participants’ homes or workplaces. The main outcome measures were barriers and enablers to accessing timely and appropriate dental care. The findings were broadly grouped into eight domains: (1) fear of dentists; (2) confusion regarding availability of dental services; (3) difficulties making dental appointments; (4) waiting times; (5) attitudes and empathy of dental health service staff; (6) cultural friendliness of dental health service space; (7) availability of public transport and parking costs; and (8) ease of access to dental clinic. The findings indicate that many of the barriers to Indigenous people accessing timely and appropriate dental care may be easily remedied. Cultural competency training enables barriers to timely access and provision of dental care to Indigenous Australians to be addressed. The findings provide important context to better enable health providers and policy makers to put in place appropriate measures to improve Indigenous people’s oral health, and the Indigenous oral health workforce in Australia.
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Meiklejohn, Judith A., Brian Arley, Ross Bailie, Jon Adams, Gail Garvey, Jennifer H. Martin, Euan T. Walpole, and Patricia C. Valery. "Community-identified recommendations to enhance cancer survivorship for Aboriginal and Torres Strait Islander people." Australian Journal of Primary Health 24, no. 3 (2018): 233. http://dx.doi.org/10.1071/py17127.
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Indigenous Australians diagnosed with cancer experience higher mortality and lower survival rates compared to non-Indigenous Australians. Reasons are multifaceted and complex. Knowledge about Indigenous cancer survivors’ perspectives of positive cancer survivorship is a gap in research evidence. The study explored cancer survivorship perspectives of Indigenous cancer survivors, their support people and healthcare workers with a view to developing recommendations for cancer survivorship. Indigenous Australians who completed cancer treatment in the previous 6 months to 5 years, their support people and primary healthcare workers were recruited from primary healthcare centres and a large tertiary Queensland hospital. Semi-structured interviews and focus groups were conducted with written and informed consent obtained prior. Participants emphasised key action areas and recommendations to enhance cancer survivorship, namely: establishing a community cancer advocate and peer support program, availability and use of a cancer-specific Indigenous primary healthcare worker and hospital-based Indigenous patient navigator, as well as adoption of question prompt lists and cancer survivorship care plans. Existing research suggests significant benefits from implementing the key recommendations identified in this study. Greater support and commitment across health sectors and funding bodies is needed to promote institutional change and health system development.
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Fisher, Matthew, Tamara Mackean, Emma George, Sharon Friel, and Fran Baum. "Stakeholder perceptions of policy implementation for Indigenous health and cultural safety: A study of Australia's ‘Closing the Gap’ policies." Australian Journal of Public Administration 80, no. 2 (May 2, 2021): 239–60. http://dx.doi.org/10.1111/1467-8500.12482.
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Dunne, Emer. "Consultation, Rapport, and Collaboration: Essential Preliminary Stages in Research with Urban Aboriginal Groups." Australian Journal of Primary Health 6, no. 1 (2000): 6. http://dx.doi.org/10.1071/py00001.
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Conducting quality research with any group involves rigorous attention to ethical guidelines. This area becomes more complicated when undertaking research in Indigenous Australian communities, given Australia's colonial history and power relations. The preliminary stages are important elements of the research process. Researchers need to engage in extensive community consultation, negotiation and collaboration to produce research beneficial to the Aboriginal community. Essential components of these areas are issues surrounding the development of rapport, informed consent, and ownership of data. This paper explores these areas drawing on the experience of a postgraduate research student to illustrate their importance. A research project focusing on mental health issues amongst Aboriginal people resident in Adelaide provides the framework for discussion of the issues.
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Walker, Roz, Kim Usher, Debra Jackson, Corinne Reid, Katrina Hopkins, Carrington Shepherd, Reakeeta Smallwood, and Rhonda Marriott. "Connection to... Addressing Digital Inequities in Supporting the Well-Being of Young Indigenous Australians in the Wake of COVID-19." International Journal of Environmental Research and Public Health 18, no. 4 (February 22, 2021): 2141. http://dx.doi.org/10.3390/ijerph18042141.
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(1) Background: This article examines whether connection to digital technologies helps connect young Indigenous people in Australia to culture, community and country to support good mental health and well-being and protect against indirect and potentially long-term effects of COVID-19. (2) Method: We reviewed literature published between February and November 2020 and policy responses related to digital strategies. We searched PubMed, Google Scholar, government policy websites and key Indigenous literature sources, identifying 3460 articles. Of these, 30 articles and 26 policy documents were included and analysed to identify existing and expected mental health outcomes among Indigenous young people associated with COVID-19 and more broadly. (3) Results: There are inequities in affordable access to digital technologies. Only 63% of Indigenous people have access to internet at home. Digital technologies and social media contribute to strong cultural identity, enhance connections to community and country and improve mental health and social and emotional well-being outcomes. (4) Discussion: Access to digital technologies can facilitate healing and cultural continuity, self-determination and empowerment for young people to thrive, not just survive, in the future. (5) Conclusion: More targeted policies and funding is urgently needed to promote digital technologies to enhance Indigenous young people’s access to mental health and well-being services, maintain cultural connections and evaluate the effectiveness of these initiatives using Indigenous well-being indicators.
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Zhao, Yuejen, John Condon, Jiqiong You, Steven Guthridge, and Vincent He. "Assessing improvements in survival for stroke patients in the Northern Territory 1992–2013: a marginal structural analysis." Australian Health Review 39, no. 4 (2015): 437. http://dx.doi.org/10.1071/ah14146.
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Objective The aim of the present study was to investigate changes in stroke survival among Indigenous and non-Indigenous patients in the Northern Territory (NT). Methods A longitudinal study was undertaken of stroke patients admitted to NT public hospitals between 1992 and 2013. The Kaplan–Meier method and proportional hazards regression were used for survival analysis. A marginal structural model was applied to adjust for time-dependent confounders and informative censoring. Results There were 4754 stroke in-patients over the period, with 3540 new cases and 837 stroke deaths. Mean age of onset for Indigenous patients (51.7 years) was 12.3 years younger than that for non-Indigenous patients. After adjustments for confounders and loss to follow-up, in-hospital deaths were more likely among Indigenous patients (hazard ratio (HR) = 1.56; P < 0.01) and less likely among males (HR = 0.86; P < 0.05) and patients from remote areas (HR = 0.72; P < 0.01). There was a 3% decrease annually in mortality hazard from 1992 to 2013. Renal disease, cancer and chronic obstructive pulmonary disease had deleterious effects on stroke survival. Conclusions Stroke survival has improved in the NT over the past two decades. The marginal structural models provide a powerful methodological tool that can be applied to hospital administrative data to assess changes in quality of care and the impact of interventions. What is known about the topic? Stroke-related mortality has fallen in the past 30 years in Australia. Indigenous Australians have much worse health outcomes than other Australians, including higher stroke incidence and mortality, but it is not known whether stroke survival has improved for Indigenous stroke patients. What does this paper add? This study measured long-term survival for Indigenous and non-Indigenous patients after hospital admissions for stroke care, using hospital admission data analysed by marginal structural models. The present study demonstrates the usefulness of this approach to the quality assessment of health care interventions. What are the implications for practitioners? Hospital administrative data can, and should, be routinely used for monitoring long-term outcomes of acute care. Although survival has improved for Indigenous stroke patients over the past two decades, their survival remains lower than that of non-Indigenous patients. Coordinated acute and primary care plays a vital role in management of chronic diseases to improve stroke survival.
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Devlin, Sue, David MacLaren, Peter D. Massey, Richard Widders, and Jenni A. Judd. "The missing voices of Indigenous Australians in the social, cultural and historical experiences of tuberculosis: a systematic and integrative review." BMJ Global Health 4, no. 6 (November 2019): e001794. http://dx.doi.org/10.1136/bmjgh-2019-001794.
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IntroductionDisparities in tuberculosis (TB) rates exist between Indigenous and non-Indigenous populations in many countries, including Australia. The social determinants of health are central to health inequities including disparities in TB rates. There are limitations in the dominant biomedical and epidemiological approaches to representing, understanding and addressing the unequal burden of TB for Indigenous peoples represented in the literature. This paper applies a social determinants of health approach and examines the structural, programmatic and historical causes of inequities for TB in Indigenous Australia.MethodsAboriginal Australians’ families in northern New South Wales who are affected by TB initiated this investigation. A systematic search of published literature was conducted using PubMed, PsycINFO, Scopus and Informit ATSIhealth databases, the Australian Indigenous Health, InfoNet and Google. Ninety-five records published between 1885 and 2019 were categorised and graphed over time, inductively coded and thematically analysed.ResultsIndigenous Australians’ voices are scarce in the TB literature and absent in the development of TB policies and programmes. Epidemiological reports are descriptive and technical and avoid analysis of social processes involved in the perpetuation of TB. For Indigenous Australians, TB is more than a biomedical diagnosis and treatment; it is a consequence of European invasion and a contributor to dispossession and the ongoing fight for justice. The introduction and spread of TB has resulted in the stealing of lives, family, community and cultures for Indigenous Australians. Racist policies and practices predominate in the experiences of individuals and families as consequences of, and resulting in, ongoing structural and systematic exclusion.ConclusionDevelopment of TB policies and programmes requires reconfiguration. Space must be given for Indigenous Australians to lead, be partners and to have ownership of decisions about how to eliminate TB. Shared knowledge between Indigenous Australians, policy makers and service managers of the social practices and structures that generate TB disparity for Indigenous Australians is essential.A social determinant of health approach will shift the focus to the social structures that cause TB. Collaboration with Indigenous partners in research is critical, and use of methods that amplify Indigenous peoples' voices and reconfigure power relations in favour of Indigenous Australians in the process is required.
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Kerrigan, Vicki, Rarrtjiwuy Melanie Herdman, David P. Thomas, and Marita Hefler. "'I still remember your post about buying smokes': a case study of a remote Aboriginal community-controlled health service using Facebook for tobacco control." Australian Journal of Primary Health 25, no. 5 (2019): 443. http://dx.doi.org/10.1071/py19008.
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Many Aboriginal Community Controlled Health Services (ACCHS) embrace Facebook as an organisational tool to share positive stories, which counter the negative narrative surrounding Aboriginal issues. However, the Facebook algorithm prioritises posts on personal pages over organisations. To take advantage of the algorithm, this project paid three Yolŋu employees of a north-east Arnhem Land ACCHS to share quit smoking messages on their personal Facebook pages. Smoking prevalence among Aboriginal and Torres Strait Islander Australians is nearly three-fold higher than non-Indigenous Australians, and previous research has identified the need for culturally appropriate communication approaches to accelerate the decline in Indigenous smoking. This research found Yolŋu participants nurtured healthy behaviours through compassionate non-coercive communications, in contrast to fear-inducing health warnings prevalent in tobacco control. Cultural tailoring of tobacco control messages was achieved by having trusted local health staff sharing, and endorsing, messages regardless of whether the content was Indigenous specific. This research also revealed online Facebook activity does not reflect the reach of posts, which may extend beyond social media users to individuals who do not have a Facebook profile.
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O'Grady, Kerry-Ann F., Amber Revell, Graeme P. Maguire, Renate Millonig, Michael A. Newman, David W. Reid, Deborah C. Hill, and Anne B. Chang. "Lung health care for Aboriginal and Torres Strait Islander Queenslanders: breathing easy is not so easy." Australian Health Review 35, no. 4 (2011): 512. http://dx.doi.org/10.1071/ah10973.
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Objectives. In Aboriginal and Torres Strait Islander peoples in Queensland, to (a) determine the disease burden of common chronic lung diseases and (b) identify areas of need with respect to lung health services. Methods. Literature reviews and analyses of hospitalisation and mortality data were used to describe disease epidemiology and available programs and services. Key stakeholder interviews and an online survey of health professionals were used to evaluate lung health services across the state and to identify services, needs and gaps. Results. Morbidity and mortality from respiratory diseases in the Indigenous population is substantially higher than the non-Indigenous population across all age groups and regions. There are inadequate clinical services and resources to address disease prevention, detection, intervention and management in an evidence-based and culturally acceptable fashion. There is a lack of culturally appropriate educational resources and management programs, insufficient access to appropriately engaged Indigenous health professionals, a lack of multi-disciplinary specialist outreach teams, fragmented information systems and inadequate coordination of care. Conclusions. Major initiatives are required at all levels of the healthcare system to adequately address service provision for Indigenous Queenslanders with lung diseases, including high quality research to investigate the causes for poor lung health, which are likely to be multifactorial. What is known about the topic? Chronic diseases, including lung disease contribute to, and influence outcomes of, the well-known health and socioeconomic disadvantage among Aboriginal and Torres Strait Islander Australians. Nationwide, the most common reason for hospitalisation of Indigenous Australians is for lung diseases (after renal dialysis). What does this paper add? There is currently no state- or nation-wide comprehensive review of chronic lung disease burden and the health services available to prevent, treat and manage lung disease. This review fills this gap in Queensland and has found that chronic lung disease burden is not homogenous. There are substantial gaps in, and barriers to, the provision of high quality, evidence based services and a paucity of well-designed research to inform policy and health service delivery. What are the implications for practitioners? Evidence-based strategies are needed at the primary, secondary and tertiary levels of the healthcare system. Fourteen recommendations relevant to practitioners and policy makers were formulated.
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Meuleners, Lynn B., Andy H. Lee, Delia Hendrie, and Michelle Fraser. "A population study on Indigenous hospitalisations for interpersonal violence." Australian Health Review 34, no. 1 (2010): 123. http://dx.doi.org/10.1071/ah09666.
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Indigenous people experience a disproportionately high burden of interpersonal violence. This paper compares the demographic characteristics and injury circumstances of male and female Indigenous Australians hospitalised due to interpersonal violence in Western Australia over a 15-year period. A population-based, retrospective study of all hospitalisations due to interpersonal violence for Indigenous people in WA was undertaken using the linked 1990–2004 data from the WA Mortality Database and the Hospital Morbidity Data System. The majority of Indigenous hospitalisations were for females (56.3%). Female victims were more likely to be admitted due to maltreatment and rape (11.9%). Age profiles, residential location and length of hospital stay were similar between both sexes. The results indicate higher rates of hospitalisation and readmissions for interpersonal violence in WA among Indigenous females than males. There may potentially be different risk factors for each sex and further investigation will have public health benefits. What is known about the topic?Indigenous people experience a disproportionately high burden of interpersonal violence compared with non-Indigenous people. In contrast to the general population, Indigenous females are hospitalised for interpersonal violence at a higher rate than their male counterparts. What does this paper add?This study used population-based data to compare the different characteristics between Indigenous male and female hospitalisations due to interpersonal violence in Western Australia. Females were hospitalised at nearly 1.3 times the rate of males and comprised the majority (65%) of hospitalisations for those admitted more than once. What are the implications for practitioners?The results provide policy makers and planners with a basis for making informed decisions on where to specifically target resources so as to reverse the increasing burden of interpersonal violence on Indigenous communities. In addition, more rigorous prospective investigation is required to determine the contributing factors of interpersonal violence hospitalisations for Indigenous people.
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Shahid, Shaouli, Lizzie Finn, Dawn Bessarab, and Sandra C. Thompson. "'Nowhere to room … nobody told them': logistical and cultural impediments to Aboriginal peoples' participation in cancer treatment." Australian Health Review 35, no. 2 (2011): 235. http://dx.doi.org/10.1071/ah09835.
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Background. Cancer mortality among Indigenous Australians is higher compared to the non-Indigenous population and attributed to poor access to cancer detection, screening, treatment and support services. A large proportion of Indigenous Australians live in rural and remote areas which makes access to cancer treatment services more challenging. Factors, such as transport, accommodation, poor socio-economic status and cultural appropriateness of services also negatively affect health service access and, in turn, lead to poor cancer outcomes. Design, setting and participants. Qualitative research with 30 in-depth interviews was conducted with Aboriginal people affected by cancer from across WA, using a variety of recruitment approaches. Results. The infrastructure around the whole-of-treatment experience affected the decision-making and experiences of Aboriginal patients, particularly affecting rural residents. Issues raised included transport and accommodation problems, travel and service expenses, displacement from family, concerns about the hospital environment and lack of appropriate support persons. These factors are compounded by a range of disadvantages already experienced by Aboriginal Australians and are vital factors affecting treatment decision-making and access. Conclusion. To improve cancer outcomes for Aboriginal people, logistical, infrastructure and cultural safety issues must be addressed. One way of ensuring this could be by dedicated support to better coordinate cancer diagnostic and treatment services with primary healthcare services. What is known about the topic? Cancer is a major cause of death among Indigenous Australians who are generally diagnosed later with their disease, have poorer continuity of care and lower uptake and completion of cancer treatment. For cancer diagnosis at an equivalent stage of cancer, Aboriginal people have poorer outcomes. What does this paper add? This study documents Aboriginal perspectives on basic infrastructure and logistical problems which impede their accessing hospital-based cancer treatments: transport, accommodation, preparation for the experience of hospital and cancer treatment, service affordability and the certainty of support services. What are the implications for practitioners? There are difficulties for practitioners in addressing the geographic, socioeconomic and cultural differences that Aboriginal people face in accessing cancer treatment. System level changes to ensure cultural safety, social support and better coordination with primary healthcare are essential to improve outcomes of Aboriginal people with cancer.
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Martin, Robyn, Christina Fernandes, Cheryl Taylor, Amanda Crow, Desmond Headland, Nicola Shaw, and Simone Zammit. "“We Don’t Want to Live Like This”: The Lived Experience of Dislocation, Poor Health, and Homelessness for Western Australian Aboriginal People." Qualitative Health Research 29, no. 2 (September 10, 2018): 159–72. http://dx.doi.org/10.1177/1049732318797616.
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Many policy interventions have attempted to address the entrenched disadvantage of Aboriginal Australians1; however, sustained improvement in social, cultural, physical, and emotional well-being is not evident. This disadvantage is compounded by paternalistic practices which do not promote Aboriginal self-determination or empowerment. This article presents the lived experience and voice of Aboriginal Australians spending time in parks in Perth, Western Australia. A community-based participatory action research approach informed by critical Indigenous methodologies involving collaboration between Aboriginal and non-Aboriginal service providers was used. Participants experienced disconnection from kin and country, serious risk to personal safety, homelessness, and problematic health; all related to, and intersecting with, time spent in the parks. The participants’ narratives highlight the enduring impacts of colonization, dispossession, and racism. These lived experiences are situated within contexts of rising moral panic from politicians, residents and mass media, and siloed policy and service delivery responses.
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Baeza, Juan, Ross Bailie, and Jenny M. Lewis. "Care for chronic conditions for indigenous Australians: Key informants’ perspectives on policy." Health Policy 92, no. 2-3 (October 2009): 211–17. http://dx.doi.org/10.1016/j.healthpol.2009.03.012.
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Harriss, Linton R., Fintan Thompson, Kenny Lawson, Mary O'Loughlin, and Robyn McDermott. "Preventable hospitalisations in regional Queensland: potential for primary health?" Australian Health Review 43, no. 4 (2019): 371. http://dx.doi.org/10.1071/ah18033.
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Objective The aims of this study were to: (1) use local health data to examine potentially preventable hospitalisations (PPHs) as a proportion of total hospital separations and estimated costs to a large regional hospital in northern Queensland, including differences associated with Indigenous status; and (2) identify priority conditions and discuss issues related to strategic local primary health intervention. Methods A cross-sectional analysis was conducted using Queensland Hospital Admitted Patient Data Collection data (July 2012–June 2014) restricted to 51087 separations generated by 29485 local residents. PPHs were identified from the International Statistical Classification of Diseases and Related Health Problems 10th Revision Australian Modification (ICD-10-AM) and procedure codes using National Healthcare Agreement definitions. Age-standardised separation rates were calculated using Australian 2001 reference population and associated economic costs were estimated using Australian-refined diagnosis related groups. Results Eleven per cent (n=5488) of all hospital separations were classified as PPH, and most were for common chronic (n=2486; 45.3%) and acute (n=2845; 51.8%) conditions. Because many acute presentations reflect chronic underlying disease, chronic conditions account for up to 76.5% of all PPHs. Age-standardised PPH rates were 3.4-fold higher for Indigenous than non-Indigenous people. Associated 2-year costs were AU$32.7million, which was 10.7% of estimated total health care expenditure for hospital separations, and were higher for Indigenous (14.9%) than non-Indigenous (9.7%) people. Conclusions High hospitalisation rates and costs for common preventable chronic conditions represent opportunities for primary healthcare interventions. In particular, community-level health services need to be more responsive to the needs of local Indigenous families. What is known about the topic? PPH rates are used as a measure of timely access to quality primary health care, and are incrementally higher in regional and remote areas than in major cities. Investment in primary healthcare services has been shown to significantly reduce costs associated with avoidable hospitalisations. What does this paper add? This study used local health data to identify the most common PPH conditions presenting to a large regional hospital in northern Queensland, including estimation of costs and differences associated with Indigenous status. Recommendations are made to strengthen primary healthcare and reduce hospital-related costs. What are the implications for practitioners? Interventions to address high PPH rates should be tailored to meet the needs of the local population. Primary health strategies targeting common chronic conditions provide the greatest opportunity to reduce avoidable hospitalisations and costs in this regional area. Investment in collaborative, evidence-based interventions is recommended and justified, especially for Indigenous Australians.
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Emden, Carolyn, Inge Kowanko, Charlotte de Crespigny, and Helen Murray. "Better medication management for Indigenous Australians: findings from the field." Australian Journal of Primary Health 11, no. 1 (2005): 80. http://dx.doi.org/10.1071/py05011.
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This paper reports findings from interviews and focus groups conducted within a multi-dimensional action research project concerning medication management among Indigenous Australians. Participants were Aboriginal people with mental health problems, carers and family members, and health and social service workers from different regions in South Australia. A meta-analysis of findings from each regional project component was conducted, and major themes conceptualised and developed into a coherent summary. The findings revealed problems of a magnitude not previously realised - mental health problems (including alcohol and drug problems) and medication management among Aboriginal people clearly are major issues requiring immediate and sustained attention if the health and welfare of the Australian Indigenous population are to be improved. Findings concerned eight major areas: social and emotional wellbeing issues; stressors on Aboriginal health services and providers; training for the Aboriginal health workforce; mainstream health services for Aboriginal people; trust and confidentiality within Aboriginal health services; English language literacy and numeracy skills of Aboriginal clients; remote living arrangements for many Aboriginal people; problems with alcohol use; and institutionalised and individual racism in the community at large.
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Wilson, George R., Melanie J. Edwards, and Jennifer K. Smits. "Support for Indigenous wildlife management in Australia to enable sustainable use." Wildlife Research 37, no. 3 (2010): 255. http://dx.doi.org/10.1071/wr09130.
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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.
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Heath, Deanne L., Kathryn Panaretto, Vivienne Manessis, Sarah Larkins, Peter Malouf, Erin Reilly, and Jacinta Elston. "Factors to Consider in Smoking Interventions for Indigenous Women." Australian Journal of Primary Health 12, no. 2 (2006): 131. http://dx.doi.org/10.1071/py06032.
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More than 18,000 Australians die annually from diseases caused by tobacco. Indigenous Australians suffer a greater smoking-related disease burden than the remainder of the general public and have a higher prevalence of tobacco use than other Australians. The overall decline in smoking rates is slowest in women of low educational status between the ages of 25-44. This is of particular concern as these young women may be pregnant or raising young children. During pregnancy, the effects on the foetus from cigarette smoke include respiratory illness, low birthweight and Sudden Infant Death Syndrome. However, if the mother is able to give up smoking by her fourth month of pregnancy, her risk of delivering a low birthweight baby decreases to nearly that of a non-smoker. As part of the planning to develop an effective smoking cessation program for young Indigenous pregnant women, the Townsville Aboriginal and Islanders Health Services (TAIHS) surveyed a group of women to assess smoking habits, attitudes to smoking, nicotine dependence and readiness for change. This paper reports on this survey and the results found can be used to develop a tailored, smoking cessation program for Indigenous women.
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Hunter, Ernest. "Double Talk: Changing and Conflicting Constructions of Indigenous Mental Health." Australian & New Zealand Journal of Psychiatry 31, no. 6 (December 1997): 820–27. http://dx.doi.org/10.3109/00048679709065507.
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Objective: The method by which psychiatric professionals and the profession itself have addressed the mental health needs of Indigenous Australians is explored. Method: A sociohistorical frame is utilised to explore the changing nature of psychiatric engagement in this field since the Second World War. Results: A series of distinct phases are definable, each of which demonstrates particular characteristics that relate to the social and political circumstances of indigenous Australia and changing investment on the part of mental health professionals. Significant difficulties have emerged at various stages and there exist quite different interpretations and uses of language relating to indigenous mental health. Conclusions: Current relations between mental health professionals and members of indigenous communities in Australia are informed by a history of which we should be aware. It has had and continues to have consequences that include significant differences in the ways in which mental health needs are conceived and articulated. These, in turn, are consequential in terms of policy and practice.
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Smith, Rosetta Lillian, Sue Devine, and Robyn Preston. "Recommended methodologies to determine Australian Indigenous community members' perceptions of their health needs: a literature review." Australian Journal of Primary Health 26, no. 2 (2020): 95. http://dx.doi.org/10.1071/py19078.
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When addressing disparities in health status of Indigenous Australians, it is necessary to consult with Indigenous people to explore their health needs. The process of improving health outcomes is complex; it requires acknowledgement of underlying cultural and social determinants of health and active engagement of Indigenous people to define the issues and identify solutions. The aim of this study is to explore the most appropriate research methodologies to determine Australian Indigenous community members’ perceptions of their health needs. A scoping review was conducted in BioMed Central, CINAHL, Informit Health, MEDLINE Ovid, ProQuest and Scopus databases and Google Scholar for all relevant literature published between 2009 and 2018. Extensive manual searches of reference lists were also undertaken. The limited number of articles relating to needs assessment with Indigenous community members prescribed broadening the scope of the review to include articles that describe methodologies to enhance Indigenous people’s engagement in the research process. Twelve papers met the inclusion criteria. Three major themes emerged: (1) the imperative to develop and implement Indigenist research methodologies; (2) participatory action research (PAR) and community-based participatory research (CBPR) as appropriate methodologies to conduct research with Indigenous community members; and (3) yarning or storytelling as a culturally appropriate Indigenous method of data collection.
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Anderson, Elayne, Jeanne Ellard, and Jack Wallace. "Torres Strait Islanders‘ understandings of chronic hepatitis B and attitudes to treatment." Australian Journal of Primary Health 22, no. 4 (2016): 316. http://dx.doi.org/10.1071/py14130.
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Indigenous Australians are disproportionally affected by hepatitis B compared with non-Indigenous Australians. The higher prevalence of hepatitis B among Indigenous Australians has been linked to an increased incidence of liver cancer in this population. There is evidence that comprehensive programs of hepatitis B virus management, which include liver cancer surveillance and appropriate antiviral therapy, offer a cost-effective approach to reduce the incidence of liver cancer in Australia. This paper reports on data from the first study investigating understandings of hepatitis B and attitudes to treatment among Torres Strait Islanders living with chronic hepatitis B. Forty-two participants completed an interview questionnaire. Participants typically had an unclear understanding of hepatitis B and reported significant gaps in monitoring and follow up. A majority of participants indicated a willingness to use treatment if required. The findings of this study suggest the need for a new service delivery model that is appropriate to remote communities such as the Torres Strait Islands, to improve hepatitis B follow up, disease monitoring and management, and where appropriate, the uptake of treatment.
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Harriss, Linton R., Fintan Thompson, Kenny Lawson, Mary O’Loughlin, and Robyn McDermott. "Corrigendum to: Preventable hospitalisations in regional Queensland: potential for primary health?" Australian Health Review 43, no. 4 (2019): 483. http://dx.doi.org/10.1071/ah18033_co.
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Objective The aims of this study were to: (1) use local health data to examine potentially preventable hospitalisations (PPHs) as a proportion of total hospital separations and estimated costs to a large regional hospital in northern Queensland, including differences associated with Indigenous status; and (2) identify priority conditions and discuss issues related to strategic local primary health intervention.Methods A cross-sectional analysis was conducted using Queensland Hospital Admitted Patient Data Collection data (July 2012–June 2014) restricted to 51087 separations generated by 29485 local residents. PPHs were identified from the International Statistical Classification of Diseases and Related Health Problems 10th Revision Australian Modification (ICD-10-AM) and procedure codes using National Healthcare Agreement definitions. Age-standardised separation rates were calculated using Australian 2001 reference population and associated economic costs were estimated using Australian-refined diagnosis related groups.Results Eleven per cent (n=5488) of all hospital separations were classified as PPH, and most were for common chronic (n=2486; 45.3%) and acute (n=2845; 51.8%) conditions. Because many acute presentations reflect chronic underlying disease, chronic conditions account for up to 76.5% of all PPHs. Age-standardised PPH rates were 3.4-fold higher for Indigenous than non-Indigenous people. Associated 2-year costs were AU$32.7million, which was 10.7% of estimated total health care expenditure for hospital separations, and were higher for Indigenous (14.9%) than non-Indigenous (9.7%) people.Conclusions High hospitalisation rates and costs for common preventable chronic conditions represent opportunities for primary healthcare interventions. In particular, community-level health services need to be more responsive to the needs of local Indigenous families.What is known about the topic? PPH rates are used as a measure of timely access to quality primary health care, and are incrementally higher in regional and remote areas than in major cities. Investment in primary healthcare services has been shown to significantly reduce costs associated with avoidable hospitalisations.What does this paper add? This study used local health data to identify the most common PPH conditions presenting to a large regional hospital in northern Queensland, including estimation of costs and differences associated with Indigenous status. Recommendations are made to strengthen primary healthcare and reduce hospital-related costs.What are the implications for practitioners? Interventions to address high PPH rates should be tailored to meet the needs of the local population. Primary health strategies targeting common chronic conditions provide the greatest opportunity to reduce avoidable hospitalisations and costs in this regional area. Investment in collaborative, evidence-based interventions is recommended and justified, especially for Indigenous Australians.
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de Crespigny, Charlotte, Inge Kowanko, Helen Murray, Carolyn Emden, and Scott Wilson. "Improving Indigenous health through better medication management: an overview." Australian Journal of Primary Health 11, no. 1 (2005): 17. http://dx.doi.org/10.1071/py05003.
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This paper provides an overview of a major South Australian research project with implications for the health of all Indigenous Australians. The researchers set out to explore the medication needs of Aboriginal people with mental health problems and found that most Aboriginal people have to deal with profound challenges to social and emotional wellbeing with significant medication implications. No previous research had investigated the problem of medication use by Aboriginal people in metropolitan, rural and remote locations to the depth and extent of this project. The research therefore is of widespread relevance and holds interest for many Indigenous and non-Indigenous individuals and groups, consumers, service providers and policy-makers. As a research team comprising Indigenous and non-Indigenous members, we were committed to implementing strategies in the course of the project with immediate benefit to project participants as well as longer-term impact on improved use of medications. The design of the project enabled these strategic interventions and we are pleased to promote this model to other researchers. Recommendations from the project concern services, coordination of care, carers and family members, workforce education, and community development. Readers are advised where the project report and other published papers can be accessed. The project was funded by the Commonwealth Department of Health and Ageing.
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Miller, Geoffrey, Robyn McDermott, Brad McCulloch, Dympna Leonard, Kerry Arabena, and Reinhol Muller. "The Well Person's Health Check: a population screening program in indigenous communities in north Queensland." Australian Health Review 25, no. 6 (2002): 136. http://dx.doi.org/10.1071/ah020136b.
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The National Indigenous Australians Sexual Health Strategy 1996-97 to 1998-99 provided the impetus and resources to assess the health of the large population of Aboriginal and Torres Strait Islander people living in rural and remote communities in northern Queensland, Australia. This paper describes the development, implementation and results of a community based screening program designed to detect and treat sexually transmissible infections and a range of non-communicable conditions and attendant risk factors. The Well Person's Health Check, conducted between March 1998 and December 2000,demonstrated a high prevalence of largely preventable health problems and initiated the development of a sustainable early detection strategy for the region.
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de Silva, Andrea M., Jacqueline M. Martin-Kerry, Katherine McKee, and Deborah Cole. "Caries and periodontal disease in Indigenous adults in Australia: a case of limited and non-contemporary data." Australian Health Review 41, no. 4 (2017): 469. http://dx.doi.org/10.1071/ah15229.
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Objective The aim of the present study was to identify all evidence about the prevalence and severity of clinically measured caries and periodontal disease in Indigenous adults in Australia published in peer-reviewed journals and to summarise trends over time. In addition, we examined whether the studies investigated associations between putative risk factors and levels of caries and periodontal disease. Methods PubMed was searched in September 2014, with no date limitations, for published peer-reviewed articles reporting the prevalence rates and/or severity of caries and periodontal disease in Indigenous adults living in Australia. Articles were excluded if measurement was not based on clinical assessment and if oral disease was reported only in a specific or targeted sample, and not the general population. Results The search identified 18 papers (reporting on 10 primary studies) that met the inclusion criteria. The studies published clinical data about dental caries and/or periodontal disease in Australian Indigenous adults. The studies reported on oral health for Indigenous adults living in rural (40%), urban (10%) and both urban and rural (50%) locations. Included studies showed that virtually all Indigenous adults living in rural locations had periodontal disease. The data also showed caries prevalence ranged from 46% to 93%. Although 10 studies were identified, the peer-reviewed literature was extremely limited and no published studies were identified that provided statistics for a significant proportion of Australia (Victoria, Tasmania, Queensland or the Australian Capital Territory). There were also inconsistencies in how the data were reported between studies, making comparisons difficult. Conclusions This review highlights a lack of robust and contemporary data to inform the development of policies and programs to address the disparities in oral health in Indigenous populations living in many parts of Australia. What is known about the topic? Many studies report that Indigenous people in Australia have poorer general health compared with non-Indigenous people. What does this paper add? This paper documents the available caries and periodontal disease prevalence and experience for Indigenous adults in Australia published in peer-reviewed journals. It demonstrates significant limitations in the data, including no data in several large Australian jurisdictions, inconsistency with reporting methods and most data available being for Indigenous adults living in rural locations. Therefore, the oral health data available in the peer-reviewed literature do not reflect the situation of all Indigenous people living in Australia. What are the implications for practitioners? It is important for oral health practitioners to have access to current and relevant statistics on the oral health of Indigenous Australians. However, we have highlighted significant evidence gaps for this population group within the peer-reviewed literature and identified the limitations of the available data upon which decisions are currently being made. This paper also identifies ways to capture and report oral health data in the future to enable more meaningful comparisons and relevance for use in policy development.
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Trivedi, Amal N., and Margaret Kelaher. "Copayment Incentive Increased Medication Use And Reduced Spending Among Indigenous Australians After 2010." Health Affairs 39, no. 2 (February 1, 2020): 289–96. http://dx.doi.org/10.1377/hlthaff.2019.01089.
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Waller, Lisa, and Kerry McCallum. "Keystone media: The Australian and Indigenous affairs." Media International Australia 161, no. 1 (October 4, 2016): 109–19. http://dx.doi.org/10.1177/1329878x16670816.
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This article conceptualises The Australian as the nation’s ‘keystone media’ on Indigenous affairs. Nielsen’s term ‘keystone media’ captures the critical importance of particular news outlets that play what he terms an outsize role in defining the state and structure of wider media and political environments. The article analyses the factors at play in The Australian’s sponsorship of a particular political agenda for this complex field of social policy. The argument is illustrated through an examination of Indigenous health coverage from 1988 to 2008, textual analysis of 137 columns written by Noel Pearson, and research interviews with key actors in the Indigenous policy realm, including journalists, public servants and Indigenous commentators. Through this examination of its reporting and collaboration with Pearson, we contend The Australian has advanced a range of neoliberal and interventionist policies to government and the public.
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Dasgupta, Paramita, Joanne F. Aitken, John Condon, Gail Garvey, Lisa J. Whop, Claire DeBats, and Peter D. Baade. "Temporal and area-level variation in prevalence of high-grade histologically confirmed cervical abnormalities among Indigenous and non-Indigenous women, Queensland, Australia, 2008–2017." Journal of Medical Screening 28, no. 3 (January 21, 2021): 341–48. http://dx.doi.org/10.1177/0969141320984199.
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Objective Despite Australia’s National Cervical Screening Program, Indigenous women have a disproportionately high burden of cervical cancer. We describe temporal and area-level patterns in prevalence of histologically conformed high-grade cervical abnormalities (hHGA) among cytologically screened women by Indigenous status. Methods This was a population-based study of 2,132,925 women, aged 20–69, who underwent cervical screening between 2008 and 2017, in Queensland, Australia. Of these, 47,136 were identified as Indigenous from linked hospital records. Overall patterns in hHGA prevalence by Indigenous status were quantified using prevalence rate ratios (PrRR) from negative binomial models. Bayesian spatial models were used to obtain smoothed prevalence estimates of hHGA across 528 small areas compared to the state average. Results are presented as maps and graphs showing the associated uncertainty of the estimates. Results Overall, screened Indigenous women had significantly higher hHGA prevalence than non-Indigenous women. However, the magnitude of the difference reduced over time ( p < 0.001). Adjusted for age and area-level variables, Indigenous women had 36% higher hHGA prevalence (PrRR 1.36, 95% confidence interval [1.21–1.52]) than non-Indigenous women between 2013 and 2017. The overall effect of age decreased over time ( p = 0.021). Although there was evidence of moderate spatial variation in 10-year prevalence estimates for both groups of women, the high levels of uncertainty for many estimates, particularly for Indigenous women, limited our ability to draw definitive conclusions about the spatial patterns. Conclusions While the temporal reduction in Indigenous: non-Indigenous differential in hHGA prevalence is encouraging, further research into the key drivers of the continuing higher risk among Indigenous women is warranted.
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MacLean, Sarah, Rebecca Ritte, Alister Thorpe, Shaun Ewen, and Kerry Arabena. "Health and wellbeing outcomes of programs for Indigenous Australians that include strategies to enable the expression of cultural identities: a systematic review." Australian Journal of Primary Health 23, no. 4 (2017): 309. http://dx.doi.org/10.1071/py16061.
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Indigenous people have long maintained that strong cultural identities are critical to health and wellbeing. The purpose of this systematic review is to examine whether interventions that entail strategies to enable expression of cultural identities for Australian Indigenous peoples are associated with measurable improvements in health and wellbeing. Peer-reviewed articles that reported quantitatively expressed health and wellbeing outcomes involving Indigenous Australian participants only were included. The cultural intervention component was defined and assessed by Indigenous researchers on the team. A narrative analysis was conducted. The protocol was registered on PROSPERO (CRD42015027387). Thirteen articles describing eleven studies were identified, including one randomised control trial (RCT), one cluster RCT and two studies with non-randomised controls. Other studies reported on case series or cross-sectional studies. All except two studies described multiple intervention strategies. Eight studies showed significant improvement in at least one psychosocial, behavioural or clinical measure, with two showing a positive direction of effect and one showing no improvement. Publication bias may discourage researchers to report negative findings of these interventions. Although studies vary in quality, this review provides evidence that interventions that include opportunities for expression of cultural identities can have beneficial effects for Australian Indigenous peoples.
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D'ABBS, PETER H., and MAGGIE BRADY. "Other people, other drugs: the policy response to petrol sniffing among Indigenous Australians." Drug and Alcohol Review 23, no. 3 (September 2004): 253–60. http://dx.doi.org/10.1080/09595230412331289400.
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Broe, G. A. Tony, Kylie Radford, Kim Delbaere, and Gail Daylight. "S2-02-02: Indigenous Australians: Lifespan, Health, Ageing and Dementia." Alzheimer's & Dementia 12 (July 2016): P212—P213. http://dx.doi.org/10.1016/j.jalz.2016.06.377.
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Dudgeon, Pat, and Roz Walker. "Decolonising Australian Psychology: Discourses, Strategies, and Practice." Journal of Social and Political Psychology 3, no. 1 (August 21, 2015): 276–97. http://dx.doi.org/10.5964/jspp.v3i1.126.
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Colonisation in Australia has had a devastating and lasting impact on the wellbeing of Aboriginal and Torres Strait Islander peoples in Australia (herein referred to as Indigenous Australians). This paper discusses the role of psychology in Australia and the negative impact that certain disciplinary theories and practices have had on Indigenous Australians. The impact has been further exacerbated by the failure of mainstream policy makers and mental health practitioners to recognise the key, distinctive cultural and social determinants that contribute to Aboriginal health and wellbeing. There is a growing response by Aboriginal psychologists, critical social theorists, and their allies to decolonise psychological theory and practice to redress this situation. This paper outlines key decolonising strategies that have been effective in interrupting those aspects of psychology that are inimical to Aboriginal wellbeing.
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Markiewicz, Anne. "Closing the Gap through Respect, Relevance, Reciprocity and Responsibility: Issues in the Evaluation of Programs for Indigenous Communities in Australia." Evaluation Journal of Australasia 12, no. 1 (March 2012): 19–25. http://dx.doi.org/10.1177/1035719x1201200103.
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This article outlines key considerations and issues inherent in undertaking effective evaluations of programs developed for Indigenous Australians, written from the perspective of a non-Indigenous evaluator. The considerations identified include a number of professional practice areas, namely the need for evaluators to: operate with an understanding and appreciation of the historical and systemic context experienced by Indigenous Australians; work from the basis of a solid code of ethics and practice standards; and operate with high levels of cultural sensitivity and the ability to appreciate Indigenous world views and differences. Another central consideration identified in the article is that evaluators need to hold a commitment to produce useful and useable evaluation findings that can inform future program design and social policy in relation to improving the health and wellbeing of Indigenous Australians. The article develops a number of principles for evaluators to follow in evaluating programs developed for Indigenous Australians. These include: having respect for the importance of historical, socioeconomic and psychological context; commitment to ensuring relevance in methodologies and approaches used; reciprocity in considering the benefits for participating Indigenous communities; and responsibility in undertaking effective communication and consultation. While most evaluators would agree with the above principles and values, the latter can be more challenging to apply in practice and examples of their application to evaluation, and the inherent challenges in the Indigenous context, are described. Such challenges include: operating within the restrictions of government silos with difficulties portraying the complex interrelationships that reflect the lives of Indigenous Australians; reaching consensus on evaluation design and implementation; working within restricted time frames with lack of opportunity to appreciate and reflect the unique differences among Indigenous communities across Australia; limitations inherent in engaging a broad and representative group of Indigenous stakeholders; and lack of control by the evaluator over the dissemination and influence of evaluation findings and results that link with subsequent decision-making processes.