Transcript INDIGENOUS HEALTH - Guilford Young College

Indigenous health
http://www.youtube.com/watch?v=PBNMEEeZaqM
Health status of Indigenous Australians:
• Experience greater levels of morbidity and
mortality
• Reduced quality of life & suffer greater level of
ill health
• Males and females have a life expectancy of
approximately 20 years less than nonindigenous Australians.
• Infant mortality rate is three times the rate of
non-indigenous populations
•
http://www.youtube.com/watch?v=_IwxhdLfseE
Key Facts
• At June 30 2011, the estimated Australian
Indigenous population was 669,739.
• The indigenous population is much younger
than the non-indigenous population.
Births and pregnancy outcome
• In 2011, there were 17,621 births registered in Australia
with one or both parents identified as Indigenous (6% of
all births registered).
• In 2011, Indigenous mothers were younger than nonIndigenous mothers; the median age was 24.8 years for
Indigenous mothers and 30.6 years for all mothers.
• In 2010, the proportion of low birthweight babies born
to Indigenous women was twice that of non-Indigenous
women (12.0% compared with 6.0%).
Indigenous mortality
• Between 1991 and 2010, there was a 33% reduction in
the death rates for Indigenous people in WA, SA and the
NT.
• For Indigenous people born 2005-2007, life expectancy
was estimated to be 67.2 years for males and 72.9 years
for females, around 10-11 years less than the estimates
for non-Indigenous males and females.
• For 2009-2011, the infant mortality rate was higher for
Indigenous infants than for non-Indigenous infants; the
rate for Indigenous infants was highest in the NT.
• For 2006 to 2010, the leading causes of death
among Indigenous people were cardiovascular
disease, neoplasms (almost entirely cancers),
and injury.
• In 2003-2005, maternal mortality ratios were
2.7 times higher for Indigenous women.
Selected health conditions
Cardiovascular disease
• In 2004-2005, 12% of Indigenous people reported
having a long-term heart or related condition; after
age-adjustment, these conditions were around 1.3
times more common for Indigenous people.
• In 2010-11, Indigenous people were hospitalised for
cardiovascular diseases at 1.6 times the rate of nonIndigenous people.
• In 2006-2010, cardiovascular disease was the leading
cause of death for Indigenous people, accounting for
26% of Indigenous deaths.
Cancer
• In 2004-2008, the most common cancers
diagnosed among Indigenous people were
lung and breast cancer.
• In 2010-11, age-standardised hospitalisation
rates for cancer were lower for Indigenous
people.
Diabetes
• In 2004-2005, 6% of Indigenous people
reported having diabetes; after ageadjustment, Indigenous people were 3.4 times
more likely to report having some form of
diabetes.
• In 2004-2008, Indigenous people died from
diabetes at almost seven times the rate of nonIndigenous people.
Social and emotional wellbeing
• In 2010, the death rate for ICD ‘Intentional selfharm’ (suicide) for Indigenous people was 2.4
times the rate reported for non- Indigenous
people.
• In 2008, after age-adjustment, Indigenous
people were 2.6 times as likely as nonIndigenous people to feel high or very high
levels of psychological distress.
Kidney health
• In 2006-2010, after age-adjustment, the notification
rate of end stage renal disease was 7.2 times higher
for Indigenous people
• In 2010-11, care involving dialysis was the most
common reason for hospitalisation among
Indigenous people; Indigenous people were
hospitalised at 11.4 times the rate for other
Australians.
• In 2006-2010, the age-standardised death rate from
kidney disease was four times higher for Indigenous
people.
Injury
• In 2010-11, after age-adjustment, Indigenous
people were hospitalised for injury at 2.0 times
the rate for other Australians.
• In 2010, injury was the third most common
cause of death among Indigenous people,
accounting for 14% of Indigenous deaths.
Eye health
• In 2004-2005, eye and sight problems were
reported by 30% of Indigenous people.
Ear health and hearing
• In 2004-2005, ear/hearing problems were
reported by 12% of Indigenous people.
Communicable diseases
• In 2005-2009, after age-adjustment, the notification rate for
tuberculosis was 11.1 times higher for Indigenous people than for
Australian-born non-Indigenous people.
• In 2009-2011, the crude notification rate for hepatitis C for
Indigenous people was 3.6 times the notification rate for nonIndigenous people.
• In 2010, notification rates for Haemophilus influenza type b were
20 times higher for Indigenous people.
• In 2006-2008, the age-standardised rate of invasive
pneumococcal disease was 7.3 times higher for Indigenous
people.
• In 2009-2011, Indigenous people had higher crude notification
rates for gonorrhoea, syphilis and chlamydia than did nonIndigenous people; Indigenous notification rates ranged from 5.6
to 64 times higher.
• In some remote communities, more than 70% of young children
Major burdens of disease
Indigenous populations have a total death rate of between
4 and 7 times higher than non-indigenous Australians.
Twice as likely to rate their health as fair or poor
Have higher prevalence of most types of health conditions
Significant differences can be seen in:
 Type 2 diabetes (3.5 times higher)
 Chronic Kidney Disease (10 times higher)
 Overweight/obesity (60% of population; 1.2 times higher)
 Hypertension (1.7 times higher)
 Injury and Poisoning rates (3 times higher)
 Maternal health - impacts of birth weight, infant mortality, 48%
drink alcohol whilst pregnant
 Communicable diseases (rates of STI’s higher, meningococcal)
 Mental illness – increase due multiple life stressors
Major Burdens of disease...
Ear Conditions – particularly in children and young
children can lead to full and partial deafness (this leads
to absenteeism from school, speech delays etc.)
Oral health – more decay, missing or filled teeth
(creating difficulties with nutrition).
Skin infections – increase due to poor living conditions
(overcrowded housing etc.)
Most Prevalent conditions (2004 – 05):
Eye sight problems (eye infections, blindness-6x)
Musculoskeletal diseases (arthritis, osteoporosis)
Diseases of the Respiratory Tract (asthma, influenza,
pneumonia)
Circulatory Diseases (heart disease)
DALY’s
• Indigenous populations experience a greater
YLL component than YLD, indicating a higher
fatality rate in Indigenous populations.
• For all sexes: CVD (24%), Cancer (14%),
Unintentional Injuries (11%), Intentional
Injuries (9%) & Diabetes (7%)
• Males – CVD, Suicide, Road Traffic Accidents
• Females – CVD, Type 2 Diabetes, Road Traffic
Accidents
Leading Causes of death
Circulatory Disease (ischemic heart disease and
stroke)
External Causes of morbidity and mortality
(accidents, intentional self-harm(suicide) and assault)
 Cancer (lung, mouth, throat, breast, prostate,
colorectal and Cervical)
 Endocrine, Nutritional and metabolic disorders
(caused mainly by Diabetes 3x)
Indigenous males and females died at 8 – 11 times the
rates for non-Indigenous males and females respectively
Image source: galdu.o
Biological determinants
 Incidence of overweight and obesity is higher in indigenous
populations;risk kidney disease, diabetes, CVD
 Insulin resistance (pre-cursor to Type 2 diabetes) is
higher in indigenous populations;
 Incidence of high blood pressure is greater in indigenous
populations;
 Blood cholesterol is higher in indigenous populations;
 Genetic predisposition -> Increase in Diabetes
Biological determinants cont…
 Indigenous mothers more likely to experience
maternal complications;
 Low birth weight infants double in indigenous
populations;
Genetics
There are a number of health concerns
for which indigenous populations have a
genetic predisposition.
These include:
 Type 2 diabetes
 Blood alcohol levels
 Cardiovascular disease
 Cancer – breast and prostate
Image source: cache.daylife.com
Example: Biological Determinant
• Low Birth Weight – Child is more likely to
experience ill health during childhood and be
more vulnerable to illness such as kidney
disease and CVD in adulthood. There is an
increased risk of infections during infancy and
increased risk of infant mortality leading to an
U5MR.
• Diabetes – increase risk of mortality and
morbidity. Linked to hypertension, CVD, eye
conditions and obesity. Negative impact on
mental health due to suffering.
Behavioural determinants
 Not accessing medical care due to attitudes
towards ‘western’ health care practices – hence
conditions go untreated for long periods of time,
don’t practice healthily behaviours
 Beliefs can impact on dietary behaviour consumption of traditional foods e.g. turtle
meat
Image source: footprints.org.au
Behavioural determinants cont…
Lifestyle
High levels of risk taking behaviours are prominent
in indigenous populations.
These include:
 Alcohol consumption => Liver disease, stroke, cancer, high
blood pressure, increased risk injury/accidents/violence
 Smoking rates => twice rate as non indigenous Australians
 Family and domestic violence
 Risk taking - Driving behaviours
 Dietary intake and food choices
 Levels of physical activity
 Use of illicit drugs / petrol sniffing
 Unsafe Sex Practices
 Immunization (lower rates until the age of 6)
Image source: diversetravel.com.au
Examples - Behaviour Determinants
• Smoking – associate with increased incidence
of mortality from various types of cancer
including lung and mouth cancers, Coronary
Heart Disease, High blood pressure, Stroke,
Respiratory Diseases such as Asthma. Can
cause complications during pregnancy such as
high blood pressure and low birth weight.
Linked to SIDS. Could lead to mental stress
and lower self esteem.
•
http://www.youtube.com/watch?v=lnLw8dwPuRc
• Unsafe Sex Practices – linked to infertility,
STI’s, unwanted pregnancies, cancer.
Social determinants
Social factors are a key determinant in the lowered
health status of indigenous Australians.
Evidence shows low SES is associated with poor
health and ↑ exposure to health risk factors.
Image source: zandrarosen.se
Social determinants cont …
The physical environment in which many Indigenous people live is a
risk factor for morbidity and mortality.
For example:
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Poor housing
Over-populated housing
Higher rates of infectious disease
Lack of sewerage
Lack of running water
Roads and transport
Opportunities for physical activity
 http://www.youtube.com/watch?v=RPf1X6sICM0&feature=related
Social determinants cont …
Indigenous Australians experience greater
disadvantage in many elements of the social
environment.
For example:
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higher rates of unemployment
low socio-economic status
poor educational achievements
lower rates of home ownership.
Knowledge (lack of education)
 Education around health behaviour is limited
Prevention of disease
 Management of health concerns
 Hygiene
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Image source: bobbybridger.com
Example of Social Determinant
• Overcrowding – (physical environment) linked
with the spread of infectious diseases, higher
rates of smoking, strains on bathrooms,
kitchen and laundry leading to unhygienic
living and risks of infections, hazardous
drinking and poor mental health – All of which
impact negatively upon indigenous physical
health.
Exam Question
Answer
A.
B.
http://www.vcaa.vic.edu.au/Documents/exams/hhd/healthhumdev_assessrep_11.pdf
Close the Gap
Close the Gap is an initiative
launched in 2007 to
eliminate the inequalities in
indigenous health.
This initiative relies on the
collaboration of all levels of
government in conjunction
with non-government
agencies such as Oxfam and
the Red Cross.
Image source: oxfam.org.au
Close the Gap cont…
 to close the gap in life expectancy within a generation
 to halve the gap in mortality rates for indigenous children under
five within a decade
 to ensure all indigenous four-year-olds in remote communities
have access to early childhood education within five years
 to halve the gap in reading, writing and numeracy achievements
for indigenous children within a decade
 to halve the gap for indigenous students in year 12 attainment or
equivalent attainment rates by 2020
 to halve the gap in employment outcomes between indigenous
and non-indigenous Australians within a decade.
http://www.youtube.com/watch?v=5S8vjhZZE4w
http://www.youtube.com/watch?v=O07GjsZk33s
Revise
Use the determinants of
health to explain the
health status of the
indigenous population of
Australia.
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