Lower than expected morbidity and mortality for an Australian Aboriginal population

10-year follow-up in a decentralised community

Kevin Rowley, Kerin O'Dea, I ANDERSON, Robyn McDermott, K Saraswati, R Tilmouth, Iris Roberts, Joseph Fitz, Z Wang, A Jenkins, J Best, Zhiqiang Wang, Alex Brown

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    Objective: To examine mortality from all causes and from cardiovascular disease (CVD), and CVD hospitalisation rate for a decentralised Aboriginal community in the Northern Territory. Design and participants: For a community-based cohort of 296 people aged 15 years or older screened in 1995, we reviewed hospital and primary health care records and death certificates for the period up to December 2004 (2800 person-years of follow-up). Main outcome measures: Mortality from all causes and CVD, and hospitalisation with CVD coded as a primary cause of admission; comparison with prior trends (1988 to 1995) in CVD risk factor prevalence for the community, and with NT-specific Indigenous mortality and hospitalisation rates. Results: Mortality in the cohort was 964/100 000 person-years, significantly lower than that of the NT Indigenous population (standardised mortality ratio [SMR], 0.62; 95% CI, 0.42-0.89). CVD mortality was 358/100 000 person-years for people aged 25 years or older (SMR, 0.52; 95% CI, 0.23-1.02). Hospitalisation with CVD as a primary cause was 13/1000 person-years for the cohort, compared with 33/1000 person-years for the NT Indigenous population. Conclusion: Contributors to lower than expected morbidity and mortality are likely to include the nature of primary health care services, which provide regular outreach to outstation communities, as well as the decentralised mode of outstation living (with its attendant benefits for physical activity, diet and limited access to alcohol), and social factors, including connectedness to culture, family and land, and opportunities for self-determination.
    Original languageEnglish
    Pages (from-to)283-287
    Number of pages5
    JournalMedical Journal of Australia
    Volume188
    Issue number5
    Publication statusPublished - 2008

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    Cardiovascular Diseases
    Morbidity
    Mortality
    Population
    Hospitalization
    Population Groups
    Primary Health Care
    Northern Territory
    Personal Autonomy
    Death Certificates
    Health Services
    Alcohols
    Outcome Assessment (Health Care)
    Exercise
    Diet

    Cite this

    Rowley, K., O'Dea, K., ANDERSON, I., McDermott, R., Saraswati, K., Tilmouth, R., ... Brown, A. (2008). Lower than expected morbidity and mortality for an Australian Aboriginal population: 10-year follow-up in a decentralised community. Medical Journal of Australia, 188(5), 283-287.
    Rowley, Kevin ; O'Dea, Kerin ; ANDERSON, I ; McDermott, Robyn ; Saraswati, K ; Tilmouth, R ; Roberts, Iris ; Fitz, Joseph ; Wang, Z ; Jenkins, A ; Best, J ; Wang, Zhiqiang ; Brown, Alex. / Lower than expected morbidity and mortality for an Australian Aboriginal population : 10-year follow-up in a decentralised community. In: Medical Journal of Australia. 2008 ; Vol. 188, No. 5. pp. 283-287.
    @article{fddac9f2f9c94f65a59cb5282948695e,
    title = "Lower than expected morbidity and mortality for an Australian Aboriginal population: 10-year follow-up in a decentralised community",
    abstract = "Objective: To examine mortality from all causes and from cardiovascular disease (CVD), and CVD hospitalisation rate for a decentralised Aboriginal community in the Northern Territory. Design and participants: For a community-based cohort of 296 people aged 15 years or older screened in 1995, we reviewed hospital and primary health care records and death certificates for the period up to December 2004 (2800 person-years of follow-up). Main outcome measures: Mortality from all causes and CVD, and hospitalisation with CVD coded as a primary cause of admission; comparison with prior trends (1988 to 1995) in CVD risk factor prevalence for the community, and with NT-specific Indigenous mortality and hospitalisation rates. Results: Mortality in the cohort was 964/100 000 person-years, significantly lower than that of the NT Indigenous population (standardised mortality ratio [SMR], 0.62; 95{\%} CI, 0.42-0.89). CVD mortality was 358/100 000 person-years for people aged 25 years or older (SMR, 0.52; 95{\%} CI, 0.23-1.02). Hospitalisation with CVD as a primary cause was 13/1000 person-years for the cohort, compared with 33/1000 person-years for the NT Indigenous population. Conclusion: Contributors to lower than expected morbidity and mortality are likely to include the nature of primary health care services, which provide regular outreach to outstation communities, as well as the decentralised mode of outstation living (with its attendant benefits for physical activity, diet and limited access to alcohol), and social factors, including connectedness to culture, family and land, and opportunities for self-determination.",
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    author = "Kevin Rowley and Kerin O'Dea and I ANDERSON and Robyn McDermott and K Saraswati and R Tilmouth and Iris Roberts and Joseph Fitz and Z Wang and A Jenkins and J Best and Zhiqiang Wang and Alex Brown",
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    Rowley, K, O'Dea, K, ANDERSON, I, McDermott, R, Saraswati, K, Tilmouth, R, Roberts, I, Fitz, J, Wang, Z, Jenkins, A, Best, J, Wang, Z & Brown, A 2008, 'Lower than expected morbidity and mortality for an Australian Aboriginal population: 10-year follow-up in a decentralised community', Medical Journal of Australia, vol. 188, no. 5, pp. 283-287.

    Lower than expected morbidity and mortality for an Australian Aboriginal population : 10-year follow-up in a decentralised community. / Rowley, Kevin; O'Dea, Kerin; ANDERSON, I; McDermott, Robyn; Saraswati, K; Tilmouth, R; Roberts, Iris; Fitz, Joseph; Wang, Z; Jenkins, A; Best, J; Wang, Zhiqiang; Brown, Alex.

    In: Medical Journal of Australia, Vol. 188, No. 5, 2008, p. 283-287.

    Research output: Contribution to journalArticleResearchpeer-review

    TY - JOUR

    T1 - Lower than expected morbidity and mortality for an Australian Aboriginal population

    T2 - 10-year follow-up in a decentralised community

    AU - Rowley, Kevin

    AU - O'Dea, Kerin

    AU - ANDERSON, I

    AU - McDermott, Robyn

    AU - Saraswati, K

    AU - Tilmouth, R

    AU - Roberts, Iris

    AU - Fitz, Joseph

    AU - Wang, Z

    AU - Jenkins, A

    AU - Best, J

    AU - Wang, Zhiqiang

    AU - Brown, Alex

    PY - 2008

    Y1 - 2008

    N2 - Objective: To examine mortality from all causes and from cardiovascular disease (CVD), and CVD hospitalisation rate for a decentralised Aboriginal community in the Northern Territory. Design and participants: For a community-based cohort of 296 people aged 15 years or older screened in 1995, we reviewed hospital and primary health care records and death certificates for the period up to December 2004 (2800 person-years of follow-up). Main outcome measures: Mortality from all causes and CVD, and hospitalisation with CVD coded as a primary cause of admission; comparison with prior trends (1988 to 1995) in CVD risk factor prevalence for the community, and with NT-specific Indigenous mortality and hospitalisation rates. Results: Mortality in the cohort was 964/100 000 person-years, significantly lower than that of the NT Indigenous population (standardised mortality ratio [SMR], 0.62; 95% CI, 0.42-0.89). CVD mortality was 358/100 000 person-years for people aged 25 years or older (SMR, 0.52; 95% CI, 0.23-1.02). Hospitalisation with CVD as a primary cause was 13/1000 person-years for the cohort, compared with 33/1000 person-years for the NT Indigenous population. Conclusion: Contributors to lower than expected morbidity and mortality are likely to include the nature of primary health care services, which provide regular outreach to outstation communities, as well as the decentralised mode of outstation living (with its attendant benefits for physical activity, diet and limited access to alcohol), and social factors, including connectedness to culture, family and land, and opportunities for self-determination.

    AB - Objective: To examine mortality from all causes and from cardiovascular disease (CVD), and CVD hospitalisation rate for a decentralised Aboriginal community in the Northern Territory. Design and participants: For a community-based cohort of 296 people aged 15 years or older screened in 1995, we reviewed hospital and primary health care records and death certificates for the period up to December 2004 (2800 person-years of follow-up). Main outcome measures: Mortality from all causes and CVD, and hospitalisation with CVD coded as a primary cause of admission; comparison with prior trends (1988 to 1995) in CVD risk factor prevalence for the community, and with NT-specific Indigenous mortality and hospitalisation rates. Results: Mortality in the cohort was 964/100 000 person-years, significantly lower than that of the NT Indigenous population (standardised mortality ratio [SMR], 0.62; 95% CI, 0.42-0.89). CVD mortality was 358/100 000 person-years for people aged 25 years or older (SMR, 0.52; 95% CI, 0.23-1.02). Hospitalisation with CVD as a primary cause was 13/1000 person-years for the cohort, compared with 33/1000 person-years for the NT Indigenous population. Conclusion: Contributors to lower than expected morbidity and mortality are likely to include the nature of primary health care services, which provide regular outreach to outstation communities, as well as the decentralised mode of outstation living (with its attendant benefits for physical activity, diet and limited access to alcohol), and social factors, including connectedness to culture, family and land, and opportunities for self-determination.

    KW - Aborigine

    KW - adolescent

    KW - adult

    KW - aged

    KW - alcohol consumption

    KW - article

    KW - Australia

    KW - cardiovascular disease

    KW - controlled study

    KW - cultural factor

    KW - death certificate

    KW - decentralization

    KW - dietary intake

    KW - family life

    KW - female

    KW - follow up

    KW - hospitalization

    KW - human

    KW - indigenous people

    KW - major clinical study

    KW - male

    KW - medical record review

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    KW - mortality

    KW - physical activity

    KW - primary health care

    KW - risk factor

    KW - social aspect

    KW - socioeconomics

    KW - trend study

    KW - health survey

    KW - middle aged

    KW - politics

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    KW - Adolescent

    KW - Adult

    KW - Aged

    KW - Cardiovascular Diseases

    KW - Female

    KW - Follow-Up Studies

    KW - Health Surveys

    KW - Hospitalization

    KW - Humans

    KW - Male

    KW - Middle Aged

    KW - Morbidity

    KW - Northern Territory

    KW - Oceanic Ancestry Group

    KW - Politics

    KW - Risk Factors

    KW - Socioeconomic Factors

    M3 - Article

    VL - 188

    SP - 283

    EP - 287

    JO - Medical Journal of Australia

    JF - Medical Journal of Australia

    SN - 0025-729X

    IS - 5

    ER -