Follow-up Study Of Indigenous Adults In North Queensland: Chronic Diseases And Sexual Health
Funder
National Health and Medical Research Council
Funding Amount
$1,493,700.00
Summary
This study aims to follow up a cohort of Indigenous adults in rural and remote north Queensland communities who participated in the Well Persons Health Check (funded by OATSIH) during 1998-2000. Out of the 2,862 Indigenous participants, 2,503 (87.5%) agreed to have another Check in a few years time. A follow-up study is proposed for the consenting WPHC participants (any any other adults who wish to participate). This study will have 5 main objectives: 1. Estimate the incidence rate of chronic di ....This study aims to follow up a cohort of Indigenous adults in rural and remote north Queensland communities who participated in the Well Persons Health Check (funded by OATSIH) during 1998-2000. Out of the 2,862 Indigenous participants, 2,503 (87.5%) agreed to have another Check in a few years time. A follow-up study is proposed for the consenting WPHC participants (any any other adults who wish to participate). This study will have 5 main objectives: 1. Estimate the incidence rate of chronic disease conditions (diabetes, renal disease, CVD) and the main determinants of these in the north Queensland cohort (It is expected that Torres Strait Islanders will have different patterns to Aborigines), 2. Estimate the change over a 5 year period in risk factors and complications (including hospitalisations) of those with existing chronic conditions 3. At a community level, evaluate the effectiveness of local interventions aimed at health improvement (e.g. one community has drastically changed rules about alcohol availability, other communities have significantly improved the supply of fresh fruit and vegetables, still others have commenced family savings programs which improve the availability of money over the week and enable savings to buy fridges etc). 4. Estimate whether the early detection of chlamydia and gonorrhoea (using routine urine PCR testing) has lowered the community prevalence of bacterial STIs, and 5. Evaluate the effectiveness of local health promotion programs (e.g. tobacco control initiatives, healthy weight programs). The study will be undertaken in collaboration with Apunipima Cape York Health Council, the Torres Strait Health Council and relevant local community organisations. It will involve skills development for local Indigenous researchers and practitioners. Results will be given back to communities and individuals, with opportunities for further planning.Read moreRead less
An Examination Of The Causes Of Mortality Following Imprisonment In New South Wales Using Data-linkage.
Funder
National Health and Medical Research Council
Funding Amount
$205,500.00
Summary
Prisoner populations are characterised by poor health status including infectious diseases, injury, risk taking behaviours (eg. smoking and self-harm), mental illness, and substance abuse. Serosurveys of blood borne viruses such as hepatitis C and hepatitis B conducted in Australian and overseas prison settings have found that over one third of inmates have been exposed to these viruses with higher rates detected in injecting drug users and female inmates. Few attempts have been made to examine ....Prisoner populations are characterised by poor health status including infectious diseases, injury, risk taking behaviours (eg. smoking and self-harm), mental illness, and substance abuse. Serosurveys of blood borne viruses such as hepatitis C and hepatitis B conducted in Australian and overseas prison settings have found that over one third of inmates have been exposed to these viruses with higher rates detected in injecting drug users and female inmates. Few attempts have been made to examine the causes of mortality among prisoners following release from detention. Most interest has focused on overdoses in the period immediately following release; the aim of this study will examine all causes of death among individuals exposed to the correctional environment and compare these to death rates for NSW. Correctional centres house a largely male (94% in NSW) population with backgrounds of disadvantage in all areas, including Indigenous Australians, people of lower socio-economic status, those with a mental illness, and the intellectually disabled. There are currently over 21,000 (June 2001) prisoners detained in Australian correctional centres with approximately 39% housed in NSW. Fifteen percent of the NSW prisoners are Indigenous but comprise only 2% of the general population. The aims of this project will be to: (1) Identify all causes of death among ex-prisoners in NSW for the period 1985 to 2001; (2). Compare death rates in the study group with those in the NSW community; (3) Correlate pre-release health information contained in medical records with specific causes of death; (4) Compare causes of mortality among various sub-groups eg. injecting drug users, the mentally ill, violent offenders, and the intellectually disabled; (5) Examine causes of mortality between Indigenous and non-Indigenous inmates; and (6) use this information to develop pre-release programmes aimed at reducing excess mortality among this group.Read moreRead less
The Impact Of Household Infrastructure Improvements On Child Health In Remote Aboriginal Communities
Funder
National Health and Medical Research Council
Funding Amount
$413,350.00
Summary
The impact of the living environment on health has been well documented in the last 150 years and it is widely acknowledged that improvements in the living, working and social conditions of industrial countries have resulted in dramatic improvements in health. In Australia the close correlation between an unhealthy environment and the poor health of the Indigenous population has been clearly recognised. In 1993-94 the Federal Government established infrastructure projects as a component in the i ....The impact of the living environment on health has been well documented in the last 150 years and it is widely acknowledged that improvements in the living, working and social conditions of industrial countries have resulted in dramatic improvements in health. In Australia the close correlation between an unhealthy environment and the poor health of the Indigenous population has been clearly recognised. In 1993-94 the Federal Government established infrastructure projects as a component in the implementation of the National Aboriginal Health Strategy. The selection of communities for funding has been based on need, and the Northern Territory has attracted funding support disproportionate to its total population, but consistent with the level of need. While there is wide acceptance of the relationship between the household environment and health status, and evidence to support this general relationship, there is a need at an international and local level for research that informs specific social policy decisions. The aim of the proposed study is to determine the impact of improvements in household infrastructure on the health of children living in remote Aboriginal communities with a view to informing the development of infrastructure projects. The outcomes of this project will be a significant advance in the understanding of the relationship between the household environment and health status, and of the improvements in health that can be achieved through improvement in household infrastructure. The relationship between specific components of household infrastructure and the ability to conduct each of a number of healthy living practices will be defined, to our knowledge, for the first time. There is a unique opportunity in the Northern Territory to conduct world class research in this area. The new information will be of value in the planning of infrastructure projects in remote Indigenous communities across Australia and in similar settings internationallyRead moreRead less
Investigating The Application Of Population Data To Improve Maternal And Child Health Services In Two Remote Communities
Funder
National Health and Medical Research Council
Funding Amount
$83,281.00
Summary
This project will contribute to the understanding of how routinely collected population health data relate to remote Aboriginal communities and how such data can be used in two field sites. Population data are widely used, but the opportunity to investigate these matters is limited. The nesting of this study within a larger project aimed at improving health services for mothers and babies provides a unique opportunity to investigate aspects of applying macro level data at a local level.
The National Survey of Adult Oral Health will interview and dentally examine 7,500 people aged 15 or more across all States and Territories of Australia. It will provide a national snap-shot of the nation's oral health, including levels of tooth loss, dental decay and gum disease. The survey, to be conducted in 2004-04, will be directed by researchers at the Australian Research Center for Population Oral Health at The University of Adelaide. It will be conducted in collaboration with the Commonw ....The National Survey of Adult Oral Health will interview and dentally examine 7,500 people aged 15 or more across all States and Territories of Australia. It will provide a national snap-shot of the nation's oral health, including levels of tooth loss, dental decay and gum disease. The survey, to be conducted in 2004-04, will be directed by researchers at the Australian Research Center for Population Oral Health at The University of Adelaide. It will be conducted in collaboration with the Commonwealth and State-Territory health departments. Occurring 17 years after the first National Oral Health Survey of Australia, this new survey will monitor changes in oral health among all Australians. The survey will identify groups at particular disadvantage in terms of oral diseases, and it will search for lifestyle and community-level hazards that increase the risk of oral disorders. The study will have a compare patterns of dental health among people born before and after the fluoride generation of adults born in the 1960s when most of Australia's capital city water supplies became fluoridated. The study has been designed to automatically capture national statistics on general health among the 7,500 study participants over the next decade. The researchers will use that information to study links that have been observed in other countries between gum disease and heart disease. Results from the survey will provide the basis for monitoring progress towards national health targets and provide information to help direct dental health services into the 21st century.Read moreRead less
Translational Public Health Research Addressing Complex Questions In Maternal, Perinatal And Indigenous Health
Funder
National Health and Medical Research Council
Funding Amount
$420,872.00
Summary
The health of women during pregnancy and the first year after giving birth is critical to the health and well-being of children. This research aims to improve understanding of the causes and consequences of poor maternal health and contribute to better informed policy and practice in maternity, early postnatal and primary care services. It focuses on 3 major themes: improving women’s health after childbirth; maternity and early postnatal care; and Indigenous women’s and children’s health.
Explaining Social Inequality In Population Oral Health Using A Multilevel Approach
Funder
National Health and Medical Research Council
Funding Amount
$103,500.00
Summary
Our preliminary research demonstrated a social gradient in the oral health of Australian adults. Adults who occupy higher positions on the social hierarchy experienced less disease and symptom experience, enhanced quality of life, and better self-rated oral health. Not only were associations made between social position and oral health, but a range of other factors such as personal control, social support, stress, life satisfaction, and workplace and childhood social environments were also assoc ....Our preliminary research demonstrated a social gradient in the oral health of Australian adults. Adults who occupy higher positions on the social hierarchy experienced less disease and symptom experience, enhanced quality of life, and better self-rated oral health. Not only were associations made between social position and oral health, but a range of other factors such as personal control, social support, stress, life satisfaction, and workplace and childhood social environments were also associated with oral wellness. This work is new Australian research and is yet to be published. In an expansion of this project, we move from describing oral health inequalities and identifying their social determinants to provide a better understanding of pathways to population oral health. In doing so we shift the focus from the individual to the social context in which individuals live. We suggest that characteristics of social environments contribute independently to the variation in oral health outcomes accounted for by the characteristics of the residents themselves. In particular, we seek to demonstrate that social cohesion (the social integration, trust, and reciprocity within an area) influences conditions linked to oral health. Previous research has demonstrated variation in health according to area. Such studies are able to demonstrate a clustering of health, but are not able to distinguish whether observed social patterns in health reflect characteristics of residents or some feature of the area itself. Such conclusions require multilevel statistical models designed to separate individual effects from contextual effects while simultaneously examining interactions between both levels. Oral health is ideally suited as a proxy for general health because of the ubiquity of dental diseases, the broad utilisation of dental services within the population, and the shared risk factors between oral disease and a wide range chronic health conditions.Read moreRead less
Reducing Maternal Depression Two Years After Birth: Follow-up Of A Cohort Within A Community Randomised Trial
Funder
National Health and Medical Research Council
Funding Amount
$359,920.00
Summary
Maternal depression following childbirth is a significant public health issue. Previous Victorian research has found that 15-17% of women experience depression 6-9 months after birth, and of those depressed then, 30% are likely still to be depressed or depressed again two years after the birth. In 1998 16 Victorian municipalities began participating in the first ever community randomised trial of prevention and early intervention in depression - PRISM (Program of Resources, Information and Suppo ....Maternal depression following childbirth is a significant public health issue. Previous Victorian research has found that 15-17% of women experience depression 6-9 months after birth, and of those depressed then, 30% are likely still to be depressed or depressed again two years after the birth. In 1998 16 Victorian municipalities began participating in the first ever community randomised trial of prevention and early intervention in depression - PRISM (Program of Resources, Information and Support for Mothers). PRISM involves eight areas participating in a range of primary care and community based strategies designed to mobilise appropriate community support for mothers and children with a view to reducing maternal depression and improving maternal physical health and recovery after birth. The other eight areas are participating as comparison communities. Evaluation in PRISM is assessing major health outcomes for mothers and wider community benefits (flow-on effects) of the intervention program. Process and impact evaluation has also been undertaken to document and assess the different program elements and enhance the reproducibility of the program if successful. All women giving birth in the 16 areas are currently being surveyed six months after birth (from August 2000-February 2002). Within PRISM it is now proposed to follow-up women again two years after birth, to assess the impact of the intervention program on: *recovery from depression among the group of mothers in both intervention and comparison areas who were depressed six months after birth; and *the overall prevalence of depression and physical ill-health in all mothers. This follow-up study has the capacity to provide infromation on the poorly documented natural history of maternal depression from birth through the next two years in a large sample, including both urban and rural residents.Read moreRead less