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1.
Disparities between the health of Indigenous and non-Indigenous populations continue to be prevalent within Australia. Research suggests that Indigenous people participate in health risk behaviour more often than their non-Indigenous counterparts, and that such behaviour has a substantial impact on health outcomes. Although this would indicate that reducing health risk behaviour may have positive effects on health outcomes, the factors that influence Indigenous health behaviour are still poorly understood. This study aimed to interview people who support Indigenous groups to gain an understanding of their views on the factors influencing health behaviour within Indigenous groups in Western Australia. Twenty nine people participated in the study. The emergent themes were mapped against the social ecological model. The results indicated that: (1) culture, social networks, history, racism, socioeconomic disadvantage, and the psychological distress associated with some of these factors interact to affect health behaviour in a complex manner; (2) the desire to retain cultural identity and distinctiveness may have both positive and negative influence on health risk behaviour; (3) strong social connections to family and kin that is intensified by cultural obligations, appears to affirm and disrupt positive health behaviour; (4) the separation between Indigenous and non-Indigenous social connection/networks that appeared to be fostered by marginalisation and racism may influence the effect of social networks on health behaviour; and (5) communication between Indigenous and non-Indigenous people may be interrupted by distrust between the groups, which reduces the influence of some non-Indigenous sources on the health behaviour of Indigenous people.  相似文献   

2.

Objectives

To quantify the independent roles of geography and Indigenous status in explaining disparities in Potentially Preventable Hospital (PPH) admissions between Indigenous and non-Indigenous Australians.

Design, setting and participants

Analysis of linked hospital admission data for New South Wales (NSW), Australia, for the period July 1 2003 to June 30 2008.

Main outcome measures

Age-standardised admission rates, and rate ratios adjusted for age, sex and Statistical Local Area (SLA) of residence using multilevel models.

Results

PPH diagnoses accounted for 987,604 admissions in NSW over the study period, of which 3.7% were for Indigenous people. The age-standardised PPH admission rate was 76.5 and 27.3 per 1,000 for Indigenous and non-Indigenous people respectively. PPH admission rates in Indigenous people were 2.16 times higher than in non-Indigenous people of the same age group and sex who lived in the same SLA. The largest disparities in PPH admission rates were seen for diabetes complications, chronic obstructive pulmonary disease and rheumatic heart disease. Both rates of PPH admission in Indigenous people, and the disparity in rates between Indigenous than non-Indigenous people, varied significantly by SLA, with greater disparities seen in regional and remote areas than in major cities.

Conclusions

Higher rates of PPH admission among Indigenous people are not simply a function of their greater likelihood of living in rural and remote areas. The very considerable geographic variation in the disparity in rates of PPH admission between Indigenous and non-Indigenous people indicates that there is potential to reduce unwarranted variation by characterising outlying areas which contribute the most to this disparity.  相似文献   

3.
Donna Green  Liz Minchin 《EcoHealth》2014,11(2):263-272
Closing the gap between the health and well-being status of Indigenous people living in remote areas of northern Australia and non-Indigenous Australians has long been a major target of federal health policy. With climate projections suggesting large increases in hot spells in desert regions and more extremes in rainfall in other areas of the north, direct and indirect impacts resulting from these changes are likely to further entrench this health and well-being disparity. This paper argues that it is time to explicitly draw on Indigenous definitions of health, which directly address the need to connect individual and community health to the health of their country, in order to develop effective climate adaptation and health strategies. We detail how current health policies overlook this ‘missing’ dimension of Indigenous connection to country, and why that is likely to be detrimental to the health and well-being of people living in remote communities in a climate-changed future.  相似文献   

4.
BackgroundIndigenous infants (infants aged under 12 months) have the highest hospital admission and emergency department presentation risks in Australia. However, there have been no recent reports comparing hospital utilisation between Indigenous and non-Indigenous infants.MethodsOur primary objective was to use a large prospective population-based linked dataset to assess the risk of all-cause hospital admission and emergency department presentation in Indigenous compared to non-Indigenous infants in Western Australia (WA). Secondary objectives were to assess the effect of socio-economic status (Index of Relative Socio-Economic Disadvantage [IRSD]) on hospital utilisation and to understand the causes of hospital utilisation.FindingsThere were 3,382 (5.4%) Indigenous and 59,583 (94.6%) non-Indigenous live births in WA from 1 January 2010 to 31 December 2011. Indigenous infants had a greater risk of hospital admission (adjusted odds ratio [aOR] 1.90, 95% confidence interval [95% CI] 1.77–2.04, p = <0.001) and emergency department presentation (aOR 2.15, 95% CI 1.98–2.33, p = <0.001) compared to non-Indigenous infants. Fifty nine percent (59.0%) of admissions in Indigenous children were classified as preventable compared to 31.2% of admissions in non-Indigenous infants (aOR 2.12, 95% CI 1.88–2.39). The risk of hospital admission in the most disadvantaged (IRSD 1) infants in the total cohort (35.7%) was similar to the risk in the least disadvantaged (IRSD 5) infants (30.6%) (aOR 1.04, 95% CI 0.96–1.13, p = 0.356).InterpretationWA Indigenous infants have much higher hospital utilisation than non Indigenous infants. WA health services should prioritise Indigenous infants regardless of their socio economic status or where they live.  相似文献   

5.
The survival inequality faced by Indigenous Australians after a cancer diagnosis is well documented; what is less understood is whether this inequality has changed over time and what this means in terms of the impact a cancer diagnosis has on Indigenous people. Survival information for all patients identified as either Indigenous (n = 3168) or non-Indigenous (n = 211,615) and diagnosed in Queensland between 1997 and 2012 were obtained from the Queensland Cancer Registry, with mortality followed up to 31st December, 2013. Flexible parametric survival models were used to quantify changes in the cause-specific survival inequalities and the number of lives that might be saved if these inequalities were removed. Among Indigenous cancer patients, the 5-year cause-specific survival (adjusted by age, sex and broad cancer type) increased from 52.9% in 1997–2006 to 58.6% in 2007–2012, while it improved from 61.0% to 64.9% among non-Indigenous patients. This meant that the adjusted 5-year comparative survival ratio (Indigenous: non-Indigenous) increased from 0.87 [0.83–0.88] to 0.89 [0.87–0.93], with similar improvements in the 1-year comparative survival. Using a simulated cohort corresponding to the number and age-distribution of Indigenous people diagnosed with cancer in Queensland each year (n = 300), based on the 1997–2006 cohort mortality rates, 35 of the 170 deaths due to cancer (21%) expected within five years of diagnosis were due to the Indigenous: non-Indigenous survival inequality. This percentage was similar when applying 2007–2012 cohort mortality rates (19%; 27 out of 140 deaths). Indigenous people diagnosed with cancer still face a poorer survival outlook than their non-Indigenous counterparts, particularly in the first year after diagnosis. The improving survival outcomes among both Indigenous and non-Indigenous cancer patients, and the decreasing absolute impact of the Indigenous survival disadvantage, should provide increased motivation to continue and enhance current strategies to further reduce the impact of the survival inequalities faced by Indigenous people diagnosed with cancer.  相似文献   

6.
Comparable survey data on Indigenous and non-Indigenous Australians are highly sought after by policymakers to inform policies aimed at closing ethnic socio-economic gaps. However, collection of such data is compromised by group differences in socio-economic status and cultural norms. We use data from the Household, Income and Labour Dynamics in Australia Survey and multiple-membership multilevel regression models that allow for individual and interviewer effects to examine differences between Indigenous and non-Indigenous Australians in approximate measures of the quality of the interview process. We find that there are both direct and indirect ethnic effects on different dimensions of interview process quality, with Indigenous Australians faring worse than non-Indigenous Australians in all outcomes ceteris paribus . This indicates that nationwide surveys must feature interview protocols that are sensitive to the needs and culture of Indigenous respondents to improve the quality of the survey information gathered from this subpopulation.  相似文献   

7.
Aquatic ecosystems are critical to the long-term viability and vibrancy of communities and economies across northern Australia. In a region that supports significant cultural and ecological water values, partnerships between Indigenous and non-Indigenous stakeholders can benefit aquatic ecosystem management. We present, as a case study from the Kimberley region of Western Australia, a collaborative research program that successfully documented Indigenous and Western Scientific knowledge of remote wetlands, using a variety of field-based activities, questionnaires, interviews and workshops. The sharing of knowledge between Indigenous and non-Indigenous research partners facilitated a comprehensive understanding of ecosystem values, threats, processes, management priorities and aspirations. These formed the basis of a management plan and monitoring tools, designed to build the capacity of an Indigenous ranger group to engage in research, monitoring and management of wetlands. The project provides a useful example of the benefits of collaborations in the context of remote-area management where local communities are responsible for environmental management and monitoring, such as is the case in northern Australia and presumably other areas of the world.  相似文献   

8.
In 1991, the Australian Commonwealth Parliament unanimously passed the Council for Aboriginal Reconciliation Act 1991. This Act implemented a 10-year process that aimed to reconcile Indigenous and non-Indigenous people by the end of 2000. One of the highest priorities of the reconciliation process was to address Indigenous socio-economic disadvantage, including health, education and housing. However, despite this prioritising, both the Keating Government (1991–1996) and the Howard Government (1996–2000) failed to substantially improve socio-economic outcomes for Indigenous people over the reconciliation decade. In this paper, I examine one of the most prominent socio-economic areas, that of Indigenous health. First, I discuss the appalling levels of Indigenous health throughout the reconciliation decade by analysing a number of health indicators, including life expectancy, infant mortality rate, standard mortality ratios, hospital rates and health Infrastructure. This analysis reveals significant and often worsening disadvantage in these health indicators. Second, I analyse a number of policies and programs concerning Indigenous socio-economic disadvantage that were developed by Commonwealth Governments in the 1990s. I argue that these policies and programs largely failed to address Indigenous socio-economic disadvantage. I also discuss alternative policies and programs that could reduce the significant levels of socio-economic disadvantage suffered by Indigenous people.  相似文献   

9.
Indigenous Australian women have much higher incidence of cervical cancer compared to non-Indigenous women. Despite an organised cervical screening program introduced 25 years ago, a paucity of Indigenous-identified data in Pap Smear Registers remains. Prevalence of cervical abnormalities detected among the screened Indigenous population has not previously been reported. We conducted a retrospective cohort study of population-based linked health records for 1,334,795 female Queensland residents aged 20–69 years who had one or more Pap smears during 2000–2011; from linked hospital records 23,483 were identified as Indigenous. Prevalence was calculated separately for Indigenous and non-Indigenous women, for cytology-detected low-grade (cLGA) and high-grade abnormalities (cHGA), and histologically confirmed high-grade abnormalities (hHGA). Odds ratios (OR) were estimated from logistic regression analysis. In 2010–2011 the prevalence of hHGA among Indigenous women (16.6 per 1000 women screened, 95% confidence interval [CI] 14.6–18.9) was twice that of non-Indigenous women (7.5 per 1000 women screened, CI 7.3–7.7). Adjusted for age, area-level disadvantage and place of residence, Indigenous women had higher prevalence of cLGA (OR 1.4, CI 1.3–1.4), cHGA (OR 2.2, CI 2.1–2.3) and hHGA (OR 2.0, CI 1.9–2.1). Our findings show that Indigenous women recorded on the Pap Smear Register have much higher prevalence for cLGA, cHGA and hHGA compared to non-Indigenous women. The renewed cervical screening program, to be implemented in 2017, offers opportunities to reduce the burden of abnormalities and invasive cancer among Indigenous women and address long-standing data deficiencies.  相似文献   

10.
China's burgeoning outbound tourist market has become a priority for Australian tourism, with national and state tourism reports advocating for ‘China‐ready’ marketing, policy and planning and increased industry training around Chinese consumer behaviour and preferences to capitalise on this market. However, studies demonstrate that Chinese tourists are generally not interested in Indigenous tourism experiences. Nevertheless, the state of Victoria is adamant about investing in Indigenous‐themed tourism products which are considered appropriate for Chinese preferences in an attempt to attract tourists from this growing inbound market. This article presents a review of relevant state government policies relating to Indigenous tourism alongside a case study of the tourism experiences developed and provided by Gunditjmara people along the Budj Bim Cultural Landscape in southwest Victoria. We demonstrate the ways that notions of ‘authenticity’ continue to shape, and constrain, Indigenous economic engagement and participation via tourism, and discuss the impact of these notions on the provision of Indigenous tourism products and experiences for Chinese and other visitors. We argue that the marketing of Gunditjmara tourism to fluctuating market demand highlights the arbitrariness of Australian governments' policies with respect to Indigenous development, and call for policymakers to focus renewed attention on the local aspirations of Indigenous entrepreneurs.  相似文献   

11.
Many programmes formally engage Australian Indigenous people in land and sea management to provide environmental services. There are also many Indigenous people who ‘look after country’ without rewards or payment because of cultural obligations. We investigated how Indigenous peoples’ mobility in and around two communities (Maningrida and Ngukurr) is affected by their formal or informal engagement in cultural and natural resource management (CNRM). Understanding factors that influence peoples’ mobility is important if essential services are to be provided to communities efficiently. We found that those providing formal CNRM were significantly less likely to stay away from settlements than those ‘looking after their country’ without payment or reward. Paying Indigenous people to engage with markets for CNRM through carbon farming or payments for environmental services (PES) schemes may alter traditional activities and reduce mobility, particularly movements away from communities that extend the time spent overnight on country. This could have both environmental and social consequences that could be managed through greater opportunities for people to engage in formal CNRM while living away from communities and greater recognition of the centrality of culture to all Indigenous CNRM, formal or otherwise.  相似文献   

12.
Ostensibly about dingoes and dogs, this paper explores aspects of the contemporary social world of Warlpiri people in the camps of the central Australian settlement of Yuendumu (Northern Territory) through canines. Analyses of dog socialisation, kinds of domestication, and the roles that camp dogs perform (such as protector, family, and witness) provide insights into Warlpiri notions of moral personhood and are employed to reflect about the ethical foundations of how the oppositional categories of Yapa (self, Indigenous, Black, colonised) and Kardiya (other, non-Indigenous, ‘whitefella’, coloniser) are conceptualised.  相似文献   

13.
Indigenous People in the Klamath River Basin have cared for and utilized ecosystems and component resources since time immemorial, proactively conserving species through continuous use and stewardship. Though many culturally significant plants are still tended and used by Indigenous people, many species are also experiencing prolonged stress from colonial forest management practices and environmental change. By integrating western and Indigenous ways of knowing, as part of a participatory and collaborative research and extension project, we present an approach to informing the conservation of four culturally significant plants (tanoak, evergreen huckleberry, beargrass, and iris) and understanding the influence of bioclimatic factors and stress on Indigenous people’s relationships with plants and the broader forest ecosystem. Mixed methods and ways of knowing generate a detailed assessment of each case study species that presence only species distribution models cannot supply alone. In this study we use MAXENT to model species distributions of our four study species and the flexible coding method in NVivo for qualitative interview and focus group data. Using species distribution models and 127 interviews and focus groups with cultural practitioners, we found significant shifts in huckleberry harvesting times, beargrass and iris cultural use quality, and tanoak acorn availability that must be addressed for the long-term vitality of these species and interconnected cultures and people. Tribes have generations of knowledge, experience, and connection to land that can help inform how to combat stressors and enhance productivity of forest foods and fibers and the health of forest ecosystems.  相似文献   

14.
BACKGROUND:For Indigenous Peoples in Canada, birthing on or near traditional territories in the presence of family and community is of foundational cultural and social importance. We aimed to evaluate the association between Indigenous identity and distance travelled for birth in Canada.METHODS:We obtained data from the Maternity Experiences Survey, a national population-based sample of new Canadian people aged 15 years or older who gave birth (defined as mothers) and were interviewed in 2006–2007. We compared Indigenous with non-Indigenous Canadian-born mothers and adjusted for geographic and sociodemographic factors and medical complications of pregnancy using multivariable logistic regression. We categorized the primary outcome, distance travelled for birth, as 0 to 49, 50 to 199 or 200 km or more.RESULTS:We included 3100 mothers living in rural or small urban areas, weighted to represent 31 100 (1800 Indigenous and 29 300 non-Indigenous Canadian-born mothers). We found that travelling 200 km or more for birth was more common among Indigenous compared with non-Indigenous mothers (9.8% v. 2.0%, odds ratio [OR] 5.45, 95% confidence interval [CI] 3.52–8.48). In adjusted analyses, the association between Indigenous identity and travelling more than 200 km for birth was even stronger (adjusted OR 16.44, 95% CI 8.07–33.50) in rural regions; however, this was not observed in small urban regions (adjusted OR 1.04, 95% CI 0.37–2.91).INTERPRETATION:Indigenous people in Canada experience striking inequities in access to birth close to home compared with non-Indigenous people, primarily in rural areas and independently of medical complications of pregnancy. This suggests inequities are rooted in the geographic distribution of and proximal access to birthing facilities and providers for Indigenous people.

Access to birth close to home, surrounded by loved ones, is taken for granted by most Canadians. The societal importance of family support during birthing has been highlighted during the severe acute respiratory syndrome and COVID-19 pandemics, despite the known and potentially fatal risks to hospital visitors, because people in labour have been one of the few patient groups exempt from visitor restrictions.1,2 For residents living in rural areas of Canada, long-distance travel for birth is a reality that is becoming increasingly common in some regions because of closures of obstetrical services in smaller community hospitals.3 This is only partially mitigated by the revitalization of rural midwifery practice.4,5Emerging evidence shows that the frequency of adverse medical events during labour and delivery for rural populations is similar for births that take place close to home and births for which people travel because of an absence of services close to home.3,4,6 Less is known about the impacts of travel for birth on breastfeeding rates, maternal mental health and family functioning. Several studies have documented the negative impacts of birthing away from home with respect to maternal satisfaction and birth experience.710 This evidence is particularly compelling for Indigenous populations for whom birthing on or near traditional territories in the presence of family and community is a long-standing practice of foundational cultural and social importance that contributes to well-being, cultural continuity and kinship.712The striking isolation, family disruption and racism experienced by Indigenous people who are forced to travel alone for birth as a result of externally imposed federal “evacuation for birth” policies11 has been met with a series of policy initiatives to support return of birth to rural and remote Indigenous communities. 1315 In April 2017, then federal Minister of Health Dr. Jane Philpott, committed to “a path to be able to return the cries of birth” to Indigenous communities and funding to support travel for a companion when Indigenous people living in rural and remote areas needed to travel away from home for birth.16 Before 2017, Indigenous pregnant people often travelled and birthed away from home alone without family or community support, because escorts were not deemed medically necessary. Although these initiatives have improved access to Indigenous perinatal programming and Indigenous birth attendant support in some local areas, over the past decade there has not been any substantial expansion of Indigenous birthing facilities outside of urban centres in Canada and at least 1 remote Indigenous birthing facility has closed.17Given this dynamic policy context, the national scope and Indigenous identifiers in the Canadian Maternity Experiences Survey (MES) provides a unique opportunity to quantify how often Indigenous and non-Indigenous people are travelling away from home for birth and to evaluate the association between Indigenous and non-Indigenous identity and distance travelled for birth in Canada.  相似文献   

15.
Increasingly, the role of health research in improving the discrepancies in health outcomes between Indigenous and non-Indigenous populations in developed countries is being recognised. Along with this comes the recognition that health research must be conducted in a manner that is culturally appropriate and ethically sound. Two key documents have been produced in Australia, known as The Road Map and The Guidelines, to provide theoretical and philosophical direction to the ethics of Indigenous health research. These documents identify research themes considered critical to improving the health of the nation’s Indigenous peoples. They also provide values that, from an Indigenous perspective, are foundational to an ethical research process. This paper examines these research themes and values within the context of a current longitudinal birth cohort study of Indigenous infants and children in south-west Sydney: the Gudaga Study. Considerable time and effort have been invested in being true to the values stated in these documents: reciprocity; respect; equality; responsibility; survival and protection; and spirit and integrity. We have learnt that it is vital to be true to these values when conducting Indigenous health research—to quite literally “walk the talk”.  相似文献   

16.
Freshwater resources underpin multiple livelihood systems around the world, particularly in highly productive tropical floodplain regions. Sustaining Indigenous people’s access to freshwater resources for customary harvesting, while developing alternative livelihood strategies can be challenging. The sustainable livelihoods approach was applied to examine the ways in which multiple livelihoods in the East Alligator River floodplain region in northern Australia influence Aboriginal people’s access to freshwater resources for customary harvesting. Interviews with Aboriginal residents were conducted to understand changes to freshwater customary harvesting practices. The dominant floodplain-based livelihoods analysed were pastoralism, biodiversity conservation and tourism and they were found to generate both opportunities and constraints for sustaining freshwater customary harvesting. Opportunities were provided through facilitating regular access to floodplain country and opportunistic access for harvesting, which assists in sustaining bio-cultural knowledge. Partnerships developed through these mainstream livelihoods built human capacity that enhanced all livelihood resource capitals (natural, human, social, financial and physical). Three key ways the dominant livelihoods constrained access to key freshwater resources were identified. Tourism required sacrificing certain hunting places and had to accommodate recreational fishing pressure. The successful recovery of the saltwater crocodile population through biodiversity conservation policy has inadvertently reduced people’s customary access to in-stream resources. Pastoralism on the floodplain had restricted traditional floodplain burning practices associated with accessing aestivating long-necked turtles, affecting access and abundance. These findings highlight the need for the development of remote Indigenous livelihood strategies to make explicit their influences on freshwater customary harvesting practices, to better support their maintenance amongst multiple, non-customary floodplain livelihoods.  相似文献   

17.

Background

Indigenous populations around the world have consistently been shown to bear a greater burden of disease, death and disability than their non-Indigenous counterparts. Despite this, little is known about what constitutes cost-effective interventions in these groups. The objective of this paper was to assess the global cost-effectiveness literature in Indigenous health to identify characteristics of successful and unsuccessful interventions and highlight areas for further research.

Methods and Findings

A systematic review of the published literature was carried out. MEDLINE, PSYCINFO, ECONLIT, EMBASE and CINAHL were searched with terms to identify cost-effectiveness evaluations of interventions in Indigenous populations around the world. The WHO definition was followed in identifying Indigenous populations. 19 studies reporting on 27 interventions were included in the review. The majority of studies came from high-income nations with only two studies of interventions in low and middle-income nations. 22 of the 27 interventions included in the analysis were found to be cost-effective or cost-saving by the respective studies. There were only two studies that focused on Indigenous communities in urban areas, neither of which was found to be cost-effective. There was little attention paid to Indigenous conceptions of health in included studies. Of the 27 included studies, 23 were interventions that specifically targeted Indigenous populations. Outreach programs were shown to be consistently cost-effective.

Conclusion

The comprehensive review found only a small number of studies examining the cost-effectiveness of interventions into Indigenous communities around the world. Given the persistent disparities in health outcomes faced by these populations and commitments from governments around the world to improving these outcomes, it is an area where the health economics and public health fields can play an important role in improving the health of millions of people.  相似文献   

18.
The Seventh Berndt Foundation Biennial LectureIt is clear from their voluminous scholarly output over five decades that Ronald and Catherine Berndt were keen observers of ‘the winds of change’ that were blowing strongly across most of Aboriginal Australia in that period. We contemporary scholars are closely watching both changes emanating from outside our communities and those that we as Indigenous Australians have instigated and moulded from within. A particular focus of this paper is how Indigenous Higher Education policies, programs and practices have been shaped by the politics of Indigenous self-determination and supported by social justice and human rights agendas. These frameworks have also guided argument, advocacy, and activism in the wider arena of Indigenous affairs, providing much of its language and forms of analysis. Today, however, there is evidence of a growing frustration that such frameworks have prevented alternative arguments, priorities, and possibilities from entering public discourse. In this paper, I discuss how these frameworks mutually constitute and uphold forms of analysis in Indigenous academia and Indigenous affairs in ways that fail to engage with the complexity of the contemporary space in which we as Indigenous people find ourselves today.  相似文献   

19.
BackgroundChikungunya fever (CHIKF) is a serious public health problem with a high rate of infection and chronic disabling manifestations that has affected more than 2 million people worldwide since 2005. In spite of this, epidemiological data on vulnerable groups such as Indigenous people are scarce, making it difficult to implement public policies in order to prevent this disease and assist these populations.ObjectiveTo describe the serological and epidemiological profile of chikungunya virus (CHIKV) in two Indigenous populations in Northeast Brazil, as well as in an urbanized control community, and to explore associations between CHIKV and anthropometric variables in these populations.Methodology/Principal findingsThis is a cross-sectional ancillary study of the Project of Atherosclerosis among Indigenous Populations (PAI) that included people 30 to 70 years old, recruited from two Indigenous tribes (the less urbanized Fulni-ô and the more urbanized Truká people) and an urbanized non-Indigenous control group from the same area. Subjects underwent clinical evaluation and were tested for anti-CHIKV IgG by enzyme-linked immunosorbent assay. Serological profile was described according to ethnicity, sex, and age. The study population included 433 individuals distributed as follows: 109 (25·2%) Truká, 272 (62·8%) Fulni-ô, and 52 (12%) from the non-Indigenous urbanized control group. Overall prevalence of CHIKV IgG in the study sample was 49.9% (216; 95% CI: 45·1–54·7). When the sample was stratified, positive CHIKV IgG was distributed as follows: no individuals in the Truká group, 78·3% (213/272; 95% CI: 72·9–83·1) in the Fulni-ô group, and 5.8% (3/52; 95% CI: 1.21–16) in the control group.Conclusions/SignificancePositive tests for CHIKV showed a very high prevalence in a traditional Indigenous population, in contrast to the absence of anti-CHIKV serology in the Truká people, who are more urbanized with respect to physical landscape, socio-cultural, and historical aspects, as well as a low prevalence in the non-Indigenous control group, although all groups are located in the same area.  相似文献   

20.

Background

The Indigenous population of Australia suffers considerable disadvantage across a wide range of socio-economic indicators, and is therefore the focus of many policy initiatives attempting to ‘close the gap’ between Indigenous and non-Indigenous Australians. Unfortunately, past population estimates have proved unreliable as denominators for these indicators. The aim of the paper is to contribute more robust estimates for the Northern Territory Indigenous population for the period 1966–2011, and hence estimate one of the most important of socio-economic indicators, life expectancy at birth.

Method

A consistent time series of population estimates from 1966 to 2011, based off the more reliable 2011 official population estimates, was created by a mix of reverse and forward cohort survival. Adjustments were made to ensure sensible sex ratios and consistency with recent birth registrations. Standard life table methods were employed to estimate life expectancy. Drawing on an approach from probabilistic forecasting, confidence intervals surrounding population numbers and life expectancies were estimated.

Results

The Northern Territory Indigenous population in 1966 numbered between 23,800 and 26,100, compared to between 66,100 and 73,200 in 2011. In 1966–71 Indigenous life expectancy at birth lay between 49.1 and 56.9 years for males and between 49.7 and 57.9 years for females, whilst by 2006–11 it had increased to between 60.5 and 66.2 years for males and between 65.4 and 70.8 for females. Over the last 40 years the gap with all-Australian life expectancy has not narrowed, fluctuating at about 17 years for both males and females. Whilst considerable progress has been made in closing the gap in under-five mortality, at most other ages the mortality rate differential has increased.

Conclusions

A huge public health challenge remains. Efforts need to be redoubled to reduce the large gap in life expectancy between Indigenous and non-Indigenous Australians.  相似文献   

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