Ethnic Differences in the Quality of the Interview Process and Implications for Survey Analysis: The Case of Indigenous Australians

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.     

Parasitic diseases of remote Indigenous communities in Australia

Indigenous Australians suffer significant disadvantage in health outcomes and have a life expectancy well below that of non-Indigenous Australians. Mortality rates of Indigenous Australians are higher than that of Indigenous populations in developed countries elsewhere in the world. A number of parasitic diseases which are uncommon in the rest of the Australian population contribute to the high burden of disease in many remote Indigenous communities. High rates of infection with enteric parasites such as Strongyloides stercoralis, hookworm and Trichuris have been recorded and infection of the skin with the ecto-parasitic mite Sarcoptes scabiei is also a substantial problem. Secondary infection of scabies lesions, including with Staphylococcus aureus and group A Streptococcus, can produce serious sequelae such as rheumatic fever and post-streptococcal glomerulonephritis. Transmission of many parasites in many remote communities is facilitated by overcrowded living conditions and infrastructure problems which result in poor sanitation and hygiene. Improvements in environmental health conditions must accompany medical initiatives to achieve sustainable improvement in the health of Indigenous Australians.     

Cost-Effectiveness Analysis of a Mobile Ear Screening and Surveillance Service versus an Outreach Screening,Surveillance and Surgical Service for Indigenous Children in Australia

Indigenous Australians experience a high rate of ear disease and hearing loss, yet they have a lower rate of service access and utilisation compared to their non-Indigenous counterparts. Screening, surveillance and timely access to specialist ear, nose and throat (ENT) services are key components in detecting and preventing the recurrence of ear diseases. To address the low access and utilisation rate by Indigenous Australians, a collaborative, community-based mobile telemedicine-enabled screening and surveillance (MTESS) service was trialled in Cherbourg, the third largest Indigenous community in Queensland, Australia. This paper aims to evaluate the cost-effectiveness of the MTESS service using a lifetime Markov model that compares two options: (i) the Deadly Ears Program alone (current practice involving an outreach ENT surgical service and screening program), and (ii) the Deadly Ears Program supplemented with the MTESS service. Data were obtained from the Deadly Ears Program, a feasibility study of the MTESS service and the literature. Incremental cost-utility ratios were calculated from a societal perspective with both costs (in 2013–14 Australian dollars) and quality-adjusted life years (QALYs) discounted at 5% annually. The model showed that compared with the Deadly Ears Program, the probability of an acceptable cost-utility ratio at a willingness-to-pay threshold of $50,000/QALY was 98% for the MTESS service. This cost effectiveness arises from preventing hearing loss in the Indigenous population and the subsequent reduction in associated costs. Deterministic and probability sensitivity analyses indicated that the model was robust to parameter changes. We concluded that the MTESS service is a cost-effective strategy. It presents an opportunity to resolve major issues confronting Australia’s health system such as the inequitable provision and access to quality healthcare for rural and remotes communities, and for Indigenous Australians. Additionally, it may encourage effective health service delivery at a time when the healthcare funding and workforce capacity are limited.     

Socialization, Land, and Citizenship among Aboriginal Australians: Reconciling Indigenous and Western Forms of Education

Socialization, Land, and Citizenship among Aboriginal Australians: Reconciling Indigenous and Western Forms of Education . Raymond Matthew Nichol. Lewiston, NY: Edward Mellen Press, 2005. 480 pp.     

The Rights and Blights of the Politics in Indigenous Higher Education

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.     

Living on Climate-Changed Country: Indigenous Health,Well-Being and Climate Change in Remote Australian Communities

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.     

Early Life Predictors of Increased Body Mass Index among Indigenous Australian Children

Aboriginal and Torres Strait Islander Australians are more likely than non-Indigenous Australians to be obese and experience chronic disease in adulthood—conditions linked to being overweight in childhood. Birthweight and prenatal exposures are associated with increased Body Mass Index (BMI) in other populations, but the relationship is unclear for Indigenous children. The Longitudinal Study of Indigenous Children is an ongoing cohort study of up to 1,759 children across Australia. We used a multilevel model to examine the association between children’s birthweight and BMI z-score in 2011, at age 3-9 years, adjusted for sociodemographic and maternal factors. Complete data were available for 682 of the 1,264 children participating in the 2011 survey; we repeated the analyses in the full sample with BMI recorded (n=1,152) after multilevel multiple imputation. One in ten children were born large for gestational age, and 17% were born small for gestational age. Increasing birthweight predicted increasing BMI; a 1-unit increase in birthweight z-score was associated with a 0.22-unit (95% CI:0.13, 0.31) increase in childhood BMI z-score. Maternal smoking during pregnancy was associated with a significant increase (0.25; 95% CI:0.05, 0.45) in BMI z-score. The multiple imputation analysis indicated that our findings were not distorted by biases in the missing data. High birthweight may be a risk indicator for overweight and obesity among Indigenous children. National targets to reduce the incidence of low birthweight which measure progress by an increase in the population’s average birthweight may be ignoring a significant health risk; both ends of the spectrum must be considered. Interventions to improve maternal health during pregnancy are the first step to decreasing the prevalence of high BMI among the next generation of Indigenous children.     

The economic value of environmental services on indigenous-held lands in Australia

Australians could be willing to pay from $878m to $2b per year for Indigenous people to provide environmental services. This is up to 50 times the amount currently invested by government. This result was derived from a nationwide survey that included a choice experiment in which 70% of the 927 respondents were willing to contribute to a conservation fund that directly pays Indigenous people to carry out conservation activities. Of these the highest values were found for benefits that are likely to improve biodiversity outcomes, carbon emission reductions and improved recreational values. Of the activities that could be undertaken to provide the services, feral animal control attracted the highest level of support followed by coastal surveillance, weed control and fire management. Respondents' decisions to pay were not greatly influenced by the additional social benefits that can arise for Indigenous people spending time on country and providing the services, although there was approval for reduced welfare payments that might arise.     

‘Anthropology and Sociology Were of No Value … in War Time’: Ronald and Catherine Berndt and War-Time Security, 1939–1945

ABSTRACT

On 3 September 1939, Australia followed the United Kingdom in declaring war on Germany. Soon afterwards a number of German nationals including Australians of German descent were placed in internment camps. For those German enemy aliens and Australians of German heritage not interned, suspicion was never far from the surface. In the case of the anthropologist Ronald Murray Berndt, what initially put him under suspicion was not his political affiliations or actions, but his German name and some of his utterances on the war which were interpreted as being pro-German. Linked to this was a concern by Australian military and government authorities that Indigenous people were potentially disloyal, and anthropologists who worked with Indigenous Australians were, by the very nature of their relationship with them, considered potential subversives. However, although Ronald Berndt always worked with his wife Catherine, only Ronald was considered a security risk. Catherine was simply seen as his wife, part of a team, about whom nothing adverse was known. This article analyses the early career of Ronald and Catherine Berndt, and the restrictions and blocks they faced in accessing field sites during WWII. An easy answer to such impairments that was made at the time and later, was that Ronald was caught during WWII in a surveillance dragnet that focused on Germanness. The reality that emerges from the archival record, however, is far more complex, and shows amongst others, the exploitation of surveillance by local establishment gatekeepers.     

New Population and Life Expectancy Estimates for the Indigenous Population of Australia's Northern Territory, 1966–2011

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.     

National Celebration or Local Act of Reconciliation? Public Ritual Performance and Inter-Ethnic Relations in an Australian City

This is a study of the reshaping of Australia Day celebrations in Lismore, a small city in New South Wales, which was motivated by an attempt to make the celebrations inclusive of Indigenous people and to portray the Australian nation as unified rather than divided along lines of race and culture. It shows how and why a group of local people went about reconstructing the Day's events, and how this helped to shape (but not to homogenise) the symbolic messages conveyed. The analysis demonstrates how the specific changes were located structurally both in local initiatives concerning the relationship between Indigenous and White Australians, and also in a wider State and Federal context affecting this relationship. The nature and significance of the changes made to Australia Day are analysed by drawing on the anthropology of performance and other work on public ritual.     

The Politics of the Gap: Indigenous Australians, Liberal Multiculturalism, and the End of the Self-Determination Era

ABSTRACT  Since the 1970s, "self-determination" has been the dominant trope for expressing national aspirations for Indigenous Australians. Through the principles of self-determination, the liberal multicultural state has attempted to deliver postcolonial justice to its first peoples. In this new century, the sheen of the self-determination era has faded. Once heralded as the antidote to the racist assimilation era, it is now depicted as the cause of social ills. In this article, I draw on an ethnographic study of White antiracists working in Indigenous health in northern Australia to analyze the brand of liberal rationality that dominated the discourse of the self-determination era. By engaging with a "tribe" of White people who identify with the aims of the self-determination era, we can decipher the logic of self-determination as an instrument of the liberal state and better understand the internal contradictions and ambiguities that have led to its recent demise.     

Double Displacement: Indigenous Australians and Artefacts of the Wet Tropics

The history of dispossession of Indigenous Australians as a result of government policies has been well documented. Going beyond this established literature, this paper explores connections between the displacement of Aboriginal people of the rainforest region of North Queensland to reserves and the ethnographic trade in museum artefacts. I provide an analysis of how Aboriginal people and some of their material products were historically sent along different trajectories. The paper sheds light on debates about the political and economic aspects of a history of displacement, circulation, and emplacement that continues to produce inequalities today.     

The Contribution of Geography to Disparities in Preventable Hospitalisations between Indigenous and Non-Indigenous Australians

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.     

Quantifying the changes in survival inequality for Indigenous people diagnosed with cancer in Queensland,Australia

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.     

Mepimbat tedul proujek: Indigenous knowledge of culturally significant freshwater turtles addresses species knowledge gaps in Northern Australia

Indigenous biocultural knowledge offers valuable insights for species conservation; however, like biological diversity, associated cultural knowledge is also often threatened. This paper demonstrates how Indigenous biocultural knowledge of species can contribute to addressing gaps in species occurrence data and conservation knowledge using a case study from the South East Arnhem Land Indigenous Protected Area (SEAL IPA), northern Australia. Using a series of mapping workshops and interviews this collaborative project recorded Indigenous biocultural knowledge of the distribution, ecology, cultural significance and threats to freshwater turtles (freshwoda teduls in the local Indigenous language, Roper River Kriol). Based on past freshwoda tedul hunting experiences, 74 Indigenous knowledge holders identified 753 past freshwoda tedul occurrences, significantly adding to the 12 occurrences previously listed for the SEAL IPA in Australia's online species database, the Atlas of Living Australia. Importantly, these were the first ‘memory’ records of past species sightings by Indigenous people to be recognized and added to Australia's national species database. In addition, a blog summarizing this research was promoted through the Atlas of Living Australia, raising awareness of the Indigenous biocultural knowledge associated with these species. The Mepimbat tedul proujek revealed the cultural significance of freshwoda teduls and reported declines in abundance since the turn of the century, implicating invasive hard-hooved ungulates (buffalo, pig) and reduced rainfall. The addition of non-sacred Indigenous knowledge to free online species databases may offer innovative solutions for storage, interaction and sharing of indigenous knowledge, with opportunities for intergenerational and cross-cultural learning and broader application in conservation management and decision-making.     

Erhard Eylmann’s Missionary Position

ABSTRACT

The German anthropologist Erhard Eylmann relied heavily on assistance provided by missionaries when he undertook fieldwork in Australia. During two periods at the Hermannsburg mission he developed a strained relationship with Carl Strehlow. In his major work Eylmann wrote a damning critique of missionaries. While there was a level of personal animosity between Eylmann and Strehlow, at the heart of the antagonism were fundamental differences concerning the nature and function of the discipline of anthropology. The missionaries sought anthropological knowledge to promote mutual understanding, above all through language, as a prelude to conversion to Christianity. They proceeded from the assumption that the future of Indigenous Australians would be within the context of the adoption of Christian belief systems. Eylmann in contrast took the view that the differences between Europeans and Indigenous Australians were physical, essential and insuperable. Sceptical about the possibility of achieving mutual understanding, he devoted his fieldwork primarily to describing, recording and collecting for the purpose of assembling a detailed record of a population he believed destined for extinction. Eylmann and German missionary anthropologists such as Strehlow had in common that they stood outside the paradigm of British social evolutionistic thinking which dominated Australian anthropology around the turn of the century at the time. At the same time, the differences in the anthropological endeavours of Eylmann and Strehlow indicate the great breadth of approaches opening up within German anthropology. In particular they point to the emergence of an ‘antihumanist’ turn at the end of the nineteenth century.     

The Kimberley Assessment of Depression of Older Indigenous Australians: Prevalence of Depressive Disorders,Risk Factors and Validation of the KICA-dep Scale

Objective

This study aimed to develop a culturally acceptable and valid scale to assess depressive symptoms in older Indigenous Australians, to determine the prevalence of depressive disorders in the older Kimberley community, and to investigate the sociodemographic, lifestyle and clinical factors associated with depression in this population.

Methods

Cross-sectional survey of adults aged 45 years or over from six remote Indigenous communities in the Kimberley and 30% of those living in Derby, Western Australia. The 11 linguistic and culturally sensitive items of the Kimberley Indigenous Cognitive Assessment of Depression (KICA-dep) scale were derived from the signs and symptoms required to establish the diagnosis of a depressive episode according to the DSM-IV-TR and ICD-10 criteria, and their frequency was rated on a 4-point scale ranging from ‘never’ to ‘all the time’ (range of scores: 0 to 33). The diagnosis of depressive disorder was established after a face-to-face assessment with a consultant psychiatrist. Other measures included sociodemographic and lifestyle factors, and clinical history.

Results

The study included 250 participants aged 46 to 89 years (mean±SD = 60.9±10.7), of whom 143 (57.2%) were women. The internal reliability of the KICA-dep was 0.88 and the cut-point 7/8 (non-case/case) was associated with 78% sensitivity and 82% specificity for the diagnosis of a depressive disorder. The point-prevalence of a depressive disorder in this population was 7.7%; 4.0% for men and 10.4% for women. Heart problems were associated with increased odds of depression (odds ratio = 3.3, 95% confidence interval = 1.2,8.8).

Conclusions

The KICA-dep has robust psychometric properties and can be used with confidence as a screening tool for depression among older Indigenous Australians. Depressive disorders are common in this population, possibly because of increased stressors and health morbidities.     

Composition of the Aboriginal harvest of fisheries resources in coastal New South Wales,Australia

A key aspect of equitable management of the world’s fishery resources is the provision of traditional fishing access for Indigenous peoples. In Australia, increased recognition of the importance of fisheries to Indigenous culture and livelihoods over recent years has created a need for information on the species targeted to support policy and management. In the State of New South Wales (NSW), research on Indigenous fisheries catch composition is limited to two major studies. Here, we compare and combine data on Indigenous catch composition from these two studies to produce a comprehensive synthesis of current knowledge of Indigenous fisheries in NSW. The species harvested include more than 150 species of finfish and invertebrates, over 90 % of which are also harvested by commercial and recreational fishers. Our findings provide an empirical basis for future development of policy and management initiatives to meet the needs of Indigenous fishers and other stakeholders, as well as the principles of sustainable fisheries harvest.