Health priorities in an Australian mining town: an intercept survey

Abstract

In developed countries men's health is poorer than women's for a range of key indicators, and being an Indigenous man in Australia widens the gap substantially. Establishing the rates of mortality and health inequality between the sexes is useful for identifying that men's health needs attention and Indigenous men need particular attention. Men's health-seeking behaviour has been suggested as one of the causes of poor outcomes. This study aimed to identify differences in health concerns between men and women, and Indigenous and non-Indigenous people in an Australian mining town with the aim of targeting health promotion activities more effectively. An intercept survey was conducted of residents of the Pilbara region towns Port Hedland and South Hedland in 2010. Settings included the main shopping centres and precincts in the towns and at community event venues. Interviewers recorded gender, age, Aboriginal or Torres Strait Islander self-identification status, whether people worked in the mining industry or not and in what capacity and occupation. Participants were asked a series of questions about health issues of concern from a list of 13 issues which included national and local health priorities. They were then asked to prioritise their choices. Three hundred and eighty participants completed the survey, 48% were male; 18.4% identified as an Indigenous person and 21% worked in the local mining industry. Men's and women's health priorities were generally similar but women prioritised 'sick kids' as their number one priority and men prioritised heart disease (χ² =28.75 df=12 p = 0.004). More than half of the Aboriginal men identified diabetes as a priority (53%) compared with the non-Aboriginal men (24%). This was significantly different (χ²=10.04 df=1 p = 0.002). Approximately one-third of Aboriginal women identified alcohol misuse as a priority (32.4%) compared with non-Aboriginal women (6%). This was also significantly different (χ²= 19.45 df=1 p = 0.001). Health promotion in the Pilbara region needs to be re-evaluated for areas such as injury prevention, which remains the commonest cause of hospitalisations after renal dialysis, yet is a low health priority in the community mindset, especially among Indigenous people.