Aboriginal Females Research Articles

Aboriginality and violence: gender and cultural differences on the Level of Service/Risk, Need, Responsivity (LS/RNR) and Violence Risk Scale (VRS)

There is an over-representation of Aboriginal/Indigenous people in the criminal justice systems of Australia, Canada, New Zealand and the United States, with offences committed by male and female Aboriginal prisoners predominantly involving physical violence against a person. Risk assessment tools used have not been developed for Aboriginal people, and validations have produced varied results. The current study focused on violent offenders and investigated the differences between four demographic groups – Aboriginal females (AF), non-Aboriginal females (NAF), Aboriginal males (AM) and non-Aboriginal males (NAM) – on the Level of Service/Risk, Need, Responsivity (LS/RNR) and Violence Risk Scale (VRS; including Screening Version, VRS–SV). Significant differences were evident between all groups; however, there were limited differences between AF and NAF with differences on the VRS–SV primarily due to static factors. Aboriginality did not appear to elevate risk for violent females. The limitations of the study are discussed plus the recommendations for future research.

231The West Australian Burden of Disease Study 2015: mental health in Aboriginal West Australians

Abstract Background Mental disorders represent a growing health problem: an estimated 45% of Australians experience a mental disorder in their lifetime. The Western Australian (WA) Burden of Disease study 2015 produced detailed data for sub-populations within the state to inform policy and planning. Using this, we describe the burden of mental, substance use disorders and self-inflicted injuries in the WA Aboriginal population. Methods The study generated estimates for over 200 diseases to create ranked disease-level estimates of burden in the WA Aboriginal population for the first time. Eleven individual conditions in the mental disorders disease group, and suicide and self-inflicted injuries were analysed. Results Mental disorders contributed 18% of Aboriginal male and 16% of Aboriginal female DALYs in WA. Among Aboriginal males, alcohol use disorders ranked 3rd among all diseases (ASR: 33.6 DALYs per 1,000 males). Among Aboriginal females, anxiety disorders ranked 3rd (ASR: 17.3 per 1,000 females). Suicide and self-inflicted injuries ranked 2nd among all diseases among Aboriginal males (ASR: 39.8 DALYs per 1,000 males) and 5th among Aboriginal females (ASR: 10.8 per 1,000 females). Conclusions The study highlighted the high burden of disease from mental disorders and self-inflicted injuries among Aboriginal West Australians: self-inflicted injuries, alcohol use disorders and anxiety disorders ranked in the top 10 of all diseases. Key messages Mental disorders contribute substantially to the disease burden in WA among the Aboriginal residents. The findings can inform health policy and planning around mental health in the Aboriginal population, as well as informing social and liquor licensing policy.

Hypertension: high prevalence and a positive association with obesity among Aboriginal and Torres Strait Islander youth in far north Queensland

ObjectiveHypertension and other chronic disease risks are common among Aboriginal and Torres Strait Islander adults but there is little evidence regarding the epidemiology of these risk factors during adolescence. This study examines the prevalence of pre‐hypertension, hypertension and other cardiovascular risk factors in Aboriginal and Torres Strait Islander people aged 15–24 years living in remote Indigenous communities in north Queensland. In so doing, it aims to better inform the approach to cardiovascular disease in this population. MethodsThis is a descriptive study that retrospectively examines health service data from a program of community screening, the Young Persons Check (YPC). Participants were 1,883 Aboriginal and Torres Strait Islander people aged 15–24 years who attended for a YPC in 11 remote communities in north Queensland between March 2009 and April 2011. ResultsOverall, the prevalence of pre‐hypertension was 34.0%; stage I hypertension was 17.7% and stage II hypertension was 3.3%. The prevalence of elevated waist circumference was 47.6%, overweight or obesity 45.9%, elevated triglycerides 18.3%, decreased HDL 54.8% and proteinuria 24.3%. The prevalence of hypertension (stage I or II) among Torres Strait Islander males was 34.1%, Aboriginal males 26.9%, Torres Strait Islander females 12.6% and Aboriginal females 13.0%. Hypertension was associated with sex (males) (OR= 4.37, p<0.000), overweight (OR=2.46, p<0.000), obesity (OR=4.59, p<0.000) and elevated triglycerides (OR=2.38, p<0.000). ConclusionPre‐hypertension, hypertension and other cardiovascular risk in this population is highly prevalent. Hypertension was particularly prevalent among male participants. The results reiterate the importance of early life experience in cardiovascular disease prevention.

Factors associated with non-attendance in a general practice super clinic population in regional Australia: A retrospective cohort study.

Non-attendance at medical appointments is associated with increased patient morbidity and is a significant drain on health service resources. Australian studies have focused on secondary healthcare settings, screening, and interventions to reduce non-attendance. To explore factors associated with non-attendance in a regional primary care setting. A retrospective cohort of all patients with a scheduled appointment between October 2011 and October 2013 at a regional, primary care clinic providing medical and allied health services in a region of New South Wales (NSW) serving a large Aboriginal population (10.7 per cent). Using multivariate logistic regression, non-attendance was regressed on a range of covariates, including number of appointments per person, gender and ethnicity, and day of the week. The overall proportion of missed appointments was 7.6 per cent. Risk factors for non-attendance were day of the week [Mondays (8.1 per cent), Fridays (8.0 per cent), and Thursdays (7.9 per cent), (χ2(4)= 20.208, p<0.0005], having fewer scheduled appointments [≤5 appointments resulted in 19.1 per cent greater risk of failure to attend (FTA) (95% CI: 11-28%)]; Aboriginality (OR=4.022, 95% CI: 3.263, 4.956), and female gender (OR=1.077; 95% CI 1.024, 1.132). There was a trend toward an interaction between gender and Aboriginality, with Aboriginal females being the group most likely to miss appointments (OR=1.272, 95% CI: 0.949, 1.705). This is the largest study of non-attendance in an Australian primary healthcare setting. While not a typical setting, the study had the advantage of a large, mixed population. The suggested high rates of non-attendance by Aboriginal females have potentially important policy implications.

Worker compensation injuries among the Aboriginal population of British Columbia, Canada: incidence, annual trends, and ecological analysis of risk markers, 1987-2010.

BackgroundAboriginal people in British Columbia (BC) have higher injury incidence than the general population, but information is scarce regarding variability among injury categories, time periods, and geographic, demographic and socio-economic groups. Our project helps fill these gaps. This report focuses on workplace injuries.MethodsWe used BC’s universal health care insurance plan as a population registry, linked to worker compensation and vital statistics databases. We identified Aboriginal people by insurance premium group and birth and death record notations. We identified residents of specific Aboriginal communities by postal code. We calculated crude incidence rate and Standardized Relative Risk (SRR) of worker compensation injury, adjusted for age, gender and Health Service Delivery Area (HSDA), relative to the total population of BC. We assessed annual trend by regressing SRR as a linear function of year. We tested hypothesized associations of geographic, socio-economic, and employment-related characteristics of Aboriginal communities with community SRR of injury by multivariable linear regression.ResultsDuring the period 1987–2010, the crude rate of worker compensation injury in BC was 146.6 per 10,000 person-years (95% confidence interval: 146.4 to 146.9 per 10,000). The Aboriginal rate was 115.6 per 10,000 (95% CI: 114.4 to 116.8 per 10,000) and SRR was 0.88 (95% CI: 0.87 to 0.89). Among those living on reserves SRR was 0.79 (95% CI: 0.78 to 0.80). HSDA SRRs were highly variable, within both total and Aboriginal populations. Aboriginal males under 35 and females under 40 years of age had lower SRRs, but older Aboriginal females had higher SRRs. SRRs are declining, but more slowly for the Aboriginal population. The Aboriginal population was initially at lower risk than the total population, but parity was reached in 2006. These community characteristics independently predicted injury risk: crowded housing, proportion of population who identified as Aboriginal, and interactions between employment rate and income, occupational risk, proportion of university-educated persons, and year.ConclusionsAs employment rates rise, so has risk of workplace injury among the Aboriginal population. We need culturally sensitive prevention programs, targeting regions and industries where Aboriginal workers are concentrated and demographic groups that are at higher risk.

In vivo facial tissue depth for Canadian aboriginal children: a case study from Nova Scotia, Canada.

This study examines facial tissue depth in Canadian Aboriginal children. Using ultrasound, measurements were taken at 19 points on the faces of 392 individuals aged 3-18 years old. The relationships between tissue thickness, age, and sex were investigated. A positive linear trend may exist between tissue thickness and age for Aboriginal females and males at multiple points. No points show significant differences in facial tissue depth between males and females aged 3-8 years old; seven points show significant differences in facial tissue depth between males and females aged 9-13 years old; and five points show significant differences in facial tissue depth between males and females aged 14-18 years old. Comparisons were made with White Americans and African Nova Scotians. These data can assist in 3-D facial reconstructions and aid in establishing an individual's identity. Previously, no data existed for facial tissue thickness in Canadian Aboriginal populations.

22 HYPERTENSION AND OTHER CHRONIC DISEASE RISK FACTORS AMONG INDIGENOUS YOUNG PEOPLE. AN OPPORTUNITY FOR PREVENTIVE ACTION

Background: The burden of chronic disease in Aboriginal and Torres Strait Islander populations is well documented (1, 2, 3). This study retrospectively examines the prevalence of hypertension and other chronic disease risk factors in a sample of 1883 Aboriginal and Torres Strait Islander people aged 15-24 years that attended for a Young Person Check in 15 remote communities in far north Queensland between March 2009 and April 2011. Methods: Data relating to the prevalence of pre-hypertension, stage I hypertension, stage II hypertension, obesity, increased waist circumference, non-fasting blood sugar levels, non-fasting lipid profiles, proteinuria and albuminuria were analysed. Results: Overall the prevalence of pre-hypertension was 34.0%, stage I hypertension was 17.7% and stage II hypertension was 3.3%. The prevalence of elevated waist circumference was 47.6%, overweight or obesity 45.9%, elevated triglycerides 18.3%, decreased HDL 54.8% and proteinuria 24.3%. The prevalence of hypertension (stage I or II) among Torres Strait Islander males was 34.1%, Aboriginal males 26.9%, Aboriginal females 13.0% and Torres Strait Islander females 12.6%. The difference in hypertension prevalence between the genders was statistically significant.(p = 0.000 for both Aboriginal and Torres Strait Islanders) Conclusion: The study indicates that many remote living Indigenous youth are already on the trajectory towards chronic disease. Consequently, primary preventive activity directed at addressing the causes of chronic disease including overweight and obesity should be directed at children, their families and the environment in which the population lives. Screening for hypertension and other risk factors should commence by adolescence. References Australian Bureau of Statistics and Australian Institute of Health and Welfare), The Health and Welfare of Australia's Aboriginal and Torres Strait Islander Peoples. Canberra, 2010 Wang Z, Knight S, Wilson A, Rowley K G, Best J D, McDermott R, Leonard D, Shaw JE and O’Dea K. Blood pressure and hypertension for Australian Aboriginal and Torres Strait Islander people. European Journal of Cardiovascular Prevention and Rehabilitation 2006;13:438-443 Miller G, McDermott R, McCulloch B, Leonard D, Arabena K, Muller R. The Well Person's Health Check: a population screening program in Indigenous communities in north Queensland. Australian Health Review 2002;25(6):136-147.

Trends in alcohol‐attributable hospitalisation in the Northern Territory, 1998–99 to 2008–09

To examine trends in hospitalisation for alcohol-attributable conditions in the Northern Territory Aboriginal and non-Aboriginal populations between the financial years 1998-99 and 2008-09. Retrospective descriptive analysis of inpatient discharge data from NT public hospitals. Alcohol-attributable hospitalisation by age, sex, Aboriginality, region of residence and medical conditions, with annual time trends. Annual rates of hospitalisation for alcohol-attributable conditions across the NT increased from 291.3 per 10,000 population to 460.0 per 10,000 (57.9%) among Aboriginal males and from 181.8 per 10,000 to 387.4 per 10,000 (113.1%) among Aboriginal females over the study period. The alcohol-attributable hospitalisation rate also increased from 58.8 per 10,000 population to 87.4 per 10,000 (48.6%) among non-Aboriginal males and from 16.8 per 10,000 to 37.2 per 10,000 (121.4%) among non-Aboriginal females. Alcohol-attributable hospitalisation rates among Aboriginal people living in Central Australia were much higher than in the Top End. In Central Australia, the rates for Aboriginal females increased throughout the study period, but for Aboriginal males declined from 2004-05 onwards. Rates of hospitalisation for alcohol-attributable conditions were high among NT Aboriginal people and increased during the study period. Although not statistically significant, the moderation in rates among Central Australian Aboriginal males after 2004-05 is encouraging. This apparent improvement is consistent with another recent study and provides tentative support that recent policy changes and interventions may be having an impact. The results of this study highlight the burden of alcohol use in the NT and emphasise the need for ongoing investment in comprehensive alcohol-management programs.

Estimates of cancer incidence, mortality and survival in aboriginal people from NSW, Australia

BackgroundAboriginal status has been unreliably and incompletely recorded in health and vital registration data collections for the most populous areas of Australia, including NSW where 29% of Australian Aboriginal people reside. This paper reports an assessment of Aboriginal status recording in NSW cancer registrations and estimates incidence, mortality and survival from cancer in NSW Aboriginal people using multiple imputation of missing Aboriginal status in NSW Central Cancer Registry (CCR) records.MethodsLogistic regression modelling and multiple imputation were used to assign Aboriginal status to those records of cancer diagnosed from 1999 to 2008 with missing Aboriginality (affecting 12-18% of NSW cancers registered in this period). Estimates of incidence, mortality and survival from cancer in NSW Aboriginal people were compared with the NSW total population, as standardised incidence and mortality ratios, and with the non-Aboriginal population.ResultsFollowing imputation, 146 (12.2%) extra cancers in Aboriginal males and 140 (12.5%) in Aboriginal females were found for 1999-2007. Mean annual cancer incidence in NSW Aboriginal people was estimated to be 660 per 100,000 and 462 per 100,000, 9% and 6% higher than all NSW males and females respectively. Mean annual cancer mortality in NSW Aboriginal people was estimated to be 373 per 100,000 in males and 240 per 100,000 in females, 68% and 73% higher than for all NSW males and females respectively. Despite similar incidence of localised cancer, mortality from localised cancer in Aboriginal people is significantly higher than in non-Aboriginal people, as is mortality from cancers with regional, distant and unknown degree of spread at diagnosis. Cancer survival in Aboriginal people is significantly lower: 51% of males and 43% of females had died of the cancer by 5 years following diagnosis, compared to 36% and 33% of non-Aboriginal males and females respectively.ConclusionThe present study is the first to produce valid and reliable estimates of cancer incidence, survival and mortality in Australian Aboriginal people from NSW. Despite somewhat higher cancer incidence in Aboriginal than in non-Aboriginal people, substantially higher mortality and lower survival in Aboriginal people is only partly explained by more advanced cancer at diagnosis.

P1-S2.68 Targeted interventions for remote Australians; trends in chlamydia and gonorrhoea notifications in aboriginal and non-indigenous Australians 2005−2009

BackgroundHigher rates of chlamydia and gonorrhoea notifications have been reported in Aboriginal and Torres Strait Islander than non-Indigenous people in Australia since the early 1990s.MethodsChlamydia and gonorrhoea notification data from...

Trends in chronic disease mortality in the Northern Territory Aboriginal population, 1997‐2004: using underlying and multiple causes of death

To assess trends in chronic disease mortality in the Aboriginal population of the Northern Territory (NT), using both underlying and multiple causes of death. Death registration data from 1997 to 2004, were used for the analysis of deaths from five chronic diseases; ischaemic heart disease (IHD), diabetes, chronic obstructive pulmonary disease (COPD), renal failure and stroke. Negative binomial regression models were used to estimate the average annual change in mortality rates for each of the five diseases. Chi squared tests were conducted to determine associations between the five diseases. The five chronic diseases contributed to 49.3% of all Aboriginal deaths in the NT. The mortality rate ratio of NT Aboriginal to all Australian death rates from each of the diseases ranged from 4.3 to 13.0, with the lowest rate ratio for stroke and highest for diabetes. There were significant statistical associations between IHD, diabetes, renal failure and stroke. The mortality rates for diabetes, COPD and stroke declined at estimated annual rates for NT Aboriginal males of 3.6%, 1.0% and 11.7% and for Aboriginal females by 3.5%, 6.1% and 7.1% respectively. There were increases in mortality rates for Aboriginal males and females for IHD and a mixed result for renal failure. NT Aboriginal people experience high chronic disease mortality, however, mortality rates appear to be declining for diabetes, COPD and stroke. The impact of chronic disease on mortality is greater than previously reported by using a single underlying cause of death. The results highlight the importance of integrated chronic disease interventions.

An integrated framework for the geographic surveillance of chronic disease

BackgroundGeographic public health surveillance is concerned with describing and disseminating geographic information about disease and other measures of health to policy makers and the public. While methodological developments in the geographical analysis of disease are numerous, few have been integrated into a framework that also considers the effects of case ascertainment bias on the effectiveness of chronic disease surveillance.ResultsWe present a framework for the geographic surveillance of chronic disease that integrates methodological developments in the spatial statistical analysis and case ascertainment. The framework uses an hierarchical approach to organize and model health information derived from an administrative health data system, and importantly, supports the detection and analysis of case ascertainment bias in geographic data. We test the framework on asthmatic data from Alberta, Canada. We observe high prevalence in south-western Alberta, particularly among Aboriginal females. We also observe that persons likely mistaken for asthmatics tend to be distributed in a pattern similar to asthmatics, suggesting that there may be an underlying social vulnerability to a variety of respiratory illnesses, or the presence of a diagnostic practice style effect. Finally, we note that clustering of asthmatics tends to occur at small geographic scales, while clustering of persons mistaken for asthmatics tends to occur at larger geographic scales.ConclusionRoutine and ongoing geographic surveillance of chronic diseases is critical to developing an understanding of underlying epidemiology, and is critical to informing policy makers and the public about the health of the population.

Anthropometric measurements of Australian Aboriginal adults living in remote areas: Comparison with nationally representative findings

To compare body size measurements in Australian Aboriginals living in three remote communities in the Northern Territory of Australia with those of the general Australian population. Height, weight, waist and hip circumferences and derivative values of body mass index (BMI), waist-hip ratio (WHR), waist-height ratio (WHT), and waist-weight ratios (WWT) of adult Aboriginal volunteers (n = 814), aged 25 to 74 years were compared with participants in the nationally representative 'AusDiab' survey (n = 10,434). The Aboriginal body habitus profiles differed considerably from the Australian profile. When compared to Australian females, Aboriginal females were taller and had lower hip circumference but had higher WC, WHR, WHT, and WWT (P < 0.01 for all). When compared with their Australian counterparts, Aboriginal males were shorter, had lower body weight, WC, hip circumference, BMI, and WHT but had higher WHR and WWT (P < 0.001 for all). Significantly more Aboriginal females were classified as overweight and or obese using cutoffs defined by WC and by WHR than by BMI. Aboriginal males were less often overweight and/or obese by BMI than their counterparts, but were significantly more often overweight or obese by WHR. There were significant variations in body size profiles between Aboriginal communities. However, the theme of excess waist measurements relative to their weight was uniform. Aboriginal people had preferential central fat deposition in relation to their overall weight. BMI significantly underestimated overweight and obesity as assessed by waist measurements among Aboriginals. This relationship of preferential central fat deposition to the current epidemic of chronic diseases needs to be explored further.

Desistance and Identity Change among Aboriginal Females

This study concerns the factors that are involved in a change from antisocial and criminal behavior to the development of a prosocial sense of identity in ten Aboriginal females. Data were obtained from recorded semi-structured interviews that included questionnaires and open-ended questions. These women had dysfunctional backgrounds and lifestyles yet ceased such behavior and entered university life. Findings indicated the resilience of these women. They overcame extreme disadvantages and “turned around” to develop purposeful and adaptive lives. Gaining a sense of their cultural background and integrating aspects of Aboriginal heritage into their sense of self were interwoven themes in the process. Findings are considered in terms of desistence and identity change from a maladaptive lifestyle with implications for cultural socialization.

Metabolic syndrome in aboriginal Canadians: Prevalence and genetic associations

Objectives The prevalence rates of type 2 diabetes (T2DM) and coronary heart disease (CHD) in Ontario Oji-Cree are among the world's highest. Since metabolic syndrome (MetS) increases risk of T2DM and CHD, we characterized prevalence and putative genetic determinants of MetS in Oji-Cree. Methods and results In 515 adult (≥18 years old) and 115 adolescent (<18 years old) Oji-Cree subjects, using the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria, we determined that 29.9% of Oji-Cree adults, and 43.4% of adults ≥35 years of age, had MetS. Furthermore, 33.9 and 8.7% of female Oji-Cree adults and adolescents, respectively, had MetS. Increased waist girth and depressed HDL cholesterol were the most prevalent individual MetS components, while increased blood pressure was least prevalent. AGT T174M, GNB3 825C>T, and APOC3 −455T>C genotypes were significantly associated with MetS ( P = 0.018, 0.0056, and 0.029, respectively) for female adults, whereas FABP2 A54T genotype was associated with MetS ( P = 0.040) for female adolescents. Conclusions The high MetS prevalence in Oji-Cree adults, especially women, is consistent with their high risk of T2DM and CHD. Functional polymorphisms in three candidate genes for plasma lipoproteins and blood pressure were associated with MetS in adult Oji-Cree. Furthermore, several female adolescents met the adult MetS criteria, suggesting that the genesis of MetS begins in youth, especially among aboriginal females.

Risk factors for isolated talipes equinovarus in Western Australia, 1980–1994

A case-control study based on routinely collected data for a West Australian (WA) cohort of births born 1980-94 inclusive was used to identify potential risk factors for the foot deformity isolated talipes equinovarus. Race and sex were identified as risk factors and risk modifiers of the condition in WA infants. In comparison with their female counterparts, Aboriginal males were at greater risk of the deformity than Caucasian males (odd ratio [OR] 7.15, 95% confidence interval [CI] 2.68, 21.12 vs. OR 1.63, 95% CI 1.24, 2.15 respectively). Sex-specific risk estimates of the deformity showed that Aboriginal males were at more than four times the risk of Caucasian males (OR 4.27, 95% CI 2.30, 8.25 respectively), but the risk amongst Aboriginal females was not dissimilar to the risk amongst Caucasian females (OR 1.12, 95% CI 0.49, 2.45). Intrauterine constraint of the fetus was not found to be an important contributing factor to the deformity after accounting for the effect of all risk factors modelled in multivariable analyses. Indicators of intrauterine constraint including prolonged gestation, high infant birthweight, young maternal age (< 20 years) and breech presentation were not associated with excess numbers of isolated talipes equinovarus cases. Limited numbers of cases associated with other indicators of intrauterine constraint, including the specific categories of short maternal stature and a twin pregnancy prevented definitive conclusions regarding their association with the deformity. Improved data quality for gestational age estimates and oligohydramnios status are required before determining the prenatal risk impact of season of conception and of reduced amniotic fluid levels, respectively, on the occurrence of the deformity.

DYS19 and DYS199 loci in a Chilean population of mixed ancestry.

The current Chilean population originated from admixture between aboriginal populations (Amerindians) and Spanish conquerors of European origin. Consequently, the unions that gave rise to the Chilean population were chiefly between Spanish males and aboriginal females, and not the converse. To test the hypothesis that the Y chromosome of the Chilean population is mainly of Spanish origin, while the other chromosomes are from mixed (European and aboriginal) origin, we studied the DYS19 and DYS199 loci in two samples. One sample was obtained from a high socioeconomic stratum, while a second sample was from a low stratum. We studied male blood donors (N = 187) from Santiago, the capital of the country. Subjects were typed for the autosomal ABO and Rh (locus D) blood groups, and for the Y-linked DYS19 and the DYS199 loci, reported as Y-chromosome haplotypes. The aboriginal admixture was estimated for each genetic marker. The percentage of aboriginal admixture was 38.17% for the ABO system and 31.28% for the Rh system in the low socioeconomic stratum and 19.22% and 22.5%, respectively, in the high stratum. Y-chromosome haplotype frequencies constructed from the DYS19 and DYS199 loci demonstrated that the main haplotypes were DYS19*14/DYS199 C, as is often the case with many European populations, and DYS19*13/DYS199 C. The aboriginal admixture from Y-haplotype frequencies was estimated to be 15.83% in the low socioeconomic stratum and 6.91% in the high stratum. These values are lower than the values found using autosomal genetic markers, and are consistent with the historical background of the population studied. This study highlights the population genetic consequences of the asymmetric pattern of genome admixture between two ancestral populations (European and Amerindian).

Aboriginal deaths in Western Australia: 1985-89 and 1990-94

ObjectiveTo examine death data for Aboriginal and non-Aboriginal persons in Western Australia (WA) in 1985-89 and 1990-94. MethodsPopulation estimates were provided by the Health Information Centre of the WA Health Department based on data from the Australian Bureau of Statistics (ABS). Death data came from the WA Registrar-General's Office. Standard methods were used to obtain rates and levels of significance. ResultsMain causes of deaths among Aboriginal males in 1990-94 were circulatory conditions, respiratory, injury and poisoning, neoplasms and endocrine diseases; in Aboriginal females they were circulatory, neoplasms, endocrine diseases, respiratory diseases, and injury and poisoning. From 1985-89 to 1990-94, the Aboriginal male all-cause age-standardised death rates fell 3% (ns) while the non-Aboriginal male rate fell 11% (p<0.05). The Aboriginal female all-cause death rate rose 11% (ns) while the non-Aboriginal rate fell 5% (p<0.05). The allcause death rate ratio (Aboriginahnon-Aboriginal) changed from 2.4 to 2.6 (males) and 2.5 to 2.9 (females). There was a major increase in deaths from endocrine diseases among Aborigines and non-Aborigines. This increase was proportionally much greater among Aborigines. In non-Aborigines there was a significant decrease in deaths from circulatory diseases (mainly ischaemic heart disease); this did not occur among Aborigines. ConclusionsOver the study period, Aboriginal health standards, as reflected by death rates, apparently worsened relative to non-Aboriginal standards. ImplicationsBetter health promotion, disease prevention and disease care are required to help achieve acceptable health standards among Aboriginal peoples.

Prevalence of diabetes mellitus and impaired glucose tolerance in Aborigines and Chinese in eastern Taiwan

The aim of this study was to determine the prevalence of diabetes mellitus and impaired glucose tolerance (IGT) in three different ethnic groups in eastern Taiwan. The study was performed among Han Chinese, aboriginal Ami and aboriginal Atayal in six rural villages. Inhabitants aged 40 years and over were invited to participate. A 75-g oral glucose tolerance test (OGTT) was used as suggested by the World Health Organization (WHO) for population screening purposes. WHO criteria were used for determining the results. A total of 1013 adults (460 men and 553 women) were examined with a response rate of 62.1%. There were no significant differences in sex, age and history of diabetes between responders and non-responders. The age-adjusted prevalence of diabetes was 11.0% (9.8% in men and 12.3% in women) in the Chinese, 9.1% (12.1% in men and 7.4% in women) in the Amis, 10.8% (11.5% in men and 9.4% in women) in the Atayal and 9.9% (11.5% in men and 8.5% in women) for the two aboriginal groups together. Although sex differences in prevalence of diabetes were not statistically significant, it seems that diabetes was slightly more prevalent in Chinese women than in Chinese men (12.3 versus 9.8%). Nonetheless, the prevalence rate of diabetes was somewhat higher in the aboriginal males than in the aboriginal females (12.1 versus 9.8% for Ami and 11.5 versus 10.7% for Atayal). The prevalence of IGT was 7.2, 8.5, 10.8 and 9.7% for the Chinese, Amis, Atayal and the two aboriginal groups, respectively. There were no substantial differences in the prevalence of diabetes and IGT among these three ethnic groups. Environment, rather than ethnicity, was more likely the predominant factor. It was found that the prevalence of diabetes in this study was about twice as high as that reported in a 1987 survey in Taiwan. The discrepancy may be due to different screening methods and assessment periods.

The impact of tobacco smoking and alcohol consumption on Aboriginal mortality in Western Australia, 1989‐1991

To compare the estimated death rates associated with alcohol and tobacco use for Australian Aboriginals in Western Australia with those for non-Aboriginals. Deaths attributable to tobacco smoking and alcohol consumption were estimated for 1989-1991 with the aetiological fractions method, using data from the Health Department of Western Australia's mortality database. Tobacco smoking was responsible for 15.4% of all deaths and 13.9% of Aboriginal deaths, and alcohol consumption for 5% and 9.2%, respectively. The age-standardised death rates per 100,000 person-years for tobacco and alcohol were: Aboriginal males, 271 and 152; other males, 113 and 29; Aboriginal females, 118 and 56; and other females, 32 and 15. Of those who died as a result of tobacco use, 49% of Aboriginal males and 48% of Aboriginal females died before 55 years of age, compared with 11% and 10%, respectively, in non-Aboriginal males. For alcohol-related deaths, 62% of Aboriginal males and 70% of Aboriginal females died before 55 years of age, compared with 35% and 23%, respectively, in non-Aboriginals. During 1989-1991 tobacco smoking and alcohol consumption were responsible for much higher death rates among Aboriginals than among non-Aboriginals in Western Australia.