Health Status Of Indigenous People Research Articles

Skookum Health

This article presents findings of a collaborative, community-based project that established partnerships between researchers at Simon Fraser University and Indigenous community members and organizations in Surrey, British Columbia. In Metro Vancouver, Surrey saw the biggest increase in its Indigenous population, which grew 77 per cent between 2006 and 2016 to 13,460. This was a timely project given that community research partners were interested in focusing on health issues and that traditional health and social service models geared towards Indigenous populations tend to focus on on-reserve populations. Research objectives included: 1) to identify the health needs and priorities of Indigenous peoples in Surrey; 2) to determine what methodologies should be used when researching culture and health; and 3) to explore how existing data connected to Surrey’s Indigenous population can be accessed to better align research priorities with the health status of Indigenous peoples in Surrey. Data was gathered through two community talking circles (n=30) and one-to-one interviews with health and social service providers (n=12). Findings from the project included: the importance of culturally safe care and support in health and social service systems; the need for training and education among health and social service providers on the history and contemporary experiences of Indigenous peoples; and the importance of having access to Elder-led cultural teachings and land-based activities that support health and wellbeing of families and communities.

Tracing the Disparity Between Healthcare Policy-Based Infrastructure and Health Belief-Lead Practices: a Narrative Review on Indigenous Populations of India.

Most Indian tribes have limited access to healthcare facilities and rely heavily on traditional healing practices. This narrative review aimed to identify the disparities in the implementation of healthcare services and in accessing and availing these services by the indigenous population in India. We also have tried to throw light on the plausibility in strengthening the efficiency and efficacy of the public health system, by utilizing the available resources to its maximum potential, so that there will be a measurable outcome in the health status of these populations in India, coherently with the relevant sustainable development goals (SDG). The evidence from published literatures supports the fact that the disparity exists in the health status of indigenous populations in India as compared to the general populations. It emphasizes the need to address the key determinants such as the lack of knowledge, traditional healing practices and poor utilization of healthcare services provided to them. Various factors such as accessibility to healthcare resources, traditional healing practices, lack of awareness regarding healthcare services and schemes provided by the government, insufficient data regarding their issues and challenges and cultural and language barriers worsen the health status of indigenous people. However, our review reiterates that a well-structured and sustainable policy with reframed infrastructure and administration of healthcare system might bring a positive change in the health status of indigenous population in India.

Nutrition and Health Status of Indigenous Peoples (IPs) in the Philippines: Results of the 2013 National Nutrition Survey and 2015 Updating Survey

In the Philippines, there is little documentation about the population size of indigenous peoples (IPs) and more so on their health and nutrition status. This study aimed to address the gap in knowledge on the IPs’ nutrition and health status in the Philippines. Analysis of secondary data collected in the 8th National Nutrition Survey (NNS) 2013 and the 2015 Updating Survey of the Nutritional Status of Filipino Children and Other Population Groups conducted by the Department of Science and Technology–Food and Nutrition Research Institute (DOST-FNRI) was done. Face-to-face interviews, anthropometric measurements, blood extraction, urine collection, and blood pressure measurements were utilized as data collection methods. Findings illustrate that majority of the IPs belonged to the poorest and poor quintile, had low educational attainment, and were rural residents. The pervasive problem of undernutrition in the form of stunting and underweight was the most pronounced problem among children and adolescents. Overnutrition was prevalent among adults. Micronutrient deficiencies also exist in the form of anemia and iodine deficiency. There is also evidence of inadequate dietary consumption among the IPs. As evidenced by the results – compared with the non-IP individuals and households – the IP population was poorer, had a significantly higher prevalence of undernutrition and iodine deficiency, and had lower adequacy of energy and other nutrient intakes. On the other hand, the selected risk factors for non-communicable diseases such as hypertension, abdominal obesity, smoking, and alcohol consumption were more pronounced among non-IPs compared to the IPs. IPs remain a marginalized sector of society, making them highly vulnerable to the same persistent nutritional and health problems non-IPs experience. Therefore, culturally sensitive and appropriate interventions should be formulated to improve IPs’ nutrition and health status in the country.

Optimism and Health Self-Perception-Related Differences in Indigenous Kiwchas of Ecuador at Low and High Altitude: A Cross-Sectional Analysis

Ortiz-Prado, Esteban, Katherine Simbaña-Rivera, Diego Duta, Israel Ochoa, Juan S. Izquierdo-Condoy, Eduardo Vasconez, Kathia Carrasco, Manuel Calvopiña, Ginés Viscor, and Clara Paz. Optimism and health self-perception-related differences in indigenous Kiwchas of Ecuador at low and high altitude: a cross-sectional analysis. High Alt Med Biol. 23:26-36, 2022. Background: Living at high altitude causes adaptive responses at every physiological and molecular level within the human body. Emotional and psychological short- or long-term consequences, including mood changes, higher mental overload, and depression prevalence, as well as increased risk to commit suicide have been reported among highlanders. The objective of this report is to explore the differences in self-reported dispositional optimism and health perception among sex-, age-, and genotype-controlled indigenous Kiwcha natives living at two different altitudes. Methods: A cross-sectional analysis of the comparison of means of subscales and summary scores of the 36-item short-form health survey (SF-36) self-reported questionnaire and the Life Orientation Test-Revised was conducted among 219 adults Kiwchas living at low (230 m) and high altitude (3,800 m) in Ecuador. Results: High-altitude dwellers presented lower scores in all the studied dimensions of SF-36 and the total score. Differences were found for the role limitation sphere due to vitality (p = 0.005), mental health (p = 0.002), and social functioning (p = 0.005). In all the cases, participants living at low altitudes scored higher than those living at high altitudes. Lowland women were more optimistic than their high-altitude counterparts. Conclusions: We observe that populations located at high altitudes have more unfavorable self-reported health states. Although our results depict the existence of significant differences in the health status of indigenous peoples living at different altitudes, further studies are needed to explain in depth the sociodemographic and/or environmental factors that might underlie these differences.

Mental health and well-being of indigenous people during the COVID-19 pandemic in Bangladesh

BackgroundThe ongoing pandemic caused by the novel coronavirus and the subsequent containment strategies has taken a heavy toll on the mental health of people irrespective of age, gender, race, ethnicity, and geographical location. Studies have documented the mental health status of non-indigenous Bangladeshi people, but little attention has been paid during the pandemic to the investigation of the mental health status of indigenous people living in remote hilly areas. To address this gap the present study aimed at investigating the prevalence and accompanying risk factors of depression, anxiety, stress, and compromised well-being among indigenous people during the pandemic. MethodsA cross-sectional survey was conducted on 422 indigenous people aged between 16 and 90 using the 21-item Bangla Depression Anxiety Stress Scale (BDASS-21) and the Bangla version of the WHO-5 Well-being Index from January 30 to April 10, 2021. Data were collected by trained research assistants from three remote hilly areas namely Bandarban, Rangamati, and Khagracchari in the Chattogram Hill Tracts (CHT). Chi-squares, logistic regression, and ANOVA were performed to examine the association of variables. ResultsThe prevalence of moderate to extremely severe depression, anxiety, stress, and low well-being among the indigenous population during the pandemic was found to be 49.3%, 47.2%, 36.7%, and 50.9%, respectively. Risk predictors for depression, anxiety, and stress included age, ethnicity, geographical locations, educational attainment, occupation, and marital status. ConclusionsThe results suggest that the ongoing pandemic has led to the rise of common mental health problems among indigenous people during the pandemic. The results can contribute to the formation of mental health policy for indigenous people and the development of suitable mental health intervention strategies especially during and after the COVID-19 pandemic.

What Determines Indigenous Peoples’ Mental Health Awareness? A Descriptive Cross-Sectional Study From Nawalpur District

Background: The health status of indigenous people including Tharu is very poor. Despite several studies on indigenous communities, no previous studies were found about mental illness and its awareness among the Tharu people in Nepal. Objectives: This study aims to find out the awareness of mental illness among adults of the Tharu community. Within the objective the present study specific to identify the level of awareness on mental illness and to identify an association between selected socio-demographic characteristics and level of awareness on mental illness. Method: The study was based on the descriptive cross-sectional design and was conducted in 3, 4, 6, 8, and 15 wards of the Madhyabindu municipality of Nawalpur District as the majority of the Tharu's household are located in these wards. This research administered a structured questionnaire to assess awareness of Tharu adults on mental illness. Data were collected in September and October 2018. The collected data were analyzed by using descriptive statistical methods where the researcher calculated mean, standard deviation, percentage, and frequency. Chi-square test was used for inferential statistics.Result: Our analysis revealed that the socioeconomic status of the Tharu community is based on agriculture. The overall level of awareness of respondents, 35.5 % had adequate awareness of mental illness whereas 34 % had moderate awareness and 30.5 % respondents had inadequate awareness of the mental illness. The level of awareness of mental illness is statistically significant with the age of respondents, gender, marital status, education status, and occupation status. Conclusion: Based on the findings of the study, it concluded that nearly one-third of Tharu adults have an adequate level of awareness regarding mental illness. Further, the awareness level of Tharu adults tends to vary according to age, sex, education, occupation, and marital status.Implication: The findings of this study imply that mental awareness among the indigenous community is still low and the findings of the study could be used by a mental health organization to plan and implement mental health-related awareness programs in an indigenous community.

Rates of new HIV diagnoses among Indigenous peoples in Canada, Australia, New Zealand, and the United States: 2009-2017.

To compare rates and trends of HIV diagnoses among Indigenous peoples in Canada (First Nations, Métis, Inuit, and other non-specified), Australia (Aboriginal and Torres Strait Islanders), the USA (American Indian, Alaska Native, Native Hawaiian, and Other Pacific Islanders), and New Zealand (Māori). We employed publicly available surveillance data from 2009 to 2017 to estimate the rate per 100 000 of HIV diagnoses. Estimated annual percentage change (EAPC) in diagnosis rates was calculated using Poisson regression. The four countries have passive population-based HIV surveillance programs. Population estimates from respective census programs were used as rate denominators. Estimated annual HIV diagnosis rate per 100 000 and EAPC were calculated for total Indigenous peoples, women, and men. As of 2017, rates of HIV were highest in Canada (16.22, 95% confidence interval (CI): 14.30--18.33) and lowest in New Zealand (1.36, 95% CI: 0.65--2.50). Australia had a rate of 3.81 (95% CI: 2.59--5.40) and the USA 3.22 (95% CI: 2.85--3.63). HIV diagnosis rates among the total Indigenous population decreased in Canada (-7.92 EAPC, 95% CI: -9.34 to -6.49) and in the USA (-4.25 EAPC, 95% CI: -5.75 to -2.73) but increased in Australia (5.10 EAPC, 95% CI: 0.39--10.08). No significant trends over time were observed in New Zealand (2.23 EAPC, 95% CI: -4.48 to 9.47). Despite limitations to conducting cross-national comparisons, there are substantial differences in HIV diagnosis rates in these four countries that may be reflective of divergent national policies and systems that affect the health status of Indigenous peoples.

Acute health care among Indigenous patients in Canada: a scoping review

ABSTRACT A recent report by the Chief Public Health Officer of Canada demonstrates the inferior health status of Indigenous Peoples in Canada when compared to non-Indigenous populations. This scoping review maps out the available literature concerning acute health care for Indigenous Peoples in Canada in order to better understand the health care issues they face. All existing articles concerning health care provided to Indigenous Peoples in Canada in acute settings were included in this review. The targeted studied outcomes were access to care, health care satisfaction, hospital visit rates, mortality, quality of care, length of stay and cost per hospitalisation. 114 articles were identified. The most studied outcomes were hospitalisation rates (58.8%), length of stay (28.0%), mortality (25.4%) and quality of care (24.6%) Frequently studied topics included pulmonary disease, injuries, cardiovascular disease and mental illness. Indigenous Peoples presented lower levels of satisfaction and access to care although they tend to be over-represented in hospitalisation rates for acute care. Greater inclusion of Indigenous Peoples in the health care system and in the training of health care providers is necessary to ensure a better quality of care that is culturally safe for Indigenous Peoples.

Anxiety and depression in two indigenous communities in Bangladesh.

The mental health status of indigenous people in Bangladesh has attracted little or no attention. The objective of the present study is to determine the extent of symptoms of anxiety and depression in the two largest indigenous communities in Bangladesh. In total, 240 participants were recruited, 120 from each of the Marma and Chakma communities with an overall mean age of 44.09 years (s.d. 15.73). Marma people were older (mean ages 48.92 v. 39.25, p < 0.001). Participants completed the Anxiety Scale (AS) and Depression Scale (DS) that have been developed and standardised in Bangladesh in the Bangla (Bengali) language. Results indicated that anxiety and depression scores were elevated in both communities, 59.2% of the participants scoring above the cut-off for clinical significance on AS and 58.8% of the participants scoring above the cut-off for clinical significance on DS. Marma people compared to Chakma people were more anxious (M = 59.49 v. 43.00, p < 0.001) and more depressed (M = 106.78 v. 82.30, p < 0.001). The demographic variables of age, sex and socioeconomic status were weakly or inconsistently related to scores. In the Marma people, females scored higher on both AS and DS, but in the Chakma community, males scored higher on AS and the same on DS. The finding of significant anxiety and depression in communities with such limited mental health services is a matter of concern and emphasises the need to formulate and implement appropriate mental health policies for indigenous people in Bangladesh and other parts of the world.

Characteristics of Indigenous adults with poorly controlled diabetes in north Queensland: implications for services.

BackgroundIndigenous Australian adults with diabetes continue to have suboptimal clinical control and poorer outcomes compared with non-Indigenous people although there is a paucity of data documenting the detailed health status of Indigenous people in Australia. To further investigate the characteristics of Indigenous Australian adults with poorly controlled diabetes we analysed baseline data from a cluster randomized trial aiming to deliver a program of integrated community-based intensive chronic disease management for Indigenous people in remote communities in far north Queensland, Australia.MethodsIndigenous adults aged 18 to 65 years from 12 clinics in rural north Queensland with established type 2 diabetes and with HbA1c ≥8.5% were invited to participate. The primary outcome variable measured at baseline was HbA1c. Other variables measured included socio-demographic indicators, health literacy, BMI, blood pressure, lipids, renal function, smoking status and quality of life measures. Data were collected between December 2010 and July 2011. Analysis was performed by ethnicity – Aboriginal or Torres Strait Islander.ResultsOne hundred and ninety three participants were included in the analysis. Very high rates of albuminuria, high rates of smoking, dyslipidaemia, hypertension and elevated BMI were recorded. Aboriginal participants reported higher levels of socio-economic disadvantage, higher smoking rates, lower BMI and worse self-reported health status than Torres Strait Islander participants.ConclusionThese results demonstrate a high potential for improved culturally sound community-based management of diabetes and other comorbid conditions in this very high risk population. They also provide further evidence for including albuminuria in cardiovascular risk calculation.

Psychogenetic Markers of Alcoholism Among Indigenous People From Far East of Russia

Introduction There is a sharp deterioration in the health status of indigenous people associated with alcoholism from Far East of Russia. Objective To study psychogenetic markers of alcoholism among young indigenous people 15-21 ages from Far East of Russia Material and Methods 40 people from the research group with the Mongoloid phenotype dependent on alcohol at the age of 15-21 years. 40 people from the comparative group with European phenotype dependent on alcohol at the age of 15-21 years. Our methods are clinical and psychopathological, psychological, DNA extraction, PCR, statistical. Results We have found that in the study group, the level of inactive form of alcohol dehydrogenase is much higher than in the comparative group and is about 0.38 + _ 0.065 and 0.11 + _0,02 at p Conclusion The distribution of psychogenetic markers in populations of the study group had significant differences. The markers ADH2, OPRM1, DAT2 determine the propensity to alcoholism. The detection rate of markers ADH2, OPRM1, DAT2 among indigenous people from the Far East is much higher than in the European population.

Self‐rated health status in an urban indigenous primary care setting: implications for clinicians and public health policy

Self-rated health status provides insights into the health beliefs of a population. This will be important for framing public health messages in the context of the need to 'close the gap' for Australian Indigenous people. Our primary objectives were to describe the self-rated health status of Indigenous people attending the Inala Indigenous Health service, identify associations with positive and negative self-rated health status and identify targets for public health awareness raising activity. Using a convenience sample, we approached all Indigenous patients attending the Inala Indigenous Health Service for an Indigenous adult health check between June 2007 and July 2008. From Indigenous adult health check data we analysed self-rated health status and chronic disease risk factors. Out of a possible 509, 413 patients were recruited (response rate 81%). The number of participants who rated their health as fair or poor was 47%. The association of greatest magnitude and statistical significance with Indigenous patients' self rated health status (negative versus positive) was waist circumference followed by smoking, depression and age. Chronic disease risk factors not associated with self-rated health status included systolic blood pressure, harmful alcohol use, marijuana use, presence of diabetes and lack of exercise. High rates of negative self-rated health status were found. Public health awareness-raising for Indigenous audiences should consider targeting chronic disease risk factors such as systolic blood pressure, harmful alcohol use, marijuana use, presence of diabetes and lack of exercise.

Indigenous well-being in four countries: an application of the UNDP'S human development index to indigenous peoples in Australia, Canada, New Zealand, and the United States.

BackgroundCanada, the United States, Australia, and New Zealand consistently place near the top of the United Nations Development Programme's Human Development Index (HDI) rankings, yet all have minority Indigenous populations with much poorer health and social conditions than non-Indigenous peoples. It is unclear just how the socioeconomic and health status of Indigenous peoples in these countries has changed in recent decades, and it remains generally unknown whether the overall conditions of Indigenous peoples are improving and whether the gaps between Indigenous peoples and other citizens have indeed narrowed. There is unsettling evidence that they may not have. It was the purpose of this study to determine how these gaps have narrowed or widened during the decade 1990 to 2000.MethodsCensus data and life expectancy estimates from government sources were used to adapt the Human Development Index (HDI) to examine how the broad social, economic, and health status of Indigenous populations in these countries have changed since 1990. Three indices – life expectancy, educational attainment, and income – were combined into a single HDI measure.ResultsBetween 1990 and 2000, the HDI scores of Indigenous peoples in North America and New Zealand improved at a faster rate than the general populations, closing the gap in human development. In Australia, the HDI scores of Indigenous peoples decreased while the general populations improved, widening the gap in human development. While these countries are considered to have high human development according to the UNDP, the Indigenous populations that reside within them have only medium levels of human development.ConclusionThe inconsistent progress in the health and well-being of Indigenous populations over time, and relative to non-Indigenous populations, points to the need for further efforts to improve the social, economic, and physical health of Indigenous peoples.

Town or country: which is best for Australia's Indigenous peoples?

Some commentators suggest that the poor health of Australia's Indigenous population is due to misguided ideology-driven policy that has forced people to live in remote communities, preventing them from benefiting from the mainstream economy. The evidence shows that the poor health status of Indigenous people is found in all areas where they live and that, on some indicators, living in remote areas has health benefits. Government policies aimed at relocating Indigenous people from their traditional lands are not supported by evidence, and may further entrench Indigenous disadvantage.

Research ethics, reconciliation, and strengthening the research relationship in Indigenous health domains: An Australian perspective

Australia has one of the best health care systems in the world. Despite this, the health of Indigenous Australians remains poor in comparison to non-Indigenous Australians and in comparison to other Indigenous peoples in other developed countries, such as Canada, the USA and New Zealand. Although the disparities in Indigenous health are the result of a complex array of interacting social and political processes, the historical failings of the nation's research endeavours to directly benefit the health status of Indigenous peoples are bring increasingly implicated in the status quo. Because of their shared memories of past bad experiences, Indigenous communities are profoundly distrustful of non-Indigenous health researchers. As a result of this distrust, opportunities to improve the performance, accountability and benefits of health research in Indigenous health domains are being lost—to the further detriment of the health of Indigenous peoples. In an attempt to redress this distrust and strengthen the research relationship in Indigenous health domains, various national research ethics guidelines and frameworks have been developed. It is evident, however, that if the research relationship in Indigenous health domains is to be improved, researchers need to do much more than merely uphold prescribed rules and guidelines. This article contends that if the research relationship in Indigenous health is to be strengthened, health researchers must also engage in the distinctive political processes of ‘recognition’ and ‘reconciliation’. In support of this contention, the processes of recognition and reconciliation are described, and their importance to improving the overall performance, accountability and benefits of Indigenous health research explained.

The Centre of Clinical Research Excellence in Aboriginal and Torres Strait Islander Health: An Operational Rationale and Some Reflections on Progress so far

The Centre of Clinical Research Excellence (CCRE) in Aboriginal and Torres Strait Islander Health was established in late 2003 through a major National Health and Medical Research Council (NHMRC) grant involving collaboration between the Aboriginal Health Council of South Australia (AHCSA), Flinders University, and Aboriginal Health Services. Our foundation research communities are the Aboriginal communities served by these Aboriginal Health Services in the Spencer Gulf / Eyre Peninsula region. In recent years a number of collaborative research programs involving chronic illness management, self-management and coordinated care have been implemented in these communities and this work is the basis of the initial CCRE activities. Key objectives of the CCRE are to improve the health status of Indigenous people through conducting relevant and meaningful Aboriginal controlled health research, providing formal training for Indigenous health researchers and developing innovative approaches to health care that can be readily translated and applied to support communities. The inclusion, empowerment and engagement of Indigenous people in the process of managing community health represent tangible strategies for achieving more equitable health outcomes for Aboriginal people. This paper outlines the CCRE operational rationale and presents early activities and outcomes across the three strategic areas of CCRE operations: research, education and training, and translation. Some critical reflections are offered on the progress and experience of the CCRE thus far. A common obstacle this CCRE has encountered is that the limited (especially staff) resources available to the Aboriginal Health Services with which we are collaborating make it difficult for them to engage with and progress the projects we are pursuing.

The development of a national bicultural and interprofessional programme in clinical teaching and supervision in New Zealand

Throughout the world, particularly in colonized countries, the health status of indigenous people and the unequal representation of indigenous people within the health workforce is of concern. In 2002, as part of a national health workforce development strategy, a qualification was developed to provide Maori (Indigenous New Zealander) health professionals with the skills and confidence to teach and supervise students on clinical placements in Maori health environments. This project required close collaboration between two education providers, one a Maori private education provider and the other a traditional government-funded tertiary institution; and for both organizations to work cooperatively with Maori communities and Maori health providers. The Christchurch College of Education (CCE) and Mauri Ora Associates are jointly involved in the administration, design and delivery of the programme, recruitment of guest lecturers, and ongoing curriculum updates. The content for the programme is mainstream, international and interprofessional but the pedagogy is Maori, with Maori customs, values and traditions upheld and practised. A national Maori health workforce development organization contracts independently with both organizations and provides an oversight and quality monitoring role. Together, the three organizations work with other Maori health professional groups and Maori elders to deliver the qualification. This paper describes how this course was designed, how it is delivered within a Maori paradigm, and how the outcomes are achieved. It also describes the cooperation between Maori and Pakeha (white New Zealanders) across health, community and educational organizations that was required to sustain this programme over five years and identifies some themes that may be applied in a global context. In sharing our experiences, we hope to inspire others to consider ways they can meet the needs of indigenous learners within their mainstream programmes.

Meeting the challenges of recruitment and retention of Indigenous people into nursing: outcomes of the Indigenous Nurse Education Working Group

It has been recognised internationally that increasing the number of Indigenous people working as health professionals is linked to the improved health status of Indigenous people. When comparing Australian Indigenous and non-Indigenous populations, Indigenous people continue to have poorer health standards and are much less likely to be involved in employment in health professions than other Australians. In 2000, the Indigenous Nurse Education Working Group (INEWG) was formed by government with the mandate to work collaboratively with universities and important professional nursing bodies across the nation in an attempt to increase the number of Indigenous registered nurses and to prepare nursing graduates with better understanding of, and skills to assist with, Indigenous health issues. This paper describes the work of the INEWG from 2000 to mid-2003; firstly in developing and implementing strategies aimed at increasing the recruitment and retention of Indigenous people into undergraduate nursing programs; and secondly by helping university schools of nursing increase faculty and student understanding of Indigenous culture, history and health issues through educational processes. Lastly, it summarises the INEWG's 2002 recommendations to achieve a higher rate of Indigenous participation in nursing. The results of research into the success of these recommendations will be the subject of a later paper.

Outcomes of Cardiac Surgery in Aboriginal Australians: What are the Problems and What?s to be Done?

Cardiac disease is an unremitting catastrophe for Aboriginal Australians, both in terms of excess morbidity and premature mortality. 1. Walsh W.F Cardiovascular health in Indigenous Australians: a call for action. Med. J. Aust. 2001; 175: 351-352 PubMed Google Scholar The enormous burden of ischaemic heart disease is actually increasing and rates of rheumatic heart disease remain among the highest reported anywhere. 2. Carapetis J.R Currie B.J Preventing rheumatic heart disease in Australia. Med. J. Aust. 1998; 168: 428-429 PubMed Google Scholar This is in stark contrast to trends in non-Aboriginal Australians and minority Indigenous peoples of Canada, the US and New Zealand where morbidity and mortality differentials between Indigenous and non-Indigenous populations are converging. 3. Paradies Y Cunningham J Placing Aboriginal and Torres Strait Islander mortality in an international context. Aust. NZ J. Public Health. 2002; 26: 11-16 Crossref PubMed Scopus (44) Google Scholar , 4. Ring I Brown N The health status of indigenous peoples and others. Br. Med. J. 2003; 327: 404-405 Crossref PubMed Scopus (97) Google Scholar Aboriginal Australians have poor outcomes at every point along the way, ranging from failure of basic preventative measures and primary care at the community level through to cardiac surgery and post-surgery rehabilitation.

The nurse’s role in improving indigenous health

The health status of indigenous peoples is a global concern with mortality and hospitalisation data indicating that the health of indigenous groups falls below that of other ethnic groups within their countries.The preliminary findings of grounded theory research project undertaken with a group of 23 New Zealand Maori women about their health priorities and ‘mainstream’ health service needs provide the foundation for an exploration of issues impacting on the health status of indigenous people.The role that nursing and nurses have in improving access and use of health services by indigenous people will be discussed. Strategies are suggested that nurses can utilise within their practice when working with local indigenous groups.