Torres Strait Islander Origin Research Articles

Comparing PCSK9 inhibitor prescription rates within high-risk populations: diabetes mellitus, multi-territory vascular disease, multivessel and recurrent coronary artery disease

Abstract Background Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors are subsidised in Australia for treatment of hypercholesterolemia in particularly high-risk patients with atherosclerotic cardiovascular disease (ASCVD). These high-risk groups are defined as: diabetes mellitus (with age≥60, Aboriginal or Torres Strait Islander origin or microalbuminuria), recurrent ASCVD (≥2 events within 5 years), multivessel coronary disease (≥50% stenosis in ≥2 large vessels) and multi-territory vascular disease (concurrent cerebrovascular or peripheral vascular disease). Methods A retrospective observational analysis was conducted on high-risk patients with LDL>2.6 admitted to a quaternary hospital with ASCVD between 2020-2022. Australian Pharmaceutical Benefits Scheme (PBS) criteria was applied to assess and compare PCSK9 inhibitor eligibility and prescription rates within high-risk populations. Results In total, 477 ASCVD patients with LDL>2.6 were included. This was further categorised into: multivessel coronary disease (n=239, 50.1%), diabetes mellitus (n=60, 12.6%), recurrent ASCVD (n=55, 11.5%) and multi-territory vascular disease (n=32, 6.7%), p<0.001. When 2020 PBS criteria was applied, the number of eligible patients were 16/239 (6.7%), 5/60 (8.3%), 13/55 (23.6%) and 4/32 (12.5%) respectively, p=0.002. Of PBS eligible patients, the number prescribed PCSK9 inhibitors were: 7/16 (43.8%) for multi-vessel coronary disease, 1/5 (20%) for diabetes mellitus, 4/13 (30.8%) for recurrent ASCVD and 1/4 (25%) for multi-territory vascular disease patients (p=0.73). Conclusion Although there was a significantly higher prevalence and proportion of eligible multivessel coronary disease patients, prescribing rates for PCSK9 inhibitor therapy remain low amongst all high-risk eligible groups including diabetes mellitus, multi-territory vascular disease, multivessel and recurrent coronary artery disease.

Disproportionate mental health presentations to emergency departments in a coastal regional community in Australia of first nation people.

Emergency department (ED) presentations for mental health (MH) help-seeking have been rising rapidly in recent years. This research aims to identify the service usage demographic for people seeking MH care in the ED, specifically in this case, to understand the usage by First Nation people. This retrospective cohort study examined the sociodemographic and presentation characteristics of individuals seeking MH care in two EDs between 2016 and 2021. Data were collected using existing records and analysed using descriptive univariate analysis with statistical significance between the two sites determined using chi-squared test, p < 0.05. The overall data presented in this analysis show an overall ED mental health presentation rate of 12.02% for those who identified as 'Aboriginal but not Torres Strait Islander origin', 0.36% as 'Both Aboriginal and Torres Strait Islander' and 0.27% as 'Torres Strait Islander' totalling 12.63%. This is an overrepresentation compared to the regional population of 4.9%. One site recorded 14.1% of ED presentations that identified as Aboriginal and/or Torres Strait Islander, over double the site's demographic of 6.3%. Given the disproportionately high representation of First Nation people in MH-related ED presentations, further research is required to prioritise a First Nation research perspective that draws on First Nation research methods, such as yarning and storytelling to understand the unique cultural needs and challenges experienced by First Nation people accessing MH care via ED. Understanding the demographic is but one step in supporting the Cultural Safety needs of First Nation people. Additionally, research should be designed, governed and led by First Nation researchers.

The impact of changes in opioid dependency treatment upon COVID-19 transmission in Sydney, Australia: a retrospective longitudinal observational study

BackgroundIn April 2020, in response to the COVID-19 public health emergency, South Eastern Sydney Local Health District (SESLHD) Drug and Alcohol services modified their delivery of opioid dependency treatment (ODT) to reduce spread of COVID-19 and maintain continuity of care by increasing use of takeaway doses (TADs), transferring clients to local community pharmacies for dosing and encouraging the use of long-acting depot buprenorphine (LADB) which enabled once a month dosing.MethodsThis study was a retrospective longitudinal case–control study conducted from August 1st, to November 30th, 2021. Eligible clients were those admitted for treatment with SESLHD ODT Services prior to August 1st,2021 and who remained in treatment beyond November 30th, 2021. COVID-19 diagnoses were determined by a COVID-19 PCR and extracted from the electronic Medical Records (eMR) Discern Reporting Portal. Demographic, clinical and dosing related data were collected from eMR and the Australian Immunisation Register (AIR).ResultsClients attending SESLHD ODT services had significantly greater odds of acquiring COVID-19 than the NSW adult population at large (OR: 13.63, 95%CI: 9.64,18.88). Additionally, amongst SESLHD ODT clients, being of Aboriginal and Torres Strait Islander origin was associated with greater odds of acquiring COVID-19 (OR = 2.18, CI: 1.05,4.53); whilst being employed (OR = 0.06, CI:0.01,0.46), receiving doses at pharmacy (OR = 0.43, CI: 0.21,0.89), and being vaccinated (OR = 0.12, CI: 0.06,0.26) were associated with lower odds. Every additional day of attendance required for dosing was associated with a 5% increase in odds of acquiring COVID-19 (OR = 1.05, CI: 1.02,1.08).ConclusionsClients attending SESLHD ODT services are significantly more likely to acquire COVID-19 than the NSW population at large. Promoting vaccination uptake, transferring clients to pharmacy, and reducing the frequency of dosing (by use of takeaway doses or long-acting depot buprenorphine) are all potential methods to reduce this risk.

Characterising variability in youth mental health service populations: A detailed and scalable approach using digital technology.

This study utilised digital technology to assess the clinical needs of young people presenting for care at headspace centres across Australia. 1490 young people (12-25years) who presented to one of 11 headspace services from four geographical locations (urban New South Wales, urban South Australia, regional New South Wales, and regional Queensland) completed a digital multidimensional assessment at initial presentation. Characteristics were compared between services and geographical locations. We identified major variation in the demographics, and the type and severity of needs across different services. Individuals from regional services were more likely to be younger, of Aboriginal and Torres Strait Islander origin, and present with psychotic-like symptoms and suicidality, while those in urban areas were more likely to have previously sought help and have problematic alcohol use. Further differences in age, distress, depressive symptoms, psychotic-like experiences, trauma, family history, alcohol use, education/employment engagement, and days out of role were identified between different urban sites. The variability between services provides insight into the heterogeneity of youth mental health populations which has implications for appropriate early intervention and prevention service provisions. We propose that integrating digital technologies has the potential to provide insights for smarter service planning and evaluation.

Emergency Department Assessment of Suspected Acute Coronary Syndrome Using the IMPACT Pathway in Aboriginal and Torres Strait Islander People

The Improved Assessment of Chest pain Trial (IMPACT) pathway is an accelerated strategy for the assessment of emergency patients presenting with suspected acute coronary syndrome (ACS). The objective of this study was to report outcomes for Aboriginal and Torres Strait Islander patients deemed low-, intermediate-, or high-risk according to this pathway. This was a prospective observational trial conducted between November 2017 and December2019. Regional hospital in Far North Queensland. Aboriginal and Torres Strait Islander people presenting to the Emergency Department with suspected ACS were asked to participate. Participants were stratified as low-, intermediate- or high-risk of ACS according to the IMPACT pathway. High-and intermediate risk patients were managed according to the IMPACT pathway. Management of low-risk patients included additional inpatient cardiac testing, which was not part of the original IMPACT pathway. The primary outcome was acute coronary syndrome within 30-days. Secondary outcomes included length of stay and prevalence of objective testing. A total of 155 participants were classified as either at low-risk (n=18 11.6%), intermediate-risk (n=87 56.1%), or high-risk (n=50 32.3%) of ACS. Thirty-day (30-day) ACS occurred in 29 (18.6%) patients, which included 26 (52.0%) high-risk patients and three (3.4%) intermediate-risk patients. No patients in the low-risk group were diagnosed with ACS during their index presentation or by 30-days. Median hospital length-of-stay was 11.9 hours (interquartile range [IQR] 5.3-20.2 hrs) for low- and 15.5 hours (IQR 5.9-29.2 hrs) for intermediate-risk patients. The IMPACT pathway, which has been associated with reduced LOS in other settings, could be safely implemented for patients of Aboriginal and Torres Strait Islander origin, classifying two-thirds as low- or intermediate risk. However, a clinically significant proportion of Aboriginal and Torres Strait Islander patients experience cardiac events, which supports the need to provide early objective testing for coronary artery disease.

Medical decision making using knowledge of patient identification as Aboriginal or Torres Strait Islander: what do medical students think?

Objective Best-practices guidelines require Australian health practitioners to ask all patients “are you [is the person] of Aboriginal and/or Torres Strait Islander origin?”. The present study investigated medical student attitudes regarding medical decisions made after asking this standard status question. Methods A hypothetical interaction between a doctor and an Aboriginal patient was presented in a pen-and-paper questionnaire in which: (1) the doctor considered (or did not consider) the patient’s Indigenous status relevant to make a medical diagnosis, and (2) the doctor registered (or did not register) the patient for the Closing the Gap PBS co-payment. Participants were first- and second-year medical students at the Australian National University who evaluated the doctor’s decisions against 20 attributes characterising professionalism and prejudice. Results Students evaluated the doctor more favourably when the doctor registered the patient for the co-payment and when the doctor did not consider Indigenous status relevant to making a medical diagnosis. Conclusions Encouragingly, medical students recognise that withholding registration for the co-payment is unprofessional. At the same time, medical students clearly do not think medical diagnoses should be made using the knowledge a patient identifies as Aboriginal. Implications With the continual development of policy and guidelines (and the prospect of diagnostic guidelines) to improve Aboriginal and Torres Strait Islander health, students and practitioners must understand how to use this knowledge of a patient’s status to benefit health outcomes.

Adequacy of antenatal steroids, rather than place of birth, determines survival to discharge in extreme prematurity in North Queensland.

The Townsville Hospital cares for babies in a large geographical area, many of who are outborn, are of Aboriginal or Torres Strait Islander origin and have families who reside in areas of deprivation. This study examined the outcomes of babies born at all locations in North Queensland to assess the predictors of poor outcomes. A retrospective observational study examined the survival of 313 babies born from 22 completed weeks gestation to 27 + 6 weeks gestation in North Queensland between January 2010 and December 2016. Additional analyses were performed for the 300 non-syndromal babies whose mothers usually resided in North Queensland, studying demographics of gestation, gender, birthweight, Indigenous status, regionality of maternal residence and adequacy of antenatal steroids. Short-term morbidities of intraventricular haemorrhage/periventricular leukomalacia (IVH/PVL), surgical necrotizing enterocolitis, retinopathy of prematurity requiring treatment and chronic lung disease and death were studied in relation to demographic factors and clinical treatment. Adequacy of steroids was significantly associated with a decreased mortality odds ratio of 2.872 (95% confidence interval 1.228-6.715), whilst no difference in outcome was seen by retrieval status or ethnic origin. Babies from remote locations were at increased risk for IVH/PVL, 2.334 (1.037-5.255). Male babies suffered more chronic lung disease, 1.608 (1.010-2.561), and IVH/PVL, 2.572 (1.215-5.445). Aboriginal and Torres Strait Islander babies were at lower risk of IVH/PVL. Steroids should be administered wherever there is any possibility of the provision of intensive care for periviable babies. Place of birth and ethnicity of mother should not unduly influence antenatal counselling.

Health-related quality of life among Indigenous Australians diagnosed with cancer.

Health-related quality of life (HRQoL) and associated factors were assessed among 155 Indigenous Australian adult cancer patients 6months post-diagnosis. The Assessment of Quality of Life-4D Questionnaire was used to assess HRQoL. Differences in the median utility score among subgroups of interest were examined using nonparametric tests. Factors associated with excellent HRQoL were assessed through logistic regression. Participants' mean age was 52years (range 20-78), and the majority were female (60%), unemployed (72%), and recruited from outpatients clinics (64%). Breast cancer (27%) was the most common diagnosis. The median HRQoL score was 0.62; 14% of participants reported excellent HRQoL (>0.90). After adjusting for age, admission status, and treatment, excellent HRQoL was more likely among participants of Torres Strait Islander origin [adjusted odds ratio (AOR) 3.68; 95% CI 1.23-11.01], those living in regional areas (AOR 5.59; 95% CI 1.42-22.06), and those whose main language spoken at home was not English (AOR 3.60; 95% CI 1.08-11.99) and less likely among those reporting less contact with Indigenous people (AOR 0.23; 95% CI 0.68-0.81). Assessing HRQoL is important to identifying and improving the length and quality of cancer survivorship, especially in groups that have significantly poorer cancer outcomes, such as Indigenous Australians. Acknowledging the study's observational nature, we found HRQoL was lower than reported for other Australians, and we identified some socio-demographic factors that were associated with excellent HRQoL. Such assessments are an important component of identifying and evaluating appropriate interventions to improve the health and well-being of Indigenous cancer patients.

P04.15 Sexual behaviour, sti testing and diagnosis down under: findings from the second australian study of health and relationships (ashr2)

Background In recent years, the number of sexually transmissible infections (STIs) has skyrocketed in Australia and cause a considerable burden on public health. The association between STIs and sexual behaviour is well-established in high-risk populations but information about the general population is less well-known. ASHR2 provides population-based data about the sexual health and practices of Australians. This analysis examines the associations between STIs and sexual behaviour. Methods Computer-assisted telephone interviews were conducted with a random sample of the Australian population aged 16–69. Participants were surveyed about their sexual behaviour and experiences with STIs. Responses were weighted based on study design, location, and the age and sex distribution of Australia. Univariate logistic regression was used to determine the associations between sexual behaviour, testing history and diagnosis. Results A total of 20 094 men and women were interviewed, with an overall participation rate of 66.2%. A higher proportion of women (17.3%) were tested than men (13.2%) in the past year. Men and women were more likely to have been tested in the past year if they identified as bisexual (or homosexual for men), were of Aboriginal and/or Torres Strait Islander origin, had >1 partner in the past year, had a previous STI and had ever injected drugs. In the year prior to being interviewed, 1.1% of men and 2.7% of women reported having an STI. Diagnosis was associated with having >1 partner in the past year, sex work as a worker and having ever injected drugs for both men and women. For men, diagnosis was also associated with sex work as a client (OR = 3.14 [95% CI: 1.78–5.56]) while diagnosis in women was associated with receiving sex education at school (OR = 1.59[95% CI: 1.14–2.21]). Conclusion Australian women are tested more frequently for STIs and are diagnosed more frequently despite sharing similar associations for STIs as men. Disclosure of interest statement No conflict of interest.

Socio-economic predictors of performance in the Undergraduate Medicine and Health Sciences Admission Test (UMAT)

BackgroundEntry from secondary school to Australian and New Zealand undergraduate medical schools has since the late 1990’s increasingly relied on the Undergraduate Medicine and Health Sciences Admission Test (UMAT) as one of the selection factors. The UMAT consists of 3 sections – logical reasoning and problem solving (UMAT-1), understanding people (UMAT-2) and non-verbal reasoning (UMAT-3). One of the goals of using this test has been to enhance equity in the selection of students with the anticipation of an increase in the socioeconomic diversity in student cohorts. However there has been limited assessment as to whether UMAT performance itself might be influenced by socioeconomic background.MethodsBetween 2000 and 2012, 158,909 UMAT assessments were completed. From these, 118,085 cases have been identified where an Australian candidate was sitting for the first time during that period. Predictors of the total UMAT score, UMAT-1, UMAT-2 and UMAT-3 scores were entered into regression models and included gender, age, school type, language used at home, deciles for the Index of Relative Socioeconomic Advantage and Disadvantage score, the Accessibility/Remoteness Index of Australia (ARIA), self-identification as being of Aboriginal or Torres Strait Islander origin (ATSI) and current Australian state or territory of abode.ResultsA lower UMAT score was predicted by living in an area of relatively higher social disadvantage and lower social advantage. Other socioeconomic indicators were consistent with this observation with lower scores in those who self-identified as being of ATSI origin and higher scores evident in those from fee-paying independent school backgrounds compared to government schools. Lower scores were seen with increasing age, female gender and speaking any language other than English at home. Divergent effects of rurality were observed, with increased scores for UMAT-1 and UMAT-2, but decreasing UMAT-3 scores with increasing ARIA score. Significant state-based differences largely reflected substantial socio-demographic differences across Australian states and territories.ConclusionsBetter performance by Australian candidates in the UMAT is linked to an increase in socio-economic advantage and reduced disadvantage.This observation provides a firm foundation for selection processes at medical schools in Australia that have incorporated affirmative action pathways to quarantine places for students from areas of socio-economic disadvantage.

A prevalence study of children with imprisoned fathers: annual and lifetime estimates

In Australia, data are not routinely collected on the parental status of prisoners, so there are no official nationwide figures and few State‐based figures. The current study uses data collected in Queensland over a six‐month period to estimate how many Queensland children, in one year and in their entire childhood, experience paternal imprisonment. Additional data were collected relating to the provision of care for the child prior to, and during, their father's imprisonment. Participants were 303 imprisoned fathers (51 per cent of Aboriginal and/or Torres Strait Islander origin) who reported a total of 753 children. Using these data and population statistics, it was estimated that 0.8 per cent of children in Queensland experienced paternal imprisonment in one year while approximately four per cent experience paternal imprisonment in their lifetime. Indigenous children were nine times more likely to experience paternal imprisonment in one year and four times more likely to experience paternal imprisonment in their lifetime compared to non‐Indigenous children. Approximately half of the children (48 per cent) lived with their father prior to his imprisonment. Results are discussed in relation to whether children were living with their father as well as the possibility of pre‐existing risks in children's lives that may subsequently interact with their father's imprisonment.

Adjusting for under-identification of Aboriginal and/or Torres Strait Islander births in time series produced from birth records: Using record linkage of survey data and administrative data sources

BackgroundStatistical time series derived from administrative data sets form key indicators in measuring progress in addressing disadvantage in Aboriginal and Torres Strait Islander populations in Australia. However, inconsistencies in the reporting of Indigenous status can cause difficulties in producing reliable indicators. External data sources, such as survey data, provide a means of assessing the consistency of administrative data and may be used to adjust statistics based on administrative data sources.MethodsWe used record linkage between a large-scale survey (the Western Australian Aboriginal Child Health Survey), and two administrative data sources (the Western Australia (WA) Register of Births and the WA Midwives’ Notification System) to compare the degree of consistency in determining Indigenous status of children between the two sources. We then used a logistic regression model predicting probability of consistency between the two sources to estimate the probability of each record on the two administrative data sources being identified as being of Aboriginal and/or Torres Strait Islander origin in a survey. By summing these probabilities we produced model-adjusted time series of neonatal outcomes for Aboriginal and/or Torres Strait Islander births.ResultsCompared to survey data, information based only on the two administrative data sources identified substantially fewer Aboriginal and/or Torres Strait Islander births. However, these births were not randomly distributed. Births of children identified as being of Aboriginal and/or Torres Strait Islander origin in the survey only were more likely to be living in urban areas, in less disadvantaged areas, and to have only one parent who identifies as being of Aboriginal and/or Torres Strait Islander origin, particularly the father. They were also more likely to have better health and wellbeing outcomes. Applying an adjustment model based on the linked survey data increased the estimated number of Aboriginal and/or Torres Strait Islander births in WA by around 25%, however this increase was accompanied by lower overall proportions of low birth weight and low gestational age babies.ConclusionsRecord linkage of survey data to administrative data sets is useful to validate the quality of recording of demographic information in administrative data sources, and such information can be used to adjust for differential identification in administrative data.

Diabetes MILES-Australia (management and impact for long-term empowerment and success): methods and sample characteristics of a national survey of the psychological aspects of living with type 1 or type 2 diabetes in Australian adults

BackgroundSuccessful management of diabetes requires attention to the behavioural, psychological and social aspects of this progressive condition. The Diabetes MILES (Management and Impact for Long-term Empowerment and Success) Study is an international collaborative. Diabetes MILES--Australia, the first Diabetes MILES initiative to be undertaken, was a national survey of adults living with type 1 or type 2 diabetes in Australia. The aim of this study was to gather data that will provide insights into how Australians manage their diabetes, the support they receive and the impact of diabetes on their lives, as well as to use the data to validate new diabetes outcome measures.Methods/designThe survey was designed to include a core set of self-report measures, as well as modules specific to diabetes type or management regimens. Other measures or items were included in only half of the surveys. Cognitive debriefing interviews with 20 participants ensured the survey content was relevant and easily understood. In July 2011, the survey was posted to 15,000 adults (aged 18-70 years) with type 1 or type 2 diabetes selected randomly from the National Diabetes Services Scheme (NDSS) database. An online version of the survey was advertised nationally. A total of 3,338 eligible Australians took part; most (70.4%) completed the postal survey. Respondents of both diabetes types and genders, and of all ages, were adequately represented in both the postal and online survey sub-samples. More people with type 2 diabetes than type 1 diabetes took part in Diabetes MILES--Australia (58.8% versus 41.2%). Most respondents spoke English as their main language, were married/in a de facto relationship, had at least a high school education, were occupied in paid work, had an annual household income > $AUS40,000, and lived in metropolitan areas.DiscussionA potential limitation of the study is the under-representation of respondents from culturally and linguistically diverse backgrounds (including Aboriginal and Torres Strait Islander origin). Diabetes MILES--Australia represents a major achievement in the study of diabetes in Australia, where for the first time, the focus is on psychosocial and behavioural aspects of this condition at a national level.

Excess Risk of Stroke in Australia's Aboriginal and Torres Strait Islander Populations

See related article, page 1515–1521 There are an estimated ≈517 000 Aboriginal and Torres Strait Islander peoples in Australia, comprising ≈2.5% of the total population.1 The greatest proportion of this group (90%) identify themselves as being of Aboriginal origin.2 The remainder represent 6% of Torres Strait Islander origin, and 4% identify as being of both Aboriginal and Torres Strait Islander origin. Within each of these groups, often collectively called “Indigenous Australians,” there is a wide diversity of languages, culture, governance, community structure, geographic locality, and history. In the current issue of Stroke , Katzenellenbogen et al3 highlight the disparity in the burden of stroke between Indigenous Australians and non-Indigenous Australians in Western Australia, the largest state of Australia (2.5 million km2), in which ≈15% of all Indigenous Australians reside and, overall, where ≈2.2 million people live (10% of the total Australian population).4 Using a high-quality comprehensive health data linkage system, these authors have found that when compared to non-Indigenous Australians, the incidence rate of stroke in Indigenous Australians was 2.6-fold in men and 3.0-fold in women. Similarly, disability-adjusted life-years were also greater in Indigenous Australians, being ≈3.2-fold that of …

Are baby boomers booming too much?: An epidemiological description of overweight and obese baby boomers

To provide a social, demographic, and health-related description of overweight and obese baby boomers (born between 1946 and 1964). Data were collected using a monthly chronic disease and risk factor surveillance system in which a representative random sample of South Australians are selected from the Electronic White Pages each month and interviewed using computer assisted telephone interviewing (CATI). In 2006-2007, 65% of baby boomers in South Australia were overweight or obese, and 26% were obese. There were statistically significant increases in both categories between 2002 and 2007. In 2006-2007, the overweight or obese groups were significantly different on a wide range of social, demographic and health-related variables when compared to their non-overweight peers at the univariate level. In the multivariate analysis the obese group was more likely to have risk factors (high blood pressure, insufficient exercise) and chronic disease (diabetes, asthma, arthritis). They were also more likely to be in lower socio-economic areas, to be of Aboriginal or Torres Strait Islander origin and have lower levels of education. Addressing the high rates of overweight and obesity within the baby boomers generation should be a policy priority. As this generation moves towards old age the significant associations between body mass index and chronic disease and disability promise to increase demand upon an already pressurized health system.

Fractures of the femoral neck in Australian Aboriginals and Torres Strait Islanders.

The objective was to study patients of Aboriginal and Torres Strait Islander origin who were admitted to Cairns Base Hospital with the diagnosis of femoral neck fracture. An analysis of all 232 admissions with this diagnosis between November 1997 and July 2000 was carried out. Information was gathered from data accumulated on the Clinical Pathways database; other local data was also considered. Patients registered as being of Aboriginal and Torres Strait Islander origin have a lower incidence of these fractures than might be expected on an overall population basis, but similar rates on age-standardised data. The female age profile is substantially older than the female non-indigenous osteoporotic fracture group. Indigenous females develop osteoporotic type fractures of the femoral neck at a later age than do non-indigenous females. This may reflect a genetic difference in bone mineral density or a healthy lifestyle in earlier days. Further research is suggested.

FRACTURES OF THE FEMORAL NECK IN AUSTRALIAN ABORIGINALS AND TORRES STRAIT ISLANDERS

ABSTRACT: The objective was to study patients of Aboriginal and Torres Strait Islander origin who were admitted to Cairns Base Hospital with the diagnosis of femoral neck fracture. An analysis of all 232 admissions with this diagnosis between November 1997 and July 2000 was carried out. Information was gathered from data accumulated on the Clinical Pathways database; other local data was also considered. Patients registered as being of Aboriginal and Torres Strait Islander origin have a lower incidence of these fractures than might be expected on an overall population basis, but similar rates on age‐standardised data. The female age profile is substantially older than the female non‐indigenous osteoporotic fracture group. Indigenous females develop osteoporotic type fractures of the femoral neck at a later age than do non‐indigenous females. This may reflect a genetic difference in bone mineral density or a healthy lifestyle in earlier days. Further research is suggested.