Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
International Journal for Equity in Health
Published in: International Journal for Equity in Health 1/2014

Open Access 01-12-2014 | Research

Inequalities in the social determinants of health of Aboriginal and Torres Strait Islander People: a cross-sectional population-based study in the Australian state of Victoria

Authors: Alison Markwick, Zahid Ansari, Mary Sullivan, Lorraine Parsons, John McNeil

Published in: International Journal for Equity in Health | Issue 1/2014

Login to get access

Abstract

Introduction

Aboriginal Australians are a culturally, linguistically and experientially diverse population, for whom national statistics may mask important geographic differences in their health and the determinants of their health. We sought to identify the determinants of health of Aboriginal adults who lived in the state of Victoria, compared with their non-Aboriginal counterparts.

Methods

We obtained data from the 2008 Victorian Population Health Survey: a cross-sectional computer-assisted telephone interview survey of 34,168 randomly selected adults. The data included measures of the social determinants of health (socioeconomic status (SES), psychosocial risk factors, and social capital), lifestyle risk factors, health care service use, and health outcomes. We calculated prevalence ratios (PR) using a generalised linear model with a log link function and binomial distribution; adjusted for age and sex.

Results

Aboriginal Victorians had a higher prevalence of self-rated fair or poor health, cancer, depression and anxiety, and asthma; most notably depression and anxiety (PR = 1.7, 95% CI; 1.4-2.2). Determinants that were statistically significantly different between Aboriginal and non-Aboriginal Victorians included: a higher prevalence of psychosocial risk factors (psychological distress, food insecurity and financial stress); lower SES (not being employed and low income); lower social capital (neighbourhood tenure of less than one year, inability to get help from family, didn´t feel valued by society, didn´t agree most people could be trusted, not a member of a community group); and a higher prevalence of lifestyle risk factors (smoking, obesity and inadequate fruit intake). A higher proportion of Aboriginal Victorians sought help for a mental health related problem and had had a blood pressure check in the previous two years.

Conclusions

We identified inequalities in health between Aboriginal and non-Aboriginal Victorians, most notably in the prevalence of depression and anxiety, and the social determinants of health (psychosocial risk factors, SES, and social capital). This has implications for evidence-based policy development and may inform the development of public health interventions.
Literature
1.
Closing the Gap in a Generation: Health Equity through Action on the Social Determinants of Health. 2008, World Health Organization, Geneva
2.
Life Expectancy and Mortality of Aboriginal and Torres Strait Islander people. Cat. no. IHW 51. 2011, AIHW, Canberra
3.
Vos T, Barker B, Stanley L, Lopez AD: The Burden of Disease and Injury in Aboriginal and Torres Strait Islander peoples 2003. 2007, School of Population Health, The University of Queensland, Brisbane
4.
Awofeso N: Racism: a major impediment to optimal Indigenous health and health care in Australia. Australian Indigenous Health Bull. 2011, 11: 1-13.
5.
Purdie N, Dudgeon P, Walker R: Working Together: Aboriginal and Torres Strait Islander Mental Health and Wellbeing Principles and Practice. 2010, Department of Health and Ageing, Canberra
6.
7.
Bond CJ: A culture of ill health: public health or aboriginality?. Med J Aust. 2005, 183: 39-41.PubMed
8.
Pyett P, Waples C: Challenging our own practices in indigenous health promotion and research. Health Promot J Austr. 2008, 19: 179-183. %Uhttp://​search.​informit.​com.​au/​documentSummary;dn=046048739783167;res=IELHEA,PubMed
9.
Henry BR, Houston S, Mooney GH: Institutional racism in Australian healthcare: a plea for decency. Med J Aust. 2004, 180: 517-520.PubMed
10.
11.
Markwick A, Haider S, Vaughan L, Ansari Z: The Health and Wellbeing of Aboriginal Victorians. Victorian Population Health Survey 2008 supplementary report. 2011, State Government of Victoria, Melbourne
12.
Ansari Z, Carson NJ, Ackland MJ, Vaughan L, Serraglio A: A public health model of the social determinants of health. Soz Praventivmed. 2003, 48: 242-251. 10.1007/s00038-003-2052-4.PubMedCrossRef
13.
14.
15.
Deddens JA, Petersen MR: Approaches for estimating prevalence ratios. Occup Environ Med. 2008, 65: 481-10.1136/oem.2007.034777. 501-486PubMedCrossRef
16.
Kessler RC, Andrews G, Colpe LJ, Hiripi E, Mroczek DK, Normand SL, Walters EE, Zaslavsky AM: Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med. 2002, 32: 959-976. 10.1017/S0033291702006074.PubMedCrossRef
17.
Australian Alcohol Guidelines: Health Risks and Benefits. 2001, National Health and Medical Research Council (NHMRC), Canberra
18.
Obesity, Preventing and Managing the Global Epidemic. 1997, World Health Organization (WHO), Geneva
19.
National Physical Activity Guidelines for Australians. 1999, DHAC, Canberra
20.
Dietary Guidelines for Australian Adults. 2003, National Health and Medical Research Council (NHMRC), Canberra
21.
Burstrom B, Fredlund P: Self rated health: is it as good a predictor of subsequent mortality among adults in lower as well as in higher social classes?. J Epidemiol Community Health. 2001, 55: 836-840. 10.1136/jech.55.11.836.PubMedCentralPubMedCrossRef
22.
Ferdinand A, Paradies Y, Kelaher M: Mental Health Impacts of Racial Discrimination in Victorian Aboriginal Communities: The Localities Embracing and Accepting Diversity (LEAD) Experiences of Racism Survey. 2012, The Lowitja Institute, Melbourne
23.
Priest N, Paradies Y, Stewart P, Luke J: Racism and health among urban Aboriginal young people. BMC Public Health. 2011, 11: 568-10.1186/1471-2458-11-568.PubMedCentralPubMedCrossRef
24.
Priest NC, Paradies YC, Gunthorpe W, Cairney SJ, Sayers SM: Racism as a determinant of social and emotional wellbeing for Aboriginal Australian youth. Med J Aust. 2011, 194: 546-550.PubMed
25.
Hamer M, Kivimaki M, Stamatakis E, Batty GD: Psychological distress as a risk factor for death from cerebrovascular disease. CMAJ. 2012, 184: 1461-1466. 10.1503/cmaj.111719.PubMedCentralPubMedCrossRef
26.
Stansfeld SA, Fuhrer R, Shipley MJ, Marmot MG: Psychological distress as a risk factor for coronary heart disease in the Whitehall II Study. Int J Epidemiol. 2002, 31: 248-255. 10.1093/ije/31.1.248.PubMedCrossRef
27.
Holden L, Scuffham P, Hilton M, Vecchio N, Whiteford H: Psychological distress is associated with a range of high-priority health conditions affecting working Australians. Aust N Z J Public Health. 2010, 34: 304-310. 10.1111/j.1753-6405.2010.00531.x.PubMedCrossRef
28.
29.
Kondo N, Sembajwe G, Kawachi I, van Dam RM, Subramanian SV, Yamagata Z: Income inequality, mortality, and self rated health: meta-analysis of multilevel studies. BMJ. 2009, 339: b4471-10.1136/bmj.b4471.PubMedCentralPubMedCrossRef
30.
Kawachi I, Adler NE, Dow WH: Money, schooling, and health: mechanisms and causal evidence. Ann N Y Acad Sci. 2010, 1186: 56-68. 10.1111/j.1749-6632.2009.05340.x.PubMedCrossRef
31.
Kawachi I, Subramanian SV, Kim D: Social Capital and Health. In Social Capital and Health. 2008, Springer, New York, 1-26.CrossRef
32.
Bourdieu P: The forms of capital. Handbook of Theory and Research in the Sociology of Education. Edited by: Richardson J. 1986, Greenwald Press, New York, 241-258.
33.
Baum F: Social capital. Social Determinants of Indigenous Health. Edited by: Carson B, Dunbar T, Chenhall RD, Bailie R. 2007, Allen and Unwin, Crows Nest, NSW, 109-130.
34.
Mignone J: Social capital and Aboriginal communities: a critical assessment synthesis and assessment of the body of knowledge on social capital with emphasis on Aboriginal communities. J Aborig Health. 2009, 5: 100-147.
35.
Wood D, Halfon N, Scarlata D, Newacheck P, Nessim S: Impact of family relocation on children´s growth, development, school function, and behavior. JAMA. 1993, 270: 1334-1338. 10.1001/jama.1993.03510110074035.PubMedCrossRef
36.
Lin KC, Twisk JW, Huang HC: Longitudinal impact of frequent geographic relocation from adolescence to adulthood on psychosocial stress and vital exhaustion at ages 32 and 42years: the Amsterdam growth and health longitudinal study. J Epidemiol. 2012, 22: 469-476. 10.2188/jea.JE20110141.PubMedCentralPubMedCrossRef
37.
Perkins R, Langton M: First Australians: An Illustrated History. 2010, Miegunyah Press, Carlton
38.
Maru YT, Davies J: Supporting cross-cultural brokers is essential for employment among Aborignal people in remote Australia. Rangeland J. 2011, 33: 327-338. 10.1071/RJ11022.CrossRef
39.
40.
Paradies Y: A systematic review of empirical research on self-reported racism and health. Int J Epidemiol. 2006, 35: 888-901. 10.1093/ije/dyl056.PubMedCrossRef
41.
Victorian Population Health Survey 2008. 2010, Department of Health, Melbourne, Victoria
42.
Coffin J: Rising to the challenge in Aboriginal health by creating cultural security. Med J Aust. 2007, 31: 22-24.
43.
44.
Hall SE, Bulsara CE, Bulsara MK, Leahy TG, Culbong MR, Hendrie D, Holman CD: Treatment patterns for cancer in Western Australia: does being Indigenous make a difference?. Med J Aust. 2004, 181: 191-194.PubMed
45.
Armstrong D: "Controversies in epidemiology", teaching causality in context at the University at Albany, School of Public Health. Scand J Public Health. 1999, 27: 81-84.PubMed
46.
Begg SJ, Vos T, Barker B, Stanley L, Lopez AD: Burden of disease and injury in Australia in the new millennium: measuring health loss from diseases, injuries and risk factors. Med J Aust. 2008, 188: 36-40.PubMed
47.
Steptoe A: Depression and Physical Illness. 2006, Cambridge University press, CambridgeCrossRef
48.
Blackman T, Harvey J, Lawrence M, Simon A: Neighbourhood renewal and health: evidence from a local case study. Health Place. 2001, 7: 93-103. 10.1016/S1353-8292(01)00003-X.PubMedCrossRef
49.
Ebrahim S, Smith GD: Systematic review of randomised controlled trials of multiple risk factor interventions for preventing coronary heart disease. BMJ. 1997, 314: 1666-1674. 10.1136/bmj.314.7095.1666.PubMedCentralPubMedCrossRef
50.
Rothman KJ: Epidemiology: An Introduction. 2002, Oxford University Press, New York
51.
52.
Jorm AF, Bourchier SJ, Cvetkovski S, Stewart G: Mental health of Indigenous Australians: a review of findings from community surveys. Med J Aust. 2012, 196: 118-121. 10.5694/mja11.10041.PubMedCrossRef
Metadata
Title
Inequalities in the social determinants of health of Aboriginal and Torres Strait Islander People: a cross-sectional population-based study in the Australian state of Victoria
Authors
Alison Markwick
Zahid Ansari
Mary Sullivan
Lorraine Parsons
John McNeil
Publication date
01-12-2014
Publisher
BioMed Central
Published in
International Journal for Equity in Health / Issue 1/2014
Electronic ISSN: 1475-9276
DOI
https://doi.org/10.1186/s12939-014-0091-5

Other articles of this Issue 1/2014

International Journal for Equity in Health 1/2014 Go to the issue

Research

Socioeconomic inequalities are still a barrier to full child vaccine coverage in the Brazilian Amazon: a cross-sectional study in Assis Brasil, Acre, Brazil

Research

Factors associated with healthcare avoidance among transgender women in Argentina

Research

Cultural continuity, traditional Indigenous language, and diabetes in Alberta First Nations: a mixed methods study

Research

A community-based approach to indigent selection is difficult to organize in a formal neighbourhood in Ouagadougou, Burkina Faso: a mixed methods exploratory study

Research

Unemployment at municipality level is associated with an increased risk of small for gestational age births - a multilevel analysis of all singleton births during 2005-2010 in Finland

Research

Income-related children’s health inequality and health achievement in China