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74 Cards in this Set

  • Front
  • Back

What are the social determinants of indigenous health? 8

– Socio-economic status

– Unemployment

– Housing

– Educational attainment

– Racial discrimination

– Exposure to violence

– Trauma

– Access to community resources

What are the historical determinants of indigenous health? 3

- Impact of past government policies

- The extent of historical oppression

- Cultural displacement

What are the political determinants of health?

UN Declaration on the Rights of Indigenous People – “the unresolved issues of land, control of resources, cultural security and the rights of selfdetermination and sovereignty, which are recognised as contributing to health and wellbeing andreducing health inequities for Indigenous Australians”

What is the cultural determinants of health? 3

- The local history of colonisation

- The extent to which a cultural group resists assimilation, maintain cultural continuity, and self-determination and sovereignty

- These will influence a community’s capacity to retain their cultural values, principles,practices and traditions.

What is intentional racism disguised as?

Intentional racism disguised in bureaucratic generosity.

What is linked with aboriginal trauma?

Research linked Govt. policies and interventions with Aboriginals trauma experiences andtrigger chronic diseases.

What is involved in childhood trauma? 5

– Violates sense of safety and trust

– Reduces sense of worth

– Increases emotional distress, shame & grief

– Increases destructive behaviour (i.e. aggression, suicide, alcohol & substance misuse, smoking, sexual promiscuity, physical inactivity & obesity).

– Intra & intergenerational transfer of negative attitudes and troubled behaviour to family and community.

What does childhood trauma require?

Requires a skilled & (culturally) competent workforce.

What is the relationship between socio-economic status and health? 2

- Poor health is the result of similar low social and economic factors.

- Where you live is just as important as how you live. Remote and rural haveless access to services. Socially the dispossession, dislocation and discrimination because of theircultural background increases health concerns and poorer health outcomes..

What is quality of life?

Determines all aspects of life,including control over their physical environment, ofdignity, of community self-esteem, and of justice.

What is NOT quality of life?

NOT the absence of disease, health professionals and medicine.

What is health and wellbeing in aboriginal communities? 4

- Holistic

- Encompasses social and emotional, physical, cultural and spiritual wellbeingof the whole community.

- Relationship with the Land, Sea, Spirit world and each other.

- When the harmony of these inter-relationships is disrupted Aboriginal illhealth presents.

Why are hospitalisation rates not indicative of aboriginal health? 4

– geographically inaccessible

– These only give the number of episodes admitted not the number of people admitted.

– Only 89% of Indigenous patients are identified in the hospital.

– More middle-years adults admitted

Why is mortality an issue in regards to data around aboriginal health?

Mortality – caution required when interpreting data dueto under-identification and delays in registration.

What is infant mortality like in aboriginal communities?

Infant mortality rates are twice higher than non-Indigenous infants.

What is the age difference like for aboriginal women?

Females was 9.5 years less than 83 years for non-Indigenousfemales.

What is the age difference like for aboriginal men?

Indigenous males born in 2010-12 could live to 69 years (i.e.10 years less than non-Indigenous males).

What are the rates of death per thousand for aboriginal vs non aboriginal people?

rate of 9.6 per 1,000 Indigenouspopulation was 1.7 times the rate for non-Indigenous

How many deaths were in 2013?

Which are the highest states for death? 2

2013 - 2,811 Indigenous deaths (under-estimated). Highestrates in Western Australia then Northern Territory

What are the 5 leading causes of death in aboriginal people, in order? 2012

Cardiovascular (ischaemic heart disease)

Neoplasms (cancers)

Injury related

Diseases of the endocrine system (diabetes)

Diseases of the respiratory system

In 2012, how many deaths could have been avoided?

How much higher is this in the indigenous population?

1,500 deaths could have been avoided.

3.7 times higher for Indigenous population

What is the leading cause of death for aboriginal men? 3




What is the leading cause of death for aboriginal females?3



Chronic Lower Respiratory disease

What are the cancer outcomes for aboriginal populations? 3

– Lower incidences but poorer outcomes.

– Higher mortality (2.5 times higher)

– Lower 5 year survival rate.

What are 4 reasons why cancer is more fatal in aboriginal communities?

Due to poor screening;

delayed prognosis;

poor access to treatment;

poor compliance to treatment.

What is arthritis like in aboriginal populations? 3

– experienced more in lower socio-economic populations.

– Indigenous population have higher levels than the general public.

– This contributes to the high disability rates

What is a precursor to diabetes?

Hypertension a pre-cursor to Diabetes

What is diabetes like in aboriginal communities? 2

– Diabetes Type II is 4 times higher

– Compliance varies – personal attitudes and environmental factors e.g. access to services

Why do indigenous australians get kidney disease earlier? 2

Indigenous disadvantaged earlier because of poverty and negative social behaviour(smoking, obesity, alcohol and substance misuse)

What is in epidemic proportions in indigenous communities?

Renal Disease: or Chronic Kidney Disease/Renal Failure – In epidemic proportions.

What is a leading cause of renal disease?

Poor compliance with Diabetes Type II

What is treatment like for end stage kidney disease? 2

End stage includes kidney transplant or haemodialysis

What happens with maternal malnutrition?

If there is maternal malnutrition – less nephrons developed and goes onto CKD earlier inlife, poor uterine growth and pre term and underweight babies.

What are the 3 types of CVD?

Includes coronary heart disease;

acute rheumatic heart disease (highest in the world);

cerebrovascular disease (including strokes, hypertension and congenital heart disease)

When does rheumatic heart disease start?

– Starts in early childhood

What is a cause of increase rheumatic heart disease?

Prevalent if there is overcrowding and poor hygiene

What does chronic respiratory disease include? 3

Bronchitis, emphysema and asthma

What is asthma like in aboriginal communities?

What is more common?

Asthma affects 1.5 times higher.

Hospitalisation more common

What is prevalent among elders?

What is it a cause of?

Pneumonia prevalent among Elders.

One of the leading causes of death.

What are attributing factors to communicable infections?

– Overcrowded living conditions

– Smoking

– Poor hygiene

– Poor nutrition

– Poor environmental conditions

– Low levels of childhood immunisation

– Poor compliance to treatment

– Lack of education

– High hospitalisation rates

– Lack of follow-up post discharge

– Inadequate treatment

– Low expectations for health

– Poor resources

Who is most likely to have Acute Respiratory infections? 3

Prevalent among young people, the elderly those with special needs.

What causes acute respiratory infections? 5

– Low levels of hand & face hygiene

– Low levels of childhood immunisation

– Parental smoking

– Poor nutrition

– Poor environmental conditions

What can acute respiratory infections cause? 3

Can lead to Otitis Media impacting education, language development and daily living.

What conditions cause 94% vision loss? 4



Refractive error


Why is refractive error an issue in indigenous communities?

20% Indigenous adults wear glasses fordistance compared to 56% mainstream

Why are blinding cataracts an issue in aboriginal communities?

12 times more common but surgeryare 7 times lower

What is the relationship b/w diabetes and eyesight in these communities?

37% have diabetes and 13% have already lostvision

What proportion of communities have trachoma?

2/3rds of remote communities have endemicproportions.

What is trachoma?

Bacteria – Chlamydia trachomatis - serovars A,B,Ba & C

How does trachoma hurt eyesight & how is it shared?

Caused by sharing infected eye secretions leading to scarring of the eyelid;in-turned eyelashes (trichiasis) and blindness if untreated

When does trachoma occur?

Occurs where living conditions are crowded and hygiene practices are poor.

What is the SAFE pneumonic for eyesight treatment?

Surgery for trichiasis

Antibiotics therapy

Facial cleanliness

Environmental improvements

What increases vector disease? 2

- rising sea levels

- Small islands between Papua New Guinea a naturalstepping stone.

What causes Japanese Encephalitis?

Through domesticated pigs living close to humans and highlarvae in the water holes, rubbish and swamps

What can Otitis Media cause?

Can result in irreversible hearing loss

What happens when children have otitis media before 3? 5

– Slow to hear

– Have impaired verbal skills

– Have impaired hearing skills

– Continue to struggle with life skills and in school

– Hinder employment opportunities

What impacts otitis media? 5


Poor hygiene

Poor resourcing of programs

Low expectation of health

Antibiotic resistant bacteria

What are barriers to oral health? 3

– Poor access to culturally appropriate and timely dental care.

– Lack of knowledge on maintain healthy teeth and mouth

– Lack of nutritional guidance

What is oral health like in these communities? 2

Have poorer oral health – suffer from more caries,periodontal diseases and tooth loss.

Most tooth decay goes untreated leading to moreextractions

What influences drug and alcohol abuse? 8

– Colonisation and the dispossession and displacement of Land

– Policies of segregation

– Transgenerational trauma triggers

– Loss of culture

– Loss of identity

– Sense of hopelessness and despair

– High levels of Stress

– Multiple grievances and losses

How does biology influence alcohol tolerance in aboriginal communities?

Research published in 1991 byAssociate Professor Wayne Halland Dr Randolph Spargo found noevidence of truth in the "fire watertheory" which maintains thatAboriginal people are biologicallyless able to handle alcohol

What % of aboriginal people drink in NT?

In the Northern Territory, it hasbeen estimated that 75% ofAboriginal people do not drinkalcohol at all

How many aboriginal women do not drink alcohol?


40% to 80% of Aboriginal womendo not drink alcohol comparedwith 19% to 25% of non-Aboriginalwomen

How many aboriginal men do not drink alcohol? Non-aboriginal?

Up to 35% of Aboriginal men donot drink alcohol compared with12% of non-Aboriginal men

When is injury and violence more common (age)?

Higher in young people 15-24 years.

What % of aboriginal people reported physical and threatened violence in 2008?

28% reported victims of physical and threatened violenceespecially in their neighbourhood or community with a high percentagereporting family violence.

What contributes to family violence? 7

– Intergenerational trauma

–Dispossession of Land and traditional language and culture

– Institutionalism and child removal policies

– Breakdown of community kinship systems andAboriginal lore

– Loss of traditional Aboriginal male and female roles and status

– Economic exclusion

– Alcohol and substance misuse

What are the health issues with babies? 4

– 1.7 times more likely to be pre-term

– Low birth weight babies increases with remoteness

– Are more likely to be admitted to Special Care Nursery or NeonatalIntensive Care Unit

– Higher rates of perinatal deaths

What are the maternal issues in the community? 5

– More likely to be teenagers and to live in remote or disadvantagedareas

– Receive less antenatal care

– Nearly half smoke during pregnancy and lower cessation rates

– Were more likely to be obese and have pre-existing health conditionlike hypertension and diabetes.

– More likely to have a spontaneous labour onset and less caesareansections

What are maternal deaths like in aboriginal communities? 2

– 9 Indigenous deaths out of 84 total deaths. Three times higher per 100,000 than non-Indigenous women. – Due to sepsis and cardiac conditions.

What is infant mortality like?

Twice as high but declined between 2001 - 2011

How many people require disability support?

19,500 people requiring special assistance.

What is the demographic like for those who are disabled?

A younger profile with the gap widening as they growolder.

Examples: – <15 years old 3.4 times likely to be deaf

– Dialysis hospitalisation – 12 times more likely

What are the barriers to disability in these communities?

– Perception of disability

– Shame

– Lack of knowledge about the necessary requirements’

– Lack of knowledge of their rights and entitlements