Indigenous Australians at higher risk of diseases: studies

By Dr. Ananya Mandal, MDMay 16 2010

Central Australia ranks first in incidences of pneumonia among children with alarming figures like 78.4 cases per 1,000 children annually. This is much higher than even South Africa, Uruguay, Gambia, Fiji or Pakistan.

Also the babies of the indigenous population have a four times higher risk of hospitalization for serious chest infections in Northern Territory compared to native American babies (427 per 1,000 babies annually compared with 116). The new study revealed that 26.6 per 1,000 population annually were diagnosed with pneumonia by the use of X-ray. This was 57.5 cases per 1,000 among children aged less than one year among infants less than a year.

This new study published in a special indigenous themed issue of the Medical Journal of Australia, is based on the analysis of all hospital admissions for indigenous children in the Territory aged from 29 days to five years from April 1, 1997, to March 31, 2005.

Lead author Kerry-Ann O'Grady, a post-doctoral training fellow at the Menzies School of Health Research in Darwin said that these findings were “unacceptable” and the first priority of national health policies should be to get these rates down. She said in a statement, “The incidence of WHO-defined radiologically confirmed pneumonia among children in the Central Australian region of NT is the highest incidence reported in published studies using the WHO protocol…This is unacceptable in a wealthy country like Australia, and reducing this disease burden should be a national health priority."

There was another study in the issue that showed that young indigenous adults had two to 11 times the risk of oral health problems than young Australians in the general population, with Aboriginal people having eight times as many decayed teeth as other Australians. Untreated teeth in the indigenous population were also 3.1 times more.

Yet another study in the issue focused on the changes in buying habits in the indigenous population after the introduction of income management in 2007 as part of the Northern Territory Emergency Response. The researchers found that this did not spur buying more fruits and vegetables and less of soft drinks, tobacco, and junk foods. Studies in the similar line concluded that this income intervention was “doing more harm than good to the health and wellbeing of our indigenous families and communities”. The Health Impact Assessment of the intervention, carried out by the Australian Indigenous Doctors Association and the Centre for Health Equity, Training Research and Evaluation at the University of NSW feels that this compulsory income management should be stopped as it was having “profound long-term negative impacts on psychological health, social health and wellbeing and cultural integrity”.

This income management is functional in more than 70 Aboriginal communities in the Northern Territory. The recipients can pay for essentials such as food, clothing and rent but cannot use the payments for alcohol, tobacco, pornography or gambling. Come July the federal government plans to extent the benefits to include non-Indigenous welfare recipients in the Territory.

According to Professor Jonathan Carapetis, Director of the Darwin-based Menzies School of Health Research, research shows that this programme may not really benefit the people. “The main findings in 10 stores in the NT was that sales of healthy food, particularly fruit and vegetables, tobacco and soft drinks did not change at all really as a result of income management,” he said. “If this program or any other program is to be expanded, then I would make a plea for higher quality data such as this to make sure we evaluate it properly,” he added.

Federal Minister for Families and Indigenous Affairs Jenny Macklin disagrees with the key findings of the report. “I think it's very difficult to compare the results from these stores across the board to the rest of the Northern Territory…I do think you have to also take into account the analysis from the larger study that looked at 66 stores, which found there was an impact, so we'll look at all of the evidence,” she said.

National Welfare Rights Network president, Kate Beaumont, says there is still not enough evidence about the benefits of income management. “Yes, there are some people who are supportive of income management and it has made a difference…Although to have blanket income management, as in what is proposed in the NT, so what goes beyond those who were previously income managed, just there's no reason for it and there's no evidence base for it.” According to the AIDA president Peter O'Mara these studies reveal that indigenous people were “the sickest in the country” and Australia was “a long way off having equality in healthcare at the moment”.