Dataset Information

Transformation of mortality in a remote Australian Aboriginal community: a retrospective observational study.

ABSTRACT:

Objectives

To describe trends in ages and causes of death in a remote-living Australian Aboriginal group over a recent 50-year period.

Design

A retrospective observational study, from 1960 to 2010, of deaths and people starting dialysis, using data from local clinic, parish, dialysis and birthweight registers.

Setting

A remote island community in the Top End of Australia's Northern Territory, where a Catholic mission was established in 1911. The estimated Aboriginal population was about 800 in 1960 and 2260 in 2011.

Participants

All Aboriginal residents of this community whose deaths had been recorded.

Outcome measures

Annual frequencies and rates of terminal events (deaths and dialysis starts) by age group and cause of death.

Results

Against a background of high rates of low birth weight, 223 deaths in infants and children and 934 deaths in adults (age > 15 years) were recorded; 88% were of natural causes. Most deaths in the 1960s were in infants and children. However, over time these fell dramatically, across the birthweight spectrum, while adult deaths progressively increased. The leading causes of adult natural deaths were chronic lung disease, cardiovascular disease and, more recently, renal failure, and rates were increased twofold in those of low birth weight. However, rates of natural adult deaths have been falling briskly since 1986, most markedly among people of age ?45 years. The population is increasing and its age structure is maturing.

Conclusions

The changes in death profiles, the expression of the Barker hypothesis and the ongoing increases in adult life expectancy reflect epidemiological and health transitions of astonishing rapidity. These probably flow from advances in public health policy and healthcare delivery, as well as improved inter-sectoral services, which are all to be celebrated. Other remote communities in Australia are experiencing the same phenomena, and similar events are well advanced in many developing countries.

SUBMITTER: Hoy WE

PROVIDER: S-EPMC5629742 | biostudies-literature | 2017 Aug

REPOSITORIES: biostudies-literature

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Publications

Transformation of mortality in a remote Australian Aboriginal community: a retrospective observational study.

Hoy Wendy E WE Mott Susan Anne SA McLeod Beverly June BJ

BMJ open 20170811 8

<h4>Objectives</h4>To describe trends in ages and causes of death in a remote-living Australian Aboriginal group over a recent 50-year period.<h4>Design</h4>A retrospective observational study, from 1960 to 2010, of deaths and people starting dialysis, using data from local clinic, parish, dialysis and birthweight registers.<h4>Setting</h4>A remote island community in the Top End of Australia's Northern Territory, where a Catholic mission was established in 1911. The estimated Aboriginal populat ...[more]

PMID: 28801414

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Project description:IntroductionThe population-based (Lililwan) study of fetal alcohol spectrum disorder (FASD) revealed a high prevalence of FASD in the remote communities of the Fitzroy Valley, Western Australia (WA) and confirmed anecdotal reports from families and teachers that challenging child behaviours were a significant concern. In response, Marninwarntikura Women's Resource Centre initiated a partnership with researchers from The University of Sydney to bring the positive parenting program (Triple P) to the Valley. Triple P has been effective in increasing parenting skills and confidence, and improving child behaviour in various Indigenous communities.Methods and analysisExtensive consultation with community leaders, service providers, Aboriginal health networks and academic institutions was undertaken and is ongoing. Based on community consultations, the intervention was adapted to acknowledge local cultural, social and language complexities. Carers of children born after 1 January 2002 and living in the Fitzroy Valley are invited to participate in Group Triple P, including additional Stepping Stones strategies for children with complex needs. Programme are delivered by local community service workers, trained and accredited as Triple P providers or 'parent coaches'. Assessments for parent coach pretraining and post-training includes their perceived ability to deliver the intervention and the cultural appropriateness of the programme. Carers complete preintervention and postintervention and 6-month follow-up assessments of parenting practices, self-efficacy and child behaviour.Ethics and disseminationApproval was granted by the University of Sydney Human Ethics Committee, WA Aboriginal Health Ethics Committee, WA Country Health Services Ethics Committee and Kimberley Aboriginal Health Planning Forum. Consultation with community is imperative for efficacy, engagement, community ownership and sustainability of the programme, and will be ongoing until findings are disseminated. Anonymous findings will be disseminated through peer-reviewed journals, community feedback sessions and scientific forums.

Dataset Information

Transformation of mortality in a remote Australian Aboriginal community: a retrospective observational study.

Objectives

Design

Setting

Participants

Outcome measures

Results

Conclusions

Publications

Transformation of mortality in a remote Australian Aboriginal community: a retrospective observational study.

Similar Datasets

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