Lower than expected morbidity and mortality for an Australian Aboriginal population: 10-year follow-up in a decentralised community.
OBJECTIVE
To examine mortality from all causes and from cardiovascular disease (CVD), and CVD hospitalisation rate for a decentralised Aboriginal community in the Northern Territory.


METHODS
For a community-based cohort of 296 people aged 15 years or older screened in 1995, we reviewed hospital and primary health care records and death certificates for the period up to December 2004 (2800 person-years of follow-up).


METHODS
Mortality from all causes and CVD, and hospitalisation with CVD coded as a primary cause of admission; comparison with prior trends (1988 to 1995) in CVD risk factor prevalence for the community, and with NT-specific Indigenous mortality and hospitalisation rates.


RESULTS
Mortality in the cohort was 964/100,000 person-years, significantly lower than that of the NT Indigenous population (standardised mortality ratio [SMR], 0.62; 95% CI, 0.42-0.89). CVD mortality was 358/100,000 person-years for people aged 25 years or older (SMR, 0.52; 95% CI, 0.23-1.02). Hospitalisation with CVD as a primary cause was 13/1000 person-years for the cohort, compared with 33/1000 person-years for the NT Indigenous population.


CONCLUSIONS
Contributors to lower than expected morbidity and mortality are likely to include the nature of primary health care services, which provide regular outreach to outstation communities, as well as the decentralised mode of outstation living (with its attendant benefits for physical activity, diet and limited access to alcohol), and social factors, including connectedness to culture, family and land, and opportunities for self-determination.
Rowley
Kevin G
KG
Onemda VicHealth Koori Health Unit, Centre for Health and Society, School of Population Health, University of Melbourne, and Department of Medicine, St Vincent's Hospital, Melbourne, VIC, Australia. rowleyk@unimelb.edu.au
O'Dea
Kerin
K
Anderson
Ian
I
McDermott
Robyn
R
Saraswati
Karmananda
K
Tilmouth
Ricky
R
Roberts
Iris
I
Fitz
Joseph
J
Wang
Zaimin
Z
Jenkins
Alicia
A
Best
James D
JD
Wang
Zhiqiang
Z
Brown
Alex
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D015876:Northern Territory / Q000453:epidemiology; D011057:Politics; D012307:Risk Factors; D012959:Socioeconomic Factors