title: Lower than expected morbidity and mortality for an Australian Aboriginal population: 10-year follow-up in a decentralised community.
abstract: 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.
authors.affiliation: 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
authors.forename: Kevin G
authors.initials: KG
authors.lastname: Rowley
authors.forename: Kerin
authors.initials: K
authors.lastname: O'Dea
authors.forename: Ian
authors.initials: I
authors.lastname: Anderson
authors.forename: Robyn
authors.initials: R
authors.lastname: McDermott
authors.forename: Karmananda
authors.initials: K
authors.lastname: Saraswati
authors.forename: Ricky
authors.initials: R
authors.lastname: Tilmouth
authors.forename: Iris
authors.initials: I
authors.lastname: Roberts
authors.forename: Joseph
authors.initials: J
authors.lastname: Fitz
authors.forename: Zaimin
authors.initials: Z
authors.lastname: Wang
authors.forename: Alicia
authors.initials: A
authors.lastname: Jenkins
authors.forename: James D
authors.initials: JD
authors.lastname: Best
authors.forename: Zhiqiang
authors.initials: Z
authors.lastname: Wang
authors.forename: Alex
authors.initials: A
authors.lastname: Brown
mesh_terms: 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