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Andersen M.J.,University of New South Wales | Andersen M.J.,Sax Institute | Williamson A.B.,University of New South Wales | Williamson A.B.,Sax Institute | And 3 more authors.
BMC Public Health | Year: 2016

Background: Poor housing is widely cited as an important determinant of the poor health status of Aboriginal Australians, as for indigenous peoples in other wealthy nations with histories of colonisation such as Canada, the United States of America and New Zealand. While the majority of Aboriginal Australians live in urban areas, most research into housing and its relationship with health has been conducted with those living in remote communities. This study explores the views of Aboriginal people living in Western Sydney about their housing circumstances and what relationships, if any, they perceive between housing and health. Methods: Four focus groups were conducted with clients and staff of an Aboriginal community-controlled health service in Western Sydney (n = 38). Inductive, thematic analysis was conducted using framework data management methods in NVivo10. Results: Five high-level themes were derived: the battle to access housing; secondary homelessness; overcrowding; poor dwelling conditions; and housing as a key determinant of health. Participants associated their challenging housing experiences with poor physical health and poor social and emotional wellbeing. Housing issues were said to affect people differently across the life course; participants expressed particular concern that poor housing was harming the health and developmental trajectories of many urban Aboriginal children. Conclusions: Housing was perceived as a pivotal determinant of health and wellbeing that either facilitates or hinders prospects for full and healthy lives. Many of the specific health concerns participants attributed to poor housing echo existing epidemiological research findings. These findings suggest that housing may be a key intervention point for improving the health of urban Aboriginal Australians. © 2016 Andersen et al. Source

Achat H.M.,Sydney West Area Health Service | Thomas P.,Aboriginal Medical Service Western Sydney | Close G.R.,Area Executive Unit | Moerkerken L.R.,Sydney West Area Health Service | Harris M.F.,University of New South Wales
Australian Journal of Primary Health | Year: 2010

This paper aimed to examine the utilisation of and preferences related to health care services by residents of a disadvantaged area and to identify factors associated with levels of current and future use. Data were collected from face-to-face structured interviews of randomly selected residents of a disadvantaged local government area in 200304. Information about respondents' health and socioeconomic status and patterns of use and preferred features of health care was analysed in PASW Statistic 17. Chi-square statistics were used to examine differences in utilisation by sex and simple logistic regression provided sex specific age-adjusted odds ratios about frequent visits. Most respondents (95%) attended a 'usual' general practitioner (GP) service and about two-fifths had obtained other health care in the last 12 months. The median number of visits was four and most providers offered bulk billing (83%). Less common were visits to the dentist (32%), emergency department (14%), specialists (29%) and the hospital (5%). Providers' skills and traits, physical access and bulk billing were key considerations for men and women when choosing a health care provider. Disadvantaged communities want skilled practitioners who reflect their demographic mix and are located at convenient and accessible clinics, which preferably bulk bill. Apart from GP visits, this group appears to make only moderate use of specialists and emergency departments, and little routine use of other primary health services. © La Trobe University 2010. Source

Abbott P.,Aboriginal Medical Service Western Sydney | Davison J.,Aboriginal Medical Service Western Sydney | Moore L.,Aboriginal Medical Service Western Sydney | Rubinstein R.,University of Sydney
Health Promotion Journal of Australia | Year: 2010

Issue addressed: Aboriginal people access diabetes and nutrition education less than non-Aboriginal people. Culturally appropriate, effective and accessible diabetes and nutrition education for Aboriginal people is urgently needed. Methods: A qualitative approach was used to explore the experiences of Aboriginal people who had attended cooking courses run at the Aboriginal Medical Service Western Sydney between 2002 and 2007. Data from 23 semi-structured interviews were analysed thematicaliy. Results: Despite reported improvements in nutrition knowledge and cooking skills, the ability of participants to implement desired dietary changes varied. A new health diagnosis, such as diabetes, pre-diabetes, heart disease or cancer and the desire of participants to influence their families to lead healthier, diabetes-free lives were strong motivators for dietary change. In contrast, lack of family support for dietary change and a sense of social isolation caused by dietary change strongly impeded some participants' attempts to improve their diets. Other significant barriers were poor oral health and depression, the higher cost of healthier food and generational food preferences. Conclusion: Aboriginal cooking course participants faced multiple barriers to dietary change - social, financial, medical and historical. The family was the most crucial determinant of participant ability to achieve sustained dietary change. Source

DiGiacomo M.,University of Technology, Sydney | DiGiacomo M.,Curtin University Australia | Davidson P.M.,University of Technology, Sydney | Davidson P.M.,Curtin University Australia | And 5 more authors.
International Journal of Environmental Research and Public Health | Year: 2011

Indigenous people throughout the world suffer a higher burden of disease than their non-indigenous counterparts contributing to disproportionate rates of disability. A significant proportion of this disability can be attributed to the adverse effects of smoking. In this paper, we aimed to identify and discuss the key elements of individual-level smoking cessation interventions in indigenous people worldwide. An integrative review of published peer-reviewed literature was conducted. Literature on smoking cessation interventions in indigenous people was identified via search of electronic databases. Documents were selected for review if they were published in a peer-reviewed journal, written in English, published from 1990-2010, and documented an individual-level intervention to assist indigenous people to quit smoking. Studies that met inclusion criteria were limited to Australia, New Zealand, Canada, and the USA, despite seeking representation from other indigenous populations. Few interventions tailored for indigenous populations were identified and the level of detail included in evaluation reports was variable. Features associated with successful interventions were integrated, flexible, community-based approaches that addressed known barriers and facilitators to quitting smoking. More tailored and targeted approaches to smoking cessation interventions for indigenous populations are required. The complexity of achieving smoking cessation is underscored as is the need to collaboratively develop interventions that are acceptable and appropriate to local populations. © 2011 by the authors; licensee MDPI, Basel, Switzerland. Source

Ward J.,SouthAustralianHealth andMedical Research Institute | Wand H.,Kirby Institute | Bryant J.,University of New South Wales | Delaney-Thiele D.,Aboriginal Medical Service Western Sydney | And 6 more authors.
Sexually Transmitted Diseases | Year: 2016

Background: Young Aboriginal and Torres Strait Islander (Aboriginal) people are recognized as a priority population for the control of sexually transmissible infections (STIs) in Australia. This article reports the prevalence of self-reported STI diagnoses and their correlates among Aboriginal people aged 16 to 29 years. Methods: Results were analyzed from a survey conducted between 2011 and 2013 at regular community events. Univariate and multivariate logistic regression models were used to identify the correlates of a history of STI diagnosis among participants who reported being sexually active and ever having been tested for STIs. All analyses were stratified by sex. Results: Of the 2877 participants in this study, 2320, comprising 60% females, self-reported ever having had vaginal or anal sex, and a further subset of 1589 (68%) reported ever being tested for any of the following STIs: chlamydia, gonorrhea, syphilis, or trichomonas. Within this latter group, the proportion who reported that they had had a positive STI diagnosis was 25%. In multivariate analysis, women who reported sexual debut before the age of 16 years (prevalence ratio [PR], 1.53; 95% confidence interval, 1.16-2.81; P < 0.05), ever having had oral sex (PR, 2.66; 1.47-4.82; P < 0.001), inconsistent condom use in the past 12 months (PR, 1.71; 1.13-2.58; P < 0.012), having had sex with someone they had just met (adjusted odds ratio, 1.74; 1.21-2.50; P < 0.003), and using ecstasy (PR, 1.81; 1.16-2.81; P < 0.009) were significantly associated with a selfreported history of an STI diagnosis. For men, being older (25-29 years; PR, 2.10; 1.10-3.96; P < 0.023), being gay or bisexual (PR, 2.22; 1.16-4.27; P < 0.016), not using a condom during last sex, (PR, 1.74; 1.10-2.76; P < 0.019), past ecstasy use (PR, 1.88; 1.11-3.20; P < 0.019), and injecting drug use (PR, 2.81; 1.35-5.88); P < 0.006) were independent predictors of ever reporting being diagnosed as having an STI. Discussion: In the first community-based survey of this population, a self-reported history of ever being diagnosed as having prevalent STIs was common in sexually active young Aboriginal people who reported STI testing in the past. This population requires targeted education and health service interventions to address the high burden of STIs. © 2016 by the American Sexually Transmitted Diseases Association. Source

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