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Addressing inequities in access to quality health care for indigenous people.

https://arctichealth.org/en/permalink/ahliterature154424
Source
CMAJ. 2008 Nov 4;179(10):985-6
Publication Type
Article
Date
Nov-4-2008
Author
David Peiris
Alex Brown
Alan Cass
Author Affiliation
George Institute for International Health, New South Wales, Australia.
Source
CMAJ. 2008 Nov 4;179(10):985-6
Date
Nov-4-2008
Language
English
Publication Type
Article
Keywords
Australasia
Canada
Communication
Culture
Health Policy
Health Services Accessibility
Health Services, Indigenous
Healthcare Disparities
Humans
Population Groups
Stress, Psychological - epidemiology
United States
Notes
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Comment On: CMAJ. 2008 Nov 4;179(10):1007-1218981441
PubMed ID
18981431 View in PubMed
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Characteristics of Indigenous primary health care service delivery models: a systematic scoping review.

https://arctichealth.org/en/permalink/ahliterature289221
Source
Global Health. 2018 Jan 25; 14(1):12
Publication Type
Article
Date
Jan-25-2018
Author
Stephen G Harfield
Carol Davy
Alexa McArthur
Zachary Munn
Alex Brown
Ngiare Brown
Author Affiliation
Wardliparingga Aboriginal Health Research Unit, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia. stephen.harfield@sahmri.com.
Source
Global Health. 2018 Jan 25; 14(1):12
Date
Jan-25-2018
Language
English
Geographic Location
U.S.
Publication Type
Article
Keywords
Aboriginal and Torres Strait Islander
American Indian
Alaska Native
Indigenous
Models of care
Primary Health Care
Service delivery
Abstract
Indigenous populations have poorer health outcomes compared to their non-Indigenous counterparts. The evolution of Indigenous primary health care services arose from mainstream health services being unable to adequately meet the needs of Indigenous communities and Indigenous peoples often being excluded and marginalised from mainstream health services. Part of the solution has been to establish Indigenous specific primary health care services, for and managed by Indigenous peoples. There are a number of reasons why Indigenous primary health care services are more likely than mainstream services to improve the health of Indigenous communities. Their success is partly due to the fact that they often provide comprehensive programs that incorporate treatment and management, prevention and health promotion, as well as addressing the social determinants of health. However, there are gaps in the evidence base including the characteristics that contribute to the success of Indigenous primary health care services in providing comprehensive primary health care. This systematic scoping review aims to identify the characteristics of Indigenous primary health care service delivery models.
This systematic scoping review was led by an Aboriginal researcher, using the Joanna Briggs Institute Scoping Review Methodology. All published peer-reviewed and grey literature indexed in PubMed, EBSCO CINAHL, Embase, Informit, Mednar, and Trove databases from September 1978 to May 2015 were reviewed for inclusion. Studies were included if they describe the characteristics of service delivery models implemented within an Indigenous primary health care service. Sixty-two studies met the inclusion criteria. Data were extracted and then thematically analysed to identify the characteristics of Indigenous PHC service delivery models.
Culture was the most prominent characteristic underpinning all of the other seven characteristics which were identified - accessible health services, community participation, continuous quality improvement, culturally appropriate and skilled workforce, flexible approach to care, holistic health care, and self-determination and empowerment.
While the eight characteristics were clearly distinguishable within the review, the interdependence between each characteristic was also evident. These findings were used to develop a new Indigenous PHC Service Delivery Model, which clearly demonstrates some of the unique characteristics of Indigenous specific models.
Notes
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PubMed ID
29368657 View in PubMed
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Environmental risk conditions and pathways to cardiometabolic diseases in indigenous populations.

https://arctichealth.org/en/permalink/ahliterature138012
Source
Annu Rev Public Health. 2011;32:327-47
Publication Type
Article
Date
2011
Author
Mark Daniel
Peter Lekkas
Margaret Cargo
Ivana Stankov
Alex Brown
Author Affiliation
Social Epidemiology and Evaluation Research Unit, Sansom Institute for Health Research, University of South Australia, Adelaide, SA, Australia. mark.daniel@unisa.edu.au
Source
Annu Rev Public Health. 2011;32:327-47
Date
2011
Language
English
Publication Type
Article
Keywords
Cardiovascular Diseases - ethnology
Environment
Humans
Metabolic Diseases - ethnology
Population Groups
Risk factors
Abstract
This review examines environments in relation to cardiometabolic diseases in Indigenous populations in developed countries. Environmental factors are framed in terms of context (features of places) and composition (features of populations). Indigenous peoples are seen to have endured sociopolitical marginalization and material disadvantage spanning generations. Past adverse collective experiences, modified by culture, are reflected by current heterogeneity in environmental context and composition. As risk conditions, unfavorable contextual and compositional exposures influence the expression of cardiometabolic risk for individuals. Minimal research has evaluated heterogeneity in risk conditions against heterogeneity in cardiometabolic diseases between or within Indigenous populations. Thus far, the features of populations, not of places themselves, have been implicated in relation to cardiometabolic diseases. Behavioral, psychosocial, and stress-axis pathways may explain the relationships between risk conditions and cardiometabolic diseases. Implications of environmental factors and their pathways as well as important research needs are discussed in relation to ecological prevention to reduce cardiometabolic diseases.
PubMed ID
21219157 View in PubMed
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Rheumatic heart disease in Indigenous children in northern Australia: differences in prevalence and the challenges of screening.

https://arctichealth.org/en/permalink/ahliterature269969
Source
Med J Aust. 2015 Sep 7;203(5):221
Publication Type
Article
Date
Sep-7-2015
Author
Kathryn V Roberts
Graeme P Maguire
Alex Brown
David N Atkinson
Bo Remenyi
Gavin Wheaton
Marcus Ilton
Jonathan Carapetis
Source
Med J Aust. 2015 Sep 7;203(5):221
Date
Sep-7-2015
Language
English
Publication Type
Article
Abstract
To compare regional differences in the prevalence of rheumatic heart disease (RHD) detected by echocardiographic screening in high-risk Indigenous Australian children, and to describe the logistical and other practical challenges of RHD screening.
Cross-sectional screening survey performed between September 2008 and November 2010.
Thirty-two remote communities in four regions of northern and central Australia.
3946 Aboriginal or Torres Strait Islander children aged 5-15 years.
Portable echocardiography was performed by cardiac sonographers. Echocardiograms were recorded and reported offsite by a pool of cardiologists.
RHD was diagnosed according to 2012 World Heart Federation criteria.
The prevalence of definite RHD differed between regions, from 4.7/1000 in Far North Queensland to 15.0/1000 in the Top End of the Northern Territory. The prevalence of definite RHD was greater in the Top End than in other regions (odds ratio, 2.3; 95% CI, 1.2-4.6, P = 0.01). Fifty-three per cent of detected cases of definite RHD were new cases; the prevalence of new cases of definite RHD was 4.6/1000 for the entire sample and 7.0/1000 in the Top End. Evaluation of socioeconomic data suggests that the Top End group was the most disadvantaged in our study population.
The prevalence of definite RHD in remote Indigenous Australian children is significant, with a substantial level of undetected disease. Important differences were noted between regions, with the Top End having the highest prevalence of definite RHD, perhaps explained by socioeconomic factors. Regional differences must be considered when evaluating the potential benefit of widespread echocardiographic screening in Australia.
PubMed ID
26852054 View in PubMed
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A systems approach to improving timeliness of immunisation.

https://arctichealth.org/en/permalink/ahliterature150790
Source
Vaccine. 2009 Jun 2;27(27):3669-74
Publication Type
Article
Date
Jun-2-2009
Author
Ross S Bailie
Damin Si
Michelle C Dowden
Christine E Selvey
Catherine Kennedy
Rhonda Cox
Lynette O'Donoghue
Helen Liddle
Christine M Connors
Sandra Thompson
Hugh Burke
Alex Brown
Author Affiliation
Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT 0811, Australia. rossb@menzies.edu.au
Source
Vaccine. 2009 Jun 2;27(27):3669-74
Date
Jun-2-2009
Language
English
Publication Type
Article
Keywords
Child, Preschool
Female
Humans
Immunization Programs
Immunization Schedule
Infant
Infant, Newborn
Male
Abstract
Timeliness of immunisation is important in achieving a protective effect at the individual and population levels. Recent international research has highlighted the importance of organisational features of the health system in timely immunisation. This paper reports on an analysis of the availability of records of timely delivery of childhood immunisations in Indigenous primary care services and organisational features of vaccination programs in different jurisdictions in Australia. The findings demonstrate wide variation in recorded timely delivery of immunisations between health centres within and between jurisdictions. Significant deficiencies in the approach to delivery and recording of immunisations appear to be principally related to fragmented systems of delivery, recording and communication between child health and primary care services. Understanding these deficiencies presents opportunities for improving timely immunisation.
PubMed ID
19464549 View in PubMed
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