Trends in health status and chronic disease risk factors over 10-14 years in a remote Australian community: A matched pair study

INTRODUCTION: Australian Indigenous people, especially those living in remote regions, have much a worse health profile and much higher rates of all-cause mortality, cardiovascular disease (CVD) and end-stage renal disease than non-Indigenous Australians. Mortality has been falling for Indigenous people since the 1990s, in recent years most markedly in females, and the increase in death rates for the major chronic diseases has been slowing. However direct evidence of better health in Indigenous over time is still lacking. This study aims to determine trends in health status over a 10-year interval in a high risk remote Australian Aboriginal community.

METHODS: Health surveys were performed between 1992-1997 and 2004-2006 on people aged ≥5 years. Outcomes were compared across age and sex-matched pairs.

RESULTS: There were 1209 matched pairs.  On the second survey, birthweights tended to be higher, and there were significant increases in heights of adolescents/ young adults and higher HDL-c levels generally. Young adult males were lighter, had lower waist circumference and blood pressures and less frequently had overt-albuminuria while elevated blood pressures were less common in older males. However, females ≥15 years had higher WC, WHR ,BMI and diastolic blood pressure and higher proportion of diabetes, notably in those aged 45 +years. Males of 15-24 years were less likely to be smokers while women age <45 years were more often current drinkers.   

CONCLUSIONS: Better nutrition among youth, better health of young adult males, stable or lower levels of albuminuria and improved HDL levels are all encouraging.  The waist increase in females might reflect better food access. Increased in diabetes in older subjects probably reflects recent enhanced survival of middle aged and older people, with, and at risk for, diabetes.