Exploring cross-sectional associations between common childhood illness, housing and social conditions in remote Australian Aboriginal communities

Bailie, Ross; Stevens, Matthew; McDonald, Elizabeth; Brewster, David; Guthridge, Steven

doi:10.1186/1471-2458-10-147

Cited by 65 publications

(95 citation statements)

References 29 publications

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“…This study's findings regarding the association between middle ear disease and previous episodes of ear infection and increasing household number are consistent with large international cohort studies (Labout et al 2011), one of which also identified low socioeconomic status as a risk factor (Paradise et al 1997). However, our findings differ from the two other epidemiological studies involving Aboriginal populations in rural and remote areas (Jacoby et al 2008;Bailie et al 2010) and a meta-analysis examining risk factors for middle ear disease (Uhari et al 1996), which found that environmental tobacco smoke and childcare attendance were important risk factors. In the Kalgoorlie cohort study, overcrowding, defined as more than one person per room, was not significantly associated with specialistdiagnosed otitis media.…”

Section: Discussioncontrasting

confidence: 54%

“…Middle ear disease was less prevalent in this urban context than in previous studies in rural/remote Aboriginal communities (Morris et al 2005;Bailie et al 2010).…”

Section: Discussioncontrasting

confidence: 46%

“…A follow-up study on the same children found that the best predictor of nasopharyngeal carriage of pathogenic bacteria for otitis media was a more formal evaluation of overcrowding involving the number of people in the house with respect to the number of bedrooms (Jacoby et al 2011). The Northern Territory study by Bailie et al (2010) may have underestimated rates of otitis media by relying on carer's recall of an ear infection in the preceding 2 weeks. This would be a potentially difficult diagnosis for the parent of an infant (Engel et al 2000), and may explain why associations with measures such as crowding were not found (Bailie et al 2010).…”

Section: Discussionmentioning

confidence: 99%

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Household number associated with middle ear disease at an urban Indigenous health service: a cross-sectional study

Spurling¹,

Askew²,

Schluter³

et al. 2014

Aust. J. Prim. Health

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Abstract. Few epidemiological studies of middle ear disease have been conducted in Aboriginal and Torres Strait Islander populations, yet the disease is common and causes hearing impairment and poorer educational outcomes. The objective of this study is to identify factors associated with abnormal middle ear appearance, a proxy for middle ear disease. Aboriginal and Torres Strait Islander children aged 0-14 years receiving a Child Health Check (CHC) at an urban Indigenous Health Service, Brisbane, Australia were recruited from 2007 to 2010. Mixed-effects models were used to explore associations of 10 recognised risk factors with abnormal middle ear appearance at the time of the CHC. Ethical approval and community support for the project were obtained. Four hundred and fifty-three children were included and 54% were male. Participants were Aboriginal (92%), Torres Strait Islander (2%) or both (6%). Abnormal middle ear appearance was observed in 26 (6%) children and was significantly associated with previous ear infection (odds ratio (OR), 8.8; 95% confidence interval (CI), 3.2-24.0) and households with eight or more people (OR, 3.8; 95% CI, 1.1-14.1) in the imputed multivariable mixed-effects model. No significant associations were found for the other recognised risk factors investigated. Overcrowding should continue to be a core focus for communities and policy makers in reducing middle ear disease and its consequences in Aboriginal and Torres Strait Islander peoples.

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Section: Discussioncontrasting

confidence: 54%

“…Middle ear disease was less prevalent in this urban context than in previous studies in rural/remote Aboriginal communities (Morris et al 2005;Bailie et al 2010).…”

Section: Discussioncontrasting

confidence: 46%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Household number associated with middle ear disease at an urban Indigenous health service: a cross-sectional study

Spurling¹,

Askew²,

Schluter³

et al. 2014

Aust. J. Prim. Health

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“…However, other risk factors can, to some extent, be influenced. One such example is day care, which has been associated with an increased risk of AOM [29,30]. Multiple studies provide evidence that breastfeeding for at least 4-6 months reduces the number of AOM episodes and the risk of recurrent AOM [31,32].…”

Section: Modifiable Risk Factorsmentioning

confidence: 99%

Acute Otitis Media in Children—Current Treatment and Prevention

Gisselsson-Solén

2015

Curr Infect Dis Rep

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Acute otitis media (AOM) is the most common bacterial infection in children, and has a very varied clinical spectrum, ranging from spontaneous resolutions to serious complications. The effect of antibiotics in AOM depends on the chosen outcome, but has been shown to reduce pain somewhat, and have a greater beneficial effect in severe cases of AOM. Today, not all episodes of AOM are treated with antibiotics, but most countries have issued guidelines that include an option of watchful waiting in many cases. Prevention of AOM reaches from modification of environmental risk factors to vaccinations and surgery. Conjugate pneumococcal vaccines and influenza vaccines have been shown to somewhat reduce the number of AOM episodes in different groups of children. Grommets, with or without adenoidectomy, are effective at least during the first 6 months after surgery.

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“…109 However, there are other household determinants such as the quality of household infrastructure and amenities that contribute to health outcomes for Aboriginal peoples. 394 Participants' perception of household crowding as an issue in their house may be the most valid measure of household crowding as it is associated with participants' sense of how habitable their house is. 393 The HA contains a question as part of the NLES asking participants if overcrowding is an issue for them.…”

Section: Physical Environmentmentioning

confidence: 99%

Computerised Aboriginal and Torres Strait Islander health assessments in primary health care research

Spurling¹

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There has been insufficient research involving Aboriginal and Torres Strait Islander peoples living in urban areas to inform strategies required to improve inequitable health outcomes and life expectancy for Aboriginal and Torres Strait Islander peoples. The injustice of these health inequities motivated me to investigate the use of computerised Aboriginal and Torres Strait Islander health assessments in primary care as a source of research data which can be used to respond to community priorities. I conducted this research at the Inala Indigenous Health Service, a Queensland Government funded primary health care service for Aboriginal and Torres Strait Islander peoples. Inala is a suburb in south-western Brisbane with a strong sense of community and identity, but also significant social and economic challenges. Staff at the Inala Indigenous Health Service have been using Aboriginal and Torres Strait Islander health assessments for both clinical and research purposes since their introduction in 2004 for adults, and 2006 for children.In this thesis, I used a mixed methods approach. The first two research projects of this thesis are situated in the postpositivist paradigm where researchers accept that scientific research produces evidence which helps establish the probability that a finding is true rather than truth itself. The first research project evaluated the feasibility of implementing computerised health assessments in primary care for dual clinical and research purposes.After finding that it was feasible, the second research project established that computerised health assessment data were sufficiently representative, complete, reliable, and valid to produce credible research findings.The final two research projects of this thesis are situated in the transformative paradigm with the explicit goal of improving the social world. I acknowledge that my position as a white, non-Indigenous, male, medical researcher influenced the conduct and outcome of all the research projects in this inquiry. To minimise the risk that this research would reproduce the damaging effects of research for Aboriginal and Torres Strait Islander peoples conducted by non-Indigenous researchers, I listened to community voices to inform my approach to research using computerised health assessment information.I conducted a qualitative study involving thematic analysis of semi-structured interviews with key informants in the Inala Aboriginal and Torres Strait Islander community regarding their priorities for health and research based on health assessment data. Rather than a discrete set of health priorities, key informants articulated an authoritative understanding of how interrelated, inter-generational, social, cultural, and environmental determinants of iii health operated in a "cycle" to influence the community's health. Furthermore, some key informants were ambivalent about Aboriginal and Torres Strait Islander health assessments because of their biomedical emphasis. These findings supported the addition of questions to health...

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Exploring cross-sectional associations between common childhood illness, housing and social conditions in remote Australian Aboriginal communities

Cited by 65 publications

References 29 publications

Household number associated with middle ear disease at an urban Indigenous health service: a cross-sectional study

Household number associated with middle ear disease at an urban Indigenous health service: a cross-sectional study

Acute Otitis Media in Children—Current Treatment and Prevention

Computerised Aboriginal and Torres Strait Islander health assessments in primary health care research

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