Gambling, housing conditions, community contexts and child health in remote indigenous communities in the Northern Territory, Australia

Abstract

BackgroundRecent government reports have identified gambling, along with alcohol abuse, drug abuse and pornography, as contributing to child neglect and abuse in Indigenous communities in the Northern Territory (NT). These reports also identify gaps in empirical evidence upon which to base sound policy. To address this shortfall, data from ten remote Indigenous communities was analysed to determine the relationship between gambling problems, housing conditions, community contexts and child health in indigenous communities.MethodsLogistic regression was used to assess associations between gambling problems, community contexts, housing conditions and child health. Separate multivariable models were developed for carer reported gambling problems in houses and six child health outcomes.ResultsCarer reported gambling problems in households across the ten communities ranged from 10% to 74%. Inland tropical communities had the highest level of reported gambling problems. Less access to a doctor in the community showed evidence of a multivariable adjusted association with gambling problems in houses. No housing variables showed evidence for a multivariable association with reported gambling problems. There was evidence for gambling problems having a multivariable adjusted association with carer report of scabies and ear infection in children.ConclusionsThe analyses provide evidence that gambling is a significant problem in Indigenous communities and that gambling problems in households is related to poor child health outcomes. A comprehensive (prevention, treatment, regulation and education) public health approach to harm minimisation associated with gambling amongst the Indigenous population is required that builds on current normative community regulation of gambling.

Built Environments and Cardiometabolic Morbidity and Mortality in Remote Indigenous Communities in the Northern Territory, Australia

“…Housing alone, however, is but a component of the built environment; thus, investigations of the influence of the built environment on health should move beyond the focus on housing-related health effects alone. For example, non-housing built environment features (i.e., women's centres, aged care facilities) were previously demonstrated to be associated with significantly lesser odds of carer-reported gambling problems (odds ratio (OR) 0.46, 95% CI 0.27-0.79 and OR 0.59, 95% CI 0.39-0.97, respectively), which are in turn associated with child health outcomes [41]. Other environmental-level factors were recently shown to influence dietary quality in remote Indigenous communities in the Northern Territory [42].…”

Gambling impacts on Aboriginal communities in New South Wales, Australia: community leaders’ perspectives

“…Efforts needed to be supported by public education and the promotion of gambling awareness in a multi-faceted community approach, one conducted in a variety of places. One suggestion was for communities to take collective leadership for a program to be built around increasing public recognition of gambling impacts, consistent with findings by Stevens and Bailie (2012). Other suggestions were to encourage support for gamblers experiencing a lack of control and to reduce any shame associated with an admission of problems: "I think we as an Aboriginal community need to get it out there in the community and say 'this is an issue within communities.'…”

“…For children a lack of leadership by people who ought to be role models, their parents and grandparents, was perceived to exacerbate the negative effects of gambling losses. The long-term prospects for some children were seen as being impaired by gambling problems in families, an outcome also reported by Stevens and Bailie (2012). For families, deteriorating relationships, a lack of ability to care for others and poverty led to extra responsibilities being placed on community assistance.…”

Association of Built Environmental Features with Rates of Infectious Diseases in Remote Indigenous Communities in the Northern Territory, Australia

“…Poorer availability of non-housing related BE features has been recently shown to associate with higher rates of cardiometabolic disease-related morbidity and mortality in remote, predominantly Indigenous, communities in the NT [ 38 ]. For example, the presence of community-level BE features (e.g., women’s centres, and aged care facilities) has been linked to the spread of infectious diseases [ 39 ].…”

“…It is promising to see new evidence implicating non-housing related BE features associated with both communicable and non-communicable diseases in remote Indigenous communities in Northern Australia [ 39 ]. Addressing these broader environmental determinants has the potential to reduce health inequities experienced by the Indigenous population.…”