Populations at Special Health Risk: Indigenous Populations

Anderson, Ian; Whyte, John D.

doi:10.1016/b978-012373960-5.00101-5

Cited by 5 publications

(6 citation statements)

References 5 publications

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“…In addition to specific risks, the evidence in relation to the specific population‐based screening criteria (Table ) is likely to be different for indigenous women . Indigenous people continue to experience poorer health than other people living in the same country , and the epidemiological patterns of diabetic disease are markedly different, implicating DIP as a major contributing factor . Efforts to reduce these health inequalities have led to an identified need to assess the potential differential impact of interventions .…”

Section: Introductionmentioning

confidence: 99%

Diabetes in pregnancy among indigenous women in Australia, Canada, New Zealand and the United States: a systematic review of the evidence for screening in early pregnancy

Chamberlain

McNamara

Williams

et al. 2013

Diabetes Metabolism Res

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Recently proposed international guidelines for screening for gestational diabetes mellitus (GDM) recommend additional screening in early pregnancy for sub-populations at a high risk of type 2 diabetes mellitus (T2DM), such as indigenous women. However, there are criteria that should be met to ensure the benefits outweigh the risks of population-based screening. This review examines the published evidence for early screening for indigenous women as related to these criteria. Any publications were included that referred to diabetes in pregnancy among indigenous women in Australia, Canada, New Zealand and the United States (n = 145). The risk of bias was appraised. There is sufficient evidence describing the epidemiology of diabetes in pregnancy, demonstrating that it imposes a significant disease burden on indigenous women and their infants at birth and across the lifecourse (n = 120 studies). Women with pre-existing T2DM have a higher risk than women who develop GDM during pregnancy. However, there was insufficient evidence to address the remaining five criteria, including the following: understanding current screening practice and rates (n = 7); acceptability of GDM screening (n = 0); efficacy and cost of screening for GDM (n = 3); availability of effective treatment after diagnosis (n = 6); and effective systems for follow-up after pregnancy (n = 5). Given the impact of diabetes in pregnancy, particularly undiagnosed T2DM, GDM screening in early pregnancy offers potential benefits for indigenous women. However, researchers, policy makers and clinicians must work together with communities to develop effective strategies for implementation and minimizing the potential risks. Evidence of effective strategies for primary prevention, GDM treatment and follow-up after pregnancy are urgently needed. Copyright © 2013 John Wiley & Sons, Ltd.

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Section: Introductionmentioning

confidence: 99%

Diabetes in pregnancy among indigenous women in Australia, Canada, New Zealand and the United States: a systematic review of the evidence for screening in early pregnancy

Chamberlain

McNamara

Williams

et al. 2013

Diabetes Metabolism Res

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“…12 In other instances health data is intentionally or unintentionally not collected for Indigenous populations, or data collection systems are not structured to disaggregate for Indigenous status, regardless of how it is defined. 13 Indeed, despite having declared two International Decades of the World's Indigenous Peoples, which included calls for gathering baseline information on Indigenous peoples, the United Nations itself recognizes that Indigenous populations are largely rendered invisible in its own initiatives: … there is still a general trend to exclude indigenous issues from development diagnostics, country development planning and other Government processes…. In country and regional reports on the status of human development and the progress made in achieving the Millennium Development Goals, as well as in common country assessment and United Nations Development Assistance Framework reports, indigenous peoples have low visibility.…”

Section: The Battle Against Invisibility and Erasurementioning

confidence: 99%

The Role of Law in Ameliorating Global Inequalities in Indigenous Peoples' Health

MacIntosh

2013

J. Law. Med. Ethics

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“…Internationally, CD care has typically focussed on individualistic, compartmentalized and biomedical interventions that are largely antithetical to Indigenous peoples' understandings and conceptions of health [7,8]. Here, health is perceived as a holistic and collective concept that encompasses the social, emotional and cultural wellbeing of the whole community.…”

Section: Introductionmentioning

confidence: 99%

“…Here, health is perceived as a holistic and collective concept that encompasses the social, emotional and cultural wellbeing of the whole community. Strategies to improve Indigenous people's health need to address the broad determinants of Indigenous health, and improve access to comprehensive, holistic, culturally informed, community-based health care [8]. Underpinned by these understandings of health and health care, a holistic model of person-centred CD case management was developed and implemented in an urban Indigenous primary health care service [9].…”

Section: Introductionmentioning

confidence: 99%

Quantitative evaluation of an outreach case management model of care for urban Aboriginal and Torres Strait Islander adults living with complex chronic disease: a longitudinal study

Askew

Togni

Egert

et al. 2020

BMC Health Serv Res

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Background Chronic diseases are the leading contributor to the excess morbidity and mortality burden experienced by Aboriginal and Torres Strait Islander (hereafter, respectfully, Indigenous) people, compared to their non-Indigenous counterparts. The Home-based Outreach case Management of chronic disease Exploratory (HOME) Study provided person-centred, multidisciplinary care for Indigenous people with chronic disease. This model of care, aligned to Indigenous peoples’ conceptions of health and wellbeing, was integrated within an urban Indigenous primary health care service. We aimed to determine the impact of this model of care on participants’ health and wellbeing at 12 months. Methods HOME Study participants were Indigenous, regular patients of the primary health care service, with a diagnosis of at least one chronic disease, and complex health and social care needs. Data were collected directly from participants and from their medical records at baseline, and 3, 6 and 12 months thereafter. Variables included self-rated health status, depression, utilisation of health services, and key clinical outcomes. Participants’ baseline characteristics were described using frequencies and percentages. Generalized estimating equation (GEE) models were employed to evaluate participant attrition and changes in outcome measures over time. Results 60 participants were enrolled into the study and 37 (62%) completed the 12-month assessment. After receiving outreach case management for 12 months, 73% of participants had good, very good or excellent self-rated health status compared with 33% at baseline (p < 0.001) and 19% of participants had depression compared with 44% at baseline (p = 0.03). Significant increases in appointments with allied health professionals (p < 0.001) and medical specialists other than general practitioners (p = 0.001) were observed at 12-months compared with baseline rates. Mean systolic blood pressure decreased over time (p = 0.02), but there were no significant changes in mean HbA1c, body mass index, or diastolic blood pressure. Conclusions The HOME Study model of care was predicated on a holistic conception of health and aimed to address participants’ health and social care needs. The positive changes in self-rated health and rates of depression evinced that this aim was met, and that participants received the necessary care to support and improve their health and wellbeing.

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Populations at Special Health Risk: Indigenous Populations

Cited by 5 publications

References 5 publications

Diabetes in pregnancy among indigenous women in Australia, Canada, New Zealand and the United States: a systematic review of the evidence for screening in early pregnancy

Diabetes in pregnancy among indigenous women in Australia, Canada, New Zealand and the United States: a systematic review of the evidence for screening in early pregnancy

The Role of Law in Ameliorating Global Inequalities in Indigenous Peoples' Health

Quantitative evaluation of an outreach case management model of care for urban Aboriginal and Torres Strait Islander adults living with complex chronic disease: a longitudinal study

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