Predicting Heart Disease in Aboriginal and Torres Strait Islander People
CRCAH Project No. IKCD96
Administering organisation: Onemda VicHealth Koori Health Unit, Centre for Health and Society, The University of Melbourne
Project Leaders:
Kevin Rowley
(Onemda VicHealth Koori Health Unit)
Contact details:
rowleyk@unimelb.edu.au
Team Members:
Alex Brown, Zaimin Wang, Joanne Luke, Joseph Fitz, Stacey Swenson, Bernadette Rickards, Paul Rickards, Leah Johnston, Zhiqiang Wang, Jim Best, Robyn McDermott, Kerin O'Dea
Program Manager:
Arwen Nikolof,
Chronic Conditions Program
Funding Source:
National Health & Medical Research Council (NHMRC)
In-Kind Supporters:
CRC for Aboriginal Health
Partners Involved:
- Baker-IDI Heart and Diabetes Research Institute
- Dept. of Medicine (St. Vincent’s Hospital), University of Melbourne
- University of South Australia
- University of Queensland
- Menzies School of Health Research
- Urapuntja Health Service
This project is endorsed as an in-kind project of the CRCAH.
Project summary:
This study is a follow-up of cardiovascular disease outcomes for a cohort of Aboriginal people in the Northern Territory who participated in a health screening program (Heart Health) in the 1990s. It aimed to identify what clinical measures best predict the risk of heart attack and stroke in Aboriginal communities in Central Australia.
Summary of outcomes:
The first community for whom data collection and analysis was complete was Utopia. The principal finding for this community was that adult mortality rates from all causes during the period 1995-2004 were about 40% lower at Utopia compared to those for Aboriginal people in the NT generally.
Other findings included:
- Death rates from cardiovascular diseases (CVD) run at about half the rate for Aboriginal people in the NT generally.
- Hospitalisation with CVD as the primary cause of admission occurred at a much lower rate for Utopia residents than for other Aboriginal people in the NT.
- Obesity and diabetes occur at lower rates for Utopia residents than for other Aboriginal people in the NT.
It is thought that the benefits of a traditional lifestyle, enabled by the decentralized nature of the community and including regular exercise and intake of bush tucker, is one reason why Utopia residents have achieved these good outcomes, along with lower rates of smoking, strong culture, and the community-directed nature of primary health care services provided by Urapuntja Health Service.
Data collection is complete for other participating communities, and the aggregated dataset is being used to identify the best predictors of cardiovascular disease, so that preventive treatment may be better targeted.
Summary of Project Implementation:
Risk factor surveys were conducted in 1988 and 1995 at Utopia and other communities, and aggregate results reported. Working in collaboration with the community-controlled Urapuntja Health Service and other local services under the terms of written, negotiated project agreements, researchers in this study collected 10-year follow-up data on mortality and hospitalisation from CVD relating to a cohort of about 700 participants in the 1995 surveys. Data for each community has been analysed and reported back in community reports.
Timeline:
The follow-up study commenced in 2004 and is due to finish in December 2010
Related Publiations/Links:
Peer-Reviewed Publications
Rowley K, Anderson I, O’Dea K, McDermott R, Saraswati K, Tilmouth R, Roberts I, Best JD, Fitz J, Jenkins A, Wang Z, Wang Z, Brown A. Lower than expected morbidity and mortality for an Australian Aboriginal population: 10 year follow up in a decentralised community. Medical Journal of Australia 2008; 188: pp283-287.
O'Neal DN, Piers LS, Iser DM, Rowley KG, Jenkins AJ, Best JD, O'Dea K. Australian Aboriginal People and Torres Strait Islanders have an atherogenic lipid profile that is characterised by low HDL-cholesterol level and small LDL particles. Atherosclerosis 2008, April 6 2008 [Epub ahead of print].
Shemesh T, Rowley KG, Piers LS, Best JD, O'Dea K. Low high-density lipoprotein cholesterol is the most prevalent metabolic abnormality for Australian Aboriginal people even when lean. European Journal of Cardiovascular Prevention and Rehabilitation 2008; 15: pp49-51.
AE Schutte, T Shemesh, K Rowley, JD Best, R McDermott, K O’Dea. The metabolic syndrome and changing relationship between blood pressure and insulin with age, as observed in Aboriginal and Torres Strait Islander peoples. Diabetic Medicine 2005; 22: 1589-1597.
Conference Presentations:
Tilmouth R, Saraswati K, Rowley K, Brown A. Culture, primary health care and health outcomes at Utopia community. WONCA Asia Pacific Regional conference and RACGP 51st Annual Scientific Convention, Melbourne, October 2008.
Luke JN, Brown A, O'Neal D, Kelaher M, O'Dea K, Best JD, Wang Z, Rowley K. Lipid treatment guidelines and cardiovascular risk for Aboriginal people in Central Australia. NT Chronic Disease Network Conference, Alice Springs, 2008.
Wang Z, Rowley K, Wang Z, O'Dea K, Brown A. Cardiovascular disease risk prediction for Aboriginal populations in central Australia. Cardiac Society of Australia and New Zealand Conference, Adelaide, 2008.
Rowley K, Brown AD, Saraswati K, Tilmouth R, Roberts I, Fitz J, Wang Z, McDermott R, Anderson I, Thomas D, O’Dea K. Outstation is not a dirty word: lower than expected morbidity and mortality for an Aboriginal population. The Chronicle 2006; 9(5): p5. Presented at the NT Chronic Disease Network Conference, Darwin, 2006.
Policy Brief
Good Health Outcomes Over Two Decades for a Decentralised NT Aboriginal Community - Utopia-policy-brief-March-2008.pdf
Media Release
Utopia Lifestyle Halves Mortality (3/3/2008) - Utopia-Media-Release-FINAL-March-2008-1.pdf