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

Author

Listed:
  • Amal Chakraborty

    (University Centre for Rural Health, The University of Sydney, Lismore, NSW 2480, Australia)

  • Margaret Cargo

    (Health Research Institute, Faculty of Health, University of Canberra, Bruce, ACT 2601, Australia)

  • Victor Maduabuchi Oguoma

    (Poche Centre for Indigenous Health, Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia, QLD 4067, Australia)

  • Neil T. Coffee

    (Health Research Institute, Faculty of Health, University of Canberra, Bruce, ACT 2601, Australia
    Deakin Rural Health, Rural Health Multidisciplinary Training (RHMT) Program, School of Medicine, Deakin University, Warrnambool, VIC 3280, Australia
    Australian Centre for Housing Research, The University of Adelaide, Adelaide, SA 5005, Australia)

  • Alwin Chong

    (Arney Chong Consulting, Adelaide, SA 5081, Australia)

  • Mark Daniel

    (Health Research Institute, Faculty of Health, University of Canberra, Bruce, ACT 2601, Australia)

Abstract

Indigenous Australians experience poorer health than non-Indigenous Australians, with cardiometabolic diseases (CMD) being the leading causes of morbidity and mortality. Built environmental (BE) features are known to shape cardiometabolic health in urban contexts, yet little research has assessed such relationships for remote-dwelling Indigenous Australians. This study assessed associations between BE features and CMD-related morbidity and mortality in a large sample of remote Indigenous Australian communities in the Northern Territory (NT). CMD-related morbidity and mortality data were extracted from NT government health databases for 120 remote Indigenous Australian communities for the period 1 January 2010 to 31 December 2015. BE features were extracted from Serviced Land Availability Programme (SLAP) maps. Associations were estimated using negative binomial regression analysis. Univariable analysis revealed protective effects on all-cause mortality for the BE features of Education, Health, Disused Buildings, and Oval, and on CMD-related emergency department admissions for the BE feature Accommodation. Incidence rate ratios (IRR’s) were greater, however, for the BE features Infrastructure Transport and Infrastructure Shelter. Geographic Isolation was associated with elevated mortality-related IRR’s. Multivariable regression did not yield consistent associations between BE features and CMD outcomes, other than negative relationships for Indigenous Location-level median age and Geographic Isolation. This study indicates that relationships between BE features and health outcomes in urban populations do not extend to remote Indigenous Australian communities. This may reflect an overwhelming impact of broader social inequity, limited correspondence of BE measures with remote-dwelling Indigenous contexts, or a ‘tipping point’ of collective BE influences affecting health more than singular BE features.

Suggested Citation

  • Amal Chakraborty & Margaret Cargo & Victor Maduabuchi Oguoma & Neil T. Coffee & Alwin Chong & Mark Daniel, 2022. "Built Environment Features and Cardiometabolic Mortality and Morbidity in Remote Indigenous Communities in the Northern Territory, Australia," IJERPH, MDPI, vol. 19(15), pages 1-14, August.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:15:p:9435-:d:877777
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    References listed on IDEAS

    as
    1. Amal Chakraborty & Mark Daniel & Natasha J. Howard & Alwin Chong & Nicola Slavin & Alex Brown & Margaret Cargo, 2021. "Identifying Environmental Determinants Relevant to Health and Wellbeing in Remote Australian Indigenous Communities: A Scoping Review of Grey Literature," IJERPH, MDPI, vol. 18(8), pages 1-19, April.
    2. Daphne Habibis, 2013. "Australian Housing Policy, Misrecognition and Indigenous Population Mobility," Housing Studies, Taylor & Francis Journals, vol. 28(5), pages 764-781, July.
    3. Camille Le Gal & Michael J. Dale & Margaret Cargo & Mark Daniel, 2020. "Built Environments and Cardiometabolic Morbidity and Mortality in Remote Indigenous Communities in the Northern Territory, Australia," IJERPH, MDPI, vol. 17(3), pages 1-9, January.
    4. Frank, Lawrence Douglas & Saelens, Brian E. & Powell, Ken E. & Chapman, James E., 2007. "Stepping towards causation: Do built environments or neighborhood and travel preferences explain physical activity, driving, and obesity?," Social Science & Medicine, Elsevier, vol. 65(9), pages 1898-1914, November.
    5. Mark Daniel & Margaret Cargo & Elisabeth Marks & Catherine Paquet & David Simmons & Margaret Williams & Kevin Rowley & Kerin O’Dea, 2009. "Rating Health and Social Indicators for Use with Indigenous Communities: A Tool for Balancing Cultural and Scientific Utility," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 94(2), pages 241-256, November.
    6. Johnston, Vanessa & Thomas, David P., 2008. "Smoking behaviours in a remote Australian Indigenous community: The influence of family and other factors," Social Science & Medicine, Elsevier, vol. 67(11), pages 1708-1716, December.
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