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

Camille Le Gal, Michael J. Dale, Margaret Cargo and Mark Daniel
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Camille Le Gal: Institut de Santé Publique, d’Epidémiologie et de Développement, Université de Bordeaux, Bordeaux 33000, France
Michael J. Dale: Health Research Institute, University of Canberra, Bruce, ACT 2617, Australia
Margaret Cargo: Health Research Institute, University of Canberra, Bruce, ACT 2617, Australia
Mark Daniel: Health Research Institute, University of Canberra, Bruce, ACT 2617, Australia

IJERPH, 2020, vol. 17, issue 3, 1-9

Abstract: The health of Indigenous Australians is dramatically poorer than that of the non-Indigenous population. Amelioration of these differences has proven difficult. In part, this is attributable to a conceptualisation which approaches health disparities from the perspective of individual-level health behaviours, less so the environmental conditions that shape collective health behaviours. This ecological study investigated associations between the built environment and cardiometabolic mortality and morbidity in 123 remote Indigenous communities representing 104 Indigenous locations (ILOC) as defined by the Australian Bureau of Statistics. The presence of infrastructure and/or community buildings was used to create a cumulative exposure score (CES). Records of cardiometabolic-related deaths and health service interactions for the period 2010–2015 were sourced from government department records. A quasi-Poisson regression model was used to assess the associations between built environment “healthfulness” (CES, dichotomised) and cardiometabolic-related outcomes. Low relative to high CES was associated with greater rates of cardiometabolic-related morbidity for two of three morbidity measures (relative risk (RR) 2.41–2.54). Cardiometabolic-related mortality was markedly greater (RR 4.56, 95% confidence interval (CI), 1.74–11.93) for low-CES ILOCs. A lesser extent of “healthful” building types and infrastructure is associated with greater cardiometabolic-related morbidity and mortality in remote Indigenous locations. Attention to environments stands to improve remote Indigenous health.

Keywords: epidemiology; built environment; Indigenous health; mortality; morbidity; cardiometabolic disease; remote (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (2)

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