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

Amal Chakraborty, Margaret Cargo, Victor Oguoma (), Neil T. Coffee, Alwin Chong and Mark Daniel
Additional contact information
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
Neil T. Coffee: Health Research Institute, Faculty of Health, University of Canberra, Bruce, ACT 2601, 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

IJERPH, 2022, vol. 19, issue 15, 1-14

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.

Keywords: built environment; cardiovascular disease; remote community; health care; Aboriginal and Torres Strait Islanders; epidemiology (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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