Improving Chronic Disease Outcomes for Indigenous Australians: Causes, Interventions and System Change
Program Grant
The National Health and Medical Research Council has awarded researchers at UniSA a prestigious Program Grant to support research into the causes, appropriate interventions and health system changes that will help reduce the incidence and adverse health impacts of diabetes and cardiovascular disease in Indigenous populations.
Diabetes and cardiovascular diseases occur in epidemic proportions among Indigenous Australians, with very early age of onset and high rates of preventable complications. This Program Grant brings together a multi skilled team of senior and junior researchers from three leading Australian Universities with Indigenous partners to better understand the development of these conditions, and to guide the development of diet, lifestyle, clinical and health system interventions in order to minimise their adverse impacts and improve health overall.
People
Research Leaders
Professor
Kerin O'Dea is the director of the Sansom Institute for Health Research,
Uni SA and her current research examines diet and lifestyle in the
prevention and treatment of non-communicable diseases (obesity, type 2
diabetes and cardiovascular diseases), with a focus on elucidating the
causal pathways and identifying critical intervention points.
Professor Robyn McDermott
is the director of SA/NT Data Linkage and Professor of Public Health in the
Sansom Institute for Health Research, Uni SA. Robyn has a strong interest in
Indigenous health, epidemiology of chronic disease and health transition,
and how primary health care can improve outcomes in resource-poor settings.
Dr Kevin Rowley is Senior Research Fellow at Onemda VicHealth Koori
Health Unit, Cente for Health and Society, Melbourne School of Population
Health, The University of Melbourne. Kevin is involved in the evaluation of
community directed health interventions with Aboriginal and Torres Strait
Islander people. His research includes clinical and social aspects of heart
health, and the ways in which health programs can be better designed and
evaluated to incorporate local priorities and knowledge.
Professor John Lynch
is Professor of Public Health at the University of Adelaide. John's research
interests include early childhood development, life course processes
regulating health behaviours and human capability formation, population
health information systems, evidence-based public health and improving the
public health research-policy nexus.
Professor Leonie Segal is foundation chair of the Health Economics &
Social Policy Group, UniSA. Her research is designed to determine the
optimal mix of health and welfare services and to analyse drivers or
incentives that can facilitate evidenced-based resource shifts. Her current
research focus is on primary care reform and child protection. Professor
Segal uses a multi-disciplinary logic-driven approach to translating
evidence into policy.
Other Research Associates
- Dr Julie Brimblecombe
- Dr Alex Brown
- Dr Margaret Cargo
- Prof Mark Daniel
- Prof Sandra Eades
- A/Prof Jane Freemantle
- Dr Jaqui Hughes
- Dr Louise Maple-Brown
- Dr Rachel Reilly
- Prof Michael Sawyer
- Dr Sue Sayers
- Dr Gurmeet Singh
- Dr Karen Walker
- Dr Mark Wenitong
- Dr Tom Wycherley
Research students
Sandy Campbell is performing a study which looks at the impact
of pre-pregnancy health on pregnancy outcomes among a cohort of young
Aboriginal and Torres Strait Islander women. This work has the potential to
not only bring new insights into the causes of poor perinatal outcomes among
these women, but also to contribute to practical policy to materially
improve these outcomes. Sandy is also investigating the influence of pre-pregnancy
health on birth outcomes in Indigenous women.
Karla Canuto is running a randomised trial of a structured
program to improve metabolic fitness in young Aboriginal women in Adelaide
entitled Improving metabolic fitness of Indigenous women: a pragmatic
controlled trial of waist loss.
Odette Gibson is conducting research in determining the impact
of levels of primary care funding and workforce skill mix on health outcomes
of adults with type 2 diabetes. It is hoped that this research will
contribute to improvements of primary care provision that results in better
health outcomes experienced by adults in remote Indigenous communities with
chronic diseases.
Yvette Roe is an early career researcher in cardiovascular
disease with a specific focus on, exploring potential differences between
Indigenous and non-Indigenous patients admitted to hospital in South
Australia for Acute Coronary Syndromes with particular emphasis on patient
engagement in the health care process on outcome. The aim is to provide
evidence-based strategies to reduce the disparity of life expectancy of
Indigenous Australians with cardiovascular disease.
Sean Taylor has just completed an Honours project looking at
health literacy and clinical management in Indigenous people with diabetes.
The project consisted of the collection of baseline interviews for the
project in 6 communities in the Torres Strait region (Badu Island, Sesia,
New Mapoon, Bamaga, Umigico, and Injinoo) and examined people ability to
read and comprehend health information and weighed this against the
management of their diabetes.
Dr Andrew Black is a public health physician and early career
researcher whose current focus is the impact of healthy food subsidy
programs on disadvantaged children's health. The aim is to develop evidence
on effective strategies to improve the nutrition and health of disadvantaged
families.
Collaborators
The Chief Investigators researching under the program grant are affiliated with three of Australia's most prominent and dynamic Universities.
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| University of South Australia | The University of Adelaide | The University of Melbourne |
Other affiliations
- Baker IDI Heart and Diabetes Institute
- James Cook University
- Monash University
- Charles Darwin University: Menzies School of Health Research, Northern Territory
- Apunipima Cape York Health Council
- Aboriginal Health Council of South Australia
- Children's Youth and Women's Health Service, SA
Research highlights
Some of our key research projects include:
Improving metabolic fitness of Indigenous women: a pragmatic controlled
trial of waist loss
This project utilises a structured group physical activity program with
Aboriginal and Torres Strait Islander women. The main aim is to reduce waist
circumference (a known predictor of cardiovascular disease) and improve
metabolic fitness.
Driven by PhD candidate Karla Canuto (pictured right with study
participants) in association with Dr Margaret Cargo and
Professor Robyn
McDermott the study has a long term objective to improve nutrition and
physical activity habits and improve their metabolic fitness.
Homelands and Centralised Communities
This project is part of a larger study spanning the last 20 years which has
involved Centralised and Decentralised indigenous Australian communities.
Professor Robyn McDermott, Professor Kerin O'Dea and Dr Kevin Rowley are researching the incidence
of obesity, prevalence of diabetes and frequency of cardiovascular disease
risk factors in centralised and decentralised communities in central
Australia. They are observing the socio-cultural health influences that
impact upon the populations and also examining the history of the
community-controlled health service of the regions.
Pre-pregnancy and reproductive health among a cohort of Indigenous women
in far North Queensland
In this study Professor McDermott and PhD student Sandra Campbell
are
examining the effect of maternal pre-pregnancy health status and maternal
characteristics on the course of pregnancy and birth outcomes. This
prospective data linkage study has sourced data from a very successful
programme known as the Well Persons Health Check which was designed to
establish the extent of specific diseases in remote communities and to
provide early detection, treatment and referral options for the patient. By
linking Well Person's Health Check data and Queensland perinatal data we are
examining associations between maternal characteristics prior to pregnancy
that are amenable to intervention, and events in subsequent pregnancies.
An evaluation of the Bulgarr Ngaru fruit and vegetable program
Dr Andrew Black and
Professor Kerin O'Dea are conducting a before and after study which has been
undertaken to document the impact of a fruit and vegetable subsidy program
on Aboriginal children's health in 3 Aboriginal community-controlled health
services. The results suggest that there are increased intake of fruit and
vegetables, particularly fruit, and that this is associated with few health
service attendances for common infections and lower antibiotic use. These
results will soon be published and add Australian evidence to the
international literature on the health effects of food subsidy programs in
high income countries.
From Left to right Kieran Roberts (Fregon Community, APY Lands), Tim Stewart (SANFL), Ben Taylor (Stephanie Alexander Kitchen Garden Foundation), Hayley Johnston (Indulkana Anangu School), Tom Wycherley (UniSA), Alec Henry (SANFL)
SANFL - Kitchen Garden Scheme
Researchers Professor Kerin O'Dea and Dr Tom Wycherley
are working in
partnership with the SANFL to develop strategies to improve the nutritional
status and health of children in the Anangu Pitjantjatjara Yankunytjatjara
(APY) Lands.
Starting initially at Indulkana community the partnership aims to implement
and evaluate school based strategies to improve the health of children by
improving their understanding and intake of healthy nutritious foods.
Indulkana Anangu School was recently awarded a funding grant to join the
Stephanie Alexander Kitchen Garden program. The partners involved (pictured
above) visited the site during construction of garden beds in late 2011. This nationwide
program is designed to provide 'Pleasurable food education' through hands-on
school based positive food experiences. In addition to the kitchen garden
program Indulkana School is also in the process of implementing a healthy
breakfast program and take-away lunches. UniSA researchers have advised on
the content of the nutrition programs and will evaluate their effectiveness
in improving health and nutritional status outcomes.
The impact of poor quality diet on people with pre-existing insulin
resistance
Early studies by this research team have found preliminary evidence to
suggest that the adverse effects of a poor quality diet may be magnified in
people that have pre-existing insulin resistance (IR). IR is a condition
where the body's sensitivity to the hormone insulin is reduced and is an
early step in the pathogenesis of impaired glucose tolerance and type 2
diabetes. These conditions are markedly increased in indigenous Australians
and can have a number of adverse health consequences including renal
disease, retinopathy, and cardiovascular disease. Dr Tom Wycherley
will be
joining Professor O'Dea to investigate how pre-existing IR impacts on a
person's response to a poor quality diet. This research will be conducted
initially in non-Indigenous Australians with a view to extend the study in
future to understand the impact poor quality diets may be having on
indigenous Australian populations.
Contact
For general information on program grant activities please contact
Research Assistant Leonie Baker:
leonie.baker@unisa.edu.au