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Luke JN, Bessarab D, Smith K, LoGiudice D, Flicker L, Gilchrist L, Dow B, Temple J. Counting the Ways That Aboriginal and Torres Strait Islander Older People Participate in Their Communities and Culture. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbae100. [PMID: 38818851 PMCID: PMC11234290 DOI: 10.1093/geronb/gbae100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Indexed: 06/01/2024] Open
Abstract
OBJECTIVES This study aimed to determine the proportion of older Aboriginal and Torres Strait Islander peoples participating in cultural events and activities and determine the demographic and sociocultural characteristics associated with participation. METHODS The Australian Bureau of Statistics National Aboriginal and Torres Strait Islander Social Survey (2014-2015) was used to measure the prevalence of participation in cultural events and activities. Multivariate logistic regression models were used to measure associations. Sociocultural factors were selected by matching survey items to the 12 sociocultural factors described in the Good Spirit Good Life Framework, a culturally validated quality-of-life tool for older people. RESULTS The majority (62.0%) of survey respondents 45 years and older participated in cultural events (e.g., ceremonies, funerals/sorry business, NAIDOC week activities, sports carnivals, festivals/carnivals) or were involved in organizations. Many (58.5%) also participated in activities (e.g., fishing, hunting, gathering wild plants/berries, arts/crafts, music/dance/theater, writing/telling of stories). In regression models including demographic and cultural variables, participation in cultural events was highest among people living remotely (odds ratio [OR] = 2.71), reporting recognition of homelands (OR = 2.39), identifying with a cultural group (OR = 3.56), and those reporting having a say in their communities (OR = 1.57), with similar odds seen for participation in activities. Participation was inversely proportional to increasing age, with a greater proportion of females participating in events and males in activities. DISCUSSION The social lives of older Aboriginal and Torres Strait Islander people were characterized by widespread participation in cultural events and activities. These findings provide important insights into services as they support older people to live a good life.
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Affiliation(s)
- Joanne Nicole Luke
- Centre for Health Policy, School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences,The University of Melbourne, Melbourne, Victoria, Australia
| | - Dawn Bessarab
- Centre for Aboriginal Medical and Dental Health, Medical School, The University of Western Australia, Perth, Western Australia, Australia
| | - Kate Smith
- Centre for Aboriginal Medical and Dental Health, Medical School, The University of Western Australia, Perth, Western Australia, Australia
| | - Dina LoGiudice
- Department of Medicine, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Leon Flicker
- Western Australian Centre for Health and Ageing, Medical School, University of Western Australia, Perth, Western Australia, Australia
| | - Lianne Gilchrist
- Centre for Aboriginal Medical and Dental Health, Medical School, The University of Western Australia, Perth, Western Australia, Australia
| | - Briony Dow
- Department of Medicine, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
- National Ageing Research Institute, Melbourne, Victoria, Australia
| | - Jeromey Temple
- Centre for Health Policy, School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences,The University of Melbourne, Melbourne, Victoria, Australia
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Deravin LM, Bramble M, Anderson J, Mahara N. Strategies that support cultural safety for First Nations people in aged care in Australia: An integrative literature review. Australas J Ageing 2023; 42:649-659. [PMID: 37518820 DOI: 10.1111/ajag.13230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 07/05/2023] [Indexed: 08/01/2023]
Abstract
OBJECTIVE The 2019 Royal Commission into Aged Care Quality and Safety highlighted the need for First Nations peoples to have improved, culturally safe care. This paper is a call to action for First Nations peoples to be involved in developing culturally safe care and services to be embedded within Australian aged care services. METHODS The first screening examined the Australian literature (peer-reviewed articles published since 2010 in English) detailing key aspects relevant to Cultural Safety for First Nations peoples supported by aged care services in Australia. The second screening assessed whether the findings of these studies aligned with the key aspects of Cultural Safety of First Nations peoples in aged care. RESULTS The initial literature search yielded 198 papers, of which 13 met the inclusion criteria for the final review. Topics that required further interrogation included barriers to communication, racism and discrimination, impacts on health outcomes, health-care workforce education needs and the importance of cultural connections to Country and kin. These topics influenced the perception of First Nations peoples feeling culturally safe when supported by aged care services. CONCLUSIONS The literature identified a need to recruit more First Nations peoples into the aged care workforce, involve more First Nations family and community members in aged care and retain a consistent workforce overall. Together these strategies were seen to address the barriers that continue to affect aged care provision for First Nations peoples.
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Affiliation(s)
- Linda Michelle Deravin
- School of Nursing, Paramedicine and Healthcare Sciences, Charles Sturt University, Bathurst, New South Wales, Australia
| | - Marguerite Bramble
- School of Nursing, Paramedicine and Healthcare Sciences, Charles Sturt University, Bathurst, New South Wales, Australia
| | - Judith Anderson
- School of Nursing, Paramedicine and Healthcare Sciences, Charles Sturt University, Bathurst, New South Wales, Australia
| | - Nicole Mahara
- School of Nursing, Paramedicine and Healthcare Sciences, Charles Sturt University, Bathurst, New South Wales, Australia
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Russell SG, Quigley R, Thompson F, Sagigi B, Miller G, LoGiudice D, Smith K, Strivens E, Pachana NA. Culturally Appropriate Assessment of Depression and Anxiety in Older Torres Strait Islanders: Limitations and Recommendations. Clin Gerontol 2023; 46:240-252. [PMID: 35694996 DOI: 10.1080/07317115.2022.2086090] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES The aim of the study was to assess the prevalence of anxiety and depression in older Aboriginal and Torres Strait Islander adults. METHODS A modified version of the PHQ-9 (KICA-dep) and the Geriatric Anxiety Inventory (GAI) were administered as part of a wider dementia prevalence study conducted in the Torres Strait. Results were compared to diagnoses obtained on Geriatric review to evaluate their applicability in the region. RESULTS A total of 236 participants completed the KICA-dep and 184 completed the GAI short form. Of these, 10.6% were identified with depression and 15.8% with anxiety. Some participants found questions about suicide ideation and self-harm offensive and others had difficulty understanding concepts on the GAI. The KICA-dep performed poorly in comparison to diagnosis on geriatric clinical review, so results are unlikely to reflect the true prevalence of depression in the region. CONCLUSIONS Further research is required to explore the underlying dimensions of depression and anxiety and terminology used to express mood symptoms in the Torres Strait. CLINICAL IMPLICATIONS • Current mental health screening tools are not applicable for the Torres Strait• More work is required to determine how symptoms of depression and anxiety are expressed within Torres Strait communities.
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Affiliation(s)
- Sarah G Russell
- College of Medicine and Dentistry, James Cook University, Cairns, Australia
- Queensland Health, Cairns and Hinterland Hospital and Health Service, Cairns, Australia
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Australia
| | - Rachel Quigley
- College of Medicine and Dentistry, James Cook University, Cairns, Australia
- Queensland Health, Cairns and Hinterland Hospital and Health Service, Cairns, Australia
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Australia
| | - Fintan Thompson
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Australia
| | - Betty Sagigi
- Queensland Health, Torres and Cape Hospital and Health Service, Thursday Island, Australia
| | - Gavin Miller
- Queensland Health, Cairns and Hinterland Hospital and Health Service, Cairns, Australia
| | - Dina LoGiudice
- Faculty of Medicine, Dentistry, and Health Services, Royal Melbourne Hospital, University of Melbourne, Victoria, Australia
| | - Kate Smith
- Centre for Aboriginal Medical and Dental Health, School of Medicine, University of Western Australia, Perth, Australia
| | - Edward Strivens
- College of Medicine and Dentistry, James Cook University, Cairns, Australia
- Queensland Health, Cairns and Hinterland Hospital and Health Service, Cairns, Australia
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Australia
| | - Nancy A Pachana
- School of Psychology, University of Queensland, Brisbane, Australia
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Temple J, Wilson T, Radford K, LoGiudice D, Utomo A, Anstey KJ, Eades S. Demographic drivers of the growth of the number of Aboriginal and Torres Strait Islander people living with dementia, 2016-2051. Australas J Ageing 2022; 41:e320-e327. [PMID: 35993283 PMCID: PMC10087408 DOI: 10.1111/ajag.13116] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 04/06/2022] [Accepted: 06/08/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To examine the demographic drivers that contribute to the future growth in the population of Aboriginal and Torres Strait Islander peoples living with dementia in Australia. METHODS Design: Multistate, Indigenous status, cohort component, population projection model. SETTING National-level, Aboriginal and Torres Strait Islander population. DATA Data prepared by the Australian Bureau of Statistics on births, deaths, migration and identification change. Australian Institute of Health and Welfare estimates of dementia prevalence alongside estimates from several studies. MAJOR OUTCOME MEASURES Number of older people living with dementia alongside a decomposition of demographic drivers of growth. RESULTS By 2051, the relative growth in the number of Aboriginal and Torres Strait Islander peoples aged 50+ with dementia ranges from 4½ to 5½ times (under three prevalence scenarios) its 2016 estimate. Cohort flow (the gradual movement of younger cohorts into the 50+ age group, and the depletion of older cohorts from death, over time) is a key driver of the growth in the number of older people living with dementia. CONCLUSIONS High growth in the number of people living with dementia poses implications for culturally appropriate care, health-care access and support for Aboriginal and Torres Strait Islander families, carers and their communities.
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Affiliation(s)
- Jeromey Temple
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Tom Wilson
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Kylie Radford
- Neuroscience Research Australia, University of New South Wales, Sydney, New South Wales, Australia
| | - Dina LoGiudice
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Ariane Utomo
- School of Geography, Earth and Atmospheric Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Kaarin J Anstey
- Neuroscience Research Australia, University of New South Wales, Sydney, New South Wales, Australia
| | - Sandra Eades
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
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Haregu T, Jorm AF, Paradies Y, Leckning B, Young JT, Armstrong G. Discrimination experienced by Aboriginal and Torres Strait Islander males in Australia: Associations with suicidal thoughts and depressive symptoms. Aust N Z J Psychiatry 2022; 56:657-666. [PMID: 34256631 DOI: 10.1177/00048674211031168] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Globally, Indigenous populations have higher rates of suicidal behavior and psychological distress compared to non-Indigenous populations. Indigenous populations also report high rates of exposure to discrimination, which could potentially contribute to poor mental health outcomes. The objectives of this paper were to estimate the prevalence of discrimination among Aboriginal and Torres Strait Islander males in Australia and to examine the role of discrimination in the association between Aboriginal and Torres Strait Islander status and suicidal thoughts and depressive symptoms. METHODS We used cross-sectional data on 13,697 males aged 18-55 years from the Australian Longitudinal Study on Male Health. We undertook a Poisson regression with robust standard error analyses to examine Aboriginal and Torres Strait Islander status and self-perceived exposure to discrimination in the past 2 years as correlates of recent suicidal ideation. We used zero-inflated negative binomial regression to assess Aboriginal and Torres Strait Islander status and self-perceived exposure to discrimination as correlates of recent depressive symptoms. RESULTS Aboriginal and Torres Strait Islander males have a twofold higher prevalence of self-perceived discrimination (39.2% vs 19.3%, p < 0.001), suicidal ideation (21.8% vs 9.4%, p < 0.001) and moderate or worse depressive symptoms (24.0% vs 12.2%, p < 0.001) as compared to their non-Indigenous counterparts. After adjusting for sociodemographics and substance use, Aboriginal and Torres Strait Islander status was significantly associated with suicidal thoughts (odds ratio = 1.49, p = 0.019) and depressive symptoms (prevalence rate ratio = 1.19, p = 0.018). About 15.3% and 28.7% of the association between Aboriginal and Torres Strait Islander status and suicidal thoughts and depressive symptoms, respectively, was explained by discrimination. CONCLUSION Our analyses add to evidence that discrimination is a contributor to mental health disparities between Aboriginal and Torres Strait Islander and non-Indigenous populations in Australia. Reducing discrimination ought to be considered as part of strategies to improve the social and emotional well-being of Aboriginal and Torres Strait Islander people.
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Affiliation(s)
- Tilahun Haregu
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Anthony F Jorm
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Yin Paradies
- Alfred Deakin Institute for Citizenship and Globalisation, Deakin University, Melbourne, VIC, Australia
| | - Bernard Leckning
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT, Australia
| | - Jesse T Young
- Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia.,School of Population and Global Health, The University of Western Australia, Perth, WA, Australia.,National Drug Research Institute, Curtin University, Perth, WA, Australia
| | - Gregory Armstrong
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
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Vang ZM, Chau S, Kobayashi K, Owen MJ, McKenzie-Sampson S, Mayrand-Thibert J, Brass G. Pain and Functional Limitations Among Midlife and Older Canadians: The Role of Discrimination, Race and Sense of Belonging. J Gerontol B Psychol Sci Soc Sci 2021:gbab137. [PMID: 34282848 DOI: 10.1093/geronb/gbab137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES We drew on fundamental cause theory and the weathering hypothesis to examine how discrimination influences aging for midlife and older adults in Canada. METHODS Using nationally representative data, we assessed the associations between discrimination and pain and functional limitations among adults 45 years of age and older. Discrimination was measured using a modified version of the Everyday Discrimination Scale. Chi-square tests were performed to check for baseline differences in the dependent and key predictor variables by race. Logistic regression was used to estimate the associations of discrimination, race, and sense of belonging with pain and functional limitations, net of sociodemographic characteristics and SES. RESULTS Indigenous respondents showed a clear health disadvantage, with higher rates of pain and functional limitations compared to Whites and Asians. Self-reported discrimination was also higher for Indigenous midlife and older adults than for their White and Asian age counterparts. Discrimination had a direct and robust association with pain (OR 1.56, 95% CI 1.31, 1.87) and functional limitations (OR 1.55, 95% CI 1.29, 1.87). However, race moderated the impact of discrimination on functional limitations for Blacks. Finally, a strong sense of belonging to one's local community was protective against pain and functional limitations for all racial groups. DISCUSSION Future research needs to further examine the impact of discrimination on Indigenous peoples' aging process. High rates of discrimination coupled with a greater burden of pain means that Indigenous midlife and older adults may require additional and targeted health and social service resources to age successfully.
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Kairuz CA, Casanelia LM, Bennett-Brook K, Coombes J, Yadav UN. Impact of racism and discrimination on physical and mental health among Aboriginal and Torres Strait islander peoples living in Australia: a systematic scoping review. BMC Public Health 2021; 21:1302. [PMID: 34217243 PMCID: PMC8254223 DOI: 10.1186/s12889-021-11363-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 06/24/2021] [Indexed: 11/26/2022] Open
Abstract
Background Racism is increasingly recognised as a significant health determinant that contributes to health inequalities. In Australia efforts have been made to bridge the recognised health gap between Aboriginal and Torres Strait Islander people and other Australians. This systematic scoping review aimed to assess, synthesise, and analyse the evidence in Australia about the impacts of racism on the mental and physical health of Aboriginal and Torrens Strait Islander peoples. Methods A systematic search was conducted to locate Australian studies in English published between 2000 and 2020. Five electronic databases were used: PubMed, CINAHL, Embase, Web of Science and the Australia’s National Institute for Aboriginal and Torres Strait Islander Health Research. The search strategy included a combination of key words related with racism, mental health, physical health and Indigenous people. Data were extracted based on review questions and findings were synthesized in a narrative summary. Results Of total 338 searched studies from five databases, 12 studies met the inclusion criteria for narrative synthesis where eight were cross-sectional studies and four prospective cohorts. General mental health and general health perception were the most frequently studied outcomes followed by child behaviour, smoking and substance consumption and specific health conditions. The prevalence of racism varied between 6.9 and 97%. The most common health outcomes associated with racism were general poor mental health and poor general health perception. More specific health outcomes such as anxiety, depression, child behaviour, asthma, increased BMI and smoking were also associated with racism but were analysed by a limited number of studies. Three studies analysed psychological distress, negative mental health, sleeping difficulties and negative perceived mental health according to severity of exposition to racism. Conclusion Racism is associated with negative overall mental and negative general health outcomes among Aboriginal and Torres Strait Islander peoples. Strategies to prevent all forms and sources of racism are necessary to move forward to bridging the health gap between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians. Further research is needed to understand in more detail the impact of racism from an Aboriginal and Torres Strait Islander definition of health and wellbeing. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11363-x.
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Affiliation(s)
- Camila A Kairuz
- Department of Public Health, Torrens University, Sydney, Australia.,The George Institute for Global Health, Sydney, Australia
| | - Lisa M Casanelia
- Department of Public Health, Torrens University, Sydney, Australia
| | | | | | - Uday Narayan Yadav
- Department of Public Health, Torrens University, Sydney, Australia. .,Centre for Primary Health Care and Equity, Faculty of Medicine and Health, UNSW, Sydney, Australia. .,Center for Research Policy and Implementation, Biratnagar, Nepal.
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Bryant J, Bolt R, Botfield JR, Martin K, Doyle M, Murphy D, Graham S, Newman CE, Bell S, Treloar C, Browne AJ, Aggleton P. Beyond deficit: 'strengths-based approaches' in Indigenous health research. SOCIOLOGY OF HEALTH & ILLNESS 2021; 43:1405-1421. [PMID: 34145599 DOI: 10.1111/1467-9566.13311] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 03/11/2021] [Accepted: 05/14/2021] [Indexed: 05/12/2023]
Abstract
Health research concerning Indigenous peoples has been strongly characterised by deficit discourse-a 'mode of thinking' that is overly focused on risk behaviours and problems. Strengths-based approaches offer a different perspective by promoting a set of values that recognise the capacities and capabilities of Indigenous peoples. In this article, we seek to understand the conceptual basis of strengths-based approaches as currently presented in health research. We propose that three main approaches exist: 'resilience' approaches concerned with the personal skills of individuals; 'social-ecological' approaches, which focus on the individual, community and structural aspects of a person's environment; and 'sociocultural' approaches, which view 'strengths' as social relations, collective identities and practices. We suggest that neither 'resilience' nor 'social-ecological' approaches sufficiently problematise deficit discourse because they remain largely informed by Western concepts of individualised rationality and, as a result, rest on logics that support notions of absence and deficit. In contrast, sociocultural approaches tend to view 'strengths' not as qualities possessed by individuals, but as the structure and character of social relations, collective practices and identities. As such, they are better able to capture Indigenous ways of knowing and being and provide a stronger basis on which to build meaningful interventions.
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Affiliation(s)
- Joanne Bryant
- Centre for Social Research in Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - Reuben Bolt
- Charles Darwin University, Casuarina, Northern Territory, Australia
| | - Jessica R Botfield
- Centre for Social Research in Health, UNSW Sydney, Sydney, New South Wales, Australia
- Family Planning NSW, Sydney, New South Wales, Australia
| | - Kacey Martin
- Centre for Social Research in Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - Michael Doyle
- Centre of Research Excellence in Indigenous Health and Alcohol, University of Sydney, Sydney, New South Wales, Australia
| | - Dean Murphy
- The Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia
| | - Simon Graham
- Department of Infectious Diseases, Melbourne Medical School, University of Melbourne, Parkville, Victoria, Australia
| | - Christy E Newman
- Centre for Social Research in Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - Stephen Bell
- UQ Poche Centre for Indigenous Health, The University of Queensland, St Lucia, Queensland, Australia
- School of Public Health, The University of Queensland, St Lucia, Queensland, Australia
| | - Carla Treloar
- Centre for Social Research in Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - Annette J Browne
- School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
| | - Peter Aggleton
- Centre for Social Research in Health, UNSW Sydney, Sydney, New South Wales, Australia
- Centre for Gender and Global Health, Institute for Global Health, UCL, London, UK
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