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Webb T, Meldrum K, Kilburn M, Wallace V, Russell S, Quigley R, Strivens E. Cultural, sociopolitical, environmental and built assets supporting health and well-being in Torres Strait Island communities: protocol for a scoping review. BMJ Open 2023; 13:e077229. [PMID: 38070909 PMCID: PMC10729014 DOI: 10.1136/bmjopen-2023-077229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 11/20/2023] [Indexed: 12/18/2023] Open
Abstract
INTRODUCTION Risks to an individual's health should be considered alongside the environmental, sociocultural and sociopolitical context(s) in which they live. Environmental mapping is an approach to identifying enablers and barriers to health within a community. The Indigenous Indicator Classification System (IICS) framework has been used to map the environment in Australian Indigenous communities. The IICS is a four-level nested hierarchical framework with subject groups including culture, sociopolitical and built at the top of the hierarchy and indicators at the bottom. The objective of this scoping review is to map the cultural, sociopolitical, environmental and built assets that support health and well-being that exist in each Torres Strait Island community. METHODS AND ANALYSIS This review will be conducted according the Joanna Briggs Institute (JBI) method for scoping reviews. It will include sources that identify cultural, sociopolitical, environmental and built assets that support health and well-being that exist in each Torres Strait Island community. Databases to be searched include: Informit; Scopus; Web of Science; HealthInfoNet, BioOne Complete and Green File. Sources of unpublished and grey literature will be located using Google and Google Scholar. Searches will be limited to the English language and literature published since January 2018 to ensure that the assets mapped reflect current conditions on each island. Data that answers the research question will be extracted from sources and recorded in an adaptation of the IICS. Quantitative analysis of the data will include summing each asset for individual islands and their associated clusters. Data will be presented graphically, diagrammatically, or in tabular form depending on what approach best conveys its meaning. ETHICS AND DISSEMINATION The Far North Queensland Human Research Ethics Committee (reference HREC/2022/QCH/88 155-1624) has approved this study. Dissemination of the review's findings will be led by Torres Strait Islander members of the research team through conferences and peer-reviewed publications.
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Affiliation(s)
- Torres Webb
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Kathryn Meldrum
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Melissa Kilburn
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Valda Wallace
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Sarah Russell
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Rachel Quigley
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Edward Strivens
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
- Cairns and Hinterland Hospital and Health Service, Queensland Health, Cairns, Queensland, Australia
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Brennan L, Brewster L, Lunn J, Egboko F, Pestotnik Stres D, Patel P, Isba R. How do hospitals address health inequalities experienced by children and young people: a grey literature scoping review protocol. BMJ Open 2023; 13:e071682. [PMID: 37105699 PMCID: PMC10151951 DOI: 10.1136/bmjopen-2023-071682] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/29/2023] Open
Abstract
INTRODUCTION Health inequalities are unfair, systematic differences in health between people. In the UK, the Health and Social Care Act 2012 recognised health inequalities as a responsibility of the National Health Service (NHS). Health inequalities were foregrounded in the publication of 2019 NHS Long Term Plan and during the SARS-CoV-2/COVID-19 pandemic. Hospitals are well placed to address health inequalities through their role as anchor institutions. While many hospitals have begun to address inequalities, children are often overlooked or assumed to have the same needs as adult populations. This grey literature scoping review aims to identify, collate and present approaches taken by hospitals to address health inequalities in children and young people. METHODS AND ANALYSIS This scoping review will follow Joanna Briggs Institute guidance. A four-step approach to identifying grey literature will be used. Literature will be examined to identify approaches that aim to address health inequalities. Literature must describe the health inequality they aim to address and be initiated by the hospital. It will exclude literature not available in English and published before 2010. Two reviewers will independently review the results of the searches using the inclusion and exclusion criteria. Data will be extracted using a data extraction tool. Study findings will be presented in tabular form detailing the interventions identified. DISSEMINATION The review will synthesise information on worldwide hospital approaches to addressing child health inequalities. The findings will be used to inform guidelines for children's hospitals in the UK and will be disseminated through national and international professional bodies, conferences and research papers.
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Affiliation(s)
- Louise Brennan
- St Helens and Knowsley Teaching Hospitals NHS Trust, Prescot, UK
- Lancaster Medical School, Lancaster University, Lancaster, UK
| | - Liz Brewster
- Lancaster Medical School, Lancaster University, Lancaster, UK
| | - Judith Lunn
- Lancaster Medical School, Lancaster University, Lancaster, UK
| | - Fiona Egboko
- Lancaster Medical School, Lancaster University, Lancaster, UK
| | | | - Pallavi Patel
- St Helens and Knowsley Teaching Hospitals NHS Trust, Prescot, UK
- Lancaster Medical School, Lancaster University, Lancaster, UK
| | - Rachel Isba
- Lancaster Medical School, Lancaster University, Lancaster, UK
- Manchester University NHS Foundation Trust, Manchester, UK
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Hudson S, Foley D, Cargo M. Indigenous Social Enterprises and Health and Wellbeing: A Scoping Review and Conceptual Framework. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14478. [PMID: 36361356 PMCID: PMC9657732 DOI: 10.3390/ijerph192114478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/24/2022] [Accepted: 11/01/2022] [Indexed: 06/16/2023]
Abstract
Indigenous people and communities are establishing social enterprises to address social disadvantage and overcome health inequities in their communities. This review sought to characterize the spectrum of Indigenous social enterprises in Australia, New Zealand, Canada, and the United States to identify the operational models and cultural values that underpin them and their impact on Indigenous health and wellbeing. The scoping review followed Arksey and O'Malley's six-stage methodological framework with recommended enhancements by Levac et al. underpinned by Indigenous Standpoint Theory, and an Indigenous advisory group to provide cultural oversight and direction. Of the 589 documents screened 115 documents were included in the review. A conceptual framework of seven different operational models of Indigenous social enterprises was developed based on differing levels of Indigenous ownership, control, and management: (1) individual, (2) collective, (3) delegative, (4) developmental, (5) supportive, (6) prescriptive and (7) paternalistic. Models with 100% Indigenous ownership and control were more likely to contribute to improved health and wellbeing by increasing self-determination and strengthening culture and promoting healing than others. Indigenous social enterprises could offer a more holistic and sustainable approach to health equity and health promotion than the siloed, programmatic model common in public health policy.
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Affiliation(s)
- Sara Hudson
- Health Research Institute, University of Canberra, 11 Kirinari St., Canberra, ACT 2617, Australia
| | - Dennis Foley
- School of Management, Faculty of Business, Government and Law, University of Canberra, 11 Kirinari St., Canberra, ACT 2617, Australia
| | - Margaret Cargo
- Health Research Institute, University of Canberra, 11 Kirinari St., Canberra, ACT 2617, Australia
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Chakraborty A, Cargo M, Oguoma VM, Coffee NT, Chong A, Daniel M. Built Environment Features and Cardiometabolic Mortality and Morbidity in Remote Indigenous Communities in the Northern Territory, Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159435. [PMID: 35954785 PMCID: PMC9368214 DOI: 10.3390/ijerph19159435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/29/2022] [Accepted: 07/29/2022] [Indexed: 02/04/2023]
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.
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Affiliation(s)
- Amal Chakraborty
- University Centre for Rural Health, The University of Sydney, Lismore, NSW 2480, Australia
- Correspondence:
| | - Margaret Cargo
- Health Research Institute, Faculty of Health, University of Canberra, Bruce, ACT 2601, Australia; (M.C.); (N.T.C.); (M.D.)
| | - 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; (M.C.); (N.T.C.); (M.D.)
- 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; (M.C.); (N.T.C.); (M.D.)
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Chakraborty A, Oguoma VM, Coffee NT, Markey P, Chong A, Cargo M, Daniel M. Association of Built Environmental Features with Rates of Infectious Diseases in Remote Indigenous Communities in the Northern Territory, Australia. Healthcare (Basel) 2022; 10:healthcare10010173. [PMID: 35052336 PMCID: PMC8775403 DOI: 10.3390/healthcare10010173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/12/2022] [Accepted: 01/13/2022] [Indexed: 01/27/2023] Open
Abstract
The health of Indigenous Australians is far poorer than non-Indigenous Australians, including an excess burden of infectious diseases. The health effect of built environmental (BE) features on Indigenous communities receives little attention. This study’s objective was to determine associations between BE features and infectious disease incidence rates in remote Indigenous communities in the Northern Territory (NT), Australia. Remote Indigenous communities (n = 110) were spatially joined to 93 Indigenous Locations (ILOC). Outcomes data were extracted (NT Notifiable Diseases System) and expressed as ILOC-specific incidence rates. Counts of buildings were extracted from community asset maps and grouped by function. Age-adjusted infectious disease rates were dichotomised, and bivariate binomial regression used to determine the relationships between BE variables and infectious disease. Infrastructure Shelter BE features were universally associated with significantly elevated disease outcomes (relative risk 1.67 to 2.03). Significant associations were observed for Services, Arena, Community, Childcare, Oval, and Sports and recreation BE features. BE groupings associated with disease outcomes were those with communal and/or social design intent or use. Comparable BE groupings without this intent or use did not associate with disease outcomes. While discouraging use of communal BE features during infectious disease outbreaks is a conceptually valid countermeasure, communal activities have additional health benefits themselves, and infectious disease transmission could instead be reduced through repairs to infrastructure, and more infrastructure. This is the first study to examine these associations simultaneously in more than a handful of remote Indigenous communities to illustrate community-level rather than aggregated population-level associations.
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Affiliation(s)
- Amal Chakraborty
- Research Centre for Palliative Care, Death and Dying, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA 5042, Australia
- Correspondence: ; Tel.: +61-(0)-422-473-881
| | - Victor Maduabuchi Oguoma
- Health Research Institute, Faculty of Health, University of Canberra, Bruce, ACT 2601, Australia; (V.M.O.); (N.T.C.); (M.C.); (M.D.)
| | - Neil T. Coffee
- Health Research Institute, Faculty of Health, University of Canberra, Bruce, ACT 2601, Australia; (V.M.O.); (N.T.C.); (M.C.); (M.D.)
| | - Peter Markey
- Centre for Disease Control, Top End Health Services, Northern Territory Department of Health, Northern Territory Government, Darwin, NT 0810, Australia;
| | - Alwin Chong
- Arney Chong Consulting, Adelaide, SA 5081, Australia;
| | - Margaret Cargo
- Health Research Institute, Faculty of Health, University of Canberra, Bruce, ACT 2601, Australia; (V.M.O.); (N.T.C.); (M.C.); (M.D.)
| | - Mark Daniel
- Health Research Institute, Faculty of Health, University of Canberra, Bruce, ACT 2601, Australia; (V.M.O.); (N.T.C.); (M.C.); (M.D.)
- South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
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Chakraborty A, Howard NJ, Daniel M, Chong A, Slavin N, Brown A, Cargo M. Prioritizing Built Environmental Factors to Tackle Chronic and Infectious Diseases in Remote Northern Territory (NT) Communities of Australia: A Concept Mapping Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5178. [PMID: 34068201 PMCID: PMC8152969 DOI: 10.3390/ijerph18105178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/07/2021] [Accepted: 05/07/2021] [Indexed: 12/31/2022]
Abstract
High prevalence of chronic and infectious diseases in Indigenous populations is a major public health concern both in global and Australian contexts. Limited research has examined the role of built environments in relation to Indigenous health in remote Australia. This study engaged stakeholders to understand their perceptions of the influence of built environmental factors on chronic and infectious diseases in remote Northern Territory (NT) communities. A preliminary set of 1120 built environmental indicators were systematically identified and classified using an Indigenous Indicator Classification System. The public and environmental health workforce was engaged to consolidate the classified indicators (n = 84), and then sort and rate the consolidated indicators based on their experience with living and working in remote NT communities. Sorting of the indicators resulted in a concept map with nine built environmental domains. Essential services and Facilities for health/safety were the highest ranked domains for both chronic and infectious diseases. Within these domains, adequate housing infrastructure, water supply, drainage system, reliable sewerage and power infrastructure, and access to health services were identified as the most important contributors to the development of these diseases. The findings highlight the features of community environments amenable to public health and social policy actions that could be targeted to help reduce prevalence of chronic and infectious diseases.
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Affiliation(s)
- Amal Chakraborty
- School of Health Sciences, University of South Australia, Adelaide, SA 5001, Australia; (N.J.H.); (M.D.); (A.B.); (M.C.)
- Research Centre for Palliative Care, Death and Dying, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA 5042, Australia
| | - Natasha J. Howard
- School of Health Sciences, University of South Australia, Adelaide, SA 5001, Australia; (N.J.H.); (M.D.); (A.B.); (M.C.)
- Wardliparingga Aboriginal Health Equity, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA 5000, Australia
| | - Mark Daniel
- School of Health Sciences, University of South Australia, Adelaide, SA 5001, Australia; (N.J.H.); (M.D.); (A.B.); (M.C.)
- Health Research Institute, Faculty of Health, University of Canberra, Bruce, ACT 2601, Australia
- South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
| | - Alwin Chong
- Australian Centre for Child Protection, University of South Australia, Adelaide, SA 5001, Australia;
| | - Nicola Slavin
- Environmental Health Branch, Department of Health, Northern Territory Government, Casuarina, NT 0810, Australia;
| | - Alex Brown
- School of Health Sciences, University of South Australia, Adelaide, SA 5001, Australia; (N.J.H.); (M.D.); (A.B.); (M.C.)
- Wardliparingga Aboriginal Health Equity, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA 5000, Australia
| | - Margaret Cargo
- School of Health Sciences, University of South Australia, Adelaide, SA 5001, Australia; (N.J.H.); (M.D.); (A.B.); (M.C.)
- Health Research Institute, Faculty of Health, University of Canberra, Bruce, ACT 2601, Australia
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