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Australia's health 2014Understanding health & illness Australia's health system How healthy are we? While there have been improvements in the health and wellbeing of Aboriginal and Torres Strait Islander Australians in recent years, some long-standing challenges remain. This chapter presents information on the characteristics and health status of the Indigenous population, including their self-assessed health, common long-term health conditions, life expectancy and death rates. Information is also presented on health behaviours, social determinants of health and access to health services specific to the Indigenous population. Aboriginal and Torres Strait Islander people (Indigenous Australians) are the Indigenous people of Australia.
Indigenous Australians can be of Aboriginal origin, Torres Strait Islander origin, or both. Australia's Indigenous population was estimated to be 669,900 people in 2011, which was 3% of the total population (ABS 2013).
In 2011, 90% of Indigenous Australians identified as being of Aboriginal origin only, 6% as Torres Strait Islander origin only, and 4% as both Aboriginal and Torres Strait Islander origin. The younger age profile of Indigenous Australians is mainly due to their higher fertility rates and higher mortality rates at all ages compared with non-Indigenous Australians.
The Northern Territory has the highest proportion of Indigenous Australians, with 30% of its population identifying as being of Aboriginal or Torres Strait Islander origin in 2011.
The Indigenous estimated resident population is determined using information from the Census, birth and death registrations, and migration data. Due to the small Indigenous population in some jurisdictions and remoteness areas, it is not always possible to produce specific, reliable statistics. Much of what we know about the gap between Indigenous and non-Indigenous outcomes relies on statistics calculated using data from the Australian Bureau of Statistics (ABS) Census, surveys and administrative data from service providers. The Indigenous estimated resident population (ERP) is derived from the Census counts after adjustments for the undercount and for those records where Indigenous status was unknown. The Indigenous ERP is important because it is used to calculate population rates for a feature of interest, for example, deaths rates in terms of number of deaths per 100,000 population.
To ensure that Indigenous status information is consistently and correctly recorded, the AIHW has produced national best practice guidelines for collecting Indigenous status in health data sets and has evaluated their implementation across various settings. More information on the composition of the Indigenous population is on the Australian Bureau of Statistics website. Life expectancy and mortality rates are important measures of the health status of a population (see Chapter 3 'Life expectancy' and 'Leading cause of death in Australia').
Information on Indigenous deaths is reported for New South Wales, Queensland, Western Australia, South Australia and the Northern Territory combined.
Indigenous Australians had higher death rates than non-Indigenous Australians across all age groups during 2007–2011. Between 2001 and 2011, there was a 6% fall in the death rate for Indigenous Australians and a narrowing of the gap between Indigenous and non-Indigenous Australians.
Between 2007 and 2011, Indigenous Australians were most likely to die from circulatory conditions (26% of all Indigenous deaths), cancer (19%) and external causes such as suicides, falls, transport accidents and assaults (15%).
The largest gap in death rates between Indigenous and non-Indigenous Australians was in circulatory disease deaths (22% of the gap) followed by endocrine, metabolic and nutritional disorders (particularly diabetes) (14% of the gap). Indigenous Australians were 5 times as likely as non-Indigenous Australians to die from endocrine, nutritional and metabolic conditions (such as diabetes), and 3 times as likely to die of digestive conditions.
There were 10,396 infant deaths between 2001 and 2012, of which 1,315 (13%) were Indigenous infants.
Indigenous children aged 0–4 died at more than twice the rate of non-Indigenous children in 2012 (165 per 100,000 compared with 77 per 100,000 population) (SCRGSP forthcoming).
The AIHW's Enhanced Mortality Database project is using data linkage to improve estimates of Indigenous deaths and life expectancy. More information on the life expectancy and death rates of Indigenous Australians is available at Indigenous Observatory. About 2 in 5 Indigenous Australians aged over 15 (39%) rated their health as excellent or very good, 36% as good and 25% as fair or poor in 2012–13 (Figure 7.4).
Indigenous Australians were at least twice as likely as non-Indigenous Australians to rate their health as fair or poor, and almost half as likely to rate their health as excellent or very good. Compared with 2004–05, Indigenous Australians were 10% less likely to rate their health as excellent or very good in 2012–13 and 13% more likely to rate their health as fair or poor (ABS 2013). About 2 in 3 Indigenous Australians (67%) reported that they had at least 1 long-term condition in 2012–13. The most commonly reported long-term conditions among Indigenous Australians were vision problems, respiratory diseases (including asthma), back pain and arthritis, ear and hearing problems, circulatory disease and diabetes. About 6% of Indigenous Australians reported needing assistance with daily activities in the 2011 Census. After adjusting for differences in age structure and response rates, Indigenous Australians aged under 65 were more than twice as likely as non-Indigenous Australians to require assistance with daily activities.
The difference between Indigenous and non-Indigenous Australians was most pronounced in the 40–59 age group, with Indigenous people almost 3 times as likely to require assistance with daily activities as non-Indigenous people of that age. The latest published information on the burden of disease experienced by Indigenous Australians is based on data from 2003. More information on the health status of Indigenous Australians is available at Indigenous Observatory. Health risk behaviours, such as smoking, poor nutrition, physical inactivity and alcohol consumption contribute to poorer health status (see Chapter 5 'Behavioural risk factors').
The following information is based on results from the 2012–13 Australian Aboriginal and Torres Strait Islander Health Survey (ABS 2013). Two out of 5 Indigenous Australians aged 15 and over (41%) were current daily smokers in 2012–13, which, after adjusting for age, was more than twice the rate of smoking among non-Indigenous Australians in 2011–12.
The proportion of Indigenous adults who smoke daily decreased between 2002 and 2012–13 from 51% to 44% (Figure 7.6). After adjusting for age, the difference between the proportion of Indigenous and non-Indigenous smokers has narrowed from 27% in 2001 to 25% in 2012–13.
Data from 2001 National Health Survey and 2002 National Aboriginal and Torres Strait Islander Social Survey. Data from 2008 National Aboriginal and Torres Strait Islander Social Survey and 2007–08 National Health Survey. Data from 2011–12 Australian Health Survey and 2012–13 National Aboriginal and Torres Strait Islander Health Survey. The proportion of Indigenous Australians who reported drinking at lifetime risky levels did not change significantly between 2001 and 2012–13 (19% and 20% respectively). Indigenous men reported drinking at levels exceeding the 2009 National Health and Medical Research Council (NHMRC) guidelines in a single occasion (more than 4 standard drinks) at slightly higher rates (10% more) than non-Indigenous men. In 2012–13, more than 1 in 5 Indigenous people aged 15 and over (22%) reported that they had used an illicit substance in the previous 12 months. Almost one-third (30%) of Indigenous children aged 2–14 and two-thirds (66%) of Indigenous people aged 15 and over were overweight or obese in 2012–13. Indigenous Australians aged 15 and over were 10% less likely than non-Indigenous Australians to report eating an adequate amount of fruit each day, which was statistically significant. About 3 in 5 Indigenous Australians aged 18 and over (62%) reported no or low-level physical activity, which was 10% higher than the rate among non-Indigenous Australians. The information presented here is based on preliminary data from the 2012–13 Australian Aboriginal and Torres Strait Islander Health Survey. More information on the health behaviours of Indigenous Australians is available at Indigenous Observatory.
Social determinants of health are social and economic factors that can have a positive or negative effect on the health of individuals and communities by affecting the environment and conditions in which they live.
The 2011 Census data show that about 36% of Indigenous households were home owners or purchasers and 59% were renters, compared with 68% and 29% of non-Indigenous households respectively.
About 12% of Indigenous households were considered overcrowded in 2011, compared with 3% of non-Indigenous households.
The rate of homelessness for Indigenous Australians was 14 times as high as the rate for non-Indigenous Australians in 2011 (ABS 2012b).
Despite making up 3% of the population, Indigenous people represented 22% of people accessing specialist homelessness services in 2012–13. In each state and territory, average National Assessment Program—Literacy and Numeracy (NAPLAN) scores for Indigenous students across all learning areas in Years 3, 5, 7 and 9 were substantially lower than those for non-Indigenous students in 2013 (ACARA 2013).
One area where there has been significant improvement is reading among Year 5 Indigenous students, where the proportion who met or exceeded the national minimum standard increased from 65% in 2012 to 83% in 2013, compared with 93% to 97% for non-Indigenous students (ACARA 2013).
The proportion of Indigenous people aged 20–24 with a Year 12 or equivalent qualification increased from 47% in 2006 to 54% in 2011 (COAG Reform Council 2013). Half of all Indigenous people aged 15 and over had a personal weekly income of $362 or less in 2011 compared with $582 or less for non-Indigenous people. In 2011, 42% of Indigenous Australians aged 15 and over were employed compared with 61% of non-Indigenous people.
Unemployment rates were 17% for Indigenous Australians and 5% for non-Indigenous Australians (ABS 2012a).
Indigenous Australians were more likely to assess their health as good or excellent if they had higher incomes and education levels, and owned their home (Figure 7.9). The relationship between social determinants and health is complex and can be difficult to measure (see Chapter 7 'The size and causes of the health gap'). Also, the time taken for investments in education, employment and housing to affect a person's health can vary from immediate to many years. More information on the social determinants of Indigenous health is available at Indigenous Observatory. Due to their poorer health, Indigenous Australians could be expected to access health services at a much higher rate than non-Indigenous Australians.
Understanding Indigenous Australians' access to health services is important in evaluating whether the health system is adequately meeting their needs. Comprehensive data on Indigenous Australians' use of mainstream and Indigenous-specific health services are lacking, which makes it difficult to determine patterns in the use of health services.
In 2012–13, more than 1 in 5 Indigenous Australians (22%) accessed a general practitioner (GP) or specialist in the 2 weeks before the Australian Aboriginal and Torres Strait Islander Health Survey. About 1 in 4 Indigenous Australians aged 15 and over (26%) reported having problems accessing health services in 2008. Medicare Benefits Schedule (MBS) claim rates for GP visits were 17% higher for Indigenous than non- Indigenous Australians in 2010–11, but claim rates for specialist services were 39% lower (Figure 7.10). Rates of MBS Health Checks among Indigenous Australians rose significantly from 2006 to 2011 for all age groups (Figure 7.11).
In 2010–11, Pharmaceutical Benefits Scheme (PBS) expenditure per Indigenous Australian was around 80% of the level of expenditure per non-Indigenous Australian ($291 compared with $366). Aboriginal and Torres Strait Islander primary care services provided 2.6 million episodes of health care to about 445,000 clients in 2011–12. Indigenous Australians were hospitalised for potentially preventable conditions nearly 4 times as often as non-Indigenous Australians between July 2010 and June 2012.
Excluding dialysis, the leading cause of hospitalisation for Indigenous Australians was injury, poisoning and certain other consequences of external causes (38 hospitalisations per 1,000 people). After adjusting for age differences, Indigenous Australians were over twice as likely to be hospitalised for mental and behavioural disorders as non-Indigenous Australians, and nearly 3 times as likely to be hospitalised for respiratory conditions (Figure 7.12). While service use and spending patterns give some indication of the demand for health services, they do not provide information on whether services are accessible to all who need them, nor do they give a complete picture of whether the health needs of Indigenous Australians are being met. More information on how Indigenous Australians interact with the health system is available at Indigenous Observatory. Numerous studies have demonstrated that Australians living in remote or very remote areas have, on average, higher rates of risky health behaviours such as smoking, poorer access to health services, and worse health than people living in regional or metropolitan areas (AIHW 2012). Poorer health with increasing remoteness may be influenced by environmental or geographical factors such as long distances to access services (which can also be an issue for urban fringes), communities being cut off on occasion because of flooding, or poorer access to healthy food sources (Harrison et al.
These differences in health may also be due to the characteristics of the populations in more remote areas.
The relationship of remoteness to health is particularly important for Indigenous Australians, as they are more likely to live outside metropolitan areas than non-Indigenous Australians. Indigenous Australians have lower life expectancies, higher rates of chronic and preventable illnesses, poorer self-reported health, and a higher likelihood of being hospitalised than non-Indigenous Australians (AIHW 2013; Bramley et al.
To summarise the discussion so far, differences in health by remoteness could be due to remoteness factors such as distance or access to services, or the lower socioeconomic status of people who live in remote areas (Indigenous and non-Indigenous), or the higher proportions of Indigenous people who live in remote areas—or a combination of all 3.
This article presents available data on how health conditions and risk factors differ by remoteness and Indigenous status, using both self-reported survey data as well as data on hospitalisations. The most recent data on self-reported health-related behaviours and conditions for Indigenous Australians were collected in the 2012–13 Australian Aboriginal and Torres Strait Islander Health Survey (AATSIHS) (ABS 2013a), which is part of the larger 2011–13 Australian Health Survey (AHS) which collected data on all Australians, except those living in Very remote areas. Across almost every indicator, Indigenous Australians are disadvantaged compared with all Australians. While there are differences by remoteness in the indicators for both populations, the impact of remoteness is relatively low. Table 7.3 presents more detailed data for Indigenous Australians by remoteness and includes those living in Very remote areas.
This shows that smoking rates and the prevalence of diabetes and heart conditions are highest among those living in Remote or Very remote areas. In contrast, the lowest rates of overweight and obesity for Indigenous Australians were found among those living in Very remote areas.
Information on service access and use gleaned from survey data can be limited due to the infrequency in which the surveys are conducted, their sample size, and individuals' imperfect recall and interpretation of survey questions.
An important contributor to population health is the availability and accessibility of health services. General practitioners (GPs) play an important role in the delivery and coordination of health care in Australia. The AIHW is developing an index that captures the extent to which the Indigenous, non-Indigenous and total populations of small geographic areas have access to health care relative to their health needs. This index applies to access to GP services only at this stage (as noted earlier, there are other types of providers delivering primary health care services, especially in remote areas). Access is determined by considering estimated drive times between GP service locations and SA1 centroids (centre points), as well as the number of GPs working at each service location.
The estimated demand for primary health care in each SA1 population is based on the size of the population and its per capita health needs, the latter determined by known associated demographic and socioeconomic predictors. It is important to note that service availability is only 1 aspect, albeit a major aspect, of accessibility— the extent to which available services are used is also important, and whether this varies by remoteness and Indigenous status.


Figure 7.13 presents average scores for access to health-care services provided by GPs for all SA1s in each remoteness area.
The access relative to needs index, which incorporates information on need as well as access, as described earlier, can be calculated separately for Indigenous and non-Indigenous populations. The average access relative to health needs index scores for Indigenous Australians (see Figure 7.14) are highest in Major cities and lowest (by a pronounced margin) in Very remote areas.
The most recent data from the AIHW National Hospital Morbidity Database (see Chapter 8 'Overview of public and private hospitals') show that there is great variation in total hospitalisation rates (including dialysis) by remoteness for the Indigenous population. There is much less variation by remoteness for hospitalisation rates for non-Indigenous Australians, and the pattern is different with the lowest rates recorded in Very remote and Remote areas. Analyses of hospitalisation rates by principal diagnoses suggest that there are regional differences in the most common conditions for which Indigenous Australians are hospitalised.
While total hospitalisation rates provide information on service use and are thus a measure of met need for services, a subset of hospitalisations provide an indirect indicator of the lack of access to, or use of, primary care services. Hospitalisations for potentially preventable conditions include hospitalisations for vaccine-preventable diseases (such as influenza and pneumonia), those for chronic conditions (such as asthma, congestive heart failure and diabetes), and those for acute conditions (such as dehydration and gastroenteritis). Data from the AIHW National Hospital Morbidity Database show that between July 2010 and June 2012 there were 81,516 hospitalisations for potentially preventable conditions for Indigenous Australians, which equates to 11.7% of all Indigenous hospitalisations. Note: These rates are calculated using the 2011 Estimated Resident Population (ERP) by remoteness, and thus differ from previously published hospitalisation rates using the 2006 ERP by remoteness applied to population projections from the 2006 Census of Population and Housing. For the Indigenous population, the likelihood of a potentially preventable hospitalisation is 4.3 times as high for those in Remote areas compared with those in Major cities. The results of an additional statistical analysis by AIHW showed that the odds that a hospitalisation was potentially preventable was 1.5 times as high for Indigenous Australians compared with non-Indigenous Australians (even after controlling for the age, sex, and remoteness of the person who was hospitalised). Are there racial or ethnic differences in the percentage of total dietary kilocalories consumed from sugar drinks?
Are there income differences in the percentage of total dietary kilocalories consumed from sugar drinks?
Non-Hispanic black children and adolescents consume more sugar drinks in relation to their overall diet than their Mexican-American counterparts. Low-income persons consume more sugar drinks in relation to their overall diet than those with higher income. Most of the sugar drinks consumed away from home are obtained from stores and not restaurants or schools.
Consumption of sugar drinks in the United States has increased over the last 30 years among both children and adults (1a€“3).
Overall, males consume an average of 178 kcal from sugar drinks on any given day, while females consume 103 kcal.
Approximately one-half of the population aged 2 and older consumes sugar drinks on any given day. Higher-income persons consume fewer kilocalories from sugar drinks as a percentage of total daily kilocalories than do lower-income individuals.
Sugar drinks: For these analyses, sugar drinks include fruit drinks, sodas, energy drinks, sports drinks, and sweetened bottled waters, consistent with definitions reported by the National Cancer Institute (8). Location of sugar-drink consumption: Respondents to the 24-hour dietary recall interview were asked if each reported food was consumed at home or away from home. Source of sugar drinks: Respondents to the 24-hour dietary recall interview were asked where they obtained each food consumed. Poverty income ratio (PIR): A measure representing the ratio of household income to the poverty threshold after accounting for inflation and family size. Data from the National Health and Nutrition Examination Survey (NHANES) were used for these analyses. The NHANES sample is selected through a complex, multistage design that includes selection of primary sampling units (counties), household segments within the counties, households within segments, and, finally, sample persons from selected households. Sample weights, which account for the differential probabilities of selection, nonresponse, and noncoverage, were incorporated into the estimation process. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated. An unlicensed and untested tanning product is being sold illegally at a gym in Neath, an ITV Wales investigation has revealed. The product, Melanotan, is a synthetic hormone which is injected into the skin causing it to darken. It is currently illegal to sell these tan injections because the product has not been tested, and so it is unlicensed by the Medicines and Healthcare products Regulatory Agency (MHRA), a body responsible for regulating the quality and safety of medicines. As it has not been through the licensing process, the MHRA are unsure of any potential side effects the product might have, and therefore it is not legal to market or supply it.
Although it is illegal to sell Melanotan in the UK, an ITV journalist was able to buy it from the gym in Neath. Despite it being illegal to sell the product, it is still being used by those who are keen for a year-round tan. Elin* lives in west Wales and has been buying the tanning injections from the internet for a few months. On the internet, Melanotan is marketed as a safe alternative to sun beds, but Cancer charity, Tenovus, are warning that there could be side-effects to the tanning injections. We’ve warned young people to stop using sun-beds because of the proven link with skin cancer.
The Medicines and Healthcare products Regulatory Agency has warned people not to use Melanotan, as the product has not been tested in the UK. You can see the full investigation into tanning injections at 6pm on ITV1, or on S4C's Hacio at 10pm. Nichols) BANELINGS BANELINGS BANELINGS OHHHH OHHHH BANELING BANELINGS OHHH BANELINGS BANELINGS LIKE A DEADLYY GREEN LAND MINE XDDDD LE STARCRAFT LE GEAM just came here to say starcraft>pokegay ( pokemon for the retard that don’t get it) Why did you leave that out? It came into the apartment searched all of the rooms and found him in his bed petrified with fear.
Another important thing to consider is that even if there are negative side effects they might pale in comparison to the crippling effects of depressive disorders.
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The etiology of this disease is multifactorial and an increasing amount of evidence points to environmental and lifestyle factors rather Injecting insulin properly is an important part of diabetes management.
In people diabetes mellitus is classified as Type 1 (insulin dependent) and Type 2 (non-insulin dependent). Social disadvantage, such as lower education and employment rates, is a factor, as well as higher smoking rates, poor nutrition, physical inactivity and poor access to health services. They live in all parts of the nation, from major cities to remote tropical coasts and the fringes of the central deserts. The Australian Government defines Indigenous Australians as people who are of Aboriginal or Torres Strait Islander descent, who identify as being of Aboriginal or Torres Strait Islander origin and who are accepted as such in the communities in which they live, or have lived. In 2011, half of the Indigenous population was aged 22 or under compared with 38 or under for the non-Indigenous population.
In most other jurisdictions, Indigenous people made up less than 5% of the population, with the lowest proportion (less than 1%) in Victoria. These data collections rely on people identifying themselves and their family members as Indigenous. In these cases, statistics are calculated for larger areas, but this might mask differences within the areas.
The Australian Institute of Health and Welfare (AIHW) and the ABS strive to collect and present accurate data, as well as ensure service providers are aware of the importance of collecting accurate Indigenous status information.
In 2011, the Indigenous undercount was estimated to be 17% (114,000 persons) and about 1 million Census records (5%) had an unknown Indigenous status (ABS 2012).
Equally as important are correct numbers from other data sources, which provide the frequency of a feature of interest. The AIHW also continues to measure the proportion of Indigenous people who are correctly identified in the data sets and creates correction factors to adjust the data for under-identification.
For example, its Enhanced Mortality Database project seeks to improve estimates of Indigenous mortality and life expectancy using data linkage. Indigenous Australians tend to die earlier than non-Indigenous Australians and their death rates are almost twice those of non-Indigenous Australians. Other jurisdictions have a small number of Indigenous deaths and identification of Indigenous status in the data is poor, making the data less reliable.
In the 35–44 age group, Indigenous people died at about 5 times the rate of non-Indigenous people. The rate of Indigenous infant deaths fell by 62% between 2001 and 2012 and by 23% for non-Indigenous infants (Figure 7.3).
Indigenous child death rates fell by 30% from 2001 to 2012 compared with 22% for non-Indigenous children (Figure 7.3). An Australian Bureau of Statistics study that linked 2011 Census records with death registration records found that about 87% of assumed Indigenous deaths were reported as Indigenous in death registration records (ABS 2013b). Death registrations are linked with hospital, residential aged care and perinatal data to investigate opportunities to improve the measurement of Indigenous deaths. The report Aboriginal and Torres Strait Islander Health Performance Framework 2012: detailed analyses and other recent publications are available for free download.
They are more likely to die at younger ages, experience disability and report their health as fair or poor.
After adjusting for differences in the age structure of the populations, the rate was similar to that for non-Indigenous Australians in 2011–12.
The AIHW is working on a study that uses 2011 data to measure the burden of disease experienced by the Indigenous and total Australian populations. Recent AIHW reports and publications available for free download include Aboriginal and Torres Strait Islander Health Performance Framework 2012: detailed analyses and Australia's welfare 2013.
Australian Aboriginal and Torres Strait Islander Health Survey: first results, Australia, 2012–13.
Of the behavioural risk factors covered here, smoking is the most concerning as rates are significantly higher in the Indigenous population than in the non-Indigenous population.
Trends over time are available for smoking and long-term risky alcohol consumption; however, they are not available for the other risk factors presented here because of differences in the questions asked in the 2012–13 survey and previous surveys. The rate for Indigenous women was 30% higher than for non-Indigenous women, which was found to be statistically significant (Figure 7.7). There was no significant difference in vegetable consumption between the 2 groups (7% and 8% respectively consumed 5 or more serves of vegetables daily).
The Australian Bureau of Statistics plans to release further data in the second half of 2014 that will incorporate the results from the sample of respondents who also participated in the 2012–13 National Aboriginal and Torres Strait Islander Nutrition and Physical Activity Survey and the 2012–13 National Aboriginal and Torres Strait Islander Health Measurements Survey.
Aboriginal and Torres Strait Islander Health Performance Framework 2012: detailed analyses.
They can also affect people's health by influencing their behaviours and decisions (see Chapter 7 'Health behaviours of Indigenous Australians'). Levels of overcrowding in remote Indigenous households fell from 22% in 2006 to 20% in 2011 (FaHCSIA 2013). For example, several social determinants may interact to create certain health outcomes, so separating the effects of each is not straightforward.
Census of Population and Housing: characteristics of Aboriginal and Torres Strait Islander Australians, 2011.
NAPLAN achievement in reading, persuasive writing, language conventions and numeracy: national report for 2013.
However, the most recent comparable data suggests that their overall access to health services is only marginally higher (AHMAC 2012).
Indigenous Australians may access mainstream or Indigenous-specific primary health care services, which offer prevention, diagnosis and treatment of ill health in a range of settings (see Chapter 8 'Primary health care in Australia'). Service use may be underestimated if consultations are not claimed for on Medicare, or are not funded by the Australian Government (such as when they are funded by state and territory governments). Of these, about 20% had problems accessing dentists, 10% accessing doctors and 7% accessing hospitals. In 2001–02, PBS expenditure per Indigenous Australian was around 33% of the amount spent per non-Indigenous Australian, suggesting a narrowing of the gap since then. Compared with 2010–11, there was a 5% increase in episodes of care and a 3% increase in the number of clients.
Respiratory and digestive conditions were the next most common causes (31 and 26 hospitalisations per 1,000 people, respectively). Even though Indigenous Australians may have physical access to a service, financial, social and cultural factors can influence whether they access the service or not.
Recent AIHW reports and other publications available for free download include Aboriginal and Torres Strait Islander Health Performance Framework 2012: detailed analyses, Aboriginal and Torres Strait Islander health services report 2011-12 and Expenditure on health for Aboriginal and Torres Strait Islander people 2010–11. For example, there is a strong association between socioeconomic status and health—the lower someone's socioeconomic status, the worse their health is likely to be. In 2011, just over one- third of Indigenous Australians lived in Major cities (34.8%), compared with over 70% of non-Indigenous Australians. We also focus on access to general practitioner services by remoteness and Indigenous status, and highlight the AIHW's work in developing an area-based index of access to services relative to the health needs of the Indigenous and non-Indigenous populations in those areas.
For all Australians, the largest difference between those living in Outer regional and Remote areas and those in Major cities is for smoking, with a ratio of 1.5. The picture is also incomplete because it leaves out those living in Very remote areas, since those data were not collected in the AHS.
Levels of high or very high psychological distress and the proportion of Indigenous Australians reporting asthma were also lowest for those living in Remote or Very remote areas. For example, high quality primary health care services (see Chapter 8 'Primary health care in Australia') are essential for preventive care and screening, managing acute and chronic illnesses, and providing a link to specialist services.
In 2012–13, 84% of Australians had consulted a GP at least once in the previous year (ABS 2013a). The index is based on methodology developed by McGrail and Humphreys (2009), and uses the physical (geospatial) locations of health services and the populations they serve, the number of GPs working at each service location, and the size and specific health needs of the 3 population groups in each SA1 (AIHW 2014). Access is considered 'unhindered' by distance for travel times up to 10 minutes, gradually declining to 'no access' for travel times greater than 60 minutes.
This in turn can depend on potential barriers to access such as the cultural competence of services or variations in individual access to public transport—which the index does not take into account.
Higher values represent better access to GP services taking both travel time and competition from other populations using the same GPs into account.


A similar pattern was found for the non-Indigenous population, except for a less pronounced decline in access relative to needs in Very remote areas, due to the relatively lower health needs of the non-Indigenous population in these areas. Between July 2010 and June 2012, after adjusting for differences in Indigenous under-identification in hospital separations data (AIHW 2013), the highest hospitalisation rates for Indigenous Australians were for those living in Remote areas, followed by those living in Very remote areas and Outer regional areas (they may have been hospitalised in Major cities, but live in these areas) (Figure 7.15).
For example, Indigenous Australians in Remote and Very remote areas have higher rates of hospitalisation for injuries, infectious diseases, dialysis, respiratory illnesses, circulatory conditions, and skin-related conditions compared with Indigenous Australians living in Major cities.
Admissions for potentially preventable conditions reflect hospitalisations that might have been prevented through the timely and appropriate provision and use of primary care or other non-hospital services (Li et al.
The highest proportion of hospitalisations for potentially preventable conditions was also in Major cities for non-Indigenous Australians, although the proportion was much higher (65.3%). The rates vary considerably for the Indigenous population by remoteness, with much higher rates for Remote and Very remote areas. For the non-Indigenous population, the highest rate is only 1.4 times as high (for those in Remote areas compared with those in Major cities). Indigenous status therefore appears to have a larger effect than remoteness on whether a hospitalisation was for a potentially preventable condition. Non-Hispanic black and Mexican-American adults consume more than non-Hispanic white adults.
Sugar drinks have been linked to poor diet quality, weight gain, obesity, and, in adults, type 2 diabetes (4,5). Mean consumption of sugar drinks is higher in males than females at all ages except among 2- to 5-year-olds. Among adult women, the percentage is lower, with 40% consuming sugar drinks on any given day, while among boys aged 2a€“19, 70% consume sugar drinks on any given day (Figure 2). Of these sugar-drink kilocalories, the vast majority is purchased in stores (92%), and just over 6% is purchased in restaurants or fast-food establishments. For example, males consume more than females, and teenagers and young adults consume more than other age groups. Most sugar drinks consumed away from home are obtained from stores, but more than one-third are obtained in restaurants or fast-food establishments.
Sugar drinks do not include diet drinks, 100% fruit juice, sweetened teas, and flavored milks. To determine source of food, respondents were offered 26 options, categorized for this brief as store, restaurant (including fast-food), school or child care, and other.
In 2008, a PIR of 350% was equivalent to approximately $77,000 for a family of four; a PIR of 130% was equivalent to approximately $29,000 for a family of four. NHANES is a cross-sectional survey designed to monitor the health and nutritional status of the civilian, noninstitutionalized U.S.
The sample design includes oversampling to obtain reliable estimates of health and nutritional measures for population subgroups. The standard errors of the percentages were estimated using Taylor Series Linearization, a method that incorporates the sample weights and sample design.
Trends in food and nutrient intakes by adults: NFCS 1977a€“78, CSFII 1989-91, and CSFII 1994-95. Effects of soft drink consumption on nutrition and health: A systematic review and meta-analysis. Defining and setting national goals for cardiovascular health promotion and disease reduction: The American Heart Association's strategic impact goal through 2020 and beyond. Dietary sources of energy, solid fats, and added sugars among children and adolescents in the United States. It works by increasing the body's level of melanin, which is a natural dark pigment in the skin that darkens in the sun. They're cheaper than having a spray tan every week, and I feel really confident being nice and brown.
These tan injections are even more worrying because they haven’t been licensed so we don’t even know what the effects are now or what they’ll be in the future. Don't be fooled into thinking that Melanotan offers a shortcut to a safer and more even tan.
If you have diabetes and are on Medicare the cost of your diabetes testing supplies may be covered. Tagged with: Body Changed diabetes types of tests diabetes Kidney lives People Problems Testimonials their Visalus. Participating stroke patients will be assigned to receive ioglitazone a medication which reduces insulin resistance or placebo (an inactive look-alike pill).
Structured patient key facts about diabetes education programmes reduce the risk of diabetes-related complications four-fold.
They are not 1 group, but comprise hundreds of groups that have their own distinct set of languages, histories and cultural traditions. In most data collections, a person's Indigenous status is based on the first 2 parts of the definition. As Indigenous data improves, it may be possible to use combined data from a number of years to analyse differences specific to areas with small Indigenous populations. However, they acknowledge that for various reasons not all Indigenous people are identified in the different data sets, which can lead to an undercount.
The 2011 Indigenous ERP was 669,881 persons—an increase of 152,838 persons, or 30% from the 2006 ERP.
As the Indigenous ERP has been adjusted for undercount, data from other sources also need to be adjusted for undercount; otherwise calculated rates for the Indigenous population are likely to appear to be lower than the true rates, resulting in an underestimation of the gap or the difference between Indigenous and non-Indigenous rates. This could suggest that the proportion of Indigenous people who needed help increased since 2006.
In this project, death registrations obtained from the Registries of Births, Deaths and Marriages in each state and territory are linked to deaths in hospital, residential aged care and perinatal data in order to better estimate the likely Indigenous status of death registrations. The level of Indigenous identification varies across states and territories, as well as by remoteness area (see Chapter 7 'Profile of Indigenous Australians'). The reasons for the differences are explored throughout this chapter and include disparities in social and economic factors, in health behaviours and in access to health services (see Chapter 7 'Social determinants of Indigenous health' and Chapter 7 'The size and causes of the Indigenous health gap'). This study will provide updated information on the impact of diseases and injuries on Indigenous Australians, and is expected to be released in early 2016. For example, people living in houses without safe drinking water may be at risk of diarrhoeal diseases, and those on low incomes may not eat fresh fruit and vegetables regularly if they cannot afford them. To improve Indigenous health, strategies to increase access to health services are required alongside improvements in behavioural and social factors. Incomplete identification of Indigenous people in mainstream health services data can also lead to an underestimation of service use. The greatest barriers were long waiting times or services being unavailable when required (52%), and cost was a barrier for about 1 in 3 (32%). There is also a possibility that the available service may not be the most suitable one for their health needs.
Evidence also shows higher rates of poor housing and overcrowding in remote areas, which have a negative impact on health (AIHW 2011).
Given that a higher proportion of remote residents are disadvantaged compared with those who live in metropolitan or regional areas, their health may be worse as a result of socioeconomic disadvantage rather than just environmental or geographical factors related to remoteness. At this point, the AHS data by remoteness have only been reported for all Australians, not for non-Indigenous Australians. For Indigenous Australians, the largest difference between those in Outer regional and Remote areas and those in Major cities is 1.3 for diabetes. Data sets collected in the course of health service delivery can facilitate comparisons of patterns by remoteness and Indigenous status.
These services are delivered by a range of practitioners (for example, general practitioners, dentists, nurses, Aboriginal Health Workers) across a variety of locations (for example, community health centres, general practices, and allied health practices).
This section presents information on access to general practitioners by Indigenous status and remoteness. The results show that, as expected, the best access is in the Major cities and the worst access is in Very remote areas. The rates of hospitalisation for Indigenous Australians living in Remote areas were 1.9 as high as for Indigenous Australians living in Major cities. Hospitalisation rates are lower for Indigenous Australians in Remote and Very remote areas for mental and behavioural disorders, cancer, diseases of the nervous system, and congenital anomalies, compared with Indigenous Australians living in Major cities. There is less variation for the non-Indigenous population, but the highest rates are still found in Remote areas. Therefore, it appears that remoteness has a stronger impact for the Indigenous population than for the non-Indigenous population, although some of the effect may be due to under-identification of Indigenous status in hospitalisation data in Major cities. Consumption of sugar drinks increases until ages 12a€“19 years and then decreases with age. Among adults, non-Hispanic black and Mexican-American persons consume more than non-Hispanic white persons, and low-income individuals consume more sugar drinks in relation to their total diet than higher-income individuals. Percentage of daily kilocalories from sugar drinks is the percentage of total daily energy obtained from sugar drinks.
Population estimates of sugar-drink kilocalories are based on data from one in-person, 24-hour dietary recall interview.
Some of those are involved with the metabolism of blood sugar and are so important that a lack of zinc1 in and of itself can cause type I or type II diabetes.
Some recent studies in Europe have shown that cinnamon derived from the Cassia plant contains a toxic compound known as What triggers my ulcers is high citric acid foods like pineapple and orange juice. Edelman The exacerbation of hyperinsulinemia by exogenous insulin therapy was strongly correlated with weight gain throughout the study Candidates for intensive management should be motivated ADA Blood Glucose Target Recommendations* ** American Diabetes Association Guidelines. Well almost 4 years of breastfeeding didn’t keep my son from developing type 1 diabetes when there is no history What are your discharge plans for this patient?Will they be discharged on insulin therapy? The increase was due to a number of factors, including natural population growth, improved Census estimates and changes in Indigenous identification. However, the change could be due to more people with a disability being identified as Indigenous in 2011 or due to the population having aged since 2006. This linkage has identified 10% more Indigenous deaths that were missing in the death registration data. The social disadvantages Indigenous people experience in relation to housing, education, income and employment have contributed to the differences in health outcomes between Indigenous and non-Indigenous Australians. Indigenous Australians represent 16% and 45% of all people living in Remote and Very remote areas respectively. Therefore, differences in health with increasing remoteness could also be explained by the poorer health of the Indigenous population living in these areas. Depending upon the data set, the benefits of this type of data are consistency in the measurement of the outcome of interest and large enough numbers to disaggregate the Indigenous and non-Indigenous populations. A lack of access to primary health care services in areas with geographically dispersed populations (such as Remote and Very remote areas) may therefore affect the overall health and wellbeing of the populations living in those areas. It is important to note, however, that there are other types of primary health care services delivered by health professionals other than GPs, particularly in remote Australia, which both Indigenous and non-Indigenous Australians use. It is important to note that hospitalisations for potentially preventable conditions are not a direct measure of the effectiveness of primary health care; however, comparisons of this indicator between population groups and geographic areas provide useful information for improvements in factors such as prevention or treatment of conditions. Consumption of sugar drinks is lowest among the oldest females (42 kcal per day) and highest among males aged 12a€“19 (273 kcal per day) (Figure 1). Over 20% of sugar-drink kilocalories consumed away from home are obtained in other places such as vending machines, cafeterias, street vendors, and community food programs, among others (Figure 6).
Census Bureau data (9).The cut point for participation in the Supplemental Nutrition Assistance Program is 130% of the poverty level.
The survey consists of interviews conducted in participants' homes, standardized physical examinations in mobile examination centers, and laboratory tests utilizing blood and urine specimens provided by participants during the physical examination.
In 2007a€“2008, African-American and overall Latino subgroups were oversampled, with sufficient sample sizes for separate analysis of the Mexican-American subgroup.
Carroll are with the Centers for Disease Control and Prevention's (CDC) National Center for Health Statistics, Division of Health and Nutrition Examination Surveys.
Diabetes Hyperlipidemia Pathophysiology insulin green and it is therapy steep that prens you are on therapuy high land on intensige side you look right across it unless you are potentiation enough to enw down.
Trowell explained that more attention would have been paid to Cleaves hypothesis had he not dismissed completely the role of saturated fats in heart disease (Burkitt later said as much). Diabetes Hyperlipidemia Pathophysiology diabetes Diabetes Hyperlipidemia Pathophysiology exercise morning what causes diabetes type one Couldn’t have asked for better! This is based on real life clinical experience, which continues to be successful in Antony's Harley Street Clinic.
While it is likely that all scenarios have contributed, further analysis is needed to separate these effects.
Future work on the project will include linkage to other data sets, the use of different methods to derive Indigenous status and an assessment of the feasibility of validating AIHW estimates by comparing the Indigenous status in the Enhanced Mortality Dataset with data sets that contain verified Indigenous status information. Examples include some services delivered by Aboriginal Community Controlled Health Services, and Aboriginal Medical Services.
Moreover, the American Heart Association has recommended a consumption goal of no more than 450 kilocalories (kcal) of sugar-sweetened beveragesa€”or fewer than three 12-oz cans of carbonated colaa€”per week (7).
The age patterns of percentage of total daily kilocalories from sugar drinks (not shown) are similar to those for kilocalories from sugar drinks. Dietary information for this analysis was obtained via an in-person, 24-hour dietary recall interview in the mobile examination center.
Sohyun Park is with CDC's National Center for Chronic Disease Prevention and Health Promotion, Division of Nutrition, Physical Activity, and Obesity. If you have used either of these products do not use them again and if you have any concerns you should seek advice from your doctor. Once he got his salt back he was pretty happy with his meals and he ended up living for a good couple of months. This brief presents the most recent national data on sugar-drink consumption in the United States.
Each year of data collection is based on a representative sample covering all ages of the civilian, noninstitutionalized population. I was given some brushpicks but when I ran out I was unable to find any in the stores diabetes insipidus and diabetes mellitus similarities locally.



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