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

Amal Chakraborty; Margaret Cargo; Victor M Oguoma; Neil T. Coffee; Alwin Chong; Mark Daniel

doi:10.3390/ijerph19159435

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

Journal article

Open access

Peer reviewed

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

Amal Chakraborty, Margaret Cargo, Victor M Oguoma, Neil T. Coffee, Alwin Chong and Mark Daniel

International Journal of Environmental Research and Public Health, Vol.19(15), pp.1-14

2022

DOI: https://doi.org/10.3390/ijerph19159435

PMID: 35954785

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Abstract

built environment

cardiovascular disease

remote community

health care

Aboriginal and Torres Strait Islanders epidemiology

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.

Details

Title: Built Environment Features and Cardiometabolic Mortality and Morbidity in Remote Indigenous Communities in the Northern Territory, Australia
Authors: Amal Chakraborty (Corresponding Author) - The University of Sydney
Margaret Cargo - University of Canberra
Victor M Oguoma - The University of Queensland
Neil T. Coffee - University of Canberra
Alwin Chong - Arney Chong Consulting (Australia)
Mark Daniel - University of Canberra
Publication details: International Journal of Environmental Research and Public Health, Vol.19(15), pp.1-14
Publisher: MDPI AG
Date published: 2022
DOI: 10.3390/ijerph19159435
ISSN: 1660-4601; 1661-7827
PMID: 35954785
Copyright note: © 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Data Availability: Not applicable.
Grant note: Funding for A.C. (Amal Chakraborty) was supported by the Australian Government Research Training Program Scholarship. This research was additionally supported by funding from the National Health and Medical Research Council (NHMRC) Project Grant (GNT1051824) awarded to M.D. A.C. (Amal Chakraborty) gratefully acknowledges receiving University of South Australia School of Health Sciences Conference Scholarship; Konrad Jamrozik Student Scholarship, Public Health Association of Australia—South Australia Branch; and SA State Population Health Student Scholarship, Australian Health Promotion Association—South Australia Branch.
Organisation Unit: Thompson Institute
Language: English
Record Identifier: 991120252402621
Output Type: Journal article

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