Now showing 1 - 10 of 34
  • Publication
    Trends in chronic disease mortality in the Northern Territory Aboriginal population, 1997-2004: using underlying and multiple causes of death.
    (2009-12)
    Fearnley, Emily
    ;
    ;
    Guthridge, Steven
    To assess trends in chronic disease mortality in the Aboriginal population of the Northern Territory (NT), using both underlying and multiple causes of death. Death registration data from 1997 to 2004, were used for the analysis of deaths from five chronic diseases; ischaemic heart disease (IHD), diabetes, chronic obstructive pulmonary disease (COPD), renal failure and stroke. Negative binomial regression models were used to estimate the average annual change in mortality rates for each of the five diseases. Chi squared tests were conducted to determine associations between the five diseases. The five chronic diseases contributed to 49.3% of all Aboriginal deaths in the NT. The mortality rate ratio of NT Aboriginal to all Australian death rates from each of the diseases ranged from 4.3 to 13.0, with the lowest rate ratio for stroke and highest for diabetes. There were significant statistical associations between IHD, diabetes, renal failure and stroke. The mortality rates for diabetes, COPD and stroke declined at estimated annual rates for NT Aboriginal males of 3.6%, 1.0% and 11.7% and for Aboriginal females by 3.5%, 6.1% and 7.1% respectively. There were increases in mortality rates for Aboriginal males and females for IHD and a mixed result for renal failure. NT Aboriginal people experience high chronic disease mortality, however, mortality rates appear to be declining for diabetes, COPD and stroke. The impact of chronic disease on mortality is greater than previously reported by using a single underlying cause of death. The results highlight the importance of integrated chronic disease interventions.
  • Publication
    Establishing contemporary trends in hepatitis B sero-epidemiology in an Indigenous population.
    (2017) ; ;
    Tong SYC
    ;
    ;
    Beaman M
    ;
    Higgins G
    ;
    Cowie BC
    ;
    Condon JR
    ;
    Davis JS
    Indigenous populations globally are disproportionately affected by chronic hepatitis B virus (HBV) infection however contemporary sero-prevalence data are often absent. In the Indigenous population of the Northern Territory (NT) of Australia the unique C4 sub-genotype of HBV universally circulates. There are no studies of the sero-prevalence, nor the impact of the vaccination program (which has a serotype mismatch compared to C4), at a population-wide level. We examined all available HBV serology results obtained from the three main laboratories serving NT residents between 1991 and 2011. Data were linked with a NT government database to determine Indigenous status and the most recent test results for each individual were extracted as a cross-sectional database including 88,112 unique individuals. The primary aim was to obtain a contemporary estimate of HBsAg positivity for the NT by Indigenous status. Based on all tests from 2007-2011 (35,633 individuals), hepatitis B surface antigen (HBsAg) positivity was 3·40% (95%CI 3·19-3·61), being higher in Indigenous (6·08%[5·65%-6·53%]) than non-Indigenous (1·56%[1·38%-1·76%]) Australians, p<0·0001. Birth cohort analysis showed HBsAg positivity fell over time for Indigenous people, with this decrease commencing prior to universal infant vaccination (which commenced in 1990), with an ongoing but slower rate of decline since 1990, (0·23% decrease per year versus 0·17%). HBsAg positivity is high in the NT, particularly in the Indigenous population. HBsAg positivity has fallen over time but a substantial part of this decrease is due to factors other than the universal vaccination program.
  • Publication
    Estimating the total prevalence and incidence of end-stage kidney disease among Aboriginal and non-Aboriginal populations in the Northern Territory of Australia, using multiple data sources.
    (2018-01-15) ;
    Guthridge S
    ;
    ; ;
    Lawton PD
    ;
    Cass A
    Most estimates for End Stage Kidney Disease (ESKD) prevalence and incidence are based on renal replacement therapy (RRT) registers. However, not all people with ESKD will commence RRT and estimates based only on RRT registry data will underestimate the true burden of ESKD in the community. This study estimates the total number of Northern Territory (NT) residents with ESKD including: those receiving RRT, those diagnosed but not receiving RRT and an estimate of "undiagnosed" cases. Four data sources were used to identify NT residents with a diagnosis of ESKD: public hospital admissions, Australia and New Zealand Dialysis and Transplant Registry registrations, death registrations and, for the Aboriginal population only, electronic primary care records. Three data sources contained information recorded between 1 July 2008 and 31 December 2013, death registration data extended to 31 December 2014 to capture 2013 prevalent cases. A capture-recapture method was used to estimate both diagnosed and undiagnosed cases by making use of probability patterns of overlapping multiple data sources. In 2013, the estimated ESKD prevalence in the NT Aboriginal population was 11.01 (95% confidence interval (CI) 10.24-11.78) per 1000, and 0.90 (95% CI 0.76-1.05) per 1000 in the NT non-Aboriginal population. The age-adjusted rates were 17.97 (95% CI 17.82-18.11) and 1.07 (95% CI 1.05-1.09) per 1000 in the NT Aboriginal and non-Aboriginal populations respectively. The proportion of individuals receiving RRT was 71.4% of Aboriginal and 75.5% of non-Aboriginal prevalent ESKD cases. The age-adjusted ESKD incidence was also greater for the Aboriginal (5.26 (95% CI 4.44-6.08) per 1000 population) than non-Aboriginal population (0.36 (95% CI 0.25-0.47) per 1000). This study provides comprehensive estimates of the burden of ESKD including those cases that are not identified in relevant health data sources. The results are important for informing strategies to reduce the total burden of ESKD and to manage the potential unmet demand, particularly from comparatively young Aboriginal patients who may be suitable for RRT but do not currently access the services for social, geographic or cultural reasons.
  • Publication
    Northern Territory Midwives Collection Mothers and Babies 2000-2002
    (Acute Care Information Services, Health Gains Planning, DHCS, 2002)
    Stewart, Margaret
    ;
    ;
    Innovation and Research
    This report presents information on the health of mothers and their babies for the years 2000, 2001 and 2002. This information will assist policy makers and health planners to provide better services for the community. In addition, the report will provide feedback to midwives, Indigenous Health Workers, community health nurses and medical practitioners involved in maternal and child health.
  • Publication
    Cause of death in patients with end-stage renal disease: assessing concordance of death certificates with registry reports.
    (2003) ;
    Cass, Alan
    ;
    Cunningham, Joan
    To assess concordance in reporting, in two Australian national datasets, of cause of death of patients with end-stage renal disease (ESRD). For deaths in 1997-99, we compared 'cause of death' and 'primary renal disease', as coded in the Australian and New Zealand Dialysis and Transplant Registry (ANZDATA), with 'underlying' and 'associated' causes of death (based on death certificates), as coded by the Australian Bureau of Statistics (ABS). Dates of birth and death and sex identified the same individuals in the two datasets. Deaths from the three States for which date of birth was not available from death certificates were excluded. Cause of death was compared at the ICD-10 chapter level. Of 1,728 ANZDATA patients from NSW, SA, WA, NT and ACT who died during 1997-99, 1,117 (65%) could be matched to a record in the ABS dataset for the corresponding jurisdictions. The death certificates of 219 (20%) of these 1,117 patients made no mention of chronic renal failure. Overall, agreement on cause of death was poor (kappa = 0.22). Using ANZDATA information on cause of death and ABS underlying cause of death, only 38% of patients had the same cause (at the ICD-10 chapter level) recorded in both datasets. Additional information on primary renal disease (ANZDATA) and up to 12 associated causes of death (ABS) was required to obtain substantial agreement. Death certificates and ANZDATA records provide differing causes of death for ESRD patients. Information from these sources was not directly comparable. Neither dataset provided a complete picture of renal disease as a cause of death in Australia.
  • Publication
    Mortality in the Northern Territory, 1967-2006
    (DoH, 2013)
    Tay, Ee Laine
    ;
    ;
    Guthridge, Steve
    ;
    Innovation and Research
    This report provides an overview of mortality in the Northern Territory over the forty year period from 1967 to 2006. Information is provided separately for Indigenous and non-Indigenous Territorians with stratification by sex and age groups.
  • Publication
    Mortality burden of disease and injury in the Northern Territory 1999-2018
    (Department of Health, 2022) ; ; ;
    The current study presents the results of life expectancy, years of life lost (YLL), all-cause and cause specific mortality in the Northern Territory (NT) for the past twenty years from 1999 to 2018. It describes 219 causes of deaths from the NT burden of disease and injury (BOD) study by counting deaths, measuring YLL and life expectancy for both Aboriginal and non-Aboriginal populations. Life expectancy, mortality and YLL are important indicators for health outcomes and health need assessments. Life expectancy at birth is widely accepted as a headline indicator of population health, which measures the number of years an average person is expected to live at birth based on current public health and mortality patterns. YLL is the fatal BOD measure for premature deaths using the age at death linked with the World Health Organisation (WHO) standard life expectancies. This study focused on the five-year period from 2014 to 2018 and compares the results with those from the three previous NT BOD studies, conducted since 1999. Underlying cause and nine additional causes of death were used to analyse deaths by disease groups, developed by WHO and Australian Institute of Health and Welfare for BOD studies. This study compares life expectancy, mortality and fatal BOD between NT subpopulations and the total Australian population by key demographic and geographic variables including age, sex, Aboriginal status and NT health region. The results of this study will provide valuable information to inform health policy, service planning, long-term investment and economic development in the NT.
  • Publication
    Mortality in the Northern Territory 1981-2004
    (Health Gains Planning, DHCS, 2007-09)
    Fearnley, Emily
    ;
    ;
    Innovation and Research
    This fact sheet updates selected mortality indicators for the Northern Territory by adding data from 2004 to previously published information. The analysis uses a compilation of annual Australian Bureau of Statistics (ABS) death datasets, and includes all deaths in Australia of NT residents, by year of death. Population estimates are based on ABS data from the 1996 and 2001 censuses.
  • Publication
    Improved life expectancy for Indigenous and non-Indigenous people in the Northern Territory, 1999-2018: overall and by underlying cause of death.
    (2022-05-29) ; ;
    Wilson T
    ;
    OBJECTIVES: To provide updated estimates of life expectancy at birth for Indigenous and non-Indigenous people in the Northern Territory, 1999-2018; to quantify the contributions of changes in life years lost to disease-specific causes of death to overall changes in life expectancy. DESIGN, SETTING, PARTICIPANTS: Analysis of Australian Coordinating Registry data on underlying and nine multiple causes of death (ICD-10) for deaths in the NT, by age, sex, and Indigenous status, 1 January 1999 - 31 December 2018. MAIN OUTCOME MEASURES: Life expectancy at birth by year and 5-year period, by Indigenous status and sex; change in life expectancy by year and 5-year period, by Indigenous status and sex; contributions in changes in life years lost to leading underlying causes of death, by 5-year period, Indigenous status and sex. RESULTS: Life expectancy for Indigenous men increased from 56.6 years in 1999 to 65.6 years in 2018 (change, 9.0 years; 95% CI, 7.9-10.0 years) and from 64.8 to 69.7 years for Indigenous women (4.9 years; 95% CI, 3.2-6.7 years); for non-Indigenous men, it increased from 77.4 to 81.0 years (3.6 years; 95% CI, 2.8-4.4 years), and from 84.3 to 85.1 years for non-Indigenous women (0.8 years; 95% CI, -0.4 to 1.9 years). Increased life expectancy for Indigenous men was primarily linked with fewer years of life lost to cancer (23% of overall change), unintentional injuries (18%), and cardiovascular disease (17%), and for Indigenous women with fewer life years lost to cancer (24%), intentional injuries (17%), and kidney disease (14%). During 1999-2018, the difference in life expectancy between Indigenous and non-Indigenous people declined by 26% for men (from 20.8 to 15.4 years) and by 21% for women (from 19.5 to 15.4 years). CONCLUSIONS: Life expectancy improved markedly during 1999-2018 for Indigenous people in the NT, particularly with respect to fewer years of life lost to cancer, injuries, and chronic disease. The smaller gains in life expectancy for non-Indigenous people were linked with improved survival for those with cancer and neurological conditions.
  • Publication
    Avoidable hospitalisation in Aboriginal and non-Aboriginal people in the Northern Territory
    (Australasian Medical Publishing Company Pty Ltd, 2009-05-18) ;
    Gray, Natalie
    ;
    Guthridge, Steve
    ;
    Pircher, Sabine
    Objectives: To analyse rates of avoidable hospitalisations in Aboriginal and non- Aboriginal residents of the Northern Territory, 1998–99 to 2005–06, and to consider the implications for primary care interventions. Design and setting: Retrospective descriptive analysis of inpatient discharge data from NT public hospitals. Main outcome measures: Avoidable hospitalisations by age, sex, Aboriginality and condition, with annual time trends. Results: Between 1998–99 and 2005–06, Aboriginal people in the NT had an avoidable hospitalisation rate of 11 090 per 100 000 population, nearly four times higher than the Australian rate of 2848 per 100 000. The rate for non-Aboriginal NT residents was 2779 per 100 000. During this period, the average annual increase in avoidable hospitalisations was 11.6% (95% CI, 11.0%–12.1%) in the NT Aboriginal population and 3.9% (95% CI, 3.3%–4.5%) in the non-Aboriginal population. The greatest increase occurred in those aged 45 years or more, and was primarily attributable to diabetes complications. Conclusions: The significantly higher rates of avoidable hospitalisations in NT Aboriginal people reflect the emerging epidemic of chronic disease in this population, highlight barriers to Aboriginal people accessing effective primary care, and emphasise the extent of potential health gains with appropriate interventions.