Long-term trends in indigenous deaths from chronic diseases in the Northern Territory: a foot on the brake, a foot on the accelerator

Abstract

Objective: To examine trends in Northern Territory Indigenous mortality from chronic diseases other than cancer. Design: A comparison of trends in rates of mortality from six chronic diseases (ischaemic heart disease [IHD], chronic obstructive pulmonary disease [COPD], cerebrovascular disease [CVD], diabetes mellitus [DM], renal failure [RF] and rheumatic heart disease [RHD]) in the NT Indigenous population with those of the total Australian population. Participants: NT Indigenous and total Australian populations, 1977–2001. Main outcome measures: Estimated average annual change in chronic disease mortality rates and in mortality rate ratios. Results: Death rates from IHD and DM among NT indigenous peoples increased between 1977 and 2001, but this increase slowed after 1990. Death rates from COPD rose before 1990, but fell thereafter. There were non-significant declines in death rates from CVD and RHD. Mortality rates from RF rose in those aged >= 50 years. The ratios of mortality rates for NT Indigenous to total Australian populations from these chronic diseases increased throughout the period. Conclusions: Mortality rates from IHD and DM in the NT Indigenous population have been increasing since 1977, but there is evidence of a slower rise (or even a fall) in death rates in the 1990s. These early small changes give reason to hope that some improvements (possibly in medical care) have been putting the brakes on chronic disease mortality among Aboriginal and Torres Strait Islander peoples.