Lower than expected morbidity and mortality for an Australian Aboriginal population: 10-year follow-up in a decentralised community

Kevin G Rowley, Kerin O’Dea, Ian Anderson, Robyn McDermott, Karmananda Saraswati, Ricky Tilmouth, Iris Roberts, Joseph Fitz, Zaimin Wang, Alicia Jenkins, James D Best, Zhiqiang Wang and Alex Brown
Med J Aust 2008; 188 (5): 283-287.


Objective: To examine mortality from all causes and from cardiovascular disease (CVD), and CVD hospitalisation rate for a decentralised Aboriginal community in the Northern Territory.

Design and participants: For a community-based cohort of 296 people aged 15 years or older screened in 1995, we reviewed hospital and primary health care records and death certificates for the period up to December 2004 (2800 person-years of follow-up).

Main outcome measures: Mortality from all causes and CVD, and hospitalisation with CVD coded as a primary cause of admission; comparison with prior trends (1988 to 1995) in CVD risk factor prevalence for the community, and with NT-specific Indigenous mortality and hospitalisation rates.

Results: Mortality in the cohort was 964/100 000 person-years, significantly lower than that of the NT Indigenous population (standardised mortality ratio [SMR], 0.62; 95% CI, 0.42–0.89). CVD mortality was 358/100 000 person-years for people aged 25 years or older (SMR, 0.52; 95% CI, 0.23–1.02). Hospitalisation with CVD as a primary cause was 13/1000 person-years for the cohort, compared with 33/1000 person-years for the NT Indigenous population.

Conclusion: Contributors to lower than expected morbidity and mortality are likely to include the nature of primary health care services, which provide regular outreach to outstation communities, as well as the decentralised mode of outstation living (with its attendant benefits for physical activity, diet and limited access to alcohol), and social factors, including connectedness to culture, family and land, and opportunities for self-determination.

  • Kevin G Rowley1,2
  • Kerin O’Dea2,3
  • Ian Anderson1
  • Robyn McDermott4
  • Karmananda Saraswati5
  • Ricky Tilmouth5
  • Iris Roberts3,6
  • Joseph Fitz3
  • Zaimin Wang7
  • Alicia Jenkins2
  • James D Best2,8
  • Zhiqiang Wang7
  • Alex Brown3,6

  • 1 Onemda VicHealth Koori Health Unit, Centre for Health and Society, School of Population Health, University of Melbourne, Melbourne, VIC.
  • 2 Department of Medicine (St Vincent’s Hospital), University of Melbourne, Melbourne, VIC.
  • 3 Menzies School of Health Research, Darwin, NT.
  • 4 University of South Australia, Adelaide, SA.
  • 5 Urapuntja Health Service, Utopia, NT.
  • 6 Centre for Indigenous Vascular and Diabetes Research, Baker Heart Research Institute, Alice Springs, NT.
  • 7 School of Population Health, University of Queensland, Brisbane, QLD.
  • 8 Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC.



We thank Elders of the Alyawarr and Anmatyerr Nations: Kumantjayi Kunoth, Hugh Heggie, and Sabina Knight. David Thomas, Dallas English, Allison Hodge, and Margaret Kelaher provided statistical advice; and Leah Johnston, Paul Rickards and Stacey Swenson provided technical assistance. This work was funded by the National Health and Medical Research Council and a VicHealth Public Health Research Fellowship to Kevin Rowley. Onemda is funded by VicHealth and the Australian Government Department of Health and Ageing.

Competing interests:

None identified.

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