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The health of urban Aboriginal people: insufficient data to close the gap

Elizabeth J Comino, Lisa R Jackson Pulver and Jenny A Knight
Med J Aust 2011; 194 (5): 270.

To the Editor: Eades and colleagues identify the scarcity of data on the health and health care needs of Aboriginal Australians.1 This is particularly so for Aboriginal children in urban settings. The Gudaga Study2 has actively worked to redress this shortcoming.

The Gudaga Study (Gudaga being an Aboriginal word meaning healthy baby) is a longitudinal study of a birth cohort of Aboriginal infants born at a large outer urban hospital.2 Gudaga staff use methods that respect the values and beliefs of Aboriginal Australians3 to systematically collect information on the health, development, and service use of study participants at 6-monthly intervals. The Gudaga research team is working with the stakeholders in Aboriginal health in the region to discuss the implications of the information for policy and practice. A number of scientific articles are currently being prepared for publication. These include articles on birth outcomes, breastfeeding, universal health home visiting, health status and service use, development, and vaccination.

Information collected by the Gudaga Study is contributing to the development of services for Aboriginal families in the region, and is changing the ways that service providers think about the health and service needs of Aboriginal families in the region. For example, the lack of data created difficulty in securing funding for services for pregnant Aboriginal women. Enumeration of the high rates of sudden infant death syndrome (3/149) and the removal of children by the Department of Community Services among participating infants (11/149 over 4 years) as a part of the Gudaga Study had two important effects. It influenced the public health service response to close the gap on Aboriginal disadvantage and influenced the decision to reorient child and family services and establish the Bulundidi Gudaga program with ongoing funding. The Bulundidi Gudaga program provides sustained home visiting of pregnant Aboriginal women and their infants by nurses, commencing during pregnancy and continuing until the infant is aged 2 years.4

This research developed over several years. It began during discussions with the Aboriginal community at Tharawal Aboriginal Corporation, Campbelltown, who raised concerns about the health of their children, difficulties in securing funding for an Aboriginal infant and maternal home visiting service that commenced 1999, the lack of relevant data on the needs of Aboriginal children, and receipt of National Health and Medical Research Council funding in 2003. The Gudaga Study commenced in 2005, and the first of the participating children are turning 5 years of age. The research is now part of a strong research program at the University of New South Wales into the health and development of Aboriginal children in urban settings.

Elizabeth J Comino, Senior Research Fellow1
Lisa R Jackson Pulver, Director2
Jenny A Knight, Senior Research Fellow1
1 Centre for Health Equity Training Research and Evaluation, Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW.
2 Muru Marri Indigenous Health Unit, School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW.
Correspondence: 
Reference Text: 
Eades SJ, Taylor B, Bailey S, et al; the SEARCH Investigators. The health of urban Aboriginal people: insufficient data to close the gap. Med J Aust 2010; 193: 521-524.
Reference Order: 
1
PubMed ID: 
21034386
Reference Text: 
Comino E, Craig P, Harris E, et al. The Gudaga Study: establishing an Aboriginal birth cohort in an urban community. Aust N Z J Public Health 2010; 34 Suppl 1: S9-S17.
Reference Order: 
2
PubMed ID: 
20618303
Reference Text: 
Knight J, Comino EJ, Harris E, Jackson-Pulver L. Indigenous research: a commitment to walking the talk. The Gudaga Study — an Australian case study. J Bioeth Inq 2009; 6: 467-476.
Reference Order: 
3
PubMed ID: 
Reference Text: 
Kemp L, Harris E, McMahon C, et al. Miller Early Childhood Sustained Home-visiting (MECSH) trial: design, method and sample description. BMC Public Health 2008; 8: 424.
Reference Order: 
4
PubMed ID: 
19113994