Volume 206 - Issue 4
The economic benefits of eliminating Indigenous health inequality in the Northern Territory
Author: Yuejen Zhao
Med J Aust 2017; 206 (4): 186. || doi: 10.5694/mja16.01224
Published online: 6 March 2017
Published online: 6 March 2017
In reply
In reply:
I thank Davey for his letter pointing out the importance of stratification in statistical comparison. However, remoteness stratification was not applied in this health economic assessment1 because the purpose of this study was to estimate the economic burden of Indigenous health inequality in the Northern Territory. This normative analysis hypothesised that urban, rural and remote areas should be treated homogenously in terms of access to public housing, education, primary care, employment and justice.2
Previous research indicated that remoteness is likely to be an independent contributing factor to Indigenous health inequality.3 In the NT, residents from remote areas are 50% more likely to be hospitalised than those from non-remote areas, and in turn, residents in very remote areas are 60% more likely to be hospitalised than those in remote areas.3 Because of the high positive correlation (Pearson correlation coefficient = 0.62, P < 0.001) between the remoteness and Indigenous proportion in the NT,1 the national data may be required to tease out the independent contribution of remoteness to Indigenous health inequality.
In the context of remote Indigenous people in the NT, we argue that the right of Indigenous people to live in major population centres should be respected, as suggested by Milligan and colleagues.4 Differential treatment and substandard health care delivery in remote areas with high Indigenous population proportions are not acceptable.5
Competing interests
No relevant disclosures.
References
- Zhao Y, Vemuri S, Arya D. The economic benefits of eliminating Indigenous health inequality in the Northern Territory. Med J Aust 2016; 205: 266-269.
- Culyer AJ. The normative economics of health care finance and provision. Oxford Rev Econ Pol 1989; 5: 34-58.
- Zhao Y, You J, Wright J, et al. Health inequity in the Northern Territory, Australia. Int J Equity Health 2013; 12: 79.
- Milligan V, Phillips R, Easthope H, et al. Urban social housing for Aboriginal people and Torres Strait Islanders: respecting culture and adapting services. AHURI final report; no. 172. Melbourne: Australian Housing and Urban Research Institute; 2011. https://www.ahuri.edu.au/__data/assets/pdf_file/0014/2075/AHURI_Final_Report_No172_Urban_social_housing_for_Aboriginal_people_and_Torres_Strait_Islanders_respecting_culture_and_adapting_services.pdf (accessed Oct 2016).
- Acevedo-Garcia D, Lochner KA, Osypuk TL, et al. Future directions in residential segregation and health research: a multilevel approach. Am J Public Health 2003; 93: 215-221.