Chronic condition risk factor change over time in a remote 
Indigenous community

Kylie Strate; Julie Brimblecombe; Louise Maple-Brown; Joanne Garrngulkpuy; Elaine Maypilama; Maria Scarlett; Kerin O'Dea; Elizabeth LM Barr

doi:10.22605/RRH4452

Original Research

Chronic condition risk factor change over time in a remote Indigenous community

AUTHORS

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Kylie Strate¹ MB BS FRACGP, GP *

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Julie Brimblecombe² PhD, Associate Professor Public Health and Nutrition

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Louise Maple-Brown³ MB BS FRACP PhD, Senior Principal Research Fellow and Endocrinologist

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Joanne Garrngulkpuy⁴ Diploma of Education, Community researcher

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Elaine Maypilama⁵ PhD, Research Fellow

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Maria Scarlett⁶ BSSc, Retired

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Kerin O'Dea⁷ PhD, Professor

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Elizabeth LM Barr⁸ PhD, Research Fellow

AFFILIATIONS

¹ Menzies School of Health Research, Charles Darwin University, Casuarina, Australia; and Miwatj Aboriginal Health Corporation, PO Box 519, Nhulunbuy, NT 0881, Australia

² Department of Nutrition, Dietetics and Food, Monash University, Victoria, Australia

³ Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT 0811, Australia; and Division of Medicine, Royal Darwin Hospital, Darwin, Australia

^{4, 5} Yalu Marnggithinyaraw Centre, Galiwin’ku community, NT 0822, Australia

⁶ Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT 0811, Australia

⁷ Centre for Population Health Research, University of South Australia, Adelaide, Australia

⁸ Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT 0811, Australia; and Baker Heart and Diabetes Institute, PO Box 6492, Melbourne, Vic., Australia

ACCEPTED: 28 August 2019

early abstract:

Objective: To determine change in chronic condition risk factors in a remote Indigenous community following a 3 year period of community led health promotion initiatives.

Methods: A comparison of data between two cross sectional surveys of Indigenous Australian community residents before and after health promotion activities, and longitudinal analysis of participants present at both surveys using multilevel mixed-effects regression.

Results: At baseline, 294 (53% women; mean age 35 years) participated and 218 attended the second survey (56% women, mean age 40 years) and 87 attended both. Body composition, BP and urinary albumin-to-creatinine ratio remained stable between baseline and follow-up. After adjusting for age and sex, haemoglobin A_1c (HbA_1c) significantly increased (57 to 63 mmol/mol [7.5% to 8.1%], p=0.021) for those with diabetes. Increases were also observed for total cholesterol (4.4 to 4.6 mmol/l, p=0.006) and triglycerides (1.5 to 1.6 mmol/l, p=0.019). While high density lipoprotein (HDL) cholesterol levels improved (0.98 to 1.02 mmol/l, p=0.018). Self-reported smoking prevalence was high but stable between baseline (57%) and follow up (56%). Similar results were observed in the longitudinal analysis to the cross-sectional survey comparison.

Conclusions: Community-led health promotion initiatives may have had some benefits on chronic condition risk factors, including stabilisation of body composition, in this remote Indigenous community. Given that less favourable trends were observed for diabetes and total cholesterol over a short time period and smoking prevalence remained high, policy initiatives that address social and economic disadvantage are needed alongside community-led health promotion initiatives.