Measuring dietary intake in remote Australian Aboriginal communities

This paper reports a comparison of the practicality, acceptability and face validity of five dietary intake methods in two remote Australian Aboriginal communities: weighed dietary intake, 24‐hour recall, ‘store‐turnover’, diet history and food frequency methods. The methods used to measure individual dietary intake were poorly accepted by the communities. Quantitative data were obtained only from the first three methods. The 24‐hour recall method tended to produce higher nutrient intakes than the weighed intake method and certain foods appeared to be selectively recalled according to perceived nutritional desirability. The ‘store‐turnover’ method was most acceptable to the communities and had less potential for bias than the other methods. It was also relatively objective, non‐intrusive, rapid, easy and inexpensive. However, food distribution patterns within the communities could not be assessed by this method. Nevertheless, other similarly isolated communities may benefit by use of the ‘store‐turnover’ method.

Apparent dietary intake in remote Aboriginal communities

Apparent per capita food and nutrient intake in six remote Australian Aboriginal communities using the ‘store-turnover’ method is described. The method is based on the analysis of community-store food invoices. The face validity of the method supports the notion that, under the unique circumstances of remote Aboriginal communities, the turnover of foodstuffs from the community store is a useful measure of apparent dietary intake for the community as a whole. In all Aboriginal communities studied, the apparent intake of energy, sugars and fat was excessive, while the apparent intake of dietary fibre and several nutrients, including folic acid, was low. White sugar, flour, bread and meat provided in excess of 50 per cent of the apparent total energy intake. Of the apparent high fat intake, fatty meats contributed nearly 40 per cent in northern coastal communities and over 60 per cent in central desert communities. Sixty per cent of the apparent high intake of sugars was derived from sugar per se in both regions. Compared with national Australian apparent consumption data, intakes of sugar, white flour and sweetened carbonated beverages were much higher in Aboriginal communities, and intakes of wholemeal bread, fruit and vegetables were much lower. Results of the store-turnover method have important implications for community-based nutrition intervention programs.

Nutrition in remote Aboriginal communities: Lessons from Mai Wiru and the Anangu Pitjantjatjara Yankunytjatjara Lands

Objective To examine the impact of efforts to improve nutrition on the Anangu Pitjantjatjara Yankunytjatjara (APY) Lands from 1986, especially in Mai Wiru stores. Methods Literature was searched in a systematic manner. In 2012, the store-turnover method was used to quantify dietary intake of the five APY communities that have a Mai Wiru (good food) store. Results were compared with those available from 1986. Prices of a standard market basket of basic foods, implementation of nutrition policy requirements and healthy food checklists were also assessed in all seven APY community stores from 2008 and compared with available data from 1986. Results Despite concerted efforts and achievements decreasing intake of sugar and increasing the availability and affordability of healthy foods, particularly fruit and vegetables, and consequent improvements in some nutrient indicators, the overall effect has been a decrease in diet quality as indicated primarily by the increased supply and proportion of energy intake from discretionary foods, particularly sugar-sweetened beverages, convenience meals and take-away foods. Conclusions The study findings reinforce the notion that, in the absence of supportive regulation and market intervention, adequate and sustained resources are required to improve nutrition and prevent diet-related chronic disease on the APY Lands. Implications This study also provides insights into food supply/security issues affecting other remote Aboriginal communities and wider Australia.

A new child protection strategy for Aboriginal communities in Western Australia

Despite numerous government inquiries and reforms, child sexual abuse in remote Aboriginal communities is a well-documented, ongoing problem. Established in Western Australia in 2009, Operation RESET is a multi-agency proactive community engagement initiative designed to improve the ability of communities and supporting agencies to detect, respond to and prevent child sexual abuse through the implementation of community engagement, capacity building and educational strategies. This comment describes the three core principles of Operation RESET: tackling child sexual abuse requires a collaborative, proactive approach between government and communities; the underlying causes and context of child sexual abuse must be recognised; and children's overall safety and wellbeing must be enhanced through integrated services that strengthen and empower families and communities. It also enumerates the seven phases of the operation's implementation, from identifying target communities to deploying an exit strategy. The comment ends by addressing the importance of empirical evaluation.

Experiencing racism in health care: the mental health impacts for Victorian Aboriginal communities

To examine experiences of racism in health settings and their impact on mental health among Aboriginal Australians.

The ‘r’ word and closure of remote Aboriginal communities in Western Australia; a potential framework for change

AbstractThe latest Australian Commonwealth Government Close the Gap Report reveals the circumstances of many of Australia’s Indigenous Peoples are either stagnant or going backwards. This paper argues that such ongoing injustice is a consequence of systemic racism that has been perpetuated since colonization and sustained in the twenty first century by discussion or mention of racism being taboo. A counter colonial educational framework is then provided that has the potential to address such institutional racism. The paper begins by providing a definition of systemic racism. Following this there is a brief explanation of the unique geographical context and the racist history of colonization in Australia. The nature of remote communities, the link between traditional law, country and identity will be outlined. Based on readily available sources such as media reports, social media links, and public policy announcements by government the paper then reflects on what has been reported about closure of remote communities in Western Australia. Government policy, announcements and events of the past year will be described and critically discussed in light of the definition of racism provided at the beginning of the article. The proposed framework requires self-reflexivity of organisations and individuals with a particular focus on aspects of sovereignty, healing, re-learning history and starting with a focus on agency instead of deficit. Being guided by this framework has the potential to avoid arbitrarily forcing people from their physical, spiritual and ancestral home, though this is likely to be a long term proposition rather than a quick fix.

Book Review of "Will the Circle Be Unbroken?": Aboriginal Communities, Restorative Justice, and the Challenges of Conflict and Change by Jane Dickson-Gilmore and Carol La Prairie

Over the past decade or two, restorative justice has become a popular approach for the criminal justice system to take in Canada, New Zealand, and Australia. In part, this is due in all three countries to an appalling disproportionality in the incarceration rates for racialized minorities. As the authors of "Will the Circle Be Unbroken?" point out, however, governments have been attracted to restorative justice for cost-cutting reasons as well. A burning question, therefore, is whether restorative justice works.

Kidney and related chronic disease profiles and risk factors in three remote Australian Aboriginal communities

Morbidities and deaths from noncommunicable chronic diseases are greatly increased in remote Australian Aboriginal communities, but little is known of the underlying community-based health profiles. We describe chronic-disease profiles and their risk factors in 3 remote communities in the Northern Territory. Consenting adults (18+ years of age) in 3 communities participated in a brief history and examination between 2000 and mid-2003 as part of a systematic program to improve chronic-disease awareness and management. Participation was 67%,128%, and 62% in communities A, B, and C, respectively with a total of 1070 people examined. Current smokers included 41% of females and 72% of males. Most men were current drinkers, but most women were not. Parameters of body weight differed markedly by community, with mean body mass index (BMC) varying from 21.4 to 27.9 kg/m(2). Rates of chronic diseases were excessive but differed markedly; an almost threefold difference in the likelihood of any morbidity existed between communities A and C. Rates increased with age, but the greatest numbers of people with morbidities were in the middle-aged group. Most people had multiple morbidities with tremendous overlap. Hypertension and kidney disease appear to be early manifestations of the integrated chronic-disease syndrome, while diabetes is a late manifestation or complication. Substantial numbers of new cases of disease were identified by testing, and blood pressure improved in treated people with hypertension. Wide variations occur in body habitus, risk factors, and chronic-disease rates among communities, but an overwhelming need for effective smoking interventions exists in all. Systematic screening is useful in identifying high-risk individuals, most at early treatable stages there. Findings are very important for estimating current treatment needs, future burdens of disease, and for needs-based health services planning. Resources required will vary according to the burden of disease. (C) 2005 by the National Kidney Foundation, Inc.