Establishing trends in atsic regional council populations using census data: A cautionary note

This paper points out that limitations in official census data for Aborigines and Torres Strait Islanders draw into question the validity of trend analysis based on time series data for Aboriginal and Torres Strait Islander Commission (ATSIC) regional council areas. Accordingly, the meaningful application of projection techniques to estimate future population profiles using existing census data is severely restricted. Among the difficulties encountered in reconstructing council area populations are census boundary changes over time, changes in enumeration techniques and coverage, the problems posed by self-identification and associated population growth, and, in some cases, the difficulty of matching ATSIC regional council boundaries with census geography. Following discussion of these problems, detailed figures showing changes in the size of the Aboriginal and Islander populations and labour force in each council area are presented using 1976 as the base year. As expected, geographic patterns of population and labour-force change are difficult to discern and exact reasons for comparative growth or decline are impossible to determine. The paper concludes that reverse projections for regional council areas using 1991 Census data would provide a more reliable basis for establishing demographic trends. Although not entirely adequate, these reconstructions for ATSIC regional councils are the only estimates of these populations that have been undertaken to date.     

Changing Australia’s Age Pension Qualification Age: Modelling Differential Effects by Race

Increasing the age at which people are eligible for the age pension is one mechanism by which governments of developed nations are attempting to manage increasing costs associated with population ageing. In Australia, there are a number of groups within the population who may be affected in unintended ways by increasing the eligibility age to 70 years by the year 2035, as was proposed in the 2014 Federal Budget. Most notably, Aboriginal and Torres Strait Islander (Indigenous) Australians currently with an average at birth life expectancy of 69.1 years for males and 73.7 years for females, nearly 11 years less than non-Indigenous Australians, may be the most affected. This study explores the consequences of the proposed future amendments to the age pension eligibility age, using projections of the likely age structures of future populations to estimate expected years of life remaining after reaching pension age. Despite projected improvements for Indigenous life expectancies, increasing the pension eligibility age under the schedule proposed in the policy would significantly reduce the expected years in post pension age, thus countering some of the anticipated benefits flowing from expected future life expectancy increases. However, if the eligibility age were to be increased more gradually, Indigenous Australians would be afforded a greater opportunity to access age pension benefits, whilst still reducing the length of time the non-Indigenous population is eligible to access the age pension, thus fulfilling policy objectives to manage increasing costs associated with population ageing.     

Review of online breastfeeding information for Aboriginal and Torres Strait Islander women

BackgroundBreastfeeding provides the healthiest start to life, but breastfeeding rates amongst Aboriginal and Torres Strait Islanders is lower than non-Indigenous women.AimTo assess the accuracy, quality and appropriate presentation of online breastfeeding information for Aboriginal and Torres Strait Islander women in Australia.MethodsAn online search conducted in Google, Bing and Yahoo search engines to identify any breastfeeding websites that provided information for Aboriginal and Torres Strait Islander women. Relevant websites were evaluated against: a) National Health and Medical Research Council clinical guidelines, b) the quality of health information on the Internet by using DISCERN instrument, and c) appropriate key design features for Aboriginal and Torres Strait Islander women.ResultsThe search located 348 sites with 31 being eligible for inclusion. Websites from governmental organizations had the highest accuracy while YouTube videos had the lowest accuracy. Three quarters (74%, n = 23) of sites incorporated the national clinical guidelines adequately, and most of the sites (77.8%, n = 24) were considered high quality. Only 23% (n = 7) of sites had sufficient key design features appropriate for Aboriginal and Torres Strait Islander women. Four websites were considered exemplary for their accuracy, quality and cultural appropriateness of information for Aboriginal and Torres Strait Islander women.ConclusionSome websites are tailored to provide breastfeeding information and support to Aboriginal and Torres Strait Islander women. However, only a few contain culturally appropriate key design features. Further participatory action research is required to design online platforms for women from different cultural backgrounds that take into account cultural principles, beliefs and values.     

Community perspectives on delivering trauma-aware and culturally safe perinatal care for Aboriginal and Torres Strait Islander parents

BackgroundSince colonisation, Aboriginal and Torres Strait Islander peoples have experienced violence, loss of land, ongoing discrimination and increased exposure to traumatic events. These include adverse childhood experiences which can lead to complex trauma, and are associated with increased incidence of high-risk pregnancies, birth complications and emergence of post-traumatic symptoms during the perinatal period, potentially impacting parenting and leading to intergenerational trauma. The perinatal period offers unique opportunities for processing experiences of trauma and healing yet can also be a time when parents experience complex trauma-related distress. Therefore, it is essential that trauma-aware culturally safe perinatal care is accessible to Aboriginal and Torres Strait Islander parents.AimThis study aimed to understand community perspectives of what ‘trauma-aware culturally safe perinatal care’ would look like for Aboriginal and Torres Strait Islander parents.MethodsData were collected during a workshop held with predominantly Aboriginal and Torres Strait Islander key stakeholders to co-design strategies to foster trauma-aware culturally safe perinatal care. Data were thematically analysed.FindingsFour overarching themes represent proposed goals for trauma-aware culturally safe care: Authentic partnerships that are nurtured and invested in to provide the foundations of care; a skilled workforce educated in trauma awareness; empowering and compassionate care for building trust; and safe and accessible environments to facilitate parent engagement.ConclusionsProvision of trauma-aware culturally safe care achieving these goals is likely to enable parents experiencing complex trauma to access appropriate support and care to foster healing in the critical perinatal period.     

Indigenous Australian population projections: problems and prospects

According to estimates from the 2006 Census, Aboriginal and Torres Strait Islander (Indigenous) Australians made up 2.5 % of the total Australian population. However, the focus of research and policy debate on Indigenous Australians far exceeds their population size for reasons of history, socio-economics, geography and demography. This has led to a need for accurate population projections of the population. In this paper, we outline a number of issues related to Indigenous population projections. These include the nature of self-identification; the impact of particular policy changes; significant differences in demographic parameters; and high rates of exogamy, especially in urban areas. We also document the relative accuracy of past and current population projections. In the final section of the paper we outline a research agenda that has the potential to lead to new and better Indigenous population projections.     

Is aboriginal fertility on the decline?

This paper examines if there has been sustained Aboriginal fertility decline since the mid-1980s, as expected in previous studies (Gray 1983, 1990; Jain 1989), by analysing fertility information obtained from the 1994 National Aboriginal and Torres Strait Islander Survey, birth registrations and midwives’ collections data by states. Although two studies (Gray and Tesfaghiorghis 1993:87–90; Dugbaza 1994) refuted this expectation, the results are questionable because of the unreliability of the data on which the estimates were based and the lack of fertility information. This study has produced more reliable age patterns of fertility at the national and state levels. The paper also examines the definition of Aboriginality and associated measurement problems, which are central to an understanding of Aboriginal demography.     

Culture and Wellbeing: The Case of Indigenous Australians

A recurring theme in Indigenous affairs in Australia is a tension between maintenance of Indigenous culture and achievement of socio-economic ‘equity’: essentially ‘self-determination’ versus ‘assimilation’. Implicit in this tension is the view that attachment to traditional cultures and lifestyles is a hindrance to achieving ‘mainstream’ economic goals. Using data from the National Aboriginal and Torres Strait Islander Social Survey, stronger attachment to traditional culture is found to be associated with enhanced outcomes across a range of socio-economic indicators. This suggests Indigenous culture should be viewed a part of the solution to Indigenous disadvantage in Australia, and not as part of the problem.     

Factors influencing Aboriginal and Torres Strait Islander women’s breastfeeding practice: A scoping narrative review

BackgroundThe nutritional and health benefits of breastfeeding for infants and young children are well-established however rates of breastfeeding initiation and duration for Aboriginal and Torres Strait Islander children are lower than non-Indigenous children.AimTo describe factors influencing breastfeeding practice amongst Aboriginal and Torres Strait Islander women.MethodsA scoping narrative review was conducted using the Joanna Briggs Institute framework. A search was conducted in four online databases (PubMed, Scopus, ANU SuperSearch, and Science Direct). Findings were analysed using [30] narrative synthesis.FindingsThis review included 9 journal articles, a conference summary and a book. This review identified four factors influencing women’s breastfeeding practice; sources of support, culturally appropriate care, intention to breastfeed and social determinants.ConclusionMultiple social determinants resulting from colonization have interrupted traditional infant feeding practices and women’s sources of support. Although Aboriginal and Torres Strait Islander women have strong intention to breastfeed, their breastfeeding outcomes are impacted by lack of pro-breastfeeding support when encountering breastfeeding challenges as well as norms surrounding the use of infant formula milk. Culturally appropriate care is essential for identifying women’s needs and avoiding stereotyping. Further research is needed to investigate the effectiveness of breastfeeding interventions for this group of women.     

The Stages of Human Capital and Economic Growth: Does the Direction of Causality Matter for the Rich and the Poor?

This paper demonstrates that key models of human mobility across several disciplines can be considered as specific cases of a broader conceptualisation of mobility in terms of its contribution to wellbeing. It is argued that this wellbeing perspective offers important advantages for the formulation of policy in areas that must respond to mobility in cross-cultural contexts, and particularly in regard to policy relating to highly mobile, indigenous peoples. An applied example is provided through a discussion of how this conceptualisation of mobility offers a different understanding of the mobility of Aboriginal and Torres Strait Islander Australians, one that may have led to superior policy outcomes.     

Participatory action research opens doors: Mentoring Indigenous researchers to improve midwifery in urban Australia

Problem

There is increasing demand for capacity building among the Aboriginal and Torres Strait Islander (Indigenous) maternal and infant health workforce to improve health outcomes for mothers and babies; yet few studies describe the steps taken to mentor novice Indigenous researchers to contribute to creating a quality evidence-base in this space.

Consistent correction of data for aboriginal populations

A consistent correction procedure is used to determine improved, consistent estimates by sex of census age distributions, intercensal births, intercensal deaths and net migration by age for the Aboriginal populations of the Northern Territory, South Australia and Western Australia during the period 1986–91. Undercount estimates and life tables show the Aboriginal populations to have lower coverage in statistical collections and much higher death risks than the total Australian population. Inter-regional net migration estimates show that component of change can no longer be ignored.     

Aboriginal migration and labour market programs

Despite the potential for government employment policies both to encourage and preclude migration among the Aboriginal workforce, little is known about the impacts of such policies. This paper seeks to construct a base line for identifying these impacts by establishing the spatial structure of labour migration among the Aboriginal and Torres Strait Islander population. It makes use of 1986 Census data to describe the volume and pattern of net and gross flows of working-age Aborigines and Islanders through the national settlement system, distinguishing between movements in remote and closely settled parts of the country. Full determination of the links between policy and migration flows awaits comparison with 1991 Census results.     

New african American life tables from 1935–1940 to 1985–1990*

New life tables for African Americans are presented from 1935 through 1990. They are based on a historical series of vital statistics data on deaths that have been corrected for age misreporting, on reconstructed population counts that have been adjusted for census underenumeration, and on births that have been corrected for underregistration. The new life tables show rapid mortality declines for both African American males and females from 1935 to 1950, and relatively steady reductions thereafter for females. The smaller declines in male mortality in young adulthood and middle age since the 1950s have led to exceptionally high ratios of male to female mortality at these ages. Corrections for census undercounts lead to higher values of life expectancy than in official life tables, but to less improvement over time. Official estimates of life expectancy at age 65 appear to be about 10% too high around 1940 but only about 1.5% too high in the late 1980s.     

Using participatory action research to co-design perinatal support strategies for Aboriginal and Torres Strait Islander parents experiencing complex trauma

Problem & backgroundSupport is important for all parents but critical for those experiencing complex trauma. The The Healing the Past by Nurturing the Future project uses participatory action research to co-design effective perinatal support for Aboriginal and Torres Strait Islander parents.AimThis research aims to identify and refine culturally appropriate support strategies for Aboriginal and Torres Strait Islander parents experiencing complex trauma.DesignWe presented our synthesised eight parent support goals and 60 strategies, collated from Elder and parent focus groups, previous participatory workshops, and evidence reviews, for discussion at a stakeholder workshop. Stakeholder perspectives were captured using a three-point agreement activity and, self- and scribe-recorded comments. Aboriginal and non-Aboriginal researchers analysised the qualitative data, to identify core factors which might facilitate or help enact the parenting related goals.FindingsOverall, stakeholders (n = 37) strongly endorsed all eight goals. Workshop attendees (57% Aboriginal) represented multiple stakeholder roles including Elder, parent and service provider. Four core factors were identified as crucial for supporting parents to heal from complex trauma: Culture (cultural traditions, practices and strengths), Relationality (family, individual, community and services), Safety (frameworks, choice and control) and Timing (the right time socio-emotionally and stage of parenting).DiscussionContext-specific support tailored to the Culture, Relationality, Safety, and Timing needs of parents is essential. These four factors are important elements to help enact or facilitate parenting support strategies.ConclusionFurther work is now required to develop practical resources for parents, and to implement and evaluate these strategies in perinatal care to address cumulative and compounding cycles of intergenerational trauma.     

‘Closing the Gap’ in Indigenous life expectancies: what if we succeed?

In 2007–2008 the Council of Australian Governments agreed to six ambitious targets for addressing longstanding disparities between Indigenous and other Australians in health, education and employment outcomes. The ‘National Integrated Strategy for Closing the Gap on Indigenous Disadvantage’ (colloquially ‘Closing the Gap’) includes the goal of eliminating life expectancy gaps within a generation. This policy says nothing about what changes in the demographic structure of the population might be expected should there be even partial success towards this ambitious target. Information is required to analyse age and sex shifts for their effects on service demand and provision. In this study we apply cohort component projections modelling to the Northern Territory, the Australian jurisdiction with the largest Indigenous component in its population and the largest life expectancy gaps, to assess the demographic effects of closing the gap within a generation. Three scenarios are modelled: (1) No changes to Indigenous life expectancies from those estimated in 2010; (2) Complete success in closing the gap within a generation; and (3) A continuation of current forecasts about how Indigenous life expectancies will change into the future. Although closing the gap would only produce a small increase in the size of the next generation’s Indigenous population, over and above that projected with lower life expectancy scenarios, it would result in substantial changes in age compositions, with associated shifts in various demographic indices. These are pertinent to the planning and funding of core services into the future.     

Comparing mortality estimates based on different administrative records

This study investigates how age and race are reported in interviews and on death certificates and how these demographic assignments affect life expectancy estimates for the total population, for males and females, and for blacks and whites. Differential reporting of demographic characteristics can produce different estimated life expectancies and thus differential assessments of the sex and race gaps in life expectancy. This difference underscores the need to define demographic characteristics carefully and to examine multivariate models and projections cautiously.     

Stillbirth in Australia 3: Addressing stillbirth inequities in Australia: Steps towards a better future

Persistent disparities in stillbirth risk and care are present in Australia. Eliminating these disparities is possible with a commitment to enhancing and scaling up models of culturally safe maternity care shown to be effective for Aboriginal and Torres Strait Islander women and those of migrant and refugee backgrounds. Campaigns to improve public awareness of stillbirth also play an important role in reducing stillbirth risk and consequences. To achieve reach and impact in communities at risk, messaging needs to be framed around the social and cultural context of women’s lives. Here we describe important initiatives underway within the Stillbirth Centre of Research Excellence to develop a coordinated national approach to stillbirth prevention and care in communities that bear a disproportionate burden of stillbirth.     

Estimating Increment-Decrement Life Tables with Multiple Covariates from Panel Data: The Case of Active Life Expectancy*

A fundamental limitation of current multistate life table methodology-evident in recent estimates of active life expectancy for the elderly-is the inability to estimate tables from data on small longitudinal panels in the presence of multiple covariates (such as sex, race, and socioeconomic status). This paper presents an approach to such an estimation based on an isomorphism between the structure of the stochastic model underlying a conventional specification of the increment-decrement life table and that of Markov panel regression models for simple state spaces. We argue that Markov panel regression procedures can be used to provide smoothed or graduated group-specific estimates of transition probabilities that are more stable across short age intervals than those computed directly from sample data. We then join these estimates with increment-decrement life table methods to compute group-specific total, active, and dependent life expectancy estimates. To illustrate the methods, we describe an empirical application to the estimation of such life expectancies specific to sex, race, and education (years of school completed) for a longitudinal panel of elderly persons. We find that education extends both total life expectancy and active life expectancy. Education thus may serve as a powerful social protective mechanism delaying the onset of health problems at older ages.     

中国第五次人口普查全国人口死亡水平间接估计

本文运用几种常见的死亡水平间接估计方法 ,以中国第五次人口普查原始数据为基础 ,估测了五普人口粗死亡率、死亡漏报水平和人口平均预期寿命。