A longitudinal observation study assessing changes in indicators of serious injury and violence with alcohol controls in four remote indigenous Australian communities in far north Queensland (2000–2015)

Clough, Alan R.; Fitts, Michelle S.; Müller, Reinhold; Ypinazar, Valmae; Margolis, Stephen A

doi:10.1186/s12889-018-6033-1

Cited by 8 publications

(21 citation statements)

References 28 publications

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“…Although it is not possible to establish a causal link from our data, cannabis [37] and alcohol have both indirect and direct mental health effects. In terms of the former, both result in major resource diversion in these welfare-dependent sustenance economies with alcohol, in particular, associated with violence [38], powerfully compromising the stability of the neurodevelopmental environment. Further, cannabis use during adolescence is associated with an increased risk of psychosis [39], and cannabis-induced psychosis can convert to schizophrenia, with highest risk for those aged 16–25 [40].…”

Section: Discussionmentioning

confidence: 99%

The Epidemiology of Psychosis in Indigenous Populations in Cape York and the Torres Strait

et al. 2019

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Background The treated prevalence of psychotic disorders in remote communities of Cape York and the Torres Strait, Australia, has been shown to be elevated compared with the Australian population. Our study used a unique dataset to assess treated incidence and prevalence of psychotic disorders and mortality over a 23-year period in the adult Indigenous population of this region. Methods Data was collated from a clinical database that contains complete psychiatric records from 1992 to 2015, extracted for all Indigenous patients who received treatment for a psychotic disorder from the Remote Area Mental Health Service, and linked to the Queensland Deaths Registry. We calculated 12-month treated prevalence and incidence for each calendar year. Mortality rates were compared to the overall and Indigenous population death rates in Queensland. Findings Between 1992 and 2015, 424 patients were treated for psychosis – an age-standardised 12-month prevalence of 1·7% in 2015, approximately two times higher in men than women, and three times higher in Aboriginal versus Torres Strait Islander populations. The highest treated prevalence was observed in 2015 in Aboriginal men (4.0%). A range of psychotic disorders were detected, including many substance-induced cases (n = 93) and schizophrenia (n = 252). The age-standardised 12-month incidence rate over the study period was 3.61 per 1000 person-years for women and 4.23 per 1000 person-years for men. Treated prevalence increased throughout the study period, largely attributable to increases in incidence of schizophrenia and schizoaffective disorder – in contrast, the incidence and prevalence of bipolar and mood disorders remained low and stable. Increased mortality risk compared to the Queensland Indigenous population (SMR = 1.9; 95% CI 1.4–2.6) was attributable to the elevated risk shown in the Aboriginal population in our study (SMR = 2.6; 95% CI 1.8–3.7). Interpretation Our results show extremely high prevalence rates of psychosis; increasing prevalence over time; differences in the distribution of psychosis between Aboriginal and Torres Strait Islander populations; and increased mortality risk for Aboriginal people living with psychosis in this region. These observations strongly suggest an aetiological role of environmental and neurodevelopmental factors, and the contribution of social factors to vulnerability and premature mortality. Role of the funding source This study was funded by who are the custodians of this database. The funder had no role in study design, data analysis, data interpretation, writing of the report, or submission for publication. All authors had full access to all the study data. The corresponding author had final responsibility for the decision to submit for publication. FJC is supported by an Australian National Health and Medical Research Council ( ) Early Career Fellowship (APP1138488). ...

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Section: Discussionmentioning

confidence: 99%

The Epidemiology of Psychosis in Indigenous Populations in Cape York and the Torres Strait

et al. 2019

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“…Since the introduction of AMPs the overall rate of assault, serious injury and aeromedical retrieval from these communities has fallen significantly 9,23 . Nevertheless, several authors have recently reported the rates of assault, 10 traumatic brain injury 11 and aeromedical retrieval 10 are gradually rising towards pre‐2008 levels. The results of our study indicate there has been a significant decline in the incidence of ocular trauma in the Cape York and Torres Strait Island Indigenous communities since the implementation of AMPs, thus supporting this health policy as a preventative strategy.…”

Section: Discussionmentioning

confidence: 99%

“…While the rate of serious injury requiring aeromedical retrieval from FNQ Indigenous communities had fallen significantly until 2010, 9 robust conclusions regarding the sustained effectiveness of AMPs have been guarded. Rates of assault, 10 traumatic brain injury 11 and aeromedical retrieval 10 have been slowly rising since the reported nadir in 2010. This study aimed to review the epidemiology of ocular trauma admitted to Cairns Hospital from the FNQ health districts in the period following the implementation of AMPs in Indigenous Communities.…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of severe ocular trauma following the implementation of alcohol restrictions in Far North Queensland

Dorman

O’Hagan

Gole

2020

Clinical Exper Ophthalmology

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Importance: Indigenous communities of Far North Queensland (FNQ) have one of the highest incidences of alcohol-related ocular trauma globally. Background: To review the epidemiology of closed-and open-globe trauma admitted to Cairns Hospital from FNQ health districts following the implementation of alcohol restrictions in Indigenous communities. Design: Retrospective study of cases from January 2014 to December 2018. Participants: A total of 142 cases identified from ICD-10 clinical-coding data. Methods: Records were reviewed to determine demographics, clinical details and outcomes. Main Outcome Measures: Annual incidence by demography and ethnicity (Indigenous vs non-indigenous). Results: Estimated annual incidence was 10.4/100 000 population (openglobe: 3.6/100 000, closed-globe: 6.8/100 000 population). Incidence rate ratio was 2.8× higher in Indigenous (22.8/100 000 population) compared to nonindigenous populations. Injury from assault was 8.2× higher in the Indigenous population. Alcohol was involved in 76% of assaults. Paediatric injuries comprised 20.4% of the cohort, with Indigenous children over-represented (44.8% of children). Visual acuity (VA) at presentation ranged from −0.08 logMAR to no-perception of light (NPL), with 41.8% poorer than +1.00 logMAR. Final VA ranged from −0.18 logMAR to NPL. Mean final VA was significantly better for closed-than open-globe injuries (+0.43 vs +1.01 logMAR). Ruptures had the poorest outcomes (mean +1.65 logMAR). Conclusions and relevance: The overall incidence of severe ocular trauma in FNQ has decreased compared to that reported from 1995 to 2002. The extremely high incidence observed in the Indigenous communities of Cape York has decreased dramatically since the introduction of Alcohol Management Plans. Nevertheless, the Indigenous population still experiences significantly higher rates of severe ocular trauma, particularly from assault.

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“…This is despite alcohol restrictions being in place in many of the remote communities which, as evidence shows, reduced violence and serious injury generally in these communities (Margolis et al 2011 ). However, recent evidence suggests that the positive effects of these restrictions are reversing (Clough et al 2018 ), making it essential to examine the possible impacts on TBI rates in more detail. We also found interesting patterns in incidence rates that clearly need further research.…”

Section: Discussionmentioning

confidence: 99%

Incidence of emergency department presentations for traumatic brain injury in Indigenous and non-Indigenous residents aged 15–64 over the 9-year period 2007–2015 in North Queensland, Australia

et al. 2018

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BackgroundTraumatic brain injury (TBI) is a leading cause of disability worldwide. Previous studies have shown that males have a higher incidence than females, and Indigenous populations have a higher rate than non-Indigenous. To date, no study has compared the incidence rate of TBI between Indigenous and non-Indigenous Australians for any cause. Here we add to this rather sparse literature.MethodsRetrospective analysis of data from North Queensland Emergency Departments between 2007 and 2015 using Australian Bureau of Statistics population estimates for North Queensland residents aged 15–64 years as denominator data. Outcome measures include incidence rate ratios (IRR) for TBI presentations by Indigenous status, age, sex, year of presentation, remoteness, and socio-economic indicator.ResultsOverall incidence of TBI presentations per 100,000 population was 97.8. Indigenous people had an incidence of 166.4 compared to an incidence in the non-Indigenous population of 86.3, providing an IRR of 1.93 (95% CI 1.77–2.10; p < 0.001). Males were 2.29 (95% CI 2.12–2.48; p < 0.001) times more likely to present than females. Incidence increased with year of presentation only in the Indigenous male population.ConclusionsThe greater burden of ED presentations for TBI in the Indigenous compared with the non-Indigenous population is of concern. Importantly, the need to provide quality services and support to people living with TBI in remote and very remote areas, and the major role of the new National Disability Insurance Scheme is discussed.

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A longitudinal observation study assessing changes in indicators of serious injury and violence with alcohol controls in four remote indigenous Australian communities in far north Queensland (2000–2015)

Cited by 8 publications

References 28 publications

The Epidemiology of Psychosis in Indigenous Populations in Cape York and the Torres Strait

The Epidemiology of Psychosis in Indigenous Populations in Cape York and the Torres Strait

Epidemiology of severe ocular trauma following the implementation of alcohol restrictions in Far North Queensland

Incidence of emergency department presentations for traumatic brain injury in Indigenous and non-Indigenous residents aged 15–64 over the 9-year period 2007–2015 in North Queensland, Australia

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