A multilevel analysis on the relationship between neighbourhood poverty and public hospital utilization: is the high Indigenous morbidity avoidable?

BMC Public Health

Research Article

Jiqiong You¹  Steven L Guthridge¹  Yuejen Zhao¹  Andy H Lee² 

[1] Health Gains Planning Branch, Northern Territory Department of Health, PO Box 40596, 0811, Casuarina, NT, Australia;School of Public Health, Curtin University, GPO Box U1987, 6845, Perth, WA, Australia;

关键词: Indigenous People;    Socioeconomic Disadvantage;    Northern Territory;    Indigenous Health;    Indigenous Status;   

DOI  :  10.1186/1471-2458-11-737

 received in 2011-03-14, accepted in 2011-09-27,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundThe estimated life expectancy at birth for Indigenous Australians is 10-11 years less than the general Australian population. The mean family income for Indigenous people is also significantly lower than for non-Indigenous people. In this paper we examine poverty or socioeconomic disadvantage as an explanation for the Indigenous health gap in hospital morbidity in Australia.MethodsWe utilised a cross-sectional and ecological design using the Northern Territory public hospitalisation data from 1 July 2004 to 30 June 2008 and socio-economic indexes for areas (SEIFA) from the 2006 census. Multilevel logistic regression models were used to estimate odds ratios and confidence intervals. Both total and potentially avoidable hospitalisations were investigated.ResultsThis study indicated that lifting SEIFA scores for family income and education/occupation by two quintile categories for low socio-economic Indigenous groups was sufficient to overcome the excess hospital utilisation among the Indigenous population compared with the non-Indigenous population. The results support a reframing of the Indigenous health gap as being a consequence of poverty and not simplistically of ethnicity.ConclusionsSocio-economic disadvantage is a likely explanation for a substantial proportion of the hospital morbidity gap between Indigenous and non-Indigenous populations. Efforts to improve Indigenous health outcomes should recognise poverty as an underlying determinant of the health gap.

【 授权许可】

CC BY   
© Zhao et al; licensee BioMed Central Ltd. 2011