Open AccessRisk of severe illness from COVID‐19 among Aboriginal and Torres Strait Islander adults: the construct of ‘vulnerable populations’ obscures the root causes of health inequities
Author(s) -
Thurber Katherine A.,
Barrett Eden M.,
Agostino Jason,
Chamberlain Catherine,
Ward James,
Wade Vicki,
Belfrage Mary,
Maddox Raglan,
Peiris David,
Walker Jennie,
Baffour Bernard,
Wenitong Mark,
Law Charlee,
Senior Timothy,
Priest Naomi,
Freeman Kate,
Schramm Tanya
Publication year - 2021
Publication title -
australian and new zealand journal of public health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.946
H-Index - 76
eISSN - 1753-6405
pISSN - 1326-0200
DOI - 10.1111/1753-6405.13172
Subject(s) - pacific islanders , medicine , odds , context (archaeology) , population , public health , demography , pandemic , environmental health , odds ratio , social determinants of health , cross sectional study , logistic regression , gerontology , covid-19 , geography , disease , nursing , sociology , archaeology , pathology , infectious disease (medical specialty)
Objective : To quantify the prevalence of known health‐related risk factors for severe COVID‐19 illness among Aboriginal and Torres Strait Islander adults, and their relationship with social determinants. Methods : Weighted cross‐sectional analysis of the 2018‐19 National Aboriginal and Torres Strait Islander Health Survey; Odds Ratios for cumulative risk count category (0, 1, or ≥2 health‐related risk factors) by social factors calculated using ordered logistic regression. Results : Of the adult population, 42.9%(95%CI:40.6,45.2) had none of the examined health‐related risk factors; 38.9%(36.6,41.1) had 1, and 18.2%(16.7,19.7) had ≥2. Adults experiencing relative advantage across social indicators had significantly lower cumulative risk counts, with 30‐70% lower odds of being in a higher risk category. Conclusions : Aboriginal and Torres Strait Islander peoples must continue to be recognised as a priority population in all stages of pandemic preparedness and response as they have disproportionate exposure to social factors associated with risk of severe COVID‐19 illness. Indigeneity itself is not a ‘risk’ factor and must be viewed in the wider context of inequities that impact health Implications for public health : Multi‐sectoral responses are required to improve health during and after the COVID‐19 pandemic that: enable self‐determination; improve incomes, safety, food security and culturally‐safe healthcare; and address discrimination and trauma.