Open AccessDoes health assessment improve health outcomes in Indigenous people? An RCT with 13 years of follow‐up
Author(s) -
Calver Janine,
Wiltshire Amy,
Holman C. D'Arcy J.,
Hunter Ernest,
Garfield Carol,
Rosman Diana L.
Publication year - 2005
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/j.1467-842x.2005.tb00058.x
Subject(s) - medicine , psychological intervention , randomized controlled trial , rate ratio , mortality rate , demography , intervention (counseling) , indigenous , population , community health , gerontology , public health , environmental health , psychiatry , nursing , ecology , sociology , biology
Objective: To examine the impact of a multi‐component health assessment on mortality and morbidity in Kimberley Aboriginal residents during a 13‐year follow‐up. Method: A population‐based randomised controlled trial using linked hospital, cancer and death records to evaluate outcomes in 620 intervention and 6,736 control subjects. Results: The intervention group had a higher rate of first‐time hospitalisation for any reason (IRR=1.37; 95% Cl 1.25‐1.50), a higher rate of injury‐related hospital episodes (IRR=1.31; 95% Cl 1.15‐1.48) and a higher notification rate of alcoholrelated cancers There was a smaller difference in the rates of multiple hospitalisations (IRR=1.14; 95% Cl 0.75‐1.74) and no improvement in overall mortality compared with controls (IRR=1.08; 95% Cl 0.91‐1.29). Conclusions: There was no overall mortality benefit despite increased health service contact associated with the intervention. Implications: Although not influencing mortality rates, multi‐component health assessment may result in a period of increased health service use in Aboriginal and Torres Strait Islander populations, thus constituting an ‘intervention’. However, this should not be confused with systematic and sustained interventions and investment in community development to achieve better health outcomes.