Healthy country, healthy people: The relationship between Indigenous health status and "caring for country"

Christopher Burgess, Fay Johnston, Helen Berry, Joseph McDonnell, Dean Yibarbuk, Charlie Gunabarra, Albert Mileran, Ross Bailie

Research output: Contribution to journalArticle

91 Citations (Scopus)

Abstract

Objective: To investigate associations between “caring for country” — an activity that Indigenous peoples assert promotes good health — and health outcomes relevant to excess Indigenous morbidity and mortality.
Design, setting and participants: Cross-sectional study involving 298 Indigenous adults aged 15–54 years in an Arnhem Land community, recruited from March to September 2005.
Main outcome measures: Self-reported involvement in caring for country, health behaviours and clinically measured body mass index (BMI), waist circumference, blood pressure, type 2 diabetes status, albumin to creatinine ratio (ACR), levels of glycated haemoglobin (HbA1c) and high-density lipoprotein (HDL) cholesterol, lipid ratio, score on the five-item version of the Kessler Psychological Distress Scale (K5), and 5-year cardiovascular disease (CVD) risk.
Results: Controlling for sociodemographic characteristics and health behaviours, multivariate regression revealed significant and substantial associations between caring for country and health outcomes. An interquartile range rise in the weighted composite caring-for-country score was significantly associated with more frequent physical activity, better diet, lower BMI (regression coefficient [b] = − 2.83; 95% CI, − 4.56 to − 1.10), less abdominal obesity (odds ratio [OR], 0.43; 95% CI, 0.26–0.72), lower systolic blood pressure (b = − 7.59; 95% CI, − 12.01 to − 3.17), less diabetes (OR, 0.12; 95% CI, 0.03–0.52), lower HbA1c level (b = − 0.45; 95% CI, − 0.79 to − 0.11), non-elevated ACR (OR, 0.28; 95% CI, 0.13–0.60), higher HDL cholesterol level (b = 0.06; 95% CI, 0.01–0.12), lower K5 score (b = − 0.97; 95% CI, − 1.64 to − 0.31) and lower CVD risk (b = − 0.77; 95% CI, − 1.43 to − 0.11).
Conclusions: Greater Indigenous participation in caring for country activities is associated with significantly better health. Although the causal direction of these associations requires clarification, our findings suggest that investment in caring for country may be a means to foster sustainable economic development and gains for both ecological and Indigenous peoples’ health
Original languageEnglish
Pages (from-to)567-572
Number of pages6
JournalMedical Journal of Australia
Volume190
Issue number10
Publication statusPublished - 2009
Externally publishedYes

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Health Status
Health
Odds Ratio
Health Behavior
Blood Pressure
HDL Cholesterol
Albumins
Creatinine
Body Mass Index
Cardiovascular Diseases
Economic Development
Abdominal Obesity
Conservation of Natural Resources
Glycosylated Hemoglobin A
Waist Circumference
Type 2 Diabetes Mellitus
Cross-Sectional Studies
Outcome Assessment (Health Care)
Psychology
Diet

Cite this

Burgess, C., Johnston, F., Berry, H., McDonnell, J., Yibarbuk, D., Gunabarra, C., ... Bailie, R. (2009). Healthy country, healthy people: The relationship between Indigenous health status and "caring for country". Medical Journal of Australia, 190(10), 567-572.
Burgess, Christopher ; Johnston, Fay ; Berry, Helen ; McDonnell, Joseph ; Yibarbuk, Dean ; Gunabarra, Charlie ; Mileran, Albert ; Bailie, Ross. / Healthy country, healthy people: The relationship between Indigenous health status and "caring for country". In: Medical Journal of Australia. 2009 ; Vol. 190, No. 10. pp. 567-572.
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abstract = "Objective: To investigate associations between “caring for country” — an activity that Indigenous peoples assert promotes good health — and health outcomes relevant to excess Indigenous morbidity and mortality.Design, setting and participants: Cross-sectional study involving 298 Indigenous adults aged 15–54 years in an Arnhem Land community, recruited from March to September 2005.Main outcome measures: Self-reported involvement in caring for country, health behaviours and clinically measured body mass index (BMI), waist circumference, blood pressure, type 2 diabetes status, albumin to creatinine ratio (ACR), levels of glycated haemoglobin (HbA1c) and high-density lipoprotein (HDL) cholesterol, lipid ratio, score on the five-item version of the Kessler Psychological Distress Scale (K5), and 5-year cardiovascular disease (CVD) risk.Results: Controlling for sociodemographic characteristics and health behaviours, multivariate regression revealed significant and substantial associations between caring for country and health outcomes. An interquartile range rise in the weighted composite caring-for-country score was significantly associated with more frequent physical activity, better diet, lower BMI (regression coefficient [b] = − 2.83; 95{\%} CI, − 4.56 to − 1.10), less abdominal obesity (odds ratio [OR], 0.43; 95{\%} CI, 0.26–0.72), lower systolic blood pressure (b = − 7.59; 95{\%} CI, − 12.01 to − 3.17), less diabetes (OR, 0.12; 95{\%} CI, 0.03–0.52), lower HbA1c level (b = − 0.45; 95{\%} CI, − 0.79 to − 0.11), non-elevated ACR (OR, 0.28; 95{\%} CI, 0.13–0.60), higher HDL cholesterol level (b = 0.06; 95{\%} CI, 0.01–0.12), lower K5 score (b = − 0.97; 95{\%} CI, − 1.64 to − 0.31) and lower CVD risk (b = − 0.77; 95{\%} CI, − 1.43 to − 0.11).Conclusions: Greater Indigenous participation in caring for country activities is associated with significantly better health. Although the causal direction of these associations requires clarification, our findings suggest that investment in caring for country may be a means to foster sustainable economic development and gains for both ecological and Indigenous peoples’ health",
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Burgess, C, Johnston, F, Berry, H, McDonnell, J, Yibarbuk, D, Gunabarra, C, Mileran, A & Bailie, R 2009, 'Healthy country, healthy people: The relationship between Indigenous health status and "caring for country"', Medical Journal of Australia, vol. 190, no. 10, pp. 567-572.

Healthy country, healthy people: The relationship between Indigenous health status and "caring for country". / Burgess, Christopher; Johnston, Fay; Berry, Helen; McDonnell, Joseph; Yibarbuk, Dean; Gunabarra, Charlie; Mileran, Albert; Bailie, Ross.

In: Medical Journal of Australia, Vol. 190, No. 10, 2009, p. 567-572.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Healthy country, healthy people: The relationship between Indigenous health status and "caring for country"

AU - Burgess, Christopher

AU - Johnston, Fay

AU - Berry, Helen

AU - McDonnell, Joseph

AU - Yibarbuk, Dean

AU - Gunabarra, Charlie

AU - Mileran, Albert

AU - Bailie, Ross

PY - 2009

Y1 - 2009

N2 - Objective: To investigate associations between “caring for country” — an activity that Indigenous peoples assert promotes good health — and health outcomes relevant to excess Indigenous morbidity and mortality.Design, setting and participants: Cross-sectional study involving 298 Indigenous adults aged 15–54 years in an Arnhem Land community, recruited from March to September 2005.Main outcome measures: Self-reported involvement in caring for country, health behaviours and clinically measured body mass index (BMI), waist circumference, blood pressure, type 2 diabetes status, albumin to creatinine ratio (ACR), levels of glycated haemoglobin (HbA1c) and high-density lipoprotein (HDL) cholesterol, lipid ratio, score on the five-item version of the Kessler Psychological Distress Scale (K5), and 5-year cardiovascular disease (CVD) risk.Results: Controlling for sociodemographic characteristics and health behaviours, multivariate regression revealed significant and substantial associations between caring for country and health outcomes. An interquartile range rise in the weighted composite caring-for-country score was significantly associated with more frequent physical activity, better diet, lower BMI (regression coefficient [b] = − 2.83; 95% CI, − 4.56 to − 1.10), less abdominal obesity (odds ratio [OR], 0.43; 95% CI, 0.26–0.72), lower systolic blood pressure (b = − 7.59; 95% CI, − 12.01 to − 3.17), less diabetes (OR, 0.12; 95% CI, 0.03–0.52), lower HbA1c level (b = − 0.45; 95% CI, − 0.79 to − 0.11), non-elevated ACR (OR, 0.28; 95% CI, 0.13–0.60), higher HDL cholesterol level (b = 0.06; 95% CI, 0.01–0.12), lower K5 score (b = − 0.97; 95% CI, − 1.64 to − 0.31) and lower CVD risk (b = − 0.77; 95% CI, − 1.43 to − 0.11).Conclusions: Greater Indigenous participation in caring for country activities is associated with significantly better health. Although the causal direction of these associations requires clarification, our findings suggest that investment in caring for country may be a means to foster sustainable economic development and gains for both ecological and Indigenous peoples’ health

AB - Objective: To investigate associations between “caring for country” — an activity that Indigenous peoples assert promotes good health — and health outcomes relevant to excess Indigenous morbidity and mortality.Design, setting and participants: Cross-sectional study involving 298 Indigenous adults aged 15–54 years in an Arnhem Land community, recruited from March to September 2005.Main outcome measures: Self-reported involvement in caring for country, health behaviours and clinically measured body mass index (BMI), waist circumference, blood pressure, type 2 diabetes status, albumin to creatinine ratio (ACR), levels of glycated haemoglobin (HbA1c) and high-density lipoprotein (HDL) cholesterol, lipid ratio, score on the five-item version of the Kessler Psychological Distress Scale (K5), and 5-year cardiovascular disease (CVD) risk.Results: Controlling for sociodemographic characteristics and health behaviours, multivariate regression revealed significant and substantial associations between caring for country and health outcomes. An interquartile range rise in the weighted composite caring-for-country score was significantly associated with more frequent physical activity, better diet, lower BMI (regression coefficient [b] = − 2.83; 95% CI, − 4.56 to − 1.10), less abdominal obesity (odds ratio [OR], 0.43; 95% CI, 0.26–0.72), lower systolic blood pressure (b = − 7.59; 95% CI, − 12.01 to − 3.17), less diabetes (OR, 0.12; 95% CI, 0.03–0.52), lower HbA1c level (b = − 0.45; 95% CI, − 0.79 to − 0.11), non-elevated ACR (OR, 0.28; 95% CI, 0.13–0.60), higher HDL cholesterol level (b = 0.06; 95% CI, 0.01–0.12), lower K5 score (b = − 0.97; 95% CI, − 1.64 to − 0.31) and lower CVD risk (b = − 0.77; 95% CI, − 1.43 to − 0.11).Conclusions: Greater Indigenous participation in caring for country activities is associated with significantly better health. Although the causal direction of these associations requires clarification, our findings suggest that investment in caring for country may be a means to foster sustainable economic development and gains for both ecological and Indigenous peoples’ health

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JO - Medical Journal of Australia

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Burgess C, Johnston F, Berry H, McDonnell J, Yibarbuk D, Gunabarra C et al. Healthy country, healthy people: The relationship between Indigenous health status and "caring for country". Medical Journal of Australia. 2009;190(10):567-572.