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A multidimensional assessment of health and functional status in older Aboriginal Australians from Katherine and Lajamanu, Northern TerritorySevo, Goran, sevo1984@yubc.net January 2003 (has links)
Human health is multidimensional: apart from physical, mental, and social aspects, it also
incorporates subjective perceptions of health, and functional status (FS). Given that elderly
persons have very distinctive health and social needs, multidimensional assessment (MA)
of health proves particularly useful in this age group.¶
Aboriginal populations suffer poor health, and there are relatively few studies addressing
the health problems of older Aboriginal Australians, mainly because of their distinctive
demographic structure, and the low proportion of their elderly. Also, there is no prior
information available on MA of health in this Australian population group.¶
This thesis offers a MA of health in older Aboriginal persons from two, urban and
rural/isolated, locations in the NT, Katherine and Lajamanu (the NT survey).¶
This thesis specifically addresses the following questions:
- what is the physical health, FS, subjective perception of health, and social
functioning amongst the NT survey participants?
- what are the possible similarities and differences in various dimensions of health
between the two major survey locations, what age and gender patterns are
observed, and what are the reasons for these patterns, similarities and
differences?
- how do various dimensions of health relate to each other, and why?
- how do current findings relate to broader Aboriginal and non-Aboriginal
populations, and why?
- what can MA add to a better understanding of various aspects of morbidity and
health care use?
- what are its possible implications for health planning?¶
Findings from this work indicate poor physical health amongst participants in almost all
investigated aspects, comparable to information available from other Aboriginal
populations. These are accompanied by low levels of ability for physical functioning. Despite this, subjective perception of health is rather optimistic amongst participants, and
levels of social functioning high. Use of health services is mainly related to available health
infrastructure. Important health differences exist between Katherine and Lajamanu, and
they became particularly visible when all dimensions of health are considered together.¶
The Main conclusions from the current work are that 1) poor physical health is not
necessarily accompanied by similar level of deterioration in other dimensions of health:
even though participants from the isolated community of Lajamanu experience most
chronic diseases, their ability for physical functioning is better, self-perceived health (SPH)
more optimistic and levels of social functioning highest 2) institutionalised participants from
Katherine suffer by far the worst health of all sample segments in this study; at least some
of the poor health outcomes are potentially avoidable, and could be improved by more
appropriate residential choices for Aboriginal elderly 3) better health infrastructure does
not necessarily bring better health in all its dimensions, suggesting that other factors
(primarily socio-economic and cultural) should be addressed in conjunction with this in
solving complex health problems of Aboriginal Australians, and 4) it provides strong
support that MA can become a useful tool in comprehensive health assessment of older
Aboriginals.
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