Indigenous health and environmental risk factors: an Australian problem with global analogues?

Our plain-English summary of Indigenous health and environmental risk factors: an Australian problem with global analogues?, by L.D. Knibbs, P.D. Sly (Global Health Action, 2014).

The study

• Authors: L.D. Knibbs, P.D. Sly
• Journal: Global Health Action
• Published: 2014;7:23766
• Cited by: 7 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Indigenous people experience poorer health than non-Indigenous people, and this well-described inequality has been observed in many countries. The contribution of different risk factors to the health 'gap' has understandably focussed on those factors for which there are sufficient data. However, this has precluded environmental risk factors - those present in air, water, food, and soil - due to a lack of data describing exposures and outcomes. These risk factors are demonstrably important at the global scale, as highlighted by the 2010 Global Burden of Disease study. Here, we describe how a greater focus on environmental risk factors is required in order to define their role in the Indigenous health gap. We use the Australian context as a case study of an issue we feel has global analogues and relevance. Suggestions for how and why this situation should be remedied are presented and discussed.

In plain English

This short communication was a commentary, not a study: it collected no new data. The authors argued that environmental risk factors, those in air, water, food and soil, have been left out of efforts to explain why Indigenous people have poorer health than non-Indigenous people, because data on exposures and outcomes are lacking. They used Indigenous Australians (Aboriginal and Torres Strait Islander peoples) as a case study. They briefly described earlier research on air pollution, asbestos, weather, contaminated water and land, lead and cadmium. On asbestos, they cited earlier work reporting that Indigenous people in historic asbestos mining regions had the world's second-highest crude incidence rate of malignant mesothelioma in the 1990s: 250 per million person-years, about 10 times the national rate. The authors wrote that there is scarce information linking environmental risk factors to Indigenous health in Australia, and too little for unequivocal conclusions. They suspected that Indigenous people may be more susceptible to some of these factors, but said it is not known how much disease these factors cause. The authors concluded that a greater focus on environmental risk factors is needed.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Short communication (commentary). No original data; the authors used Australia as a case study.
• Who was studied: No study population. The commentary discussed Indigenous Australians (Aboriginal and Torres Strait Islander peoples), with reference to Indigenous peoples worldwide.
• Exposure: Environmental risk factors in general: ambient and indoor air pollution, asbestos (no fiber type named), weather and climate, contaminated water and land (copper sulphide, uranium and radionuclides, lead, cadmium).
• Main results:
  • Citing earlier studies (references 11 and 12), the authors reported that Indigenous people in historic asbestos mining regions in Australia had the world's second-highest crude incidence rate of malignant mesothelioma in the 1990s, 250 per million person-years, about 10 times the national rate. This was not a finding of this article.
  • The authors stated that there is scarce information on the association between environmental risk factors and Indigenous peoples' health in Australia.
  • The authors suspected that Indigenous people may be more susceptible to some environmental risk factors, but said it is not known how much disease these factors cause.
• The authors' conclusion: The authors concluded that a greater focus on environmental risk factors is required to define their role in the Indigenous health gap.
• Limitations the authors state:
  • The authors stated that there is too little information to draw unequivocal conclusions about the effects of these risk factors.
  • The authors noted a lack of information on how exposures and health effects vary across urban, rural and remote areas.

Related studies

• Asbestos still poses a threat to global health: now is the time for action — P.D. Sly, R. Chase, et al. (2010)
• Current and future risks of asbestos exposure in the Australian community — C. Gray, R.N. Carey, et al. (2016)
• Malignant mesothelioma: global incidence and relationship with asbestos — C. Bianchi, T. Bianchi (2007)
• Contribution of environmental factors to cancer risk — P. Boffetta, F. Nyberg (2003)
• Global mesothelioma deaths reported to the World Health Organization between 1994 and 2008 — V. Delgermaa, K. Takahashi, et al. (2011)
• Occupational and environmental risk factors for idiopathic pulmonary fibrosis in Australia: case-control study — M.J. Abramson, T. Murambadoro, et al. (2020)

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