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Risk 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

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posted on 14.01.2022, 03:12 by KA Thurber, EM Barrett, J Agostino, Catherine ChamberlainCatherine Chamberlain, J Ward, V Wade, M Belfrage, R Maddox, D Peiris, J Walker, B Baffour, M Wenitong, C Law, T Senior, N Priest, K Freeman, T Schramm
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.

Funding

KT (NHMRC Fellowship, ref: 1156276), NP (NHMRC Fellowship, ref: 1123677); the Lowitja Institute. The funders had no role in the study; the researchers were independent from the funders.

History

Publication Date

01/12/2021

Journal

Australian and New Zealand Journal of Public Health

Volume

45

Issue

6

Pagination

(p. 658-663)

Publisher

WILEY

ISSN

1326-0200

Rights Statement

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.