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Title: Communicable diseases in rural and remote Australia: the need for improved understanding and action
Contributor(s): Quinn, E K (author); Massey, Peter D  (author); Speare, R (author)
Publication Date: 2015
Open Access: Yes
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Abstract: Introduction: Rural and remote communities of Australia, particularly those including Aboriginal people, experience greater morbidity and mortality across a range of health outcomes compared to urban communities. Previous national data have demonstrated that rural and remote communities experience a disproportionate burden of communicable diseases compared to their urban counterparts. This systematic review was undertaken to describe the types of research that have explored the epidemiology of communicable diseases in rural and remote communities in Australia, with particular reference to the social determinants of health. Methods: We conducted a keyword search of several databases (EMBASE, MEDLINE/PubMed, RURAL, Aboriginal and Torres Strait Islander Health Database, Web of Science Core Collection, and Google and Google Scholar websites) for peer-reviewed and grey literature that described or analysed the epidemiology of communicable diseases in rural and/or remote communities of Australia from 2004 to 2013. Exclusion criteria were applied to keep the review focused on rural and/or remote communities and the population-level epidemiological analysis of communicable diseases. Results: From 2287 retrieved articles, a total of 50 remained after applying exclusion criteria. The majority of included articles were descriptive studies (41/50). Seven of the total 50 articles contained analytical studies; one systematic literature review and one experimental study were also identified. Due to the diversity of approaches in measuring disease burden, we performed a narrative synthesis of the articles according to the review objectives. Most of the articles investigated the disease burden in remote (n=37/50) and Aboriginal communities only (n=21/50). The studies highlighted a high prevalence or incidence of skin, eye and respiratory infections for remote Aboriginal communities, particularly children over the past decade. There was emerging evidence to suggest that housing and social conditions play an important role in determining the risk of skin, ear, respiratory and gastrointestinal infections in children. Other health service and sociocultural factors were also discussed by authors as influencing the epidemiology of communicable diseases in rural and remote communities. Conclusions: This systematic review identified several communicable diseases that continue to cause considerable morbidity in remote Aboriginal communities, including skin, eye and respiratory infections, particularly for children. Overall there is a substantial amount of descriptive epidemiology published, but few analytical or experimental studies. Despite a lack of empirical investigation into the social determinants of the burden of communicable disease, there is emerging evidence that has demonstrated a significant association between housing conditions and skin, ear, respiratory and gastrointestinal infections in children. There is also growing recognition of other social and environmental factors that can influence the burden of diseases in rural and remote communities. Further investment into higher quality community-based research that addresses the social determinants of communicable diseases in remote communities is warranted. The lack of research investigating zoonoses and tropical diseases was noted.
Publication Type: Journal Article
Source of Publication: Rural and Remote Health, v.15, p. 1-19
Publisher: Australian Rural Health Education Network
Place of Publication: Australia
ISSN: 1445-6354
Fields of Research (FoR) 2008: 111701 Aboriginal and Torres Strait Islander Health
111712 Health Promotion
111708 Health and Community Services
Fields of Research (FoR) 2020: 450401 Aboriginal and Torres Strait Islander and disability
420603 Health promotion
420305 Health and community services
Socio-Economic Objective (SEO) 2008: 920301 Aboriginal and Torres Strait Islander Health - Determinants of Health
920413 Social Structure and Health
920408 Health Status (e.g. Indicators of Well-Being)
Socio-Economic Objective (SEO) 2020: 200207 Social structure and health
200413 Substance abuse
210301 Aboriginal and Torres Strait Islander determinants of health
Peer Reviewed: Yes
HERDC Category Description: C1 Refereed Article in a Scholarly Journal
Appears in Collections:Journal Article

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