In spite of much effort over the past 25 years, the life expectancy of the indigenous people remains nearly 20 years behind the non-Aboriginal white population of Australia. These figures compare unfavourably with the improved life expectancy over the past 25 years of other indigenous peoples, such as the New Zealand Maori and the American Indian populations. By 1990-94, the average Australian indigenous all-cause mortality rate was 1.9 times the Maori rate, 2.4 times the US indigenous rate and 3.15 times the all-Australian rate. The persistence of this discrepancy in Australia is obviously a matter of great concern. There is clearly a gap between available knowledge and its application. Some indication of the possibility of reversal of the current situation is given by a recent report of the beneficial impact of the Homelands Movement on Health Outcomes in Central Australian Aborigines. The study compared the prevalence of obesity, hypertension and diabetes in two groups of Aboriginal adults: those living in homelands versus those living in centralized communities in Central Australia. Baseline studies revealed a lower prevalence of diabetes, hypertension and obesity in the homelands group, compared with those living in centralized communities. They were also less likely to die and less likely to be hospitalized for any cause, particularly infections, injury involving alcohol and other injury. Mean age at death was 58 and 48 years for the residents of homelands and centralized communities, respectively. The benefits were most marked in young adults. It is suggested that the homelands communities have a greater degree of control of their own lives than those living in the centralized communities and this may be an important factor in their improved health status. Improvement in indigenous health should be one of the key issues of reconciliation. Priorities include community control of Aboriginal Health Services under the National Aboriginal Community Controlled Health Organisation (NACCHO), throughout Australia, a greater priority for prevention and public health services (housing, water supply and environmental services) education and economic issues, improved training of indigenous health professionals and increased funding. A national professional organization including NACCHO needs to be established to bridge the big gap between available knowledge and its application for the benefit of the indigenous people of Australia.
During the American-Australian Scientific Expedition to Arnhem Land in 1948, a nutritionist (Margaret McArthur), a medical officer (Brian Billington), a biochemist (Kelvin Hodges) and also the 'flying dentist' (John Moody) observed the nutrition and health of Aborigines in the settlements on Groote Eylandt, at Yirrkala and at Oenpelli, Northern Territory. The results of their research were published in the Records of the American-Australian Scientific Expedition to Arnhem Land Volume 2 Anthropology and Nutrition. (Melbourne University Press, 1960). Although seasonal and regional variations in food supply were a constant problem for nomadic Aborigines living on 'bush tucker' gathered from marine, freshwater and terrestrial ecosystems, the variety of food provided a well-balanced diet according to the international recommendations of 1948. In contrast, improvements in the 1948 diet of Aborigines in the settlements were strongly recommended. 1 An increase in the quantity of food given to older children and adolescents.2 Regular distribution of fresh fruit and vegetables throughout the year from settlement gardens.3 Regular supplies of fish, meat and other animal products, particularly for children, adolescents, pregnant and lactating mothers.4 Increased production of milk and greater care in its handling.5 Greater use of whole grain cereals in preference to refined products.
During 1948, scientists (an anthropologist, a nutritionist and a plant ecologist) of the American–Australian Scientific Expedition to Arnhem Land observed the daily activities of families of nomadic Aborigines in the monsoonal climate of Groote Eylandt, Bickerton Island, Port Bradshaw, Yirrkala and Oenpelli, Northern Territory. The close relationship between the hunter–gatherers and the marine and terrestrial landscape is described at Hemple Bay in Port Langdon, north-eastern Groote Eylandt. Food-gathering from both land and sea was followed hourly to assess the nutritional value of ‘bush tucker’ in comparison with that of natives eating freshly picked fruit and vegetables grown in the garden of the Umbakumba Settlement. The ecological distributions of food plants used by the Aborigines, together with their seasonality, determined the migratory pattern of the hunter–gatherers throughout the year. With only a few exceptions, the diets which were seen at the four camps in Arnhem Land were well-balanced and provided amounts of most nutrients comparable with the recommended international dietary allowances. Seasonal and regional variations in food supply were a constant problem to these nomadic people.
Between 1988 and 1993 the International Union of Nutritional Sciences Committee 'Nutrition and Ageing' established the international 'Food Habits in Later Life' (FHILL) Program. The FHILL program documented current and distant past food habits of more than 2000 Caucasian and Asian elderly people, which also included 54 older Aboriginal Australians in a community called Junjuwa in the Fitzroy Valley, Kimberley region, Western Australia. The program primarily used a quantitative food frequency questionnaire to collect food intake data. However, in some communities this was neither practical nor feasible due to differences in cultural interpretation of questions relating to 'time', 'frequency' and 'quantity'. To overcome this hurdle, FHILL was coupled to a qualitative socioanthropological methodolgy known as RAP 'Rapid Assessment Procedures'. This paper reviews published qualitative data using RAP to describe distant past food intake on cattle stations prior to the 1960s and food intake of Aborigines aged 50 years and over in 1988 in Junjuwa. Aboriginal food habits on cattle stations prior to the 1960s appeared to be more nutrient dense, due to greater food variety and higher intakes of lean fresh and salted buffalo meat (probably high in omega-3 fatty acids), offal, vegetables and bush foods; buffalo fat was rationed and used in meat stews. High intakes of tea and sugar appears to have remained unchanged. Food intake was more or less constant from day to day in contrast to the 'feast' and 'famine' days observed in the community studied in 1988, which was related to the pension cycle. In contrast to the more varied cattle station diet, the community-dwelling older Aborigines in 1988 consumed more than 50% of their total energy intake from three foods: sugar, fatty beef/lamb and white flour (damper). Exploring distant past food intake on cattle stations has helped explain desirable and undesirable food preferences of the older Aborigines in 1988. For example, the desire for stewed fatty meat, salty preserved meat, onions, potatoes, white leavened and unleavened bread (damper), rice, oats, salty sauces/curry, sugar and tea, but a lack of desirable oils, leafy greens, yoghurt, legumes and nuts is partly a reflection of the food habits and preferences of Anglo-Australians in the bush more than 50 years ago.
The aim of this survey was aimed to determine current breast-feeding and infant-feeding practices among a community of urban indigenous Australians in Brisbane, the largest city of Queensland, in Australia. In mid-1998, a questionnaire was administered to 61 mothers with infants up to the age of 2 years. Breast-feeding had been initiated by 59% (95% CI: 46.7-71.3) of the mothers; however, by 4 months after birth only 24.6% (95% CI: 13.8-35.4) of the mothers were breast-feeding. Only 19.7% (95% CI: 9.7-29.7) of the infants were solely breast-fed during their first 4 months of life. Of the infants in the survey who were older than 6 months, only 25% (95% CI: 18.2-31.8) had been introduced to solid food after 6 months. The current diet of 80% (95% CI: 44.9-100) of infants aged 4-6 months and 37.5% (95% CI: 13.8-61.2) of infants aged 0-3 months included solids. This survey has indicated the need to appropriately promote breast-feeding as the best source of nutrition for new babies. The initiation rate of breast-feeding is low compared with other Australian rural indigenous and urban indigenous communities. Barriers to continued breast-feeding should also be addressed, as well as appropriate weaning practices.
Factors contributing to the variation in plasma lipoprotein (a) (Lp(a)) concentration were surveyed in an Aboriginal population (175 men and 219 women), aged 24-86 years, from Western Australia. The plasma Lp(a) levels were highly skewed towards low levels in this population, with a median of 84 mg/L and a mean of 166 mg/L. Approximately 20% had plasma Lp(a) above the threshold value of 300 mg/L, while 52% had Lp(a) levels below 100 mg/L. The most commonly occurring phenotype was apolipoprotien(a) S4. In this phenotype, Lp(a) concentrations ranged from not detectable to 468 mg/L. There was a positive relationship between cigarette smoking and plasma Lp(a) concentration in men. Apolipoprotein A1 and bilirubin were positively associated with Lp(a) in the 40-60 age group and a positive relationship between weight and Lp(a) concentrations was observed in those aged 60 years or over. Thus, although Lp(a) is mainly genetically determined, there are clearly other factors which contribute to variations in Lp(a) concentrations.