Factors relating to high psychological distress in Indigenous Australians and their contribution to Indigenous–non-Indigenous disparities

Bridgette J. McNamara*, Emily Banks, Lina Gubhaju, Grace Joshy, Anna Williamson, Beverley Raphael, Sandra Eades

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    23 Citations (Scopus)

    Abstract

    Objective: To explore factors associated with high psychological distress among Aboriginal and non-Aboriginal Australians and their contribution to the elevated distress prevalence among Aboriginal people. Methods: Questionnaire data from 1,631 Aboriginal and 233,405 non-Aboriginal 45 and Up Study (NSW, Australia) participants aged ≥45 years were used to calculate adjusted prevalence ratios for high psychological distress (Kessler-10 score ≥22) for socio-demographic, health and disability-related factors, and to quantify contributions to differences in distress prevalence. Results: While high-distress prevalence was increased around three-fold in Aboriginal versus non-Aboriginal participants, distress-related risk factors were similar. Morbidity and physical disability had the strongest associations; high distress affected 43.8% of Aboriginal and 20.9% of non-Aboriginal participants with severe physical limitations and 9.5% and 3.9% of those without limitations, respectively. Differences in distress prevalence between Aboriginal and non-Aboriginal participants were essentially attributable to differences in SES, morbidity, disability/functional limitations and social support (fully-adjusted PR 1.19 [95% 1.08, 1.30]); physical morbidity and disability explained the bulk. Conclusions: The markedly elevated prevalence of high distress among older Aboriginal Australians appears largely attributable to greater physical morbidity and disability. Implications for public health: Addressing upstream determinants of physical morbidity and improved integration of social and emotional wellbeing care into primary care and chronic disease management are essential.

    Original languageEnglish
    Pages (from-to)145-152
    Number of pages8
    JournalAustralian and New Zealand Journal of Public Health
    Volume42
    Issue number2
    DOIs
    Publication statusPublished - Apr 2018

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