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Oral health of Torres Strait Islander shows improvements

15 May, 2008

A joint report released by the Australian Bureau of Statistics (ABS) and the Australian Institute of Health and Welfare (AIHW), The Health and Welfare of Australia’s Aboriginal and Torres Strait Islander Peoples – 2008, shows that there have been some improvements in the health and welfare of Aboriginal and Torres Strait Islander peoples.

However in the area of oral health, Aboriginal and Torres Strait Islander people are still not faring as well as their non-Indigenous counterparts. This articles looks briefly at some of the issues in the report which may be of interest to the dental profession.

Oral Health

Oral health refers to the health of a number of tissues in the mouth, including mucous membrane, connective tissue, muscles, bone, teeth and periodontal structures or gums.

It may also refer to immunological, physiological, sensory and digestive system functioning, but is most often used to refer to two specialised tissues of the mouth: the teeth and the gums.

Oral health outcomes are usually measured in terms of the number of decayed, missing or filled baby (deciduous) and adult (permanent) teeth
(dmft and DMFT scores) (AIHW 2007k).

The latest available data on DMFT scores for Indigenous adults come from adults seeking dental care in Australia in 2004–06. Indigenous adults had a greater average number of decayed and missing teeth and a lower average number of filled teeth than non-Indigenous adults across most age groups.

Hospitalisations related to Oral Health Problems

In 2005–06 there were 2,395 hospitalisations of Indigenous people in New South Wales, Victoria, Queensland, Western Australia, South Australia and the Northern Territory combined, for diseases of the oral cavity, salivary glands and jaw.

The majority of these hospitalisations were for dental caries (54%), followed by diseases of the pulp and periapical tissues (14%). Indigenous Australians were less likely to be hospitalised for diseases of the oral cavity, salivary glands and jaw than other Australians.

[It should be noted that in many of the administrative data sources used such as the hospitals data, Indigenous people are under-identified and the rates of illness reported are therefore likely to be underestimates of the true rates of illness in the Aboriginal and Torres Strait Islander population.]

Provision of Health Services

In 2004–05, the estimated expenditure on health goods and services for Indigenous Australians was $2,304 million or 2.8% of total health expenditure. More than two-thirds (67%) of the 2004–05 expenditure was on publicly provided health services, such as public hospitals (46%) and community health services (22%).

The average expenditure on some goods and services provided outside public hospitals was lower for Indigenous Australians than for non-Indigenous Australians. For example, average expenditures on high level residential care, medical services, medications, and dental and other health practitioners were less than half of that for non-Indigenous Australians.

Access to Health Services

Information on the use of health care services when needed by Aboriginal and Torres Strait Islander people was collected in the 2004–05 National Aboriginal and Torres Strait Islander Health Survey (NATSIHS); a survey of around 10,400 Indigenous Australians of all ages.

In 2004–05, 21% of Indigenous Australians reported that they needed to go to a dentist in the previous 12 months, but had not gone; 15% needed
to go to a doctor, but had not gone; 8% needed to go to another type of health professional (e.g. nurse, Aboriginal health worker), but had not gone; and 7% needed to go to a hospital, but had not gone.

Indigenous people in non-remote areas were more likely than those in remote areas to report that they had needed to go to a dentist, doctor, or other health professional, but had not gone (AHMAC 2006).

The 2004–05 NATSIHS also collected information on the reasons that Indigenous people did not use health care services when needed, and on barriers to access.

Factors such as cost, transport and distance, and long waiting times and were reported by a high proportion of those who had not seen a dentist when needed (AHMAC 2006).

While a higher proportion of Indigenous people in non-remote areas reported cost as a reason for not seeking health care when needed, transport/distance and the service not being available in the area were more commonly given as reasons by people in remote areas.

For example, cost was reported as a reason for not seeing a dentist when needed by 32% of respondents in non-remote areas, compared with 15% of
those in remote areas (graph 10.3). On the other hand, respondents in remote areas were much more likely than those in non-remote areas to report transport/distance (28% compared with 7%), or a service not being available in the area (28% compared with 3%) as reasons for not seeing a dentist when needed (AHMAC 2006).

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