Aboriginal premature mortality within South Australia 1999-2006: a cross-sectional analysis of small area results

<p>Abstract</p> <p>Background</p> <p>This paper initially describes premature mortality by Aboriginality in South Australia during 1999 to 2006. It then examines how these outcomes vary across area level socio-economic disadvantage and geographic remoteness.</p> <p>Methods</p> <p>The retrospective, cross-sectional analysis uses estimated resident population by sex, age and small areas based on the 2006 Census, and Unit Record mortality data. Premature mortality outcomes are measured using years of life lost (YLL). Subsequent intrastate comparisons are based on indirect sex and age adjusted YLL results. A multivariate model uses area level socio-economic disadvantage rank, geographic remoteness, and an interaction between the two variables to predict premature mortality outcomes.</p> <p>Results</p> <p>Aboriginal people experienced 1.1% of total deaths but 2.2% of YLL and Aboriginal premature mortality rates were 2.65 times greater than the South Australian average. Premature mortality for Aboriginal and non-Aboriginal people increased significantly as area disadvantage increased. Among Aboriginal people though, a significant main effect for area remoteness was also observed, together with an interaction between disadvantage and remoteness. The synergistic effect shows the social gradient between area disadvantage and premature mortality increased as remoteness increased.</p> <p>Conclusions</p> <p>While confirming the gap in premature mortality rates between Aboriginal South Australians and the rest of the community, the study also found a heterogeneity of outcomes within the Aboriginal community underlie this difference. The results support the existence of relationship between area level socio-economic deprivation, remoteness and premature mortality in the midst of an affluent society. The study concludes that vertically equitable resourcing according to population need is an important response to the stark mortality gap and its exacerbation by area socio-economic position and remoteness.</p

Reflexive Interdisciplinary Research: The Making of a Research Programme on the Rural Economy and Land Use

This paper provides an account of the origins and formation of the UK Research Councils' Rural Economy and Land Use (RELU) programme and its approach to promoting interdisciplinary working between social and natural scientists. The programme is set in the context of broader developments in science policy, including a policy discourse centred upon sustainable development and the knowledge economy and associated demands for greater accountability in science. Interdisciplinarity promises research that will be more relevant and responsive to public needs and concerns. In describing the provenance of the RELU programme, therefore, the paper seeks to lay out the different stages in its initiation and design to show how, to varying degrees, these were open to external scrutiny and influence. The process of developing the programme illustrates that it is not straightforward to make research agendas and funding more transparent and accountable. It also provides insights into the challenges that interdisciplinarity and accountability present to established science institutions. Copyright 2006 Blackwell Publishing Ltd.