The social determinants of Aboriginal and Torres Strait Islander adults who do not smoke in regional Australia

IF 1.9 4区医学 Q2 NURSING

Australian Journal of Rural Health Pub Date : 2024-02-17 DOI:10.1111/ajr.13084

Christina Heris PhD, Reuben Z. Caudell, Eden M. Barrett PhD, Makayla-May Brinckley BPsych (Hons), Rubijayne Cohen BS, Michelle Kennedy PhD, Lisa J. Whop PhD, Tom Calma AO, FANZSOG, FAA, FASSA, FAHA, Hon DSc, Raglan Maddox PhD

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Abstract

Introduction

Commercial tobacco use was systematically embedded as a valuable commodity through colonisation that continues to be exploited for profit by the Tobacco Industry. There have been significant declines in current smoking prevalence among Aboriginal and Torres Strait Islander peoples 18 years and over, from 55% in 1994 to 43% in 2018–2019. This paper seeks to better understand smoke-free behaviours, and to systematically quantify associations between a range of SDOH and non-smoking/never-smoking among Aboriginal and Torres Strait Islander adults (≥18) living in regional Australia.

Objective

To explore the social determinants of health (SDOH) related to non- and never-smoking among Aboriginal and Torres Strait Islander peoples in regional Australia.

Design

Cross-sectional analysis of the NATSIHS, weighted to the Aboriginal and Torres Strait Islander adult population living in regional Australia, was conducted. Participants were characterised as people who were current smokers, never-smokers and non-smokers (ex- and never-smokers). The social determinants of health exposures related to socioeconomic position, well-being and access to healthcare.

Setting

Regional Australia is distinct from urban and remote areas, based on the ASGS Remoteness Structure (ABS) 2018–2019.

Participants

Aboriginal and Torres Strait Islander adults (≥18 years) who were selected, consented and asked questions about smoking in the National Aboriginal and Torres Strait Islander Health Survey (NATSIHS 2018/19).

Results

High income was associated with non-smoking (Prevalence Ratio [PR] = 2.07; 95% CI: 1.66–2.57) and never-smoking (PR = 2.02; 1.46–2.79), as was completing year 10 (non-smoking PR = 1.34; 1.12–1.61 and never-smoking PR = 1.56; 1.20–2.03). Better food security was associated with a higher prevalence of never-smoking (PR = 2.42; 1.48–3.98). Lower psychological distress scores were associated with non-smoking (PR = 1.30; 1.10–1.53) and never-smoking (PR = 1.56; 1.21–2.01). Never-smoking was more frequent in participants reporting no experiences of unfair treatment (PR = 1.59; 1.22–2.06). Having a usual healthcare provider was associated with non-smoking (PR = 1.38; 1.02–1.86). Positive exposure to the SDOH were associated with non- and never-smoking among Aboriginal and Torres Strait Islander adults in regional Australia. Structural and systemic changes to address the SDOH, including discrimination and racism, are expected to accelerate non-smoking behaviours and improve health outcomes for Aboriginal and Torres Strait Islander peoples.

Abstract Image

查看原文本刊更多论文

澳大利亚地区土著居民和托雷斯海峡岛民成年人不吸烟的社会决定因素。

导言：商业烟草使用在殖民化过程中被系统地植入为一种有价值的商品，烟草业继续利用这种商品牟利。目前，18 岁及以上土著居民和托雷斯海峡岛民的吸烟率大幅下降，从 1994 年的 55% 降至 2018-2019 年的 43%。本文旨在更好地了解无烟行为，并系统量化居住在澳大利亚地区的土著居民和托雷斯海峡岛民成年人（≥18 岁）中一系列 SDOH 与不吸烟/从不吸烟之间的关联：探讨与澳大利亚地区原住民和托雷斯海峡岛民不吸烟和从不吸烟有关的健康社会决定因素（SDOH）：设计：根据居住在澳大利亚地区的土著居民和托雷斯海峡岛民成年人口的情况，对国家土著居民和托雷斯海峡岛民健康调查（NATSIHS）进行了横断面分析。参与者包括当前吸烟者、从不吸烟者和不吸烟者（曾吸烟者和从不吸烟者）。健康风险的社会决定因素与社会经济地位、福利和医疗保健服务有关：根据2018-2019年澳大利亚统计局（ABS）的偏远地区结构（ASGS Remoteness Structure），澳大利亚地区有别于城市和偏远地区：在全国土著居民和托雷斯海峡岛民健康调查（NATSIHS 2018/19）中被选中、同意并被问及吸烟问题的土著居民和托雷斯海峡岛民成年人（≥18 岁）：高收入与不吸烟（吸烟率[PR] = 2.07；95% CI：1.66-2.57）和从不吸烟（吸烟率 = 2.02；1.46-2.79）有关，与完成第10年学业有关（不吸烟吸烟率 = 1.34；1.12-1.61，从不吸烟率 = 1.56；1.20-2.03）。较好的食品安全与较高的从不吸烟率相关（PR = 2.42; 1.48-3.98）。较低的心理压力得分与不吸烟（PR = 1.30；1.10-1.53）和从不吸烟（PR = 1.56；1.21-2.01）有关。从不吸烟的受试者更经常报告没有受到不公平待遇的经历（PR = 1.59; 1.22-2.06）。拥有固定的医疗服务提供者与不吸烟有关（PR = 1.38; 1.02-1.86）。在澳大利亚地区的土著居民和托雷斯海峡岛民成年人中，SDOH的积极暴露与不吸烟和从不吸烟有关。为解决SDOH问题（包括歧视和种族主义）而进行的结构性和系统性变革有望加速原住民和托雷斯海峡岛民的不吸烟行为并改善其健康状况。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Australian Journal of Rural Health 医学-公共卫生、环境卫生与职业卫生

CiteScore

2.30

自引率

16.70%

发文量

122

审稿时长

12 months

期刊介绍： The Australian Journal of Rural Health publishes articles in the field of rural health. It facilitates the formation of interdisciplinary networks, so that rural health professionals can form a cohesive group and work together for the advancement of rural practice, in all health disciplines. The Journal aims to establish a national and international reputation for the quality of its scholarly discourse and its value to rural health professionals. All articles, unless otherwise identified, are peer reviewed by at least two researchers expert in the field of the submitted paper.