RESUMEN
This study examines social determinants impacting the health and wellbeing of Aboriginal and Torres Strait Islander men in Australia. Social determinants prevent many men from thriving in community environments which also impacts on their social, work and family lives. We examine the impact on men's health and identify how men who participate in Men's Sheds/groups engage in learning about health interventions. Our study extends the work of Percival et al. and their Indigenous health promotion model. A qualitative case study approach conducted 'gatherings' and 'yarning circles' (focus groups) with men from urban, regional and remote areas of the country. We argue that men's groups can serve as a central intervention to support men to build their confidence to learn about health and wellbeing and how to thrive through activities in community life. Findings support health interventions delivered through training and mentoring around various health and other services, healthy eating, sport and fathering programmes (to name a few) to enhance awareness and men's vitality for learning. There are implications for our healthcare system to better understand the conditions of Aboriginal men's health and support these vulnerable groups. Our study proposes men's groups as culturally safe environments to promote and deliver central health promotion interventions that support men to thrive in all facets of their lives.
Asunto(s)
Pueblos Indígenas , Nativos de Hawái y Otras Islas del Pacífico , Padre , Humanos , Masculino , Salud del Hombre , Grupos RacialesRESUMEN
Decades of reports and policy have drawn attention to the significant social and occupational impairment of many young Aboriginal men in Central Australia. However, the role of mental ill-health as a contributing factor to this impairment, and culturally appropriate intervention targets have received insufficient attention in the psychiatry literature. Despite having the worst health outcomes of any population in Australia, Aboriginal men chronically underuse primary health care services. It's proposed that interventions ensuring cultural continuity through Identity-strengthening with a particular focus on positive Aboriginal masculinities will address a critical mental health gap for young men. In Central Australian and broader Indigenous populations, tangible and measurable kinship, language, religious and economic (KLRE) activities are catalytic vehicles for restoring traditional knowledge that suffer ongoing pressures as a result of colonization and assimilationist Government policy. By transforming KLRE knowledge content from ethnographic archives, these culturally rich repositories may be utilized to create education and engagement materials that will support young Aboriginal men's efforts to obtain and maintain positive mental health. This proposal focuses on building resilience through the acquisition of KLRE knowledge which young Aboriginal men can utilize as resources for enhancing positive identity and mental health outcomes.
Asunto(s)
Pueblos Indígenas , Salud Mental , Australia , Humanos , Lenguaje , Masculino , Nativos de Hawái y Otras Islas del PacíficoRESUMEN
OBJECTIVE: To compare prostate cancer mortality for Aboriginal and non-Aboriginal men and to describe prostate cancer treatments received by Aboriginal men. PATIENTS AND METHODS: We analysed cancer registry records for all men diagnosed with prostate cancer in New South Wales (NSW) in 2001-2007 linked to hospital inpatient episodes and deaths. More detailed information on androgen-deprivation therapy and radiotherapy was obtained from medical records for 87 NSW Aboriginal men diagnosed in 2000-2011. The main outcomes were primary treatment for, and death from, prostate cancer. Analysis included Cox proportional hazards regression and logistic regression. RESULTS: There were 259 Aboriginal men among 35,214 prostate cancer cases diagnosed in 2001-2007. Age and spread of disease at diagnosis were similar for Aboriginal and non-Aboriginal men. Prostate cancer mortality 5 years after diagnosis was higher for Aboriginal men (17.5%, 95% confidence interval (CI) 12.4-23.3) than non-Aboriginal men (11.4%, 95% CI 11.0-11.8). Aboriginal men were 49% more likely to die from prostate cancer (hazard ratio 1.49, 95% CI 1.07-1.99) after adjusting for differences in demographic factors, stage at diagnosis, health access and comorbidities. Aboriginal men were less likely to have a prostatectomy for localised or regional cancer than non-Aboriginal men (adjusted odds ratio 0.60, 95% CI 0.40-0.91). Of 87 Aboriginal men with full staging and treatment information, 60% were diagnosed with localised disease. Of these, 38% had a prostatectomy (± radiotherapy), 29% had radiotherapy only and 33% had neither. CONCLUSION: More research is required to explain differences in treatment and mortality for Aboriginal men with prostate cancer compared with non-Aboriginal men. In the meantime, ongoing monitoring and efforts are needed to ensure Aboriginal men have equitable access to best care.
Asunto(s)
Nativos de Hawái y Otras Islas del Pacífico/estadística & datos numéricos , Neoplasias de la Próstata/etnología , Neoplasias de la Próstata/terapia , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Humanos , Masculino , Persona de Mediana Edad , Nueva Gales del Sur/epidemiología , Modelos de Riesgos Proporcionales , Neoplasias de la Próstata/mortalidad , Estudios Retrospectivos , Resultado del Tratamiento , Población Blanca/estadística & datos numéricos , Adulto JovenRESUMEN
AIMS: Mental illness is widespread among Aboriginal men in Australia. However, they do not access mental health services in proportion to their need. Although several reports implicate cultural differences of mental health services as the cause of underutilization, very little is known about help seeking by Aboriginal men who are mentally unwell. This study explores the help-seeking behaviour of Aboriginal men who are mentally unwell in a rural Victorian community. METHODS: The study was carried out using a combination of culturally appropriate research methodologies. Within a Qualitative Description design, semi-structured interviews were conducted with a range of Aboriginal people including men, carers and those involved in service delivery. A total of 17 Aboriginal people were interviewed, of whom 15 were men. Data were analysed thematically. RESULTS: Four themes emerged from the data collected. They included 'Difficulty in recognizing mental health problems', 'Barriers to disclosing one's problems', 'Reluctance to contact services' and 'Alternate coping strategies'. CONCLUSIONS: These findings suggest that there is a need for programmes that aim to improve mental health literacy and promote help seeking among Aboriginal men who are mentally unwell. Such programmes need to be developed jointly by mental health services as well as Aboriginal stakeholders, and implemented in a culturally sensitive and acceptable way.