Cheryl McMullen1, Ashley Eastwood1, Jeanette Ward1,2. 1. Kimberley Population Health Unit, WA Country Health Services - Kimberley Region, Western Australia. 2. School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, Ontario, Canada.
Abstract
OBJECTIVES: To determine local values for environmental attributable fractions and explore their applicability and potential for public health advocacy. METHODS: Using World Health Organization (WHO) values for environmental attributable fractions, responses from a practitioner survey (73% response rate) were considered by a smaller skills-based panel to determine consensus values for Kimberley environmental attributable fractions (KEAFs). Applied to de-identified data from 17 remote primary healthcare facilities over two years, numbers and proportions of reasons for attendance directly attributable to the environment were calculated for all ages and children aged 0-4 years, including those for Aboriginal patients. RESULTS: Of 150,357 reasons for attendance for patients of all ages, 31,775 (21.1%) were directly attributable to the environment. The proportion of these directly due to the environment was significantly higher for Aboriginal patients than others (23.1% v 14.6%; p<0.001). Of 29,706 reasons for attendance by Aboriginal children aged 0-4 years, 7,599 (25.6%) were directly attributable to the environment, significantly higher than for non-Aboriginal children aged 0-4 years (25.6% v 18.6%; p<0.001). CONCLUSIONS: By addressing environmental factors, 20% of total primary healthcare demand could be prevented and, importantly, some 25% of presentations by Aboriginal children. IMPLICATIONS: KEAFs have potential to monitor impact of local environmental investments.
OBJECTIVES: To determine local values for environmental attributable fractions and explore their applicability and potential for public health advocacy. METHODS: Using World Health Organization (WHO) values for environmental attributable fractions, responses from a practitioner survey (73% response rate) were considered by a smaller skills-based panel to determine consensus values for Kimberley environmental attributable fractions (KEAFs). Applied to de-identified data from 17 remote primary healthcare facilities over two years, numbers and proportions of reasons for attendance directly attributable to the environment were calculated for all ages and children aged 0-4 years, including those for Aboriginal patients. RESULTS: Of 150,357 reasons for attendance for patients of all ages, 31,775 (21.1%) were directly attributable to the environment. The proportion of these directly due to the environment was significantly higher for Aboriginal patients than others (23.1% v 14.6%; p<0.001). Of 29,706 reasons for attendance by Aboriginal children aged 0-4 years, 7,599 (25.6%) were directly attributable to the environment, significantly higher than for non-Aboriginal children aged 0-4 years (25.6% v 18.6%; p<0.001). CONCLUSIONS: By addressing environmental factors, 20% of total primary healthcare demand could be prevented and, importantly, some 25% of presentations by Aboriginal children. IMPLICATIONS: KEAFs have potential to monitor impact of local environmental investments.
Authors: Amal Chakraborty; Natasha J Howard; Mark Daniel; Alwin Chong; Nicola Slavin; Alex Brown; Margaret Cargo Journal: Int J Environ Res Public Health Date: 2021-05-13 Impact factor: 3.390
Authors: Rosemary Wyber; Catalina Lizama; Vicki Wade; Glenn Pearson; Jonathan Carapetis; Anna P Ralph; Asha C Bowen; David Peiris Journal: BMJ Open Date: 2022-03-10 Impact factor: 2.692