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      Investigating disparity in access to Australian clinical genetic health services for Aboriginal and Torres Strait Islander people

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          Abstract

          Globally, there is a recognised need that all populations should be able to access the benefits of genomics and precision medicine. However, achieving this remains constrained by a paucity of data that quantifies access to clinical genomics, particularly amongst Indigenous populations. Using administrative data from clinical genetic health services across three Australian jurisdictions (states/territories), we investigate disparities in the scheduling and attendance of appointments among Aboriginal and/or Torres Strait Islander people, compared to non-Indigenous people. For 14,870 appointments scheduled between 2014–2018, adjusted Multivariate Poisson Regression models revealed that Aboriginal and/or Torres Strait Islander people were scheduled fewer appointments (IRR 0.73 [0.68–0.80], <0.001) and attended at lower rates (IRR 0.85 [0.78–0.93], <0.001). Within this population, adults, females, remote residents, and those presenting in relation to cancer or prenatal indications experienced the greatest disparity in access. These results provide important baseline data related to disparities in access to clinical genomics in Australia.

          Abstract

          Globally it is recognised that Indigenous populations should be able to access the benefits of genomics and precision medicine. Here, authors show that there are disparities in access to clinical genetic health services for Aboriginal and/or Torres Strait Islander people in Australia.

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          Most cited references45

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          The Missing Diversity in Human Genetic Studies

          The majority of studies of genetic association with disease have been performed in Europeans. This European bias has important implications for risk prediction of diseases across global populations. In this commentary, we justify the need to study more diverse populations using both empirical examples and theoretical reasoning.
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            Indigenous and tribal peoples' health (The Lancet-Lowitja Institute Global Collaboration): a population study.

            International studies of the health of Indigenous and tribal peoples provide important public health insights. Reliable data are required for the development of policy and health services. Previous studies document poorer outcomes for Indigenous peoples compared with benchmark populations, but have been restricted in their coverage of countries or the range of health indicators. Our objective is to describe the health and social status of Indigenous and tribal peoples relative to benchmark populations from a sample of countries.
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              Colonisation, racism and indigenous health

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                Author and article information

                Contributors
                jnluke@unimelb.edu.au
                Journal
                Nat Commun
                Nat Commun
                Nature Communications
                Nature Publishing Group UK (London )
                2041-1723
                24 August 2022
                24 August 2022
                2022
                : 13
                : 4966
                Affiliations
                [1 ]GRID grid.1008.9, ISNI 0000 0001 2179 088X, Centre for Health Policy, , The University of Melbourne, ; Melbourne, VIC Australia
                [2 ]GRID grid.1058.c, ISNI 0000 0000 9442 535X, Victorian Clinical Genetics Services, , Murdoch Children’s Research Institute, ; Parkville, VIC Australia
                [3 ]Machado Joseph Disease Foundation, Alyangula, NT Australia
                [4 ]GRID grid.416100.2, ISNI 0000 0001 0688 4634, Genetic Health Queensland, , Royal Brisbane and Women’s Hospital, ; Brisbane, QLD Australia
                [5 ]GRID grid.1003.2, ISNI 0000 0000 9320 7537, School of Medicine, , University of Queensland, ; St Lucia, QLD Australia
                [6 ]GRID grid.1021.2, ISNI 0000 0001 0526 7079, Alfred Deakin Institute for Citizenship and Globalisation, , Deakin University, ; Geelong, VIC Australia
                [7 ]GRID grid.1011.1, ISNI 0000 0004 0474 1797, James Cook University, ; Townsville, QLD Australia
                [8 ]GRID grid.1043.6, ISNI 0000 0001 2157 559X, Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, , Charles Darwin University, ; Casuarina, NT Australia
                [9 ]GRID grid.266886.4, ISNI 0000 0004 0402 6494, School of Medicine, , The University of Notre Dame Australia, ; Sydney, NSW Australia
                [10 ]GRID grid.1042.7, ISNI 0000 0004 0432 4889, Immunology, , Walter Eliza Hall Institute, ; Parkville, VIC Australia
                [11 ]GRID grid.1021.2, ISNI 0000 0001 0526 7079, School of Humanities and Social Science, , Deakin University, ; Burwood, VIC Australia
                [12 ]GRID grid.1012.2, ISNI 0000 0004 1936 7910, Telethon Kids Institute and Division of Paediatrics, Faculty of Health and Medical Sciences, , University of Western Australia, ; Perth, WA Australia
                [13 ]GRID grid.1008.9, ISNI 0000 0001 2179 088X, Department of Paediatrics, , University of Melbourne, ; Parkville, VIC Australia
                [14 ]GRID grid.413880.6, ISNI 0000 0004 0453 2856, Genetic Services of Western Australia, Western Australian Department of Health, ; Perth, WA Australia
                [15 ]GRID grid.413880.6, ISNI 0000 0004 0453 2856, Western Australian Register of Developmental Anomalies, Western Australian Department of Health, ; Perth, WA Australia
                Author information
                http://orcid.org/0000-0002-5105-8427
                http://orcid.org/0000-0003-3866-3224
                http://orcid.org/0000-0001-5065-5716
                http://orcid.org/0000-0001-6564-2715
                http://orcid.org/0000-0003-4920-9553
                Article
                32707
                10.1038/s41467-022-32707-0
                9400572
                36002448
                2e428b77-0745-407f-8fa8-692a83db9e45
                © The Author(s) 2022

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 7 October 2021
                : 11 August 2022
                Categories
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                © The Author(s) 2022

                Uncategorized
                epidemiology,genetic services
                Uncategorized
                epidemiology, genetic services

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