Investigators: Frieda McLoughlin, Marianne Mullane, Rebecca Pavlos, Stephanie Enkel, John Jacky, Kristen White, Phillipa May, Rachael Donovan, Jonathan Carapetis and Asha Bowen
In Australia, Aboriginal and Torres Strait Islander people have not equitably received the health benefits of economic, political, social, and cultural inclusion that their non-Indigenous counterparts have profited from. The legacy of colonisation and sustained public policy that hampers Aboriginal and Torres Strait Islander wellbeing means that approximately one third of the gap in observed health outcomes can be linked to social determinants of health – all entirely amenable. Until Australia achieves parity in opportunities for Aboriginal and Torres Strait Islander people, strategies must be targeted towards addressing these underlying drivers of ill health. Skin health is one such example.
The Skin Health Situational Analysis was conducted in 2017 with and for stakeholders in the Kimberley region as a precursor to the SToP Trial to highlight all that was already known prior to commencement in 2018. It was completed to be a resource for communities in the Kimberley who would like to develop strategies to prevent skin infections. In addition, research and service organisations may use this report as a resource to inform future planning and priorities, in conjunction with community consultation and evidenced-based approaches. The SToP trial is governed at its highest level by a partnership of the Kimberley Aboriginal Medical Services, Nirrumbuk Aboriginal Corporation, WA Country Health Services and Telethon Kids Institute working in partnership to achieve healthy skin.
To begin data collection, a desktop review of information about skin health management and service delivery was conducted. Then, 42 Kimberley stakeholders were interviewed to gain a deeper understanding of the broader context in which a comprehensive skin program would sit, informing most of the Situational Analysis. Additionally, 87 questionnaire responses (48 questions) were analysed and have informed this report in conjunction with transcripts from two focus group meetings (environmental health and health promotion) and community consultations (for the SToP Trial in nine remote Kimberley communities during 2017). The combined results from this comprehensive analysis are presented in this review and whilst accurate when conducted in 2017, remain thematically relevant for ongoing work to achieve healthy skin for all.
Key findings
- Skin infections are common in the Kimberley, however there is evident good will in services working together to reduce this burden.
- The environment, including homes and resourcing within communities contributes to poor skin health. Despite this, interventions in these areas can improve skin health and overall wellbeing of individuals, families, and communities.
- Addressing the social determinants of health is critical to preventing skin infections. As their incidence is determined by a complex array of factors, a holistic approach is required to address skin infections.
- The Kimberley has led the way in Australian environmental health by developing the Environmental Health referral form to better integrate health care assessment with prevention activities.
- Achieving the Healthy Living Practices will require attention to housing maintenance systems, environmental health and health services working together.
Our people
Situational Analysis Research Team: Frieda McLoughlin, Marianne Mullane, Rebecca Pavlos, Stephanie Enkel, John Jacky, Kristen White, Phillipa May, Rachael Donovan, Jonathan Carapetis and Asha Bowen
SToP Trial Partnership Steering Group: Jonathan Carapetis (chair), Asha Bowen, Bec Smith (WA Department of Health Country Health Service), Vicki O'Donnell (Kimberley Aboriginal Medical Services (KAMS)), Raymond Christophers (Nirrumbuk Aboriginal Corporation)
SToP Trial Investigators:
Chief Investigators
Associate Professor Asha Bowen, Professor Jonathan Carapetis, Associate Professor Steven Tong, Professor Juli Coffin, Professor Andrew Steer, Associate Professor Roz Walker, Dr Julie Ann Marsh, Mr Raymond Christophers
Associate Investigators
Dr Clancy Read, Dr David Atkinson, Dr David Hendrickx, Ms Edie Wright, Mr Glenn Pearson, Ms Kristen White, Dr Pippa May, A/Prof Tom Snelling, Ms Vicki O’Donnell, Ms Bec Smith, Dr Tim Barnett, Mr Jeffery Cannon.
