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Abstract
Background: In Australia, Aboriginal and Torres Strait Islander children have a greater burden of burn injury than other Australian children, yet to date, no research has examined this from an Indigenous perspective. This is the first thesis to use Indigenous research methodologies to provide a detailed examination of how health inequity impacts on Aboriginal and Torres Strait Islander children with an acute burn injury.
Methods: The research comprised a systematic review of international injury literature, two epidemiological studies using Burns Registry of Australia and New Zealand data, a quantitative study with Aboriginal families and psychometric assessment of a survey. Indigenous research methodologies (decolonising, knowledge interface) woven with quantitative research methods were employed throughout.
Results: Inequities in injury burden are greatest in children from low socio-economic status backgrounds and those who experience longer hospital length of stay (LOS). Aboriginal and Torres Strait Islander children have a hospital LOS 4 days longer than other Australian children with acute burns. Remoteness, flame burns, percentage total body surface area are contributing factors. These health inequities, low socio-economic status and Streptococcus sp. infection are greater in Aboriginal and Torres Strait Islander children than other Australian children. While knowledge interface methodology acted to decolonise outcomes, there were limitations in data in the data source, a Western epidemiological data repository and its employed classification codes.
The manifestation of these inequities creates additional burden through Out-of-Pocket Healthcare Expenditure (OOPHE) on Aboriginal and Torres Strait Islander families. Travel, accommodation and medication are all OOPHE costs impacting families for their child’s burns treatment. Financial stain was reported through inability to pay bills and social isolation. The modification of a pre-existing OOPHE survey was found to be impracticable for Aboriginal and Torres Strait Islander families.
Conclusion: This thesis describes the health inequity impacts on Aboriginal and Torres Strait Islander children with an acute burn injury through an Indigenous perspective. Engagement with Indigenous research methodologies exposed the invisible white possessive logic ingrained in burns quantitative research. Change is needed to shift this paradigm and work towards an agenda of Indigenous data sovereignty and more accurate understandings of burn injury burden.