Cost and affordability of healthy, equitable and more sustainable diets in the Torres Strait Islands.

OBJECTIVES: To assess the cost, cost differential and affordability of current and recommended (healthy, equitable, culturally acceptable and more sustainable) diets in the Torres Strait Islands and compare with other Queensland locations. METHODS: The Aboriginal and Torres Strait Islander Healthy Diets ASAP (Australian Standardised Affordability and Pricing) methods protocol was applied in five randomly selected communities in the Torres Strait Islands. RESULTS: The current diet was 32% more expensive than that recommended; 'discretionary' foods comprised 64% of the current diet cost. Families could save at least A$281.38 a fortnight by switching to recommended diets. However, these cost 35-40% more than elsewhere in Queensland. Recommended diets would cost 35% of median and 48% of welfare household income in the Torres Straits. CONCLUSIONS: While less expensive than the current diet, recommended diets are unaffordable for most households. Consequently, many Torres Strait Islander families are at high risk of food insecurity and diet-related disease. IMPLICATIONS FOR PUBLIC HEALTH: Urgent policy action is required to further lower the relative price of recommended diets, and also increase household incomes and welfare supplements to equitably improve food security and diet-related health, and contribute to environmental sustainability in the Torres Strait Islands.

Stable prevalence of asthma symptoms in school-aged children in the Torres Strait region.

BACKGROUND AND OBJECTIVE: To (i) determine if the prevalence of asthma has altered in two previously studied communities and (ii) obtain baseline measures in two further communities in the Torres Strait region, Australia. METHODS: A population-based cross-sectional study of school-aged children was conducted. Five schools in four communities were selected: 361 children aged 5-17 years participated. The study used the same epidemiological tool that had been utilized to measure asthma prevalence (locally adapted International Study of Asthma and Allergy in Childhood questionnaire). RESULTS: The overall response rate was 30%; response rates in individual communities ranged from 23% to 100%. The prevalence of self-reported wheezing in the last 12 months decreased from 10.7% to 6.6% (P = 0.109) on Thursday Island and from 3.1% to zero (P = 0.358) on Warraber Island. The percentage of children with asthma symptoms was lower in this current study but changes were not statistically significant. Overall self-reported prevalence of ever wheezing was 12.5%; 5.4% reported wheezing in the previous 12 months, 5.9% reported wheezing after exercise and 12.2% reported ever having asthma. There was considerable inter-community variation in the prevalence of symptoms. CONCLUSIONS: Asthma prevalence in school-aged children living in the Torres Strait region remains high but, as in mainstream Australian children, the prevalence is stable.

Obesity, diabetes and associated cardiovascular risk factors among Torres Strait Islander people.

OBJECTIVE: To describe the lifestyle-related chronic disease and risk factor prevalence among Torres Strait Islander people of the Torres Strait and Northern Peninsula Area Health Service District and to compare this information with that available for the general Australian population. METHODS: Voluntary community-based screening for persons aged 15 years and older, including oral glucose tolerance test, anthropometry, health questionnaire, measurement of lipids and lipoprotein levels, blood pressure and urinary albumin to creatinine ratio. RESULTS: Nine communities participated in screening between 1993 and 1997. Five hundred and ninety-two participants (286 male and 306 female) identified as Torres Strait Islander. There were high prevalences of overweight (30%), obesity (51%), abdominal obesity (70%), diabetes (26%), hypercholesterolaemia (33%), albuminuria (28%), hypertension (32%) and tobacco smoking (45%). Only 8.5% of men and 6.5% of women were free of any cardiovascular risk factors (abdominal obesity, hypercholesterolaemia, hypertension, dyslipidaemia, smoking, diabetes, albuminuria). Comparisons of this information for Torres Strait Islander people with results from the AusDiab survey show rates of obesity three times higher and diabetes six times higher than for other Australians. CONCLUSIONS: There is a very high prevalence of preventable chronic disease and associated risk factors among Torres Strait Islander people of the Torres Strait and Northern Peninsula Area. IMPLICATIONS: Effective interventions to prevent and manage obesity, diabetes and associated cardiovascular risk factors are essential if the health of the Torres Strait Islander people is to improve. Such interventions could inform initiatives to stem the burgeoning epidemic of obesity and diabetes among all Australians.