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

Joanne Luke; Philippa Dalach; Lindsay Tuer; Ravi Savarirayan; Angeline Ferdinand; Julie McGaughran; Emma Kowal; Libby Massey; Gail Garvey; Hugh Dawkins; Misty Jenkins; Yin Paradies; Glenn Pearson; Chloe A Stutterd; Gareth Baynam; Margaret Kelaher

doi:10.1038/s41467-022-32707-0

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

Nat Commun. 2022 Aug 24;13(1):4966. doi: 10.1038/s41467-022-32707-0.

Authors

Joanne Luke¹, Philippa Dalach², Lindsay Tuer^{3

4}, Ravi Savarirayan³, Angeline Ferdinand², Julie McGaughran^{5

6}, Emma Kowal⁷, Libby Massey^{4

8}, Gail Garvey⁹, Hugh Dawkins¹⁰, Misty Jenkins¹¹, Yin Paradies¹², Glenn Pearson¹³, Chloe A Stutterd^{3

14}, Gareth Baynam^{13

15

16}, Margaret Kelaher²

Affiliations

¹ Centre for Health Policy, The University of Melbourne, Melbourne, VIC, Australia. jnluke@unimelb.edu.au.
² Centre for Health Policy, The University of Melbourne, Melbourne, VIC, Australia.
³ Victorian Clinical Genetics Services, Murdoch Children's Research Institute, Parkville, VIC, Australia.
⁴ Machado Joseph Disease Foundation, Alyangula, NT, Australia.
⁵ Genetic Health Queensland, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia.
⁶ School of Medicine, University of Queensland, St Lucia, QLD, Australia.
⁷ Alfred Deakin Institute for Citizenship and Globalisation, Deakin University, Geelong, VIC, Australia.
⁸ James Cook University, Townsville, QLD, Australia.
⁹ Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Charles Darwin University, Casuarina, NT, Australia.
¹⁰ School of Medicine, The University of Notre Dame Australia, Sydney, NSW, Australia.
¹¹ Immunology, Walter Eliza Hall Institute, Parkville, VIC, Australia.
¹² School of Humanities and Social Science, Deakin University, Burwood, VIC, Australia.
¹³ Telethon Kids Institute and Division of Paediatrics, Faculty of Health and Medical Sciences, University of Western Australia, Perth, WA, Australia.
¹⁴ Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia.
¹⁵ Genetic Services of Western Australia, Western Australian Department of Health, Perth, WA, Australia.
¹⁶ Western Australian Register of Developmental Anomalies, Western Australian Department of Health, Perth, WA, Australia.

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.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Australia / epidemiology
Female
Health Services
Humans
Indigenous Peoples*
Native Hawaiian or Other Pacific Islander* / genetics
Pregnancy
Racial Groups