Aboriginal health: a sick minority skews statistics.

Overall morbidity and mortality rates are higher among Aboriginal people than in the general Australian population. It is unclear, however, whether this is because of general poor health or a minority with very high levels of disease within a reasonably healthy Aboriginal community. At Cherbourg Community, almost all health care is given by the hospital. All visits to the casualty/outpatient departments at the hospital have been recorded since 1993. These data have been analysed to find the patterns of visiting by person, by diagnosis and by year. Over the 5 years with complete data, most people made less than five visits per year (low visit group) to the hospital ambulatory clinic, but at the other extreme, approximately 14% of people made 50% of the visits (high visit group). People who made many visits in 1 year made approximately three times as many visits as the low visit group in other years. When the high and low visit groups were compared, the high visit group was more likely to be female and to come for problems related to infection, but were less likely to come with injuries or accidents. The age distribution was similar in both groups. If the number of visits to a health service is an indicator of health, then most Aboriginal people at Cherbourg have reasonable health, but a sizeable minority have health problems that extend over several years. This group skews the overall statistics of Aboriginal health and should be targeted for extra attention.