Chronic disease – diabetes, cardiovascular disease and kidney disease – is the dominant driver behind the inequity of health outcomes in Aboriginal people, and the critical transition period for the development of chronic disease is most likely in adolescence and early adult life. We urgently need improved understanding of the causal pathways for chronic disease in young Aboriginal people, based upon robust, longitudinal cohort data, to inform sustainable, community-based and evidence-informed programs to improve the health of young Aboriginal people.
The Antecedents for Renal Disease in Aboriginal Children (ARDAC) Study, established in 2002, was designed to address these twin knowledge gaps. It was born out of the anguish felt by Ms Rita Williams; a senior Aboriginal Health Education Officer who had been working at The Children’s Hospital at Westmead for 20-years and who observed the high rates of end-stage kidney disease among Aboriginal young people. She wanted answers. Why was it happening? When in the life course of Aboriginal people did it happen? What can be done about it?
Over 3 phases, ARDAC has evolved into a long-running prospective, population-based cohort study, involving 3758 young people (2156 Aboriginal and 1602 non-Aboriginal) across NSW, with more than 12,000 person-years of direct follow up. It has resulted in new knowledge about the trajectories towards obesity/overweight, hypertension and albuminuria (risk factors for chronic disease) from early childhood to early adult life, and the complex interplay between age, gender, economic disadvantage, geography in Aboriginal people, and has established partnerships with 12 Aboriginal Community Controlled Health Services (ACCHSs) and other community organisations.
Using the findings from the data collected in phase one to three, the ARDAC study will evolve from a descriptive epidemiological project into an action-research project. The ultimate aim is to engage local Aboriginal communities in developing and implementing community-empowered, evidence-informed programs and services to reduce the burden of chronic disease in their people.