A comparison of rural Australian First Nations and Non-First Nations survey responses to COVID-19 risks and impacts: Implications for health communications

Abstract Introduction This study investigated differences between rural Australian First Nations and non-First Nations survey respondents’ perceptions of COVID-19-related risks and analysed other variables that could predict an exacerbation of anxiety related to COVID-19 harms. Methods A cross-sectional online and paper survey of rural residents from the western regions of NSW, Australia, was conducted. Descriptive and multivariate statistical analyses were used to assess links between First Nations status and demographic measures including postcode, age, gender, education, rural or town/village location, proximity to medical services and living situation. The analysis included five items related to perceptions about COVID-19: perceived likelihood of contracting COVID-19 in the next 12 months, perceived harmfulness of the virus, how often people felt afraid, perception about respondents’ ability to do something about the virus and perceived economic impacts of the pandemic. Results There were significant differences between First Nations (n=60) and non-First Nations (n= 639) respondents across all sociodemographic categories. The results reflect a significantly higher level of anxiety among the First Nations Australians in the sample: they felt afraid more often, felt it was highly likely they would catch the virus and if they did catch the virus perceived that it would be very harmful. Living with children under eighteen years of age and in small rural towns were key factors linked to feeling afraid of COVID-19 and First Nations status. Conclusion Health risk communication in pandemic response should include an equitable focus on rural areas, recognising that First Nations Australians are a significant proportion of the rural population with different risk factors and concerns than those of non-First Nations Australians. This principle of First Nations-led design is critical to all health policy and planning. The Australian Government should include rural areas in planning pandemic responses, recognising that First Nations populations are a significant proportion of the rural population creating syndemic conditions.

摘要与引言：本研究旨在探究澳大利亚乡村地区原住民（First Nations）与非原住民受访群体对新冠疫情相关风险的认知差异，并分析可预测新冠疫情危害相关焦虑加剧的其他变量。
研究方法：本研究针对澳大利亚新南威尔士州（NSW）西部地区的乡村居民开展了横断面线上与纸质问卷调查。本研究采用描述性统计与多变量统计分析方法，评估原住民身份与人口统计学变量（包括邮政编码、年龄、性别、受教育程度、乡村/城镇/村落位置、就医距离及居住状况）之间的关联。分析涵盖5项新冠认知相关条目：未来12个月内感染新冠的感知可能性、病毒的感知危害性、受访者感到恐惧的频率、受访者对自身应对病毒能力的认知，以及疫情带来的感知经济影响。
研究结果：原住民受访群体（n=60）与非原住民受访群体（n=639）在所有社会人口学类别中均存在显著差异。结果显示，样本中的澳大利亚原住民焦虑水平显著更高：他们更频繁地感到恐惧，认为自己感染新冠的可能性极高，且若感染病毒则认为其危害性极强。与18岁以下儿童同住以及居住在小型乡村城镇，是与新冠恐惧及原住民身份相关的关键因素。
研究结论：疫情应对中的健康风险沟通应公平关注乡村地区，需认识到澳大利亚原住民在乡村人口中占比可观，且其风险因素与担忧点与非原住民存在差异。原住民主导的设计原则对所有卫生政策与规划均至关重要。澳大利亚政府应将乡村地区纳入疫情应对规划，同时认识到原住民人口在乡村人口中占比可观，且易形成综合征流行（syndemic）状况。