As part of their contribution to the East Kimberley Impact Assessment Project, Gracey and Spargo (1987) surveyed the change in health status of Aboriginal people across the Kimberley over the 15 years from 1970 to 1985—in effect the period leading up to and just beyond the commencement of mining at Argyle. Their main observation was to declare the almost complete eradication of leprosy and a suppression in the prevalence of preventible infectious diseases, although they were careful to point out that rates for such conditions as enteric disease, chronic ear disease, and trachoma were still relatively high. Alongside these improvements, they also noted the onset of a ‘new’ disease profile associated with urbanisation and lifestyle changes and reflected in increased prevalence of obesity, hypertension, diabetes and coronary heart disease, as well as in a rising incidence of sexually transmitted diseases, alcoholism and related disorders, and in injury and poisoning consequent on motor vehicle accidents and violence (Gracey and Spargo 1987: 16).

As a follow-up study, Gracey, Gunzburg and Spargo (1989) conducted a two-week medical survey of Warmun community and gathered information from 136 adults representing 93% of the adult population aged over 20 years. They found a high level of ill health in the population. Overall, 65% of adults showed signs of previous trachoma, 43% had evidence of respiratory tract disease (mostly bronchitis and pneumonia), 27% had suffered from leprosy and had been treated, 19% had high blood pressure, and 29% had urinary tract infections (mostly women). There was a relatively low rate of documented heart disease (15%), but high rates of sexually transmitted disease (STD), with 35% having syphilis and 21% gonorrhoea. While similar community-base data were not available for the present study, it is interesting to compare these findings with the various profiles of morbidity available for the wider region from hospital separations as discussed above, and from clinic presentations data shown in Table 7.9.

Clearly, many of the conditions that were described for Warmun, and for the Kimberley in general in the mid-1980s remain prevalent today in the form of enteric diseases, respiratory diseases, high blood pressure, urinary tract infection and sexually transmitted diseases. Compared to the Gracey et al. observations, it would appear that heart disease is now more prevalent, while conditions such as trachoma, and certainly leprosy, far less so. Diabetes would also appear to be more prevalent if the lack of any reference to this condition in the 1980s Warmun study is any guide, although the high rates of sexually transmitted disease noted in the 1980s appear to have risen further, with STDs accounting for as much as 47% of all infectious disease notifications in the Kununurra postcode area in 2002, for 22% in the Wyndham area, and 74% in the Halls Creek area.

Further insight into current disease prevalence in the Northern East Kimberley is provided by the Ord Valley Aboriginal Health Service (OVAHS) Ferret database for regular clients resident in Kununurra and surrounding outstations as at January 2003. Table 7.10 refers to those aged 20 years and over and indicates the number of active cases by disease type and their prevalence out of a total of 918 clients in rising rank order of prevalence. These data underline the impact of so-called ‘lifestyle’ diseases on the current health profile of the regional population. The most prevalent reported include diabetes, high blood pressure, high cholesterol and kidney failure, all of which are related to dietary factors, alcohol consumption, lack of exercise and smoking. Sexually transmitted disease also appears again as a major component of current regional morbidity.