Carrington Shepherd
Honorary Research Associate
PhD
Areas of research expertise: Population health; Aboriginal and Torres Strait Islander health; Social inequalities in health; child mortality.
Carrington is a Senior Research Fellow with extensive experience in quantitative research projects at The Kids since 2005. He was awarded his doctorate in 2013, which examined the role of socioeconomic factors on the health and development of Aboriginal populations-this is one of the few studies internationally to explicitly look at the socioeconomic patterning of health in an Indigenous population, and the first to examine these patterns among Aboriginal children using population-representative data.
Carrington has a passionate interest in bridging the knowledge gap on social inequalities in Aboriginal health in Australia and his research explores how social determinants and pathways can lead to enhanced life outcomes. He also leads the Child Mortality Research program which features the use of unique population data to investigate ways of reducing preventable and unexplained deaths in the early life course.
Projects
Ngulluk Moort, Ngulluk Boodja, Ngulluk Wirin (Our Family, Our Country, Our Spirit) Out-of-Home Care Study
We are co-designing an innovative evaluation framework to establish a comprehensive evidence base on what works, what does not work, when and for who, and why.
Ngulluk Koolunga Ngulluk Koort (Our Children, Our Heart) Program
Brings the Aboriginal community(s) of Perth together with service providers & policy makers to improve outcomes for Aboriginal kids and their families.
Western Australian Aboriginal Children’s Outcomes – The Impact of Parent’s Mental Health
Pathways between racial discrimination and the health and wellbeing of Aboriginal and Torres Strait Islander children and young people
Determinants and Outcomes of Preterm Birth & Pathways into Developmental Disorders
The Child Mortality Research Program
Indigenous young people's resilience and wellbeing
Identifying social pathways to enhanced life outcomes in Aboriginal and Torres Strait Islander children
An investigation of parental mental health among the Aboriginal population in Western Australia, and its impact on children’s outcomes
‘Defying the odds’: Exploring the impact of perinatal outcomes, maternal social and health outcomes and level of culturally appropriate service availability on the health of Western Australian Aboriginal infants and children
Published research
Ngulluk Moort, Ngulluk Boodja, Ngulluk Wirin (our family, our country, our spirit): An Aboriginal Participatory Action Research study protocol
Globally, Indigenous children have historical and contemporary connections with government child protection services that have caused significant harm to their long-term health and wellbeing. Innovative, culturally secure and recovery focussed service provision is required.
Shoulder dystocia in babies born to Aboriginal mothers with diabetes: a population-based cohort study, 1998–2015
Australian Aboriginal and Torres Strait Islander women with diabetes in pregnancy (DIP) are more likely to have glycaemic levels above the target range, and their babies are thus at higher risk of excessive fetal growth. Shoulder dystocia, defined by failure of spontaneous birth of fetal shoulder after birth of the head requiring obstetric maneuvers, is an obstetric emergency that is strongly associated with DIP and fetal size.
Looking after bubba for all our mob: Aboriginal and Torres Strait Islander community experiences and perceptions of stillbirth
The stillbirth rate among Aboriginal and Torres Strait Islander women and communities in Australia is around double that of non-Indigenous women. While the development of effective prevention strategies during pregnancy and improving care following stillbirth for women and families in communities has become a national priority, there has been limited progress in stillbirth disparities. With community permission, this study aimed to gain a better understanding of community experiences, perceptions, and priorities around stillbirth.
First Nations Peoples’ perceptions, knowledge and beliefs regarding stillbirth prevention and bereavement practices: A mixed methods systematic review
First Nations Peoples endure disproportionate rates of stillbirth compared with non-First Nations Peoples. Previous interventions have aimed at reducing stillbirth in First Nations Peoples and providing better bereavement care without necessarily understanding the perceptions, knowledge and beliefs that could influence the design of the intervention and implementation.
Mapping the citation network on vitamin D research in Australia: a data-driven approach
Vitamin D research can vary geographically, as vitamin D status is influenced by latitude, season, dietary intake, body mass index, ethnicity, and public health initiatives. Over the last two decades, research on vitamin D has increased in Australia, where the potential for sun exposure (a major source of vitamin D) is high. We aimed to identify key topics and gaps in vitamin D research in Australia using a data-driven approach.
Hospital and emergency department discharge against medical advice in Western Australian Aboriginal children aged 0–4 years from 2002 to 2018: A cohort study
Discharge against medical advice (DAMA) is a priority issue for the health system. Little is known about the factors associated with DAMA for Aboriginal and/or Torres Strait Islander (Aboriginal) children in Australia.
The impact of diabetes during pregnancy on neonatal outcomes among the Aboriginal population in Western Australia: a whole-population study
Aboriginal and Torres Strait Islander (hereafter Aboriginal) women have a high prevalence of diabetes in pregnancy (DIP), which includes pre-gestational diabetes mellitus (PGDM) and gestational diabetes mellitus (GDM). We aimed to characterize the impact of DIP in babies born to Aboriginal mothers.
First Nations populations' perceptions, knowledge, attitudes, beliefs, and myths about prevention and bereavement in stillbirth: a mixed methods systematic review protocol
The objective of this review is to investigate First Nations populations' perceptions, knowledge, attitudes, beliefs, and myths about stillbirth.
Overweight/obesity and other predictors of gestational diabetes among Aboriginal and non-Aboriginal women in Western Australia
This population-based study investigated the association of BMI and other predictors with gestational diabetes mellitus among Australian Aboriginal and non-Aboriginal mothers. We conducted a state-wide retrospective cohort study that included all singleton births in Western Australia between 2012 and 2015 using population health datasets linked by the Western Australian Data Linkage Branch.
The perinatal and childhood outcomes of children born to Indigenous women with mental health problems: A scoping review
Maternal mental health problems are common during the perinatal period and have been associated with several negative outcomes in children. However, few studies have examined the associations between maternal mental health problems and offspring outcomes among Indigenous people, and the findings across these studies have been inconsistent. This scoping review examined the birth and childhood (≤12 years) health and development outcomes of the children of Indigenous women with mental health problems.
Perinatal outcomes of Aboriginal women with mental health disorders
Maternal mental disorders have been associated with adverse perinatal outcomes such as low birthweight and preterm birth, although these links have been examined rarely among Australian Aboriginal populations. We aimed to evaluate the association between maternal mental disorders and adverse perinatal outcomes among Aboriginal births.
Severe maternal morbidity following stillbirth in Western Australia 2000–2015: a population-based study
There is scant literature about the management of stillbirth and the subsequent risk of severe maternal morbidity (SMM). We aimed to assess the risk of SMM associated with stillbirths compared with live births and whether this differed by the presence of maternal comorbidities.
Connection to... Addressing Digital Inequities in Supporting the Well-Being of Young Indigenous Australians in the Wake of COVID-19
This article examines whether connection to digital technologies helps connect young Indigenous people in Australia to culture, community and country to support good mental health and well-being and protect against indirect and potentially long-term effects of COVID-19.
Caesarean section following antepartum stillbirth in Western Australia 2010–2015: A population-based study
There is scant literature about antepartum stillbirth management but guidelines usually recommend reserving caesarean sections for exceptional circumstances. However, little is known about caesarean section rates following antepartum stillbirth in Australia.
Prevalence and predictors of vitamin D deficiency in a nationally representative sample of Australian Aboriginal and Torres Strait Islander adults
Vitamin D deficiency (serum 25-hydroxyvitamin D (25(OH)D) concentration <50 nmol/l) is recognised as a public health problem globally. The present study details the prevalence and predictors of vitamin D deficiency in a nationally representative sample of Australian Aboriginal and Torres Strait Islander adults aged >/=18 years.
Trends and burden of diabetes in pregnancy among Aboriginal and non-Aboriginal mothers in Western Australia, 1998-2015
Diabetes in pregnancy (DIP), which includes pre-gestational and gestational diabetes, is more prevalent among Aboriginal women. DIP and its adverse neonatal outcomes are associated with diabetes and cardiovascular disease in the offspring.
Patterns of recurrent preterm birth in Western Australia: A 36-year state-wide population-based study
It is known that a previous preterm birth increases the risk of a subsequent preterm birth, but a limited number of studies have examined this beyond two consecutive pregnancies. This study aimed to assess the risk and patterns of (recurrent) preterm birth up to the fourth pregnancy.
Measuring social and emotional wellbeing in aboriginal youth using strong souls: A rasch measurement approach
Currently, there are few robustly evaluated social and emotional wellbeing (SEWB) measures available for use with Aboriginal youth in research, policy, and practice.
Knowing your audience: Investigating stillbirth knowledge and perceptions in the general population to inform future public health campaigns
The prevalence of stillbirth in many high income countries like Australia has remained unchanged for over 30 years. The 2018 Australian government Senate Select Committee on Stillbirth Research and Education highlighted the need for a public health campaign to encourage public conversations and increase awareness.
Disparities in severe neonatal morbidity and mortality between Aboriginal and non-Aboriginal births in Western Australia: a decomposition analysis
The health disadvantages faced by Australian Aboriginal peoples are evidenced in early life, although few studies have focused on the reasons for population-level inequalities in more severe adverse outcomes. This study aimed to examine the scale of disparity in severe neonatal morbidity (SNM) and mortality between Aboriginal and non-Aboriginal births and quantify the relative contributions of important maternal and infant factors.
A psychometric evaluation of the Connor–Davidson Resilience Scale for Australian Aboriginal youth
There is a paucity of quantitative measures of resilience specifically validated for young Aboriginal people in Australia. We undertook the first investigation of validity and reliability of the Connor-Davidson Resilience Scale in a sample of Australian Aboriginal people, with a focus on youth. We conducted a cross-sectional study of resilience among a sample of 122 Aboriginal youth (15–25 years old) in New South Wales and Western Australia, featuring self-completes of the 10-item CD-RISC in online (N = 22) and face-to-face (N = 100) settings.
Comparison of stillbirth trends over two decades in Wales, United Kingdom and Western Australia: An international retrospective cohort study
Stillbirth is a critical public health issue worldwide. While the rates in high-income countries are relatively low, there are persistent between-country disparities. We compared stillbirth rates and trends in Wales and the State of Western Australia (WA), Australia, and provide insights into any differences.
The impact of maternal prenatal mental health disorders on stillbirth and infant mortality: a systematic review and meta-analysis
Evidence about the association between maternal mental health disorders and stillbirth and infant mortality is limited and conflicting. We aimed to examine whether maternal prenatal mental health disorders are associated with stillbirth and/or infant mortality. MEDLINE, Embase, PsycINFO, and Scopus were searched for studies examining the association of any maternal prenatal (occurring before or during pregnancy) mental health disorder(s) and stillbirth or infant mortality. A random-effects meta-analysis was used to calculate pooled odds ratios (ORs) with 95% confidence intervals (CIs). The between-study heterogeneity was quantified using the I2 statistic. Subgroup analyses were performed to identify the source of heterogeneity.
Racial discrimination and allostatic load among First Nations Australians: a nationally representative cross-sectional study
Increased allostatic load is linked with racial discrimination exposure, providing a mechanism for the biological embedding of racism as a psychosocial stressor. We undertook an examination of how racial discrimination interacts with socioecological, environmental, and health conditions to affect multisystem dysregulation in a First Nations population.
Prevalence and predictors of vitamin D deficiency in a nationally representative sample of Australian Aboriginal and Torres Strait Islander adults
Vitamin D deficiency (serum 25-hydroxyvitamin D (25(OH)D) concentration <50 nmol/l) is recognised as a public health problem globally. The present study details the prevalence and predictors of vitamin D deficiency in a nationally representative sample (n 3250) of Australian Aboriginal and Torres Strait Islander adults aged ≥18 years. We used data from the 2012-2013 Australian Aboriginal and Torres Strait Islander Health Survey (AATSIHS). Serum 25(OH)D concentrations were measured by liquid chromatography-tandem MS.
"Cultural Security Is an On-Going Journey..." Exploring Views from Staff Members on the Quality and Cultural Security of Services for Aboriginal Families in Western Australia
Cultural security is a key element of accessible services for Indigenous peoples globally, although few studies have examined this empirically. We explored the scope, reach, quality, and cultural security of health and social services available to Aboriginal and/or Torres Strait Islander families in Western Australia (WA), from the point of view of staff from the services.
Socioethnic disparities in severe maternal morbidity in Western Australia: a statewide retrospective cohort study
To assess the scale of ethnic inequalities in severe maternal morbidity (SMM) rates and quantify the contribution of maternal characteristics to these disparities. This is a retrospective cohort study. A whole-of-population linked administrative data from 2002 to 2015 in Western Australia.
Identifying young Aboriginal and Torres Strait Islander children in linked administrative data: A comparison of methods
In the ongoing debate on optimum methods for identification of Indigenous people within linked administrative data, few studies have examined the impacts of method on population counts and outcomes in family-based linkage studies of Aboriginal children.
Psychosocial disadvantage and residential remoteness is associated with Aboriginal women's mental health prior to childbirth
Optimal mental health in the pre-conception, pregnancy and postpartum periods is important for both maternal and infant wellbeing. Few studies, however, have focused on Indigenous women and the specific risk and protective factors that may prompt vulnerability to perinatal mental disorders in this culturally diverse population.
Profile of severely growth-restricted births undelivered at 40 weeks in Western Australia
Higher levels of poor perinatal outcomes among FGR births highlight the importance of appropriate management including fetal growth monitoring
Role of maternal mental health disorders on stillbirth and infant mortality risk: a protocol for a systematic review and meta-analysis
We plan to examine whether prenatal maternal mental health disorders impact the risk of stillbirth and infant mortality
Stillbirth risk prediction using machine learning for a large cohort of births from Western Australia, 1980–2015
Almost half of stillbirths could be potentially identified antenatally based on a combination of factors
Racial discrimination and child and adolescent health in longitudinal studies: A systematic review
This review emphasises the need to gain evidence for the mechanisms linking early racism exposure to adverse health outcomes in later life
Raising strong, solid Koolunga: Values and beliefs about early child development among Perth's Aboriginal community
We detail the unique findings from an Aboriginal early child development research project with a specific focus on the Nyoongar/Aboriginal community of Perth
Modelling factors for Aboriginal and Torres Strait Islander child neurodevelopment outcomes: A latent class analysis
This study highlights a range of unique profiles that can be used for improving the early development of young Aboriginal children
Predicting Long-Term Survival Without Major Disability for Infants Born Preterm
Apgar score, birth weight, sex, socioeconomic status, and maternal ethnicity, in addition to gestational age, have pronounced impacts on disability-free survival.
Disparities between Aboriginal and non-Aboriginal perinatal mortality rates in Western Australia from 1980 to 2015
This study aimed to examine the pattern of stillbirth and neonatal mortality rate disparities over time in Western Australia
The impact of pre-pregnancy body mass index and gestational weight gain on placental abruption risk: a systematic review and meta-analysis
Mothers that are underweight prior to or in early pregnancy are at a moderately increased risk of placental abruption
Delivering Elder- and Community-Led Aboriginal Early Childhood Development Research: Lessons from the Ngulluk Koolunga Ngulluk Koort Project
We describe the application of a participatory action research methodology that is grounded in Aboriginal worldviews
Caregiver-perceived racial discrimination is associated with diverse mental health outcomes in Aboriginal and Torres Strait Islander children aged 7-12 years
Exposure to racial discrimination in Aboriginal children increased the risk for a spectrum of interrelated factors linked to negative mental health
The Contribution of Geogenic Particulate Matter to Lung Disease in Indigenous Children
The aim of this study was to assess the relationship between dust levels and health in Indigenous children in Western Australia
Trends in mental health related contacts among mothers of Aboriginal children in Western Australia (1990-2013)
Many of the mental health issues that women develop earlier in life are chronic at the time of conception, during pregnancy and at birth
Trends and predictors of extreme preterm birth: Western Australian population-based cohort study
First study to show that the increase in extreme preterm birth in high-income jurisdiction is no longer evident after medical terminations and birth defects are excluded
Prevalence of Racial Discrimination in a Cohort of Aboriginal and Torres Strait Islander Children
This study looked at the frequency of racism experiences over time in a population of Aboriginal and Torres Strait Islander children
Exploring factors impacting early childhood health among Aboriginal and Torres Strait Islander families and communities
The impact of perinatal outcomes, maternal social and health outcomes and level of culturally secure service availability on the health outcomes of Western Australian Aboriginal infants and children
The impact of racial discrimination on the health of Australian Indigenous children aged 5–10 years: analysis of national longitudinal data
Direct and persistent vicarious racial discrimination are detrimental to the physical and mental health of Indigenous children in Australia
Associations between school absence and academic achievement: Do socioeconomics matter?
School attendance should therefore be a priority for all schools, and not just those with high rates of absence or low average achievement.
Maternal ethnicity, stillbirth and neonatal death risk in Western Australia 1998–2010
Difference in stillbirth and neonatal death rates in Western Australia (1998-2010) by maternal ethnicity
A cross-sectional survey of environmental health in remote Aboriginal communities in Western Australia
Poor environmental health is prevalent in remote Aboriginal communities and requires further delineation to inform environmental health policy
Stillbirth and neonatal death rates across time: The influence of pregnancy terminations and birth defects in a Western Australian population-based cohort study
Changes in clinical practice related to pregnancy terminations have played a substantial role in shaping stillbirth and neonatal death rates in WA
Relationships between Psychosocial Resilience and Physical Health Status of Western Australian Urban Aboriginal Youth
The aim of this study was to investigate the extent to which factors previously documented as buffering the impact of high-risk family environments on...
Addressing the relationship between racism and inequality in suicide...
In 2009 over 40 leading researchers and academics from across Australia signed the Boatshed Racism Roundtable Declaration that proposed four areas of action...
The social determinants of Aboriginal and Torres Strait Islander suicide...
Consideration of suicide among Aboriginal and Torres Strait Islander peoples must be situated within a context that recognises the impact of racism...
What we know about suicide prevention for Aboriginal and Torres Strait Islander peoples
This fact sheet addresses what we currently know about suicide prevention for Aboriginal and Torres Strait Islander peoples.
Suicide prevention for Aboriginal and Torres Strait Islander young people: Fact Sheet 3
This is the third fact sheet regarding the Aboriginal and Torres Strait Islander Suicide Prevention Evaluation Project.
Violence Risk Assessment in Australian Aboriginal Offender Populations: A Review of the Literature
The utilization of violence risk instruments in forensic populations is increasing and a plethora of empirical investigations support their ability to...
Early Vocabulary Development of Australian Indigenous Children: Identifying Strengths
The current study sought to increase our understanding of the factors involved in the early vocabulary development of Australian Indigenous children.
Patterns and trends in mortality of Western Australian infants, children and young people 1980-2008
This report is the third in a series examining patterns and trends in mortality among Western Australian infants, children and young people, and covers...
Breastfeeding Duration and Residential Isolation amid Aboriginal Children in Western Australia
The objective of this study was to examine the factors that impact on breastfeeding duration among Western Australia Aboriginal children. We hypothesised...
Socioeconomic disparities in the mental health of Indigenous children in Western Australia
The burden of mental health problems among Aboriginal and Torres Strait Islander children is a major public health problem in Australia.
Socioeconomic disparities in physical health among Aboriginal and Torres Strait Islander children in Western Australia
We sought to provide insights by examining socio-economic disparities in physical health outcomes among Aboriginal and Torres Strait Islander children in WA.
Social gradients in the health of indigenous australians
We begin to bridge this knowledge gap by assessing evidence on social gradients in indigenous health in Australia.
Awareness and impact of the ‘Bubblewrap’ advertising campaign among Aboriginal smokers in Western Australia
Antismoking mass media campaigns have been shown to reduce smoking prevalence in the mainstream community.