Skip to main content Accessibility help
×
Home
  • Print publication year: 2007
  • Online publication date: September 2009

12 - Health changes in Papua New Guinea: from adaptation to double jeopardy?

Summary

Introduction

Are the health patterns of Papua New Guinea (PNG) changing? If so, in what ways are they doing so? Specifically, are they changing in line with theoretical models which invoke modernization, development and globalization to account for the decline of infections and the rise of lifestyle- and ageing-related health problems? Or does communicable disease – persistent, recrudescent or emergent – still predominate? In this review, I aim to discuss selected evidence on the health of Papua New Guineans, with a particular focus on examining past trends and on considering, so far as possible, future prospects – whether by projection from the past or on some other rationale. In the process, I shall consider the adequacy of conventional health modernization models to describe PNG's present situation.

To be modern is to have characteristics typical of recent times and the present day, by contrast with the more distant past. This sounds open-ended; but, in the health sciences as in the arts and social sciences, modernity is (explicitly or implicitly) expected to bring changes of a specific character. This follows usually from the concept that socioeconomic modernization, discussed by Ulijaszek (1995), is accompanied, anywhere in the world and whenever it may take place, by a demographic, health or epidemiological transition (Caldwell et al. 1990; Riley 2001). In such transitions, not only are death rates alleviated and life expectancies increased, but also one set of causes of ill-health (life-threatening and otherwise) declines in importance, to be replaced by a different set.

Related content

Powered by UNSILO
References
Adels, B. R. and Gajdusek, D. C. (1963). Survey of measles patterns in New Guinea, Micronesia and Australia. American Journal of Hygiene 77, 317–43.
Allen, B. J. (1983). A bomb or a bullet or the bloody flux? Population change in the Aitape inland, Papua New Guinea, 1941–1945. Journal of Pacific History 18, 218–35.
Allen, B. J.(1989). Infection, innovation and residence: illness and misfortune in the Torricelli foothills from 1800. In A Continuing Trial of Treatment: Medical Pluralism in Papua New Guinea, ed. Frankel, S. and Lewis, G.. Dordrecht: Kluwer, pp. 35–68.
Allen, B. J.(1992). The geography of Papua New Guinea. In Human Biology in Papua New Guinea: The Small Cosmos, ed. Attenborough, R. D. and Alpers, M. P.. Oxford: Clarendon Press, pp. 36–66.
Allen, S. J., O'Donnell, A., Alexander, N. D. E., et al. (1997). α + -thalassemia protects children against disease caused by other infections as well as malaria. Proceedings of the National Academy of Sciences of the USA 94, 14736–41.
Alpers, M. P. (1992). Kuru. In Human Biology in Papua New Guinea: The Small Cosmos, ed. Attenborough, R. D. and Alpers, M. P.. Oxford: Clarendon Press, pp. 313–34.
Alpers, M. P. and Attenborough, R. D. (1992). Human biology in a small cosmos. In Human Biology in Papua New Guinea: The Small Cosmos, ed. Attenborough, R. D. and Alpers, M. P.. Oxford:Clarendon Press, pp. 1–35.
Anderson, H. R. and Woolcock, A. J. (1992). Chronic lung disease and asthma in Papua New Guinea. In Human Biology in Papua New Guinea: The Small Cosmos, ed. Attenborough, R. D. and Alpers, M. P.. Oxford: Clarendon Press, pp. 289–301.
Attenborough, R. D. (2002). Ecology, homeostasis and survival in human population dynamics. In Human Population Dynamics: Cross-Disciplinary Perspectives, ed. Macbeth, H. and Collinson, P.. Cambridge: Cambridge University Press, pp. 186–208.
Attenborough, R. D. and Alpers, M. P. (1995). Change and variability in Papua New Guinea's patterns of disease. In Human Populations: Diversity and Adaptation, ed. Boyce, A. J. and Reynolds, V.. Oxford: Oxford University Press, pp. 189–216.
Attenborough, R. D., Gardner, D. S. and Gibson, F. D. (1996). Malaria and Filariasis amongst the Mianmin of the Highland Fringes of Sandaun Province, Papua New Guinea: A Report. Canberra: Department of Archaeology and Anthropology, Australian National University.
Attenborough, R. D., Burkot, T. R. and Gardner, D. S. (1997). Altitude and the risk of bites from mosquitoes infected with malaria and filariasis among the Mianmin people of Papua New Guinea. Transactions of the Royal Society of Tropical Medicine and Hygiene 91, 8–10.
Ballard, C., Brown, P., Bourke, R. M. and Harwood, T. (eds.) (2005). The Sweet Potato in Oceania: A Reappraisal. Pittsburgh & Sydney: Ethnology Monographs and Oceania Monographs.
Barnett, J. (2002). Resilence and adaptation. In Asia-Pacific Network Workshop on Ethnographic Perspectives on Resilience to Climate Variability in Pacific Island Countries, ed. Barnett, J. and Busse, M.. Christchurch, New Zealand: Macmillan Brown Centre for Pacific Studies, University of Canterbury, pp. 5–11.
BBC News (2004). Bhutan forbids all tobacco sales. BBC. http://news.bbc.co.uk/2/hi/south_asia/4012639.stm (accessed December 2005).
Beebe, N. W. and Cooper, R. D. (2002). Distribution and evolution of the Anopheles punctulatus group (Diptera: Culicidae) in Australia and Papua New Guinea. International Journal for Parasitology 32, 563–74.
Benjamin, A. L. and Dramoi, V. (2002). Outbreak of measles in the National Capital District, Papua New Guinea in 2001. Papua New Guinea Medical Journal 45, 178–84.
Biddulph, J. (1983). Legislation to protect breastfeeding. Papua New Guinea Medical Journal 26, 9–12.
Bockarie, M. J., Alexander, N., Bockarie, F., et al. (1996). The late biting habit of parous Anopheles mosquitoes and pre-bedtime exposure of humans to infective female mosquitoes. Transactions of the Royal Society of Tropical Medicine and Hygiene 90, 23–5.
Boyden, S. (2004). The Biology of Civilisation: Understanding Human Culture as a Force in Nature. Sydney: University of New South Wales Press.
Brinkhoff, T. (2003). City population. http://www.citypopulation.de (accessed 25 November 2005).
Brown, G. V. and Reeder, J. C. (2002). Malaria vaccines. Medical Journal of Australia 177, 230–1.
Bruce, M. C. and Day, K. P. (2003). Cross-species regulation of Plasmodium parasitemia in semi-immune children from Papua New Guinea. Trends in Parasitology 19, 271–7.
Burkot, T. R., Graves, P. M., Paru, R., Wirtz, R. A. and Heywood, P. F. (1988). Human malaria transmission studies in the Anopheles punctulatus complex: sporozoite rates, inoculation rates and sporozoite densities. American Journal of Tropical Medicine and Hygiene 39, 135–44.
Burton, J. (1983). A dysentery epidemic in New Guinea and its mortality. Journal of Pacific History 18, 236–61.
Burton-Bradley, B. G. (ed.) (1990). A History of Medicine in Papua New Guinea: Vignettes of an Earlier Period. Kingsgrove, New South Wales: Australasian Medical Publishing Company.
Caldwell, J. C. (1986). Routes to low mortality in poor countries. Population and Development Review 12, 171–220.
Caldwell, J. C., Gajanayake, I., Caldwell, P. and Peiris, I. (1989). Sensitization to illness and the risk of death: an explanation for Sri Lanka's approach to good health for all. Social Science and Medicine 28, 365–79.
Caldwell, J. C., Findley, S., Caldwell, P., et al. (eds.) (1990). What We Know about Health Transition: The Cultural, Social and Behavioural Determinants of Health. Canberra: Health Transition Centre, Australian National University.
Carrad, E. V. (1987). Review of Disease Patterns in Papua New Guinea. Port Moresby: University of Papua New Guinea Press.
Cattani, J. A. (1992). The epidemiology of malaria in Papua New Guinea. In Human Biology in Papua New Guinea: The Small Cosmos, ed. Attenborough, R. D. and Alpers, M. P.. Oxford: Clarendon Press, pp. 302–12.
Cattani, J. A., Moir, J. S., Gibson, F. D., et al. (1986a). Small-area variations in the epidemiology of malaria in Madang Province. Papua New Guinea Medical Journal 29, 11–17.
Cattani, J. A., Tulloch, J. L., Vrbova, H., et al. (1986b). The epidemiology of malaria in a population surrounding Madang, Papua New Guinea. American Journal of Tropical Medicine and Hygiene 35, 3–15.
Centre for International Economics (2002). Potential Economic Impacts of an HIV/AIDS Epidemic in Papua New Guinea. Canberra: AusAID.
Clark, J. T. and Kelly, K. M. (1993). Human genetics, paleoenvironments and malaria: relationships and implications for the settlement of Oceania. American Anthropologist 95, 612–30.
Connell, J. (1997). Health in Papua New Guinea: a decline in development. Australian Geographical Studies 35, 271–93.
Conyers, R. A. J. (1971). Myocardial infarction in a New Guinean. Medical Journal of Australia ii, 412–17.
Cortés, A., Benet, A., Cooke, B. M., Barnwell, J. W. and Reeder, J. C. (2004). Ability of Plasmodium falciparum to invade Southeast Asian ovalocytes varies between parasite lines. Blood 104, 2961–6.
Crane, G. G. (1986). Recent studies of hyperreactive malarious splenomegaly (tropical splenomegaly syndrome) in Papua New Guinea. Papua New Guinea Medical Journal 29, 35–40.
Curry, C., Bunungam, P., Annerud, C. and Babona, D. (2005). HIV antibody seroprevalence in the emergency department at Port Moresby General Hospital, Papua New Guinea. Emergency Medicine Australasia 17, 359–62.
Davies, M. (2002). Public Health and Colonialism: The Case of German New Guinea 1884–1914. Wiesbaden: Harrassowitz Verlag.
Dengler, L. and Preuss, J. (2003). Mitigation lessons from the July 17, 1998 Papua New Guinea tsunami. Pure and Applied Geophysics 160, 2001–31.
Denham, T. P., Haberle, S. G., Lentfer, C., et al. (2003). Origins of agriculture at Kuk swamp in the highlands of New Guinea. Science 301, 189–93.
Denoon, D., Dugan, K. and Marshall, L. (1989). Public Health in Papua New Guinea: Medical Possibility and Social Constraint, 1884–1984. Cambridge: Cambridge University Press.
Desowitz, R. S. and Spark, R. A. (1987). Malaria in the Maprik area of the Sepik region, Papua New Guinea: 1957–1984. Transactions of the Royal Society of Tropical Medicine and Hygiene 81, 175–6.
Dowse, G. K., Spark, R. A., Mavo, B., et al. (1994). Extraordinary prevalence of non-insulin-dependent diabetes mellitus and bimodal plasma glucose distribution in the Wanigela people of Papua New Guinea. Medical Journal of Australia 160, 767–74.
Duke, T. (2003). The crisis of measles and the need to expand the ways of delivering vaccines in Papua New Guinea. Papua New Guinea Medical Journal 46, 1–7.
Edwards, K. N. (1994). Rural health service crisis in Papua New Guinea: causes, implications and possible solutions. Papua New Guinea Medical Journal 37, 145–51.
Ewers, W. H. (1972). Malaria in the early years of German New Guinea. Journal of the Papua and New Guinea Society 6, 3–30.
Fenner, F., Henderson, D. A., Arita, I., Jezek, Z. and Ladnyi, I. D. (1988). Smallpox and Its Eradication. Geneva: World Health Organization.
Fix, A. G. (2003). Simulating hemoglobin history. Human Biology 75, 607–18.
Foley, W. A. (1992). Language and identity in Papua New Guinea. In Human Biology in Papua New Guinea: The Small Cosmos, ed. Attenborough, R. D. and Alpers, M. P.. Oxford: Clarendon Press, pp. 136–49.
Forge, A. (1972). Normative factors in the settlement size of neolithic cultivators (New Guinea). In Man, Settlement and Urbanism, ed. Ucko, P. J., Tringham, R. and Dimbleby, G. W.. London: Duckworth, pp. 363–76.
Forge, A.(1990). The power of culture and the culture of power. In Sepik Heritage: Tradition and Change in Papua New Guinea, ed. Lutkehaus, N., Kaufmann, C., Mitchell, W. E., Osmundsen, L. and Schister, M.. Durham, North Carolina: Carolina Academic Press, pp. 160–70.
Froment, A. (2001). Evolutionary biology and health of hunter-gatherer populations. In Hunter-Gatherers: An Interdisciplinary Perspective, ed. Panter-Brick, C., Layton, R. H. and Rowley-Conwy, P.. Cambridge: Cambridge University Press, pp. 239–66.
Gajdusek, D. C. (1990). Raymond Pearl Memorial Lecture, 1989: Cultural practices as determinants of clinical pathology and epidemiology of venereal infections: implications for predictions about the AIDS epidemic. American Journal of Human Biology 2, 347–51.
Garner, P. A., Talwat, E. N., Hill, G., Reid, M. S. and Garner, M. F. (1986). Yaws reappears. Papua New Guinea Medical Journal 29, 247–52.
Genton, B., Al-Yaman, F., Mgone, C. S., et al. (1995a). Ovalocytosis and cerebral malaria. Nature 378, 564–5.
Genton, B., Al-Yaman, F., Beck, H.-P., et al. (1995b). The epidemiology of malaria in the Wosera area, East Sepik Province, Papua New Guinea, in preparation for vaccine trials. I. Malariometric indices and immunity. Annals of Tropical Medicine and Parasitology 89, 359–76.
Genton, B., Anders, R., Alpers, M. P. and Reeder, J. C. (2003). The malaria vaccine development program in Papua New Guinea. Trends in Parasitology 19, 264–70.
Greenburg-Hudd, S. (1998). Dental palaeopathology and subsistence in protohistoric and historic skeletal remains from Papua New Guinea. M. Litt. thesis, Archaeology & Anthropology, Australian National University, Canberra.
Groube, L. M. (1993). Contradictions and malaria in Melanesian and Australian prehistory. In A Community of Culture: The People and Prehistory of the Pacific, ed. Spriggs, M., Yen, D. E., Ambrose, W., Jones, R., Thorne, A. and Andrews, A.. Canberra: Department of Prehistory, Research School of Pacific Studies, Australian National University, pp. 164–86.
Groube, L. M.(2000). Plasmodium falciparum: the African genesis. In Australian Archaeologist: Collected Papers in Honour of Jim Allen, ed. Anderson, A. and Murray, T.. Canberra: Coombs Academic Publishing, Australian National University, pp. 131–44.
Groube, L. M., Chappell, J., Muke, J. and Price, D. (1986). A 40,000-year-old occupation site at Huon Peninsula, Papua New Guinea. Nature 324, 453–5.
Hanson, L. W., Allen, B. J., Bourke, R. M. and McCarthy, T. J. (2001). Papua New Guinea Rural Development Handbook. Canberra: The Australian National University.
Heywood, P. F. and Hide, R. L. (1994). Nutritional effects of export-crop production in Papua New Guinea: a review of the evidence. Food and Nutrition Bulletin 15, 233–49.
Hide, R. (2003). Pig Husbandry in New Guinea: A Literature Review and Bibliography. Canberra: Australian Centre for International Agricultural Research.
Hodge, A. M., Dowse, G. K., Erasmus, R. T., et al. (1996). Serum lipids and modernization in coastal and highland Papua New Guinea. American Journal of Epidemiology 144, 1129–42.
Hope, G. S. and Haberle, S. (2005). The history of the human landscapes of New Guinea. In Papuan Pasts: Cultural, Linguistic and Biological Histories of Papuan-Speaking Peoples, ed. Pawley, A. K., Attenborough, R. D., Golson, J. and Hide, R. L.. Canberra: Pacific Linguistics, The Australian National University, pp. 541–54.
Hope, G. S., Golson, J. and Allen, J. (1983). Palaeoecology and prehistory in New Guinea. Journal of Human Evolution 12, 37–60.
Hughes, J. (1997). A history of sexually transmitted diseases in Papua New Guinea. In Sex, Disease and Society: A Comparative History of Sexually Transmitted Diseases and HIV/AIDS in Asia and the Pacific, ed. Lewis, M., Bamber, S. and Waugh, M.. Westport, CT: Greenwood Press, pp. 231–47.
Hume, J. C. C., Lyons, E. J. and Day, K. P. (2003). Malaria in antiquity: a genetics perspective. World Archaeology 35, 180–92.
Inaoka, T. (1995). Health and survival in modernizing Papua New Guinea societies. Anthropological Science 103, 339–47.
Inaoka, T.(n.d.). The modernization of Papua New Guinea and the changes in disease patterns – recent health transition and emerging/re-emerging infectious diseases. JCAS Area Studies Research Reports 2, 201–17 [In Japanese: transl. A. Callaway].
Joy, D. A., Feng, X., Mu, J., et al. (2003). Early origin and recent expansion of Plasmodium falciparum. Science 300, 318–21.
Kasehagen, L., Müller, I., McNamara, D. T.et al. (2006). Changing patterns of Plasmodium blood stage infections in the Wosera region of Papua New Guinea as monitored by light microscopy and high through-put PCR, American Journal of Tropical Medicine & Hygiene 67, 588–96.
Kazura, J. W., and Bockarie, M. J. (2003). Lymphatic filariasis in Papua New Guinea: interdisciplinary research on a national health problem. Trends in Parasitology 19, 260–3.
Kevau, I. H. (1990). Clinical documentation of twenty cases of acute myocardial infarction in Papua New Guineans. Papua New Guinea Medical Journal 33, 275–80.
King, H. and Collins, A. M. (1989). A modernity score for individuals in Melanesian society. Papua New Guinea Medical Journal 32, 11–22.
King, H., Finch, C., Collins, A. M., et al. (1989). Glucose tolerance in Papua New Guinea: ethnic differences, association with environmental and behavioural factors and the possible emergence of glucose intolerance in a highland community. Medical Journal of Australia 151, 204–10.
Kirk, R. L. (1992). Population origins in Papua New Guinea – a human biological overview. In Human Biology in Papua New Guinea: The Small Cosmos, ed. Attenborough, R. D. and Alpers, M. P.. Oxford: Clarendon Press, pp. 172–97.
Kovats, R. S., Campbell-Lendrum, D. H., McMichael, A. J., Woodward, A. and Cox, J. S. (2001). Early effects of climate change: do they include changes in vector-borne disease? Philosophical Transactions of the Royal Society of London, Series B: Biological Sciences 356, 1057–68.
Kunitz, S. J. (1994). Disease and Social Diversity: The European Impact on the Health of Non-Europeans. New York: Oxford University Press.
Lavu, E. K., Oswyn, G. and Vince, J. D. (2002). Sickle-cell/β+-thalassaemia in a Papua New Guinean: the first reported case of the sickle gene in Papua New Guinea. Medical Journal of Australia 176, 70–1.
Lawrence, G. (1992). Pigbel. In Human Biology in Papua New Guinea: The Small Cosmos, ed. Attenborough, R. D. and Alpers, M. P.. Oxford: Clarendon Press, pp. 335–44.
Leclerc, M. C., Durand, P., Gauthier, C., et al. (2004). Meager genetic variability of the human malaria agent Plasmodium vivax. Proceedings of the National Academy of Sciences of the USA 101, 14455–60.
Lehmann, D. (2002). Demography and causes of death among the Huli in the Tari basin. Papua New Guinea Medical Journal 45, 51–62.
Lemeki, M. (2003). Sexually transmitted diseases and HIV/AIDS: knowledge and sexual behaviour among Eastern Highlands youth, Papua New Guinea. MA thesis, Australian National University, Canberra.
Lilley, I. (1992). Papua New Guinea's human past: the evidence of archaeology. In Human Biology in Papua New Guinea: The Small Cosmos, ed. Attenborough, R. D. and Alpers, M. P.. Oxford: Clarendon Press, pp. 150–71.
Livingstone, F. B. (1989). Simulation of the diffusion of the β-globin variants in the Old World. Human Biology 61, 297–309.
Lourie, J. A. (1986). Trends in birthweight over 43 years at Kwato, Milne Bay Province. Papua New Guinea Medical Journal 29, 337–43.
Lourie, J. A.(ed.) (1987). Ok Tedi Health and Nutrition Project Papua New Guinea 1982–1986: Final Report. Port Moresby and Tabubil: University of Papua New Guinea and Ok Tedi Mining Limited.
Lourie, J. A., Budd, G. and Anderson, H. R. (1992). Physiological adaptability in Papua New Guinea. In Human Biology in Papua New Guinea: The Small Cosmos, ed. Attenborough, R. D. and Alpers, M. P.. Oxford: Clarendon Press, pp. 268–80.
Macintyre, M. (2004). ‘Thoroughly modern mothers’: maternal aspirations and declining mortality on the Lihir islands, Papua. Health Sociology Review 13, 43–53.
Maitland, K., Williams, A. I., Bennett, N. M., et al. (1996). The interaction Plasmodium falciparum and P. vivax in children on Espiritu Santo island, Vanuatu. Transactions of the Royal Society of Tropical Medicine and Hygiene 90, 614–20.
Manning, L. A. and Ogle, G. D. (2002). Yaws in the periurban settlements of Port Moresby, Papua New Guinea. Papua New Guinea Medical Journal 45, 206–12.
Mayxay, M., Pukrittayakamee, S., Newton, P. N. and White, N. J. (2004). Mixed-species malaria infections in humans. Trends in Parasitology 20, 233–40.
McBride, W. J. (2005). HIV/AIDS in Papua New Guinea: an unfolding disaster? Emergency Medicine Australasia 17, 304–6.
McMurray, C. (2004). Morbidity and Mortality Patterns in the Pacific. United Nations Economic and Social Commission for Asia and the Pacific. http://www.unescap.org/esid/psis/population/popseries/apss163/index.asp (accessed 12 September 2005).
Mgone, C. S., Koki, G., Paniu, M. M., et al. (1996).Occurrence of the erythrocyte band 3 (AE1) gene deletion in relation to malaria endemicity in Papua New Guinea. Transactions of the Royal Society of Tropical Medicine and Hygiene 90, 228–31.
Mikloucho-Maclay, N. N. (1975). New Guinea Diaries, 1871–1883. Madang (PNG): Kristen Pres.
Ministry of Health (2001). National Health Plan 2001–2010: Health Vision 2010. Port Moresby: Ministry of Health, Independent State of Papua New Guinea.
Misch, K. A. (1988). Ischaemic heart disease in urbanized Papua New Guinea: an autopsy study. Cardiology 75, 71–5.
Müller, I., Vounatsu, P., Allen, B. J. and Smith, T. (2001). Spatial patterns of child growth in Papua New Guinea and their relation to environment, diet, socio-economic status and subsistence activities. Annals of Human Biology 28, 263–80.
Müller, I., Betuela, I. and Hide, R. L. (2002a). Regional patterns of birthweights in Papua New Guinea in relation to diet, environment and socio-economic factors. Annals of Human Biology 29, 74–88.
Müller, I., Taime, J., Ibam, E., et al. (2002b). Complex patterns of malaria epidemiology in the highlands region of Papua New Guinea. Papua New Guinea Medical Journal 45, 200–5.
Müller, I., Bockarie, M., Alpers, M. P. and Smith, T. (2003). The epidemiology of malaria in Papua New Guinea. Trends in Parasitology 19, 253–9.
Müller, I., Tulloch, J., Marfurt, J., Hide, R. and Reeder, J. C. (2005). Malaria control in Papua New Guinea results in complex epidemiological changes. Papua New Guinea Medical Journal, 48, 151–7.
Naraqi, S., Feling, B. and Leeder, S. R. (2003). Disease and death in Papua New Guinea. Medical Journal of Australia 178, 7–8.
National AIDS Council Secretariat and Department of Health (2002). HIV/AIDS Quarterly Report: March 2002. Port Moresby: National AIDS Council Secretariat.
National Statistical Office (2002). Papua New Guinea 2000 Census: Final Figures. Port Moresby: National Statistical Office of Papua New Guinea.
National Statistical Office(2003a). Papua New Guinea 2000 Census: National Report. Port Moresby: National Statistical Office of Papua New Guinea.
National Statistical Office(2003b). Recent Fertility and Mortality Indices and Trends in Papua New Guinea: A Report Based on the Analysis of 2000 Census Data. Port Moresby: National Statistical Office of Papua New Guinea.
Natsuhara, K., Inaoka, T., Umezaki, M., et al. (2000). Cardiovascular risk factors of migrants in Port Moresby from the highlands and island villages, Papua New Guinea. American Journal of Human Biology 12, 655–64.
Norgan, N. G. (1997). Human adaptability studies in Papua New Guinea: original aims, successes and failures. In Human Adaptability: Past, Present and Future, ed. Ulijaszek, S. J. and Huss-Ashmore, R.. Oxford: Oxford University Press, pp. 102–25.
Ogle, G. D. (2001). Type 2 diabetes mellitus in Papua New Guinea – an historical perspective. Papua New Guinea Medical Journal 44, 81–7.
Ohtsuka, R. (1986). Low rate of population increase of the Gidra Papuans in the past: a genealogical-demographic analysis. American Journal of Physical Anthropology 71, 13–23.
Owen, I. L. (2005). Parasitic zoonoses in Papua New Guinea. Journal of Helminthology 79, 1–14.
Pawley, A. K., Attenborough, R. D., Golson, J. and Hide, R. L. (eds.) (2005). Papuan Pasts: Cultural, Linguistic and Biological Histories of Papuan-Speaking Peoples. Canberra: Pacific Linguistics, The Australian National University.
Peters, W. (1960). Studies on the epidemiology of malaria in New Guinea. Transactions of the Royal Society of Tropical Medicine and Hygiene 54, 242–60.
Poka, H. and Duke, T. (2003). In search of pigbel: gone or just forgotten in the highlands of Papua New Guinea? Papua New Guinea Medical Journal 46, 135–42.
Pollard, T. M. (1997). Environmental change and cardiovascular disease: a new complexity. Yearbook of Physical Anthropology 40, 1–24.
Radford, A. J., Leeuwen, H. and Christian, S. H. (1976). Social aspects in the changing epidemiology of malaria in the highlands of New Guinea. Annals of Tropical Medicine and Parasitology 70, 11–23.
Riley, I. D. (1983). Population change and distribution in Papua New Guinea: an epidemiological approach. Journal of Human Evolution 12, 125–32.
Riley, I. D.(2002). Pneumonia vaccine trials at Tari. Papua New Guinea Medical Journal 45, 44–50.
Riley, I. D. and Lehmann, D. (1992). The demography of Papua New Guinea: migration, fertility and mortality patterns. In Human Biology in Papua New Guinea: The Small Cosmos, ed. Attenborough, R. D. and Alpers, M. P.. Oxford: Clarendon Press, pp. 67–92.
Riley, I. D., Lehmann, D. and Alpers, M. P. (1992). Acute respiratory infections. In Human Biology in Papua New Guinea: The Small Cosmos, ed. Attenborough, R. D. and Alpers, M. P.. Oxford: Clarendon Press, pp. 281–8.
Riley, J. C. (2001). Rising Life Expectancy: A Global History. Cambridge: Cambridge University Press.
Secretariat of the Pacific Community (2004). Pacific Island Populations 2004. Secretariat of the Pacific Community (Demography/Population Programme). http://www.spc.int/demog/ (accessed 12 September 2005).
Serjeantson, S. W., Board, P. G. and Bhatia, K. K. (1992). Population genetics in Papua New Guinea: a perspective on human evolution. In Human Biology in Papua New Guinea: The Small Cosmos, ed. Attenborough, R. D. and Alpers, M. P.. Oxford: Clarendon Press, pp. 198–233.
Sharp, P. T. (1982). Highlands malaria: malaria in Enga Province of Papua New Guinea. Papua New Guinea Medical Journal 25, 253–60.
Sinnett, P. F. (1977). The People of Murapin. Faringdon:E. W. Classey.
Sinnett, P. F., Kevau, I. H. and Tyson, D. (1992). Social change and the emergence of degenerative cardiovascular disease in Papua New Guinea. In Human Biology in Papua New Guinea: The Small Cosmos, ed. Attenborough, R. D. and Alpers, M. P.. Oxford: Clarendon Press, pp. 373–86.
Smith, T., Genton, B., Baea, K., et al. (2001). Prospective risk of morbidity in relation to malaria infection in an area of high endemicity of multiple species of Plasmodium. American Journal of Tropical Medicine and Hygiene 64, 262–7.
Specht, J. (2005). Revisiting the Bismarcks: some alternative views. In Papuan Pasts: Cultural, Linguistic and Biological Histories of Papuan-Speaking Peoples, ed. Pawley, A. K., Attenborough, R. D., Golson, J. and Hide, R. L.. Canberra: Pacific Linguistics, The Australian National University, pp. 235–88.
Spencer, M. (1999). Public Health in Papua New Guinea 1870–1939. Brisbane: Australian Centre for International and Tropical Health and Nutrition.
Spencer, T. E. T., Spencer, M. and Venters, D. (1974). Malaria vectors in Papua New Guinea. Papua New Guinea Medical Journal 17, 22–30.
Spriggs, M. (1997). The Island Melanesians. Oxford: Blackwell.
Swadling, P. and Hide, R. L. (2005). Changing landscape and social interaction: looking at agricultural history from a Sepik-Ramu perspective. In Papuan Pasts: Cultural, Linguistic and Biological Histories of Papuan-Speaking peoples, ed. Pawley, A. K., Attenborough, R. D., Golson, J. and Hide, R. L.. Canberra:Pacific Linguistics, The Australian National University, pp. 289–327.
Swadling, P. and Hope, G. (1992). Environmental change in New Guinea since human settlement. In The Naive Lands: Prehistory and Environmental Change in Australia and the Southwest Pacific, ed. Dodson, J.. Melbourne: Longman Cheshire, pp. 13–42.
Tefuarani, N., Sleigh, A. and Hawker, R. (2002). Congenital heart diseases: a future burden for Papua New Guinea. Papua New Guinea Medical Journal 45, 175–7.
Teitelbaum, M. S. (1975). Relevance of demographic transition theory for developing countries. Science 188, 420–5.
Temu, P. I. (1991). Adult medicine and the ‘new killer diseases’ in Papua New Guinea: an urgent need for prevention. Papua New Guinea Medical Journal 34, 1–5.
Townsend, P. K. (1985). Infant mortality in the Saniyo-Hiowe population, Ambunti District, East Sepik Province. Papua New Guinea Medical Journal 28, 177–82.
Tracer, D. P., Sturt, R. J., Sturt, A. and Braithwaite, L. M. (1998). Two decade trends in birth weight and early childhood growth in Papua New Guinea. American Journal of Human Biology 10, 483–93.
Trowell, H. C. (1981). Hypertension, obesity, diabetes mellitus and coronary heart disease. In Western Diseases: Their Emergence and Prevention, ed. Trowell, H. C. and Burkitt, D. P.. London: Edward Arnold, pp. 3–32.
Trowell, H. C. and Burkitt, D. P. (eds.) (1981). Western Diseases: Their Emergence and Prevention. London: Edward Arnold.
Tulu, A. N. (1996). Determinants of malaria transmission in the highlands of Ethiopia: the impacts of global warming on morbidity and mortality ascribed to malaria. Ph.D. thesis, University of London.
Tyson, D. C. (1987). An ecological analysis of child malnutrition in an Abelam community, Papua New Guinea. Ph.D. thesis, Australian National University, Canberra.
Ulijaszek, S. J. (1995). Development, modernisation and health intervention. In Health Intervention in Less Developed Nations, ed. Ulijaszek, S. J.. Oxford: Oxford University Press, pp. 82–136.
Ulijaszek, S. J.(1997). Modernization, nutritional status and hypertension in a rural Papua New Guinea population (abstract). Annals of Human Biology 24, 281.
Ulijaszek, S. J.(2001). Secular trend in birthweight among the Purari delta population, Papua New Guinea. Annals of Human Biology 28, 246–55.
Ulijaszek, S. J., Koziel, S. and Hermanussen, M. (2005). Village distance from urban centre as the prime modernization variable in differences in blood pressure and body mass index of adults of the Purari delta of the Gulf province, Papua New Guinea. Annals of Human Biology 32, 326–38.
United Nations Children's Fund (2004a). The State of the World's Children 2005: Childhood Under Threat. New York: UNICEF.
United Nations Children's Fund(2004b). Progress for Children. New York: UNICEF.
Kaa, D. J. (1971). The demography of Papua and New Guinea's indigenous population. PhD thesis, Australian National University, Canberra.
Vines, A. P. (1970). An Epidemiological Sample Survey of the Highlands, Mainland and Islands Regions of the Territory of Papua and New Guinea. Port Moresby: Department of Public Health, Territory of Papua and New Guinea.
Ward, R. G. and Lea, D. A. M. (eds.) (1970). An Atlas of Papua and New Guinea. Port Moresby and Glasgow: University of Papua and New Guinea and Collins – Longman.
Webb, S. (1995). Palaeopathology of Aboriginal Australians: Health and Disease across a Hunter-Gatherer Continent. Cambridge: Cambridge University Press.
Wiesenfeld, S. L. (1967). Sickle-cell trait in human biological and cultural evolution. Science 157, 1134–40.
Wigley, S. C. (1977). The first hundred years of tuberculosis in New Guinea. In The Melanesian Environment, ed. Winslow, J. H.. Canberra: Australian National University Press, pp. 471–84.
Wigley, S. C.(1991). Tuberculosis and Papua New Guinea: the Australian connection. In History of Tuberculosis in Australia, New Zealand and Papua New Guinea, ed. Proust, A. J.. Canberra: Brolga Press, pp. 103–17.
World Health Organization (2000). The World Health Report 2000 – Health Systems: Improving Performance. Geneva: World Health Organization.
World Health Organization Regional Office for the Western Pacific (2005). Countries and Areas: Papua New Guinea. World Health Organization. http://www.wpro.who.int/countries/png/ (accessed 12 September 2005).
Yen, D. E. (2005). Reflection, refraction and recombination. In The Sweet Potato in Oceania: A Reappraisal, ed. Ballard, C., Brown, P., Bourke, R. M. and Harwood, T.. Pittsburgh and Sydney: Ethnology Monographs and Oceania Monographs, pp. 181–7.
Zimmerman, P. A., Woolley, I., Masinde, G. L.et al. (1999). Emergence of FY∗Anull in a Plasmodium vivax – endemic region of Papua New Guinea. Proceedings of the National Academy of Sciences of the USA 96, 13973–7.
Zimmerman, P. A., Patel, S. S., Maier, A. G., Bockarie, M. J. and Kazura, J. W. (2003). Erythrocyte polymorphisms and malaria parasite invasion in Papua New Guinea. Trends in Parasitology 19, 250–2.