Register      Login
Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association
RESEARCH ARTICLE

Picture of the health status of Aboriginal children living in an urban setting of Sydney

Suzie Gardner A C , Susan Woolfenden A , Lola Callaghan A , Trudy Allende B , Jennifer Winters B , Grace Wong A , Shea Caplice B and Karen Zwi A
+ Author Affiliations
- Author Affiliations

A Department of Community Child Health, Sydney Children’s Hospital, Corner Avoca and Barker Streets, Randwick, Sydney, NSW 2031, Australia. Email: susan.woolfenden@sesiahs.health.nsw.gov.au; karen.zwi@health.nsw.gov.au

B Malabar Midwives Royal Hospital for Women, Barker Street, Randwick, NSW 2031, Australia. Email: shea.caplice@sesiahs.health.nsw.gov.au

C Corresponding author. Email: suziegardner5@gmail.com

Australian Health Review 40(3) 337-344 https://doi.org/10.1071/AH14259
Submitted: 20 January 2015  Accepted: 30 July 2015   Published: 28 September 2015

Abstract

Objectives The aims of the present study were to: (1) describe the health status and health indicators for urban Aboriginal children (age 0–16 years) in south-east Sydney; and (2) evaluate the quality of routinely collected clinical data and its usefulness in monitoring local progress of health outcomes.

Methods Aboriginal maternal and child health routine data, from multiple databases, for individuals accessing maternal and child health services between January 2007 and December 2012 were examined and compared with state and national health indicators.

Results Reductions in maternal smoking, premature delivery and low birthweight delivery rates were achieved in some years, but no consistent trends emerged. Paediatric services had increased referrals each year. The most frequent diagnoses were nutritional problems, language delay or disorder and developmental delay or learning difficulties. Twenty per cent of children had a chronic medical condition requiring long-term follow-up. Aboriginal children were more likely to be discharged from hospital against medical advice than non-Aboriginal children. Routinely collected data did not include some information essential to monitor determinants of health and health outcomes.

Conclusions Aboriginal children living in this urban setting had high levels of need. Routinely recorded data were suboptimal for monitoring local health status and needed to reflect national and state health indicators. Routinely collected data can identify service gaps and guide service development.

What is known about this topic? Despite improvements in some areas, there continue to be significant gaps in maternal and child health outcomes between Aboriginal and non-Aboriginal Australians. These are poorly documented at a local service level.

What does this paper add? Intensive, local services offered to Aboriginal women and children can result in rapid service engagement. Health service data routinely collected by local services can be used to demonstrate reductions in antenatal risk factors in pregnant Aboriginal women, even within the short time frame of 6 years. However, improvements in child health outcomes may require longer time frames. In this urban setting, the most frequent diagnoses in Aboriginal children attending the service were nutritional problems, language delay or disorder and developmental delay or learning difficulties.

What are the implications for practitioners? Key information regarding determinants of health should be routinely monitored at a local level to understand local rates and health needs in addition to evaluating and quantifying the effectiveness of service delivery or health promotion activities.

Additional keywords: Indigenous, midwives.


References

[1]  Australian Bureau of Statistics (ABS). Australian Bureau of Statistics demographic, social and economic characteristics overview: Aboriginal and Torres Strait Islander: people and where they live. 2012. Available at: http://www.abs.gov.au/AUSSTATS/abs@.nsf/lookup/4704.0Chapter200Oct+2010 [verified July 2015].

[2]  Eades STB, Bailey S, Williamson AB, Craig JC, Redman S. The health of urban Aboriginal people: insufficient data to close the gap. Med J Aust 2010; 193 521–4.

[3]  Study of Environment on Aboriginal Resilience and Child Health Investigators Study of environment on Aboriginal resilience and child health (SEARCH): study protocol. BMC Public Health 2010; 10 287
Study of environment on Aboriginal resilience and child health (SEARCH): study protocol.Crossref | GoogleScholarGoogle Scholar | 20507632PubMed |

[4]  Priest N, Mackean T, Water E, Davis E, Riggs E. Indigenous child health research; a critical analysis of Australian studies. Aust N Z J Public Health 2009; 33 55–63.
Indigenous child health research; a critical analysis of Australian studies.Crossref | GoogleScholarGoogle Scholar | 19236360PubMed |

[5]  Australian Institute of Health and Welfare (AIHW). The health and welfare of Australia’s Aboriginal and Torres Strait Islander people, an overview 2011. Catalogue no. IHW 42. Canberra: AIHW; 2011.

[6]  Walker S. Child development: risk factors for adverse outcomes in developing countries. Lancet 2007; 369 145–57.
Child development: risk factors for adverse outcomes in developing countries.Crossref | GoogleScholarGoogle Scholar | 17223478PubMed |

[7]  Huang J-H, Huang H-L. Inattention and development of toddlers born in preterm and with low birth weight. Kaohsiung J Med Sci 2012; 28 390–6.
Inattention and development of toddlers born in preterm and with low birth weight.Crossref | GoogleScholarGoogle Scholar | 22726902PubMed |

[8]  Hertzman C. Bucking the inequality gradient through early child development. BMJ 2010; 340 c468
| 20147358PubMed |

[9]  Tamayo T. Impact of early psychosocial factors (childhood socioeconomic factors and adversities) on future risk of type 2 diabetes, metabolic disturbances and obesity: a systematic review. BMC Public Health 2010; 10 525
Impact of early psychosocial factors (childhood socioeconomic factors and adversities) on future risk of type 2 diabetes, metabolic disturbances and obesity: a systematic review.Crossref | GoogleScholarGoogle Scholar | 20809937PubMed |

[10]  Gluckman P, Hanson MA, Cooper C, Thornburg KL. Effect of in utero and early-life conditions on adult health and disease. N Engl J Med 2008; 359 61–73.
Effect of in utero and early-life conditions on adult health and disease.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD1cXotFSit7o%3D&md5=26314044f5d72034ddebc61e67fb60ffCAS | 18596274PubMed |

[11]  Graham H, Power C. Childhood disadvantage and health inequalities: a framework for policy based on lifecourse research. Child Care Health Dev 2004; 30 671–8.
Childhood disadvantage and health inequalities: a framework for policy based on lifecourse research.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD2crls1Wksg%3D%3D&md5=64f9abc9c0d90ac3f98b1ec0c777b533CAS | 15527477PubMed |

[12]  National Institute of Child Health and Human Development Early Child Care Research Network. Duration and developmental timing of poverty and children’s cognitive and social development from birth through third grade. Child Dev 2005; 76 795–810.
National Institute of Child Health and Human Development Early Child Care Research Network. Duration and developmental timing of poverty and children’s cognitive and social development from birth through third grade.Crossref | GoogleScholarGoogle Scholar | 16026497PubMed |

[13]  Landry S, Smith KE, Swank PR, Assel MA, Vellet S. Does early responsive parenting have a special importance for children’s development or is consistency across early childhood necessary? Dev Psychol 2001; 37 387–403.
Does early responsive parenting have a special importance for children’s development or is consistency across early childhood necessary?Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD38%2FhtVKntQ%3D%3D&md5=2094f36c07fb223b23eb1ea62a0ec567CAS | 11370914PubMed |

[14]  Morisset C, Barnard KE, Greenberg MT, Booth CL. Environmental influences on early language development: the context of social risk. Dev Psychopathol 1990; 2 127–49.
Environmental influences on early language development: the context of social risk.Crossref | GoogleScholarGoogle Scholar |

[15]  Department of Families, Housing, Community Services and Indigenous Affairs. Closing the gap. Prime Minister’s report 2013. 2013. Available at: http://apo.org.au/node/32807 [verified 21 July 2015].

[16]  Australian Bureau of Statistics (ABS). Census of population and housing-counts of Aboriginal and Torres Strait Islander Australians, 2011. Canberra: ABS; 2012.

[17]  Australian Institute of Health and Welfare (AIHW). The health and welfare of Australia’s Aboriginal and Torres Strait Islander People. Canberra: AIHW; 2008.

[18]  Aboriginal Affairs NSW. Portrait of La Perouse Partnership Community compared with NSW. Available at: http://aboriginalaffairs.nsw.gov.au/wp-content/uploads/2012/11/Community-Portrait06N-La-Perouse1.pdf [verified July 2015].

[19]  Australian Bureau of Statistics (ABS). Randwick LGA. 2011 Census QuickStats. 2011. Available at: http://www.censusdata.abs.gov.au/census_services/getproduct/census/2011/quickstat/SSC11944?opendocument&navpos=220 [verified July 2015].

[20]  Australian Bureau of Statistics (ABS). Population by age and sex, Australian States and Territories. Canberra: ABS; 2010.

[21]  Hinkson M. Aboriginal Sydney: a guide to important places of the past and present. Available at: http://www.environment.nsw.gov.au/heritageapp/ViewHeritageItemDetails.aspx?ID=5061399 [verified 19 August 2015].

[22]  Homer C, Henry K, Schmied V, Kemp L, Leap N, Briggs C. ‘It looks good on paper’: transitions of care between midwives and child and family health nurses in New South Wales. Women Birth 2009; 22 64–72.
‘It looks good on paper’: transitions of care between midwives and child and family health nurses in New South Wales.Crossref | GoogleScholarGoogle Scholar | 19217366PubMed |

[23]  Centre for Epidemiology and Evidence. The health of Aboriginal people of NSW: report of the Chief Health Officer, 2012. Sydney: NSW Ministry of Health; 2012.

[24]  Duncan C, Williams K, Nathanson D, Thomas S, Cottier C, O’Meara M, Zwi K. Emergency department presentations by Aboriginal children: issues for consideration for appropriate health services. J Paediatr Child Health 2013; 49 E448–50.
Emergency department presentations by Aboriginal children: issues for consideration for appropriate health services.Crossref | GoogleScholarGoogle Scholar | 23692582PubMed |

[25]  Ansari Z. The concept and usefulness of ambulatory care sensitive conditions as indicators of quality and access to primary health care. Aust J Primary Health 2007; 13 91–110.
The concept and usefulness of ambulatory care sensitive conditions as indicators of quality and access to primary health care.Crossref | GoogleScholarGoogle Scholar |

[26]  Alfrandre D. What is wrong with discharges against medical advice (and how to fix them). JAMA 2013; 310 2393–4.
What is wrong with discharges against medical advice (and how to fix them).Crossref | GoogleScholarGoogle Scholar |

[27]  Yong TYFJ, Hakendorf P, Ben-Tovim D, Thompson CH, Li JY. Characteristics and outcomes of discharges against medical advice among hospitalised patients. Intern Med J 2013; 43 798–802.
Characteristics and outcomes of discharges against medical advice among hospitalised patients.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC3svjtlOnsQ%3D%3D&md5=d7a206f8edf29e5be105523917e816beCAS |

[28]  Department of Health and Community Services (DHCS). Self-discharge against medical advice from Northern Territory Hospitals. 2007. Available at: http://www.cdu.edu.au/sites/default/files/nursing/documents/SelfDischargereport.pdf [verified 7 September 2015].