Injury and preventable diseases |
Infant mortality |
Birthweight |
Hearing impediments |
Children with tooth decay |
Providing a child with a good start can have a profound effect on the rest of their life. Health, growth and development in the first three years of life play crucial roles in later outcomes. Stress and neglect in these early years can have significant effects on later health and educational outcomes. Policy action in these early years can lead to significant benefits in the longer term.
Injury and preventable diseases
A wide range of social, cultural, physical and economic factors influence the health of children. The actions of communities and governments can promote the health of children – most childhood diseases and injuries can be successfully prevented or treated without hospitalisation. This indicator examines injury and preventable diseases that result in children being hospitalised.
KEY MESSAGES
In 2004-05, Indigenous children under four were twice as likely to be hospitalised for potentially preventable diseases and injuries than non-Indigenous children (251 per 1000 compared to 123 per 1000) (table 5.1.1).
For the period 2001 to 2005, the death rate from external causes and preventable diseases was around five times as high for Indigenous children (from 6 to 11 per 10 000 population) as for non-Indigenous children (from 1 to 3 per 10 000 population) in Queensland, WA, SA and the NT (figure 5.1.2).
THINGS THAT WORK
The Jabba Jabba Indigenous Immunisation program, in Queensland’s Sunshine Coast, was developed to provide culturally appropriate access for ‘hard to reach’ sections of the Indigenous community and to provide an entry point to mainstream health services (box 5.1.2).
The Keeping Kids Healthy Makes a Better World program has operated in four communities in the NT: Mt Liebig, Titjikala, Nyirripi and Willowra. As well as improving the nutrition of 0–5 year olds, the program has improved engagement in the community, cultural awareness and family cohesion (box 5.1.2).
A team approach to child nutrition on Tiwi Islands (NT) started in 2006. A nutritionist worked with a multidisciplinary team, the creche and local women to support the nutrition of children aged less than five years (box 5.1.2).
Infant mortality
The survival of infants in their first year of life is generally viewed as an indicator of the general health and wellbeing of a population.
While there has been a dramatic decline in infant mortality rates in the past century for all Australians, the mortality rate for Indigenous infants is still significantly higher than for infants in the rest of the population.
KEY MESSAGES
Indigenous infant mortality rates in most of the states and territories for which data are available have improved in recent years. Nevertheless, mortality rates for Indigenous infants in these jurisdictions remain two to three times as high as those for the total population of infants (figures 5.2.1 and 5.2.2).
THINGS THAT WORK
The NSW Aboriginal Maternal and Infant Health Strategy, operating since 2001, improves access to culturally appropriate maternity services for Aboriginal mothers (box 5.2.2).
The ‘Mums and Babies’ project, operating since 2000, provides a collaborative model of antenatal and postnatal care for women at the Townsville Aboriginal and Islander Health Service, Queensland (box 5.2.2).
Birthweight
Infants with a low birthweight are more likely to die or have problems early in life. Low birthweight may influence the development of chronic diseases in adulthood, including diabetes and heart disease.
KEY MESSAGES
From 2002 to 2004, babies born to Indigenous mothers were more than twice as likely to have low birthweight (13 per 1000 live births) than babies born to non-Indigenous mothers (6 per 1000 live births) (table 5.3.2).
Average birthweights and proportions of low birthweight babies to Indigenous mothers did not change between 1998–2000 and 2002–2004 (tables 5A.3.1 to 5A.3.5).
From 2002 to 2004, the average birthweight of live births to Indigenous mothers was 3161 g, compared with 3380 g for babies born to non-Indigenous mothers - a difference of 219 g (table 5.3.2).
THINGS THAT WORK
Congress Alukura, based in Alice Springs NT, is a women’s health and birthing centre developed in the 1980s to address the needs of Aboriginal women in Central Australia (box 5.3.2).
The Strong Women, Strong Babies, Strong Culture Program in the NT supports Indigenous women to teach young pregnant women and new mothers to care for themselves and their children in ways that reflect traditional cultural values and practices (box 5.3.2).
Djuli Galban operates in Kempsey, NSW, with a focus on antenatal and early postnatal care and education (box 5.3.2).
The Koori Maternity Strategy in Victoria provides culturally appropriate maternity care to Koori women (box 5.3.2).
The Marrang Aboriginal Child and Family Health Model was developed to improve access and health outcomes for Aboriginal families in Orange, NSW (box 5.3.2).
Nganampa Health Council Child and Maternal Health Program is an intensive antenatal and early postnatal care program operating in the Anangu Pitjantjatjara lands of SA since the mid 1980s (box 5.3.2).
Ngua Gundi - the Mother/Child Project - was funded by the Commonwealth Birthing Services Project to address the low use of antenatal services by young Aboriginal mothers in Woorabinda, Queensland (box 5.3.2).
Hearing impediments
Otitis media, the main cause of hearing problems experienced by Indigenous children, is characterised by very early onset, persistence and high rates of severity. It can become a chronic disease which is carried from childhood into adolescence.
Hearing impediments, if not treated early, may affect children’s attendance at school, and their capacity to learn and socialise. This, in turn, can contribute to future disadvantage.
KEY MESSAGES
In 2004-05, the prevalence of hearing conditions for Indigenous children was three times as high as for non-Indigenous children (table 5A.4.1).
Between 2001 and 2004-05, there was no statistically significant change in the overall prevalence of hearing problems among Indigenous children (figure 5.4.1).
From 2001-02 to 2004-05, hospitalisations for middle ear and mastoid diseases decreased for Indigenous children aged 0–3 years (from 13 per 1000 to 10 per 1000) (tables 5A.4.6 to 5A.4.9).
THINGS THAT WORK
There was a decrease in the rates of skin infections and ear perforations following the installation of a swimming pool in Burringurrah (box 5.4.3).
Following a 2005 study of hearing loss hearing in children in a Townsville primary school, in-class and out-of-class hearing assessment tools and professional development programs were developed to maximise students’ academic success (box 5.4.3).
Children with tooth decay
Dental health is an indicator of early growth and development, including nutrition and access to dental health care. Unless treated early, tooth decay may result in pain, infection and destruction of soft tissue in the mouth. Poor dental health can affect speech and language development, as well as school attendance and performance, with implications for self-esteem, employment and social wellbeing.
Historically, Indigenous people had less tooth decay due to their traditional diet. As their diet changed to include food rich in fermentable carbohydrates, they have become as exposed to tooth decay risk factors as non-Indigenous people. This risk is worsened where there is limited access to dental health services and lack of preventive measures and education.
KEY MESSAGES
Data on tooth decay were available only for NSW, SA and the NT. For these jurisdictions:
- Indigenous children had higher numbers of both infant and adult teeth with decay than non-Indigenous children, in both metropolitan and rural areas (table 5.5.1)
- fewer Indigenous children than non-Indigenous children had decay-free infant and adult teeth across all age groups and in both metropolitan and rural areas (table 5.5.2).
National data on dental hospitalisation rates and procedure rates showed:
- Indigenous children aged less than five years had the highest dental hospitalisation rate of any group, almost one and a half times the rate for non-Indigenous children of that age group (table 5A.5.8)
- extraction rates were greater for Indigenous children than for non-Indigenous children. The rate of extraction procedures for Indigenous boys was almost one and a half times as high as the rate for non-Indigenous boys (figure 5.5.4).
THINGS THAT WORK
Since 2005, the Wuchopperen Indigenous Health Service ‘Filling the Gap Indigenous Dental Program’, has provided care to approximately 20 000 Aboriginal and Torres Strait Islander people in and around Cairns, Queensland (box 5.5.2).
Following the successful employment of an Aboriginal Liaison Officer in Northern Adelaide, the SA Dental Service established a broader Aboriginal Liaison Program in late 2005 to improve access to dental care by Indigenous people (box 5.5.3).
Report Chapter 5: Early child development and growth
(PDF document)
Attachment 5A
(Excel document)
See next strategic area for action: Early school engagement and performance (preschool to year 3).