H. pylori infection is common among newly arrived refugees. The long latency of infection to development of complications and the availability of testing and relatively effective eradication regimens all add weight to a decision to screen in this population.

The concept of Culturally and Linguistically Diverse (CALD) populations is unique to Australia. It was introduced in 1996 and is intended to refer to ethno-cultural groups that are neither Aboriginal or Torres Strait Islander nor considered from mainstream English-speaking Anglo-Celtic backgrounds. CALD children have been identified as a priority population by the Australian government because they may experience inequities in health outcomes compared to Anglo-Australian children. Inequities in the health and wellbeing of CALD children are driven by myriad processes including racial discrimination, socioeconomic disadvantage, and limited access to health services. But who are CALD children? Despite the availability of statistical standards for data collection on CALD characteristics such as country of birth and language spoken, the concept itself lacks an official operational definition. Applying definitions specified by various organisations to data from the 2016 Australian Census, the estimated proportion of CALD children ranged from 11% to 44% of Australian children aged 0 to 17 years. There are few published studies on CALD children in Australian child health research, with most studies focused on refugees. There is no consensus on how CALD is defined in child health research in Australia. We propose several considerations in the use of the CALD concept in child health research. This includes adhering to the Australian Bureau of Statistics standards on Cultural and Linguistic Diversity, use of multiple indicators to identify CALD, and acknowledging the significant heterogeneity of CALD communities which may contribute to observed differences in health. If we are to advance health and well-being equity for CALD children, we need a more carefully considered and consistent approach to understanding which children are CALD.

Aim To describe the cumulative incidence of child protection (CP) system contact, maltreatment type, source of reports to age 7 years, and socio‐demographic characteristics for culturally and linguistically diverse (CALD) Australian children. Methods We used CP, education, health, and birth registrations data for children followed from birth up to age 7 from the South Australian Better Evidence, Better Outcomes, Linked Data (SA BEBOLD) platform. Participants: SA born children enrolled in their first year of school from 2009 to 2015 (n = 76 563). CALD defined as non‐Aboriginal or Torres Strait Islander, spoken language other than English, Indigenous or Sign, or had at least one parent born in a non‐English speaking country. Outcomes measures: For CALD and non‐CALD children, we estimated the cumulative incidence (risk) of CP contacts up to age 7, relative risk and risk differences for all levels of CP contact from notification to out‐of‐home care (OOHC), primary maltreatment type, reporter type, and socio‐economic characteristics. Sensitivity analyses explored different population selection criteria and CALD definitions. Results By age 7, 11.2% of CALD children had ‘screened‐in’ notifications compared to 18.8% of non‐CALD (risk difference [RD] 7.6 percentage points (95% confidence interval: 6.9–8.3)), and 0.6% of CALD children experienced OOHC compared to 2.2% of non‐CALD (RD 1.6 percentage points (95% confidence interval: 1.3–1.8)). Emotional abuse was the most common substantiated maltreatment type for CALD and neglect for non‐CALD. Among both groups, the most common reporter sources were police and education sector. Socio‐economic characteristics were broadly similar. Sensitivity analyses results were consistent with primary analyses. Conclusion By age 7, CALD children had lower risk of contact with all levels of CP. Estimates based on primary and sensitivity analyses suggested CALD children were 5–9 percentage points less likely to have a report screened‐in, and from 1.0 to 1.7 percentage points less likely to have experienced OOHC.

Aim To determine the cumulative incidence of child protection (CP) system contact, maltreatment type, source of reports up to age 7, and sociodemographic characteristics for Culturally and Linguistically Diverse (CALD) Australian children. Methods A South Australian (SA) whole-of-population linked administrative data study of children followed from birth up to age 7, using child protection, education, health, and birth registrations data. Participants: SA born children enrolled in their first year of school from 2009-2015 (N = 76 563). CALD defined as non-Aboriginal or Torres Strait Islander, spoken language other than English, Indigenous or Sign, or had at least one parent born in a non-English speaking country. Outcomes measures: For CALD and non-CALD children the cumulative incidence of CP reports up to age 7, relative risk and risk differences for all CP contact (reporting through to out-of-home care (OOHC)) and age, primary maltreatment type, reporter type, and socioeconomic characteristics were estimated. Sensitivity analyses explored population selection and different CALD definitions. Results By age 7, 11.2% of CALD children were screened in compared to 18.8% of non-CALD (RD 7.6 percentage points (95% CI: 6.9-8.3)), and 0.6% of CALD children experienced OOHC compared to 2.2% of non-CALD (RD 1.6 percentage points (95% CI: 1.3-1.8)). Among both groups, most common abuse type was emotional and the most common reporter types were police and education sector. Socioeconomic characteristics were broadly similar. Sensitivity analyses results were consistent with primary analyses. Conclusion By age 7, contact with any level of child protection was lower for CALD compared to non-CALD children. Estimates based on primary and sensitivity analyses suggested CALD children were 5 to 9 percentage points less likely have a report screened-in, and from 1.0 to 1.7 percentage points less likely to have experienced OOHC.