Socioeconomic disparities in physical health among Aboriginal and Torres Strait Islander children in Western Australia

Shepherd, Carrington; Li, Jianghong; Zubrick, Stephen R.

doi:10.1080/13557858.2012.654768

Cited by 9 publications

(11 citation statements)

References 42 publications

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“…The exact reasons underlying the inequality in otitis media prevalence between Aboriginal and non-Aboriginal children are not fully understood, although they are likely to be multifactorial and interrelated. Some risk factors for otitis media that remain common in many Aboriginal families include large numbers of children living in the same household,10 11 recent ear infections among family members,12 13 poor housing quality,14 high nasal pathogen loads15 16 and infant bottle feeding 13…”

Section: Introductionmentioning

confidence: 99%

Inequalities in ventilation tube insertion procedures between Aboriginal and non-Aboriginal children in New South Wales, Australia: a data linkage study

et al. 2013

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ObjectivesAustralian Aboriginal children experience earlier, more frequent and more severe otitis media, particularly in remote communities, than non-Aboriginal children. Insertion of ventilation tubes is the main surgical procedure for otitis media. Our aim was to quantify inequalities in ventilation tube insertion (VTI) procedures between Australian Aboriginal and non-Aboriginal children, and to explore the influence of birth characteristics, socioeconomic background and geographical remoteness on this inequality.DesignRetrospective cohort study using linked hospital and mortality data from July 2000 to December 2008.Setting and participantsA whole-of-population cohort of 653 550 children (16 831 Aboriginal and 636 719 non-Aboriginal) born in a New South Wales hospital between 1 July 2000 and 31 December 2007 was included in the analysis.Outcome measureFirst VTI procedure.ResultsVTI rates were lower in Aboriginal compared with non-Aboriginal children (incidence rate (IR), 4.3/1000 person-years; 95% CI 3.8 to 4.8 vs IR 5.8/1000 person-years; 95% CI 5.7 to 5.8). Overall, Aboriginal children were 28% less likely than non-Aboriginal children to have ventilation tubes inserted (age-adjusted and sex-adjusted rate ratios (RRs) 0.72; 95% CI 0.64 to 0.80). After adjusting additionally for geographical remoteness, Aboriginal children were 19% less likely to have ventilation tubes inserted (age-adjusted and sex-adjusted RR 0.81; 95% CI 0.73 to 0.91). After adjusting separately for private patient/health insurance status and area socioeconomic status, there was no significant difference (age-adjusted and sex-adjusted RR 0.96; 95% CI 0.86 to 1.08 and RR 0.93; 95% CI 0.83 to 1.04, respectively). In the fully adjusted model, there were no significant differences in VTI rates between Aboriginal and non-Aboriginal children (RR 1.06; 95% CI 0.94 to 1.19).ConclusionsDespite a much higher prevalence of otitis media, Aboriginal children were less likely to receive VTI procedures than their non-Aboriginal counterparts; this inequality was largely explained by differences in socioeconomic status and geographical remoteness.

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Section: Introductionmentioning

confidence: 99%

Inequalities in ventilation tube insertion procedures between Aboriginal and non-Aboriginal children in New South Wales, Australia: a data linkage study

et al. 2013

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“…18,19 Although asthma prevalence and hospitalisation rate estimates for the general Australian population increase with increasing area-level socio-economic disadvantage, 20 Shepherd et al reported significantly lower odds of ever having asthma among Western Australian Aboriginal children living in more disadvantaged areas. 15 The reasons for these disparate patterns are unclear; however, our results suggest that among children in the SEARCH cohort, the relationship between asthma and socio-economic disadvantage is consistent with that in the general population. The inverse association between asthma and household size inferred in our analyses has also been reported in several previous studies and may be at least partly attributable to an effect of sibling-mediated microbial exposure on post-natal maturation of the immune system.…”

Section: Discussionmentioning

confidence: 53%

“…Analyses of cross-sectional data for 5289 Aboriginal and Torres Strait Islander children recruited into the Western Australian Aboriginal Child Health Survey indicated that the odds of asthma decline steeply with increasing geographic isolation and are lower among children living in socioeconomically disadvantaged areas than among children from more advantaged areas; however, no associations were found between asthma and a range of other potential risk factors, including maternal smoking during pregnancy and current carer smoking. 14,15 This paper presents a cross-sectional study of asthma prevalence in a cohort of urban Aboriginal children recruited into the Study of Environment on Aboriginal Resilience and Child Health (SEARCH). Study aims were: (i) to describe socio-demographic patterns of asthma prevalence in the SEARCH cohort; (ii) to quantify the strength of associations between asthma prevalence and both pre-natal maternal smoking and current exposure to carer smoking; and (iii) to compare estimates of associations between asthma prevalence and pre-natal maternal and current carer smoking in the SEARCH cohort with estimates for other populations, derived from meta-analyses of published crosssectional data.…”

mentioning

confidence: 99%

Asthma in urban Aboriginal children: A cross‐sectional study of socio‐demographic patterns and associations with pre‐natal and current carer smoking

Skinner

Falster

Gunasekera

et al. 2020

J Paediatrics Child Health

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Aim To describe socio‐demographic patterns of asthma prevalence in urban Aboriginal children and quantify associations between asthma prevalence and pre‐natal maternal and current carer smoking. Methods Analyses used carer‐reported survey data for 1290 urban Aboriginal children aged 2–17 years from the Study of Environment on Aboriginal Resilience and Child Health. Multilevel log‐binomial regression was used to estimate asthma prevalence ratios (PRs) for child‐ and family‐level socio‐demographic factors, pre‐natal maternal smoking and current carer smoking. Smoking‐related PRs were compared with general‐population estimates derived from meta‐analyses of published cross‐sectional data. Results Overall, 33.9% of children had ever had asthma, and 12.9% had received treatment for asthma in the past month. Prevalence estimates declined with increasing household income and increasing household size (posterior probabilities of decreasing trend >0.98), while children exposed to pre‐natal maternal smoking had a higher risk of asthma ever than unexposed children (PR 1.18 (95% credible interval 1.00–1.40)). Recently treated asthma prevalence was not significantly associated with pre‐natal maternal (0.98 (0.71–1.41)) or current carer smoking (0.97 (0.68–1.37)); however, there was substantial uncertainty in our PR estimates, and 95% credible intervals contained general‐population estimates derived from the meta‐analyses (1.37 (1.17–1.65) for pre‐natal smoking, 1.28 (1.15–1.44) for current parental or household smoking). Conclusion Among urban Aboriginal children in the Study of Environment on Aboriginal Resilience and Child Health cohort, asthma prevalence declines as household income and household size increase, while children exposed to pre‐natal maternal smoking are at increased risk of ever having asthma. Our results emphasise the importance of reducing smoking in Aboriginal communities, particularly among pregnant women.

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“…We include additional independent variables in the modeling: at the individual level of influence, e.g., proportion of optimal birth weight/gestational age [ 46 , 47 ], cigarette smoking [ 48 ]; at the family level , e.g., parental cigarette smoking [ 19 , 49 ], poor quality housing [ 19 , 50 ]; and at the neighborhood level , e.g., a Census-based measure of neighborhood socioeconomic disadvantage [ 51 , 52 ].…”

Section: Introductionmentioning

confidence: 99%

Relationships between Psychosocial Resilience and Physical Health Status of Western Australian Urban Aboriginal Youth

et al. 2015

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BackgroundPsychosocial processes are implicated as mediators of racial/ethnic health disparities via dysregulation of physiological responses to stress. Our aim was to investigate the extent to which factors previously documented as buffering the impact of high-risk family environments on Aboriginal youths’ psychosocial functioning were similarly beneficial for their physical health status.Method and ResultsWe examined the relationship between psychosocial resilience and physical health of urban Aboriginal youth (12–17 years, n = 677) drawn from a representative survey of Western Australian Aboriginal children and their families. A composite variable of psychosocial resilient status, derived by cross-classifying youth by high/low family risk exposure and normal/abnormal psychosocial functioning, resulted in four groups- Resilient, Less Resilient, Expected Good and Vulnerable. Separate logistic regression modeling for high and low risk exposed youth revealed that Resilient youth were significantly more likely to have lower self-reported asthma symptoms (OR 3.48, p<.001) and carer reported lifetime health problems (OR 1.76, p<.04) than Less Resilient youth.ConclusionThe findings are consistent with biopsychosocial models and provide a more nuanced understanding of the patterns of risks, resources and adaptation that impact on the physical health of Aboriginal youth. The results support the posited biological pathways between chronic stress and physical health, and identify the protective role of social connections impacting not only psychosocial function but also physical health. Using a resilience framework may identify potent protective factors otherwise undetected in aggregated analyses, offering important insights to augment general public health prevention strategies.

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Socioeconomic disparities in physical health among Aboriginal and Torres Strait Islander children in Western Australia

Cited by 9 publications

References 42 publications

Inequalities in ventilation tube insertion procedures between Aboriginal and non-Aboriginal children in New South Wales, Australia: a data linkage study

Inequalities in ventilation tube insertion procedures between Aboriginal and non-Aboriginal children in New South Wales, Australia: a data linkage study

Asthma in urban Aboriginal children: A cross‐sectional study of socio‐demographic patterns and associations with pre‐natal and current carer smoking

Relationships between Psychosocial Resilience and Physical Health Status of Western Australian Urban Aboriginal Youth

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