Identified health concerns and changes in management resulting from the Healthy Kids Check in two Queensland practices

To the Editor: Thomas and colleagues, in their article on identification rates for health and developmental problems of preschoolers before and after Healthy Kids Check (HKC) services,1 make a valuable contribution to the literature on the outcomes of health assessments.

Their research showed that HKCs were more likely than routine general practitioner visits (in the first 4 years of life) to detect oral health, vision and behavioural problems (prevalence rates among 557 children of 1.8% v 0, 3.8% v 1.4% and 2.3% v 1.8%, respectively), suggesting that HKCs presented an opportunity for families to deal with previously unmet health needs. However, the numbers of height and weight problems and oral health problems reported in this study were surprisingly small. National prevalence rates of more than 20% for childhood overweight2 and 40% for untreated dental caries3 were not matched in this study, where the rates for height and weight problems and oral health problems were only 3.2% and 1.8%, respectively.

It is possible that the communities involved experienced exceptional health status (the socioeconomic status of clinic populations was not described) or that only healthy children attended HKCs — or it is perhaps more likely that these problems remained undetected. Such discrepancies in the rates are significant because HKCs were established, in part, to detect early lifestyle risk factors; an aim that cannot be realised if there is incomplete recording of these developmental indicators.

The findings of Thomas and colleagues suggest that HKCs are partially improving the early detection of lifestyle risk factors. However, a more comprehensive evaluation of HKC outcomes — incorporating the views of clinicians and parents with long-term follow-up of children across various health settings — is needed to determine the true impact.