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The general health of a cohort of Aboriginal children (0–7 years) in Sydney

Elizabeth J Comino, Emma Elcombe, Bin B Jalaludin, Lynn A Kemp, Darryl Wright and Mark F Harris
Med J Aust 2017; 207 (1): 37-38. || doi: 10.5694/mja16.01346
Published online: 3 July 2017

In both urban and rural locations, the health of Indigenous children is worse than that of non-Indigenous Australian children.1 General data on the health of urban Indigenous children are scarce.2 Here we describe reports by parents about specific common childhood illnesses in urban Aboriginal children and parental responses to these illnesses.

The data were collected from a birth cohort of 149 Aboriginal children and their parents (Gudaga Study, recruited 2005–2007),3 using best practice methods for research in an Aboriginal community.4 During semi-annual structured interviews with an Aboriginal project officer, parents provided information about respiratory tract infections (“a cold, runny nose, cough, bronchitis, or chest infection”), gastrointestinal conditions (“vomiting and/or diarrhoea”), ear health (“problems with his/her ears”), asthma/wheeze, and tonsillitis that had been experienced by their child in the preceding month. The parent’s response to these conditions was coded as “gave medication” or “sought professional advice”; 96% of those who sought professional advice reported having seen their doctor or general practitioner. Parents were also asked to rate their own general health and that of their child on a 5-point Likert scale. Data were analysed according to the child’s age group at interview. We did not attempt to verify parental responses or to justify the responses reported.

The general characteristics of the cohort have been described elsewhere.3 About 65% of mothers were of Indigenous heritage, 22% were less than 20 years old when they first gave birth, 11% had post-school qualifications, and 58% had a partner.

Parents frequently reported the listed childhood illnesses, and that they had given medication or sought professional advice (Box). While ear health problems, asthma or wheeze, and tonsillitis were less frequently reported than respiratory tract infections and gastrointestinal problems, they were more likely to elicit a parental treatment response. The mean parental score for their children’s general health ranged between 3.6 (standard deviation [SD], 1.2) and 4.6 (SD, 0.7) across the 7 years each child was followed; scores for the parents’ own health ranged between 3.3 (SD, 1.2) and 3.7 (SD, 1.0). Child and own health scores at each interview were associated (linear mixed model, P < 0.001), and the overall means were correlated (Pearson’s r = 0.52; P < 0.001).

This is one of only a few reported studies to systematically track the prevalence of common childhood illnesses in a cohort of urban Aboriginal children, and to explore their general health and that of their parents. Although it was a small cohort study, its strength lies in its recruitment of a population of urban Aboriginal children, the high rates of follow-up, and the systematic description of a range of general child health problems across early childhood. The reported problems varied over time, reflecting the development of the survey and the children.

Our findings indicate that parents responded to their children’s health problems by seeking professional advice or giving medication. Although the poorer general health of Indigenous Australian adults is recognised,1,2 the correlation between parent-rated adult and child health scores highlights the importance of ongoing programs for improving the general health of Indigenous Australian families. National programs that support local organisations and community development, such as Close the Gap,5 require sustained support in both urban and rural communities.

Box – Summary of the number of children with illness in previous month and parent report of actions taken to treat, by condition and child’s age

Age group

Children assessed

Reported illness in previous month


Reported parental response to illness*


Children affected by illness

Total reports of illness

Any action taken

Gave medication

Sought professional advice

Other


Respiratory tract infections (recorded from 6 months)

 0.5–1.0 year

141

126 (89%)

200

 1.5–3.0 years

137

135 (98%)

374

241 (64%)

158 (42%)

125 (33%)

3 (1%)

 3.5–5.0 years

133

123 (92%)

288

222 (77%)

236 (82%)

174 (60%)

2 (1%)

 5.5–7.0 years

127

72 (57%)

124

94 (76%)

80 (64%)

51 (41%)

5 (4%)

Ear health (recorded from 6 months)

 0.5–1.0 year

141

28 (20%)

33

18 (54%)

16 (48%)

16 (48%)

0

 1.5–3.0 years

137

50 (36%)

70

64 (91%)

55 (79%)

59 (84%)

2 (3%)

 3.5–5.0 years

133

47 (35%)

59

49 (83%)

41 (70%)

48 (81%)

3 (5%)

 5.5–7.0 years

127

18 (14%)

22

18 (82%)

16 (73%)

17 (77%)

2 (9%)

Gastrointestinal tract conditions (recorded from 6 months)

 0.5–1.0 year

141

78 (55%)

101

 1.5–3.0 years

137

91 (66%)

148

52 (35%)

19 (13%)

46 (31%)

3 (2%)

 3.5–5.0 years

133

59 (44%)

81

38 (47%)

13 (16%)

35 (43%)

2 (2%)

 5.5–7.0 years

127

27 (21%)

33

20 (61%)

11 (33%)

11 (33%)

3 (9%)

Asthma/wheeze (recorded from 2 years)

 0.5–1.0 year

 1.5–3.0 years

134

46 (34%)

68

59 (87%)

54 (79%)

42 (62%)

1 (2%)

 3.5–5.0 years

133

45 (34%)

69

62 (90%)

62 (90%)

40 (58%)

0

 5.5–7.0 years

127

21 (16%)

37

34 (92%)

33 (89%)

23 (62%)

0

Tonsillitis (recorded from 2.5 years)

 0.5–1.0 year

 1.5–3.0 years

129

11 (8.5%)

12

12 (100%)

11 (92%)

9 (75%)

1 (8%)

 3.5–5.0 years

133

25 (19%)

31

24 (77%)

22 (71%)

21 (68%)

0

 5.5–7.0 years

127

10 (7.9%)

13

11 (85%)

11 (85%)

9 (69%)

0


* Percentages are relative to the total number of illnesses reported (may contain several reports from a single child). For example, between the ages of 5.5 and 7 years, 72 children reported 124 separate instances of respiratory tract infections; action was taken on 94 occasions (76% of 124). “Sought professional advice” included “saw the doctor/GP”, “went to the chemist” and “went to hospital/emergency”. “Gave medication” included prescription and non-prescription medications. “Other” included seeking advice from family and friends. † The numbers vary by condition because of variations in the number of interviews. ‡ Parents were not asked during the 6- and 12-month interviews about what actions were taken.

Received 24 November 2016, accepted 10 March 2017

  • Elizabeth J Comino1,2
  • Emma Elcombe2
  • Bin B Jalaludin3
  • Lynn A Kemp4
  • Darryl Wright5
  • Mark F Harris1

  • 1 Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW
  • 2 Centre for Health Equity Training, Research & Evaluation (CHETRE), Ingham Institute, University of New South Wales, Sydney, NSW
  • 3 Healthy People and Places Unit, South Western Sydney Local Health District, Sydney, NSW
  • 4 Western Sydney University, Penrith, NSW
  • 5 Tharawal Aboriginal Corporation, Sydney, NSW

Correspondence: e.comino@unsw.edu.au

Acknowledgements: 

We gratefully acknowledge the Tharawal people of southwest Sydney for their ongoing encouragement and enthusiastic support of our research. We also thank the parents and children who participated in this study; without their willingness to be involved, this study would not be possible. The support of the Tharawal Aboriginal Corporation, South West Sydney Local Health District, the University of New South Wales, and the NSW Aboriginal Health and Medical Research Council is also acknowledged. The Gudaga research team comprises a multidisciplinary team of Aboriginal and non-Aboriginal academic investigators and health service providers. We acknowledge their contribution to the development and implementation of the Gudaga Study, particularly the contributions of other project staff to this work, including the Aboriginal project officer Cheryl Jane Anderson, and Holly Mack and Ros Eames-Brown. The research was funded by project grants from the National Health and Medical Research Council (300430, 510171, and APP1023666) and Australian Research Council (DP120100828).

Competing interests:

No relevant disclosures.

  • 1. Anderson I, Robson B, Connolly M, et al. Indigenous and tribal peoples’ health (The Lancet-Lowitja Institute Global Collaboration): a population study. Lancet 2016; 388: 131-157.
  • 2. Eades SJ, Taylor B, Bailey S, et al. The health of urban Aboriginal people: insufficient data to close the gap. Med J Aust 2010; 193: 521-524. <MJA full text>
  • 3. Comino EJ, Craig P, Harris E, et al. The Gudaga Study: establishing an Aboriginal birth cohort in an urban community. Aust N Z J Public Health 2010; 34 Suppl 1: S9-S17.
  • 4. Comino EJ, Knight J, Grace R, et al. The Gudaga research program: a case study in undertaking research with an urban Aboriginal community. Aust Social Work 2016; 69: 443-455.
  • 5. Macklin J. Budget: Closing the gap between Indigenous and non-Indigenous Australians. Statement by the Minister for Families, Housing, Community Services and Indigenous Affairs, 13 May 2008. http://www.budget.gov.au/2008-09/content/ministerial_statements/download/indigenous.pdf (accessed Apr 2017).

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