MJA Practice Essential – Paediatric
13. Children in Australian society
Karen J Zwi FRACP, MRCP, MSc,
Richard L Henry MD, FRACP,
Karen J Zwi FRACP, MRCP, MSc
Senior Lecturer; and Community Paediatrician
School of Women's and Children's Health, University of New South Wales, and Sydney Children's Hospital, Sydney, NSW.
Search for more papers by this authorRichard L Henry MD, FRACP
Senior Associate Dean
Faculty of Medicine, University of New South Wales, Sydney, NSW.
Search for more papers by this authorKaren J Zwi FRACP, MRCP, MSc,
Richard L Henry MD, FRACP,
Karen J Zwi FRACP, MRCP, MSc
Senior Lecturer; and Community Paediatrician
School of Women's and Children's Health, University of New South Wales, and Sydney Children's Hospital, Sydney, NSW.
Search for more papers by this authorRichard L Henry MD, FRACP
Senior Associate Dean
Faculty of Medicine, University of New South Wales, Sydney, NSW.
Search for more papers by this authorAbstract
- Although children in Australia generally have good health, some alarming indicators of poor health and wellbeing exist, which are related to major socioeconomic discrepancies.
- The pathways connecting socioeconomic disadvantage to child health outcomes are complex and poorly understood.
- Reducing social disadvantage requires strategies beyond the health arena, involving political, moral, cultural and economic initiatives.
- Developing “social capital” — cohesion in communities, a sense of belonging and involvement in community affairs — may be a key strategy in improving health indicators.
- Overseas studies of early intervention and home visiting programs in early childhood have shown improvements in child health and development outcomes. Similar programs have been introduced in Australia and face considerable challenges in their widespread roll-out and evaluation.
- Health professionals need to develop practical ways to interact with community programs and thus improve social capital.
References
- 1Abello A, Harding A. The dynamics of child poverty in Australia. National Centre for Social and Economic Modelling (NATSEM). Canberra: University of Canberra, March 2004. (Discussion Paper No. 60.) Available at: www.natsem.canberra.edu.au/publications/papers/dps/dp60/dp60.pdf (accessed Nov 2004).
- 2 Australian Bureau of Statistics. Health of children. Canberra: ABS, 2004. (Catalogue No. 4829.0.) Available at: www.abs.gov.au/Ausstats/[email protected]/w2.1.1!OpenView&Start=1&Count=1000&Expand=18#18 (accessed Jul 2005).
- 3Al-Yaman F, Bryant M, Sargent H. Australia's children: their health and wellbeing 2002. Canberra: Australian Institute of Health and Welfare, 2002. (AIHW Catalogue No. PHE 36.) Available at: www.aihw.gov.au/publications/phe/ac02/ac02-c00.pdf (accessed Jul 2005).
- 4Sawyer MG, Arney FM, Baghurst PA, et al. The mental health of young people in Australia: key findings from the child and adolescent component of the National Survey of Mental Health and Well-being. Aust N Z J Psychiatry 2001; 35: 806–814. 11990891.
- 5 Australian Institute of Health and Welfare. Child protection Australia 2003-4. Child Welfare Series No. 36. Canberra: AIHW, 2005. (AIHW Catalogue No. CWS-24.) Available at: www.aihw.gov.au/publications/index.cfm/title/10095 (accessed Jul 2005).
- 6Davidson N, Skull S, Burgner D, et al. An issue of access: delivering equitable health care for newly arrived refugee children in Australia. J Paediatr Child Health 2004; 40: 569–575. 15367155.
- 7Draper G, Turrell G, Oldenburg B. Health inequalities in Australia: mortality differences by socioeconomic disadvantage. Health Inequalities Monitoring Series No. 1. Canberra: Australian Institute of Health and Welfare, 2005. (AIHW Catalogue No. PHE-55.) Available at: www.aihw.gov.au/publications/index.cfm/title/10041 (accessed Jul 2005).
- 8Marmot M. Economic and social determinants of disease. Bull World Health Organ 2001; 79: 988–989. 11693982.
- 9Draper G, Turrell G, Oldenburg B. Health inequalities in Australia: mortality. Health Inequalities Monitoring Series No 1. Canberra: Queensland University of Technology and the Australian Institute of Health and Welfare, 2004. (AIHW Catalogue No. PHE-55.) Available at: www.aihw.gov.au/publications/index.cfm/title/10041 (accessed Jul 2005).
- 10 The Royal Australasian College of Physicians. Inequity and health — a call to action. Policy statement 2005. Sydney: RACP, 2005. Available at: www.racp.edu.au/hpu/policy/inequity/index.htm (accessed Jul 2005).
- 11McCracken K. What if New South Wales was more equal? NSW Public Health Bull 2002; 13: 123–127.
- 12 Australian Bureau of Statistics. Measuring Australia's progress 2002. Canberra: ABS, 2004. (Catalogue No. 1370.0.) Available at: www.abs.gov.au/Ausstats/[email protected]/0/3eba282aaaea6cdbca256b90007da224?OpenDocument (accessed Nov 2004).
- 13Traynor VJ, Rose VK, Harris E, et al. What role for Divisions of General Practice in addressing health inequity within their communities? [letter]. Med J Aust 2000; 173: 79. 10937033.
10.5694/j.1326-5377.2000.tb139259.x Google Scholar
- 14Harris MF, Mercer PJT. Reactive or preventive: the role of general practice in achieving a healthier Australia. Med J Aust 2001; 175: 92–93. . 11556427
- 15Cyander M, Frost B. Mechanisms of brain development: sculpting by the physical and social environment. In: D Keating, C Hertzman, editors. Children of the information age: developmental health as the wealth of nations. Chapter 8. New York: Guilford Press, 1999.
- 16Sainsbury P, Harris E. Understanding the causes of health inequalities: incorporating personal, local, national, and global perspectives [guest editorial]. NSW Public Health Bull 2002; 13: 121–123.
- 17Elliman D, Hall D. Health for all children, 4th edition. Oxford: Oxford University Press, 2003.
- 18Waterston T, Alperstein G, Stewart-Brown S. Social capital: a key factor in child health inequalities. Arch Dis Child 2004; 89: 456–459. 15102639.
- 19Alperstein G, Raman S. Promoting mental health and emotional well-being among children and youth: a role for community child health? Child Care Health Dev 2003; 29: 269–274. 12823331.
- 20Attree P. Growing up in disadvantage: a systematic review of the qualitative evidence. Child Care Health Dev 2004; 30: 679–899. 15527478.
- 21Ring IT, Firman D. Reducing indigenous mortality in Australia: lessons learnt from other countries. Med J Aust 1998; 169: 528–533. http://www.mja.com.au/public/issues/nov16/ring/ring.html; 9861910.
- 22Henry BR, Houston S, Mooney G. Institutional racism in Australian healthcare: a plea for decency. Med J Aust 2004; 180: 517–520. /journal/2004/180/10/institutional-racism-australian-healthcare-plea-decency. 15139829
- 23Stewart-Brown S. Legislation on smacking [editorial]. BMJ 2004; 329: 1195–1196. 15550403.
- 24Webb E. Discrimination against children. Arch Dis Child 2004; 89: 804–808. 15321851.
- 25Sloper P, Lightfoot J. Involving disabled and chronically ill children and young people in health service development. Child Care Health Dev 2003; 29: 15–20. 12534563.
- 26 NSW Commission for Children & Young People. What we're doing. Ask the children. Available at: www.kids.nsw.gov.au/ourwork/ask.html (accessed Mar 2005).
- 27Sanz EJ. Concordance and children's use of medicines. BMJ 2003; 327: 858–860. 14551105.
- 28Pridmore P, Stephens D. Children as partners for health: a critical review of the child-to-child approach. London: Zed Books, 2000.
- 29 Centre for Community Child Health. A review of early childhood literature. Prepared for the Department of Family and Community Services as a background paper for the National Families Strategy. Canberra: Department of Family and Community Services, 2000. Available at: www.facs.gov.au/internet/facsinternet.nsf/vIA/families/$file/early_childhood.pdf (accessed Jul 2005).
- 30 National Public Health Partnership. Work program. Available at: www.nphp.gov.au/ (accessed Jul 2005).
- 31Vinson V, Baldry E. Spatial clustering of child maltreatment: are micro-social environments involved? Canberra: Australian Institute of Criminology. Trends and Issues in Crime and Criminal Justice, 1999: 1–6. Available at: www.aic.gov.au/conferences/children/baldry.html (accessed Jul 2005).
- 32Morrell S, Page A, Taylor R. Unemployment and youth suicide. Economic and Labour Relations Review 2001; 12: 4–17.
10.1177/103530460101200102 Google Scholar
- 33 Australian Government. National Drug Strategic Framework. Available at: www.nationaldrugstrategy.gov.au/framework/ (accessed Jul 2005).
- 34 Eat Well Australia: an agenda for action for public health nutrition, 2000-2010. Available at: www.nphp.gov.au/publications/signal/eatwell1.pdf (accessed Jul 2005).
- 35 National ATSI Nutrition Strategy and Action Plan. Available at: www.nphp.gov.au/workprog/signal/nutstrat.htm (accessed Jul 2005).
- 36 National Strategic Framework for Aboriginal and Torres Strait Islander Health. Available at: www.health.gov.au/internet/wcms/publishing.nsf/Content/health-oatsih-pubs-healthstrategy.htm (accessed Jul 2005).
- 37 Draft National Injury Prevention Plan: 2004 Onwards. Available at: www.nphp.gov.au/workprog/sipp/documents/draftnipp_190804.pdf (accessed Jul 2005).
- 38 Towards the Development of a National Agenda for Early Childhood. Available at: www.facs.gov.au/internet/facsinternet.nsf/family/early_childhood.htm (accessed Jul 2005).
- 39 Immunise Australia Program. Available at: www.immunise.health.gov.au (accessed Nov 2004).
- 40 National Asthma Council. Available at: www.nationalasthma.org.au (accessed Jul 2005).
- 41Healthy Weight 2008 — Australia's Future. The national action agenda for children and young people and their families. Available at: www.healthyactive.gov.au/docs/healthy_weight08.pdf (accessed Jul 2005).
- 42 National Mental Health Plan 2003-2008. Available at: www.health.gov.au/internet/wcms/publishing.nsf/Content/mentalhealth-mhinfo-nmhs-2003.htm (accessed Jul 2005).
- 43Stanley F. From Susser's causal paradigms to social justice in Australia? Int J Epidemiol 2002; 31: 40–45. 11914291.
- 44 Stronger Families and Communities Strategy 2004-2008: communities for children. Available at: http://www.facs.gov.au/internet/facsinternet.nsf/aboutfacs/programs/sfsc-communities_for_children_invitation.htm (accessed Mar 2005).
- 45 Cabinet Office. Families First. A NSW Government initiative. A support network for raising children. Sydney: Office of Children and Young People, 1999. Available at: www.familiesfirst.nsw.gov.au (accessed Jul 2005).
- 46 Families First Outcomes Evaluation Framework. For the Cabinet Office of New South Wales. University of New South Wales Research Consortium, March 2002. Available at: www.sprc.unsw.edu.au/reports/Families_First_Outcomes_EvalFramework.pdf (accessed Nov 2004).
- 47Olds DL, Eckenrode J, Henderson CR, et al. Long term effects of home visitation on maternal life course and child abuse and neglect: fifteen-year follow-up of a randomized trial. JAMA 1997; 278: 637–643. 9272895.
- 48Olds DL, Robinson J, O'Brien R, et al. Home visiting by paraprofessionals and by nurses: a randomized controlled trial. Pediatrics 2002; 110: 486–496. 12205249.
- 49Boocock SS. Early childhood programs in other nations — goals and outcomes. Future Child 1995; 5: 94–114. 8835516.
- 50 The High/Scope Educational Research Foundation. Lifetime Effects: the High/Scope Perry Preschool Study Through Age 40. Available at: www.highscope.org/Research/PerryProject/perrymain.htm (accessed Jul 2005).
- 51Sanders MR, Markie-Dadds C, Tully LA, Bor W. The triple P – positive parenting program: a comparison of enhanced, standard and self-directed behavioral family intervention for parents of children with early onset conduct problems. J Consult Clin Psychol 2000; 68: 624–640. 10965638.
- 52Gilliam WS, Zigler EF. A critical meta-analysis of all evaluations of state-funded preschool from 1997 to 1998: implications for policy, service delivery and program evaluation. Yale University Child Study Center. Early Child Res Q 2001; 15: 441–473.
- 53Barnett WS, Hustedt JT. Head Start's lasting benefits. Infants Young Child 2005; 18: 16–24.
- 54Olds D, Pettitt L, Hiatt S, et al (author reply to: Home visiting by Guterman NB, Anisfeld E, McCord M). Pediatrics 2003; 111: 1491–1494. 12777576.
- 55Meltzer H, Gatward R, Goodman R, Ford T. Mental health of children and adolescents in Great Britain. Int Rev Psychiatry 2003; 15: 185–187. 12745331.
- 56Roberts I, Kramer MS, Suissa S. Does home visiting prevent childhood injury? A systematic review of randomized controlled trials. BMJ 1996; 312: 29–33. 8555855.
- 57Resnick MD, Bearman PS, Blum RW, et al. Protecting adolescents from harm: findings from the National Longitudinal Study on Adolescent Health. JAMA 1997; 278: 823–832. 9293990.
- 58 National Health and Medical Research Council. How to use the evidence: assessment and application of scientific evidence. Handbook series on preparing clinical practice guidelines. Table 1.3: Designation of levels of evidence. Canberra: NHMRC, February 2000: 8. Available at: http://www.nhmrc.gov.au/publications/synopses/cp65syn.htm (accessed Jun 2005)
