Early childhood key to closing health gap: AMA

 

Robust and properly targeted investment in the health and development of Indigenous children in their early years is “one of the keys” to breaking the cycle of ill-health and premature death afflicting Aboriginal and Torres Strait Islander peoples, according to AMA President, Dr Steve Hambleton.

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Dr Hambleton told a recent Health Conference that improving early childhood health should be a priority in efforts to close the gap in life expectancy and well being between Indigenous people and the rest of the community.

In his speech, the AMA President paid tribute to pioneering Indigenous health leader Puggy Hunter and his work to promote partnerships and information sharing in primary health care.

In this spirit, Dr Hambleton said there was already good evidence about what would work to boost the health of Aboriginal and Torres Strait Island children in their crucial formative years, and what was needed was the political will to make a “substantial funding commitment” to these measures.

“We know that robust and properly targeted and sustained investment in healthy early childhood development is one of the keys to breaking the cycle of ill-health and premature death,” Dr Hambleton told the conference.

He said that to be effective, efforts to improve child health had to encompass the conditions in which they live and develop, including the family environment, living conditions, access to culturally appropriate health care and opportunities for education and work.

“The timing for this investment is crucial. It needs to be in the early years, where a healthy childhood can lay the foundation for resilience [later in life],” the AMA President said.

Dr Hambleton said health at infancy was a “strong indicator” of how people would fare in later life, pointing out that the life of an Indigenous person born in the middle of the last decade was likely to be up to 11 and a half years shorter than that of a non-Indigenous person born at the same time.

He said Indigenous babies were twice as likely to die as those in the rest of the population, most commonly from complications during pregnancy or birth, as well as respiratory and cardiovascular disorders suffered just before or after delivery.

The AMA President told the conference that a number of factors contributed to these problems, including smoking, drinking and poor diet among pregnant women.

But Dr Hambleton said improving early Indigenous childhood health also involved addressing social problems that undermined well being, including family poverty, poor housing, low educational attainment and emotional stress.

He said there was “decades of evidence” that a number of early childhood programs were effective in helping protect the health of infants, particularly Nurse Home Visiting maternal health and Abecedarian programs.

For every dollar spent on regular home visits to mothers by registered nurses, $5.70 was saving in future health and social costs, Dr Hambleton said, while Abecedarian programs had been shown to be effective in helping disadvantaged children attain higher levels of education and lower instances of risky behaviour.

“It is true that neither of these successful long-term interventions is cheap,” he said. “They are quite costly to implement where they would be needed in Indigenous communities. [But], their success is manifest, and they will bring about health benefits and savings that far exceed their cost.”

Dr Hambleton said that although some progress had been made in improving Indigenous health, outcomes still remained very poor compared with the broader community, and warned that the current $1.6 billion Council of Australian Governments National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes was due to expire next year.

“There is a need to renew [it] with comparable funding, and build on the groundwork that has been established,” he said.

To help maintain the momentum of effort, the AMA plans to release a major report on early Indigenous childhood health and development next year.

Dr Hambleton said the AMA’s 2013 Aboriginal and Torres Strait Islander Health report card will “highlight the importance of healthy early development, and the role that tried and true interventions can play, [including] recommendations about how governments ought to be supporting these interventions more”.

AR