“ Aboriginal and Torres Strait Islander children in Australia continue to face significant disadvantage across a range of domains relevant to their rights and wellbeing, including in relation to health and education outcomes, discrimination, exposure to family violence, and overrepresentation in child protection and youth justice systems.
Most recommendations made throughout this report apply to all children living in Australia, including Aboriginal and Torres Strait Islander children.
However, given the significant disadvantage experienced by Aboriginal and Torres Strait Islander children, this chapter (12 ) contains recommendations which are specific to their circumstances.”
Extract from Australia’s first Children’s Commissioner, Megan Mitchell who today launched her final report – one of the most comprehensive assessments of children’s rights ever produced in Australia.
See Pages 256 to 271 Aboriginal and Torres Strait Islander children or read Health extract below
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The report makes clear that the mental health of Australian children is not being cared for sufficiently and that Governments must do more to ensure children’s wellbeing.
Commissioner Mitchell said: “Not only do children require better access to mental health services, but they also need earlier intervention and higher quality care.”
The report calls on the Federal Government to develop a National Plan for Child Wellbeing and to appoint a Cabinet level Minister with responsibility for children’s issues at the national level.
National data shows one in seven children aged four to 17 were diagnosed with mental health disorders in a 12-month period, and rates of suicide and self-harm are increasing.
Suicide was the leading cause of death for children aged five to 17 in 2017, and Indigenous children accounted for almost 20% of all child suicides. There were 35,997 hospital admissions for self-harm in the ten years to 2017.
Other urgent concerns highlighted in the report include that, from 2013 to 2017 there was a 27% increase in reported substantiations of child abuse and neglect. The number of children in out-of- home care has increased by 18% over the last five years. Also, approximately 17% of children under the age of 15 live in poverty.
Commissioner Mitchell said: “The increase in neglect and abuse of children is a particularly worrying trend, as is the increase in children living in out of home care. We must do better.”
The report shows children in vulnerable situations suffer most through a lack of government focus. This includes Indigenous children, children with a disability, those from culturally and linguistically diverse backgrounds, and LGBTI children.
Commissioner Mitchell said: “There is a gap between the rights we have promised vulnerable children and how those rights are implemented. It is vital that we address the gap in order to better protect children’s rights.”
Attorney General Christian Porter tabled the report in Parliament on Thursday, 6 February.
Aboriginal and Torres Strait Islander peoples are the oldest civilisation on earth, extending back over 65,000 years. Aboriginal and Torres Strait Islander peoples are vastly diverse in culture, language and in spiritual beliefs.[i] At the time of colonisation, there were over 500 separate Aboriginal and Torres Strait Islander nations, over 250 languages spoken, and 800 dialectical varieties.[ii]
In its Concluding Observations (2019), the Committee on the Rights of the Child urged the Australian Government to ensure that Aboriginal and Torres Strait Islander children and their communities are meaningfully involved in the planning, implementation and evaluation of policies concerning them.[iii]
Health Inequality
The disparity in health status between Aboriginal and Torres Strait Islander children and their non-Indigenous counterparts remains a crucial human rights issue within Australia.[iv] This is despite the investment in Closing the Gap—a national strategy to reduce health and related inequalities for Aboriginal and Torres Strait Islander peoples, which has been in place since 2008.
In its Concluding Observations (2019), the Committee on the Rights of the Child urged the Australian Government to promptly address the disparities in the health status of Aboriginal and Torres Strait Islander children.[v]
The Australian Institute of Health and Welfare (AIHW) reported in 2018 that there are major gaps in data on important health issues affecting Aboriginal and Torres Strait Islander children.[vi] This includes culturally-appropriate data that measures wellbeing, treatment of mental health conditions, sexual health (including use of contraception and sexual health services), and use of primary health care services.[vii]
It pointed out that data for Aboriginal and Torres Strait Islander children aged 10–14 years is limited, compared to those aged 15–19 and 20–24, as both the Australian Aboriginal and Torres Strait Islander People Health Survey 2012–13 and the National Aboriginal and Torres Strait Islander Health Survey 2014–15 were more focused on adults.[viii]
In 2018–19, the National Aboriginal and Torres Strait Islander Health Survey (NATSIHS) has, for the first time, included up to two child members of each selected household aged 0 to 17.[ix] The results from NATSIHS 2018–19 will be available in late 2019.[x] The inclusion of those aged 0 to 17 is a welcome addition.
The Australian Human Rights Commission (the Commission) also welcomes Mayi Kuwayu: The National Study of Aboriginal and Torres Strait Islander Wellbeing and hopes that it will collect data on children aged 0–17.[xi]
Child mortality
Since the Closing the Gap target baseline was set in 2008, Aboriginal and Torres Strait Islander child mortality rates have declined by 10%.[xii]
However, the gap between Aboriginal and Torres Strait Islander children and non-Indigenous children has not narrowed, because the non-Indigenous rate has declined at a faster rate.[xiii] It is for this reason that measuring the gap is not always helpful.
Aboriginal and Torres Strait Islander infants are three times as likely as non-Indigenous infants to die between one and six months of age, and twice as likely to die for all other age categories except for one day to one week old, where the risks are equivalent.[xiv]
Aboriginal and Torres Strait Islander children are 2.1 times more likely to die before their fifth birthday compared to their non-Indigenous peers.[xv]
Ear disease
Ear disease is a significant health issue facing Aboriginal and Torres Strait Islander children. Aboriginal and Torres Strait Islander children aged 0–14 are 2.9 times more likely to have long-term ear or hearing problems compared with non-Indigenous children.[xvi]
Limited access to primary health care for Aboriginal and Torres Strait Islander children can result in delayed diagnosis, treatment and management of health conditions.
Long-term ear or hearing problems are linked to delays in speech and language development.[xvii] These can have lasting impacts on educational and workforce outcomes.
The AIHW pointed out in its report on Australia’s Health 2018 that there is no national statistical profile of ear disease and associated hearing loss for Aboriginal and Torres Strait children based on diagnostic assessment. It argued that, without good-quality surveillance, it is difficult to understand the size and key determinants associated with the hearing problem.[xviii]
Obesity
The most recent data available from the AIHW shows that in 2012–13, 30% of Aboriginal and Torres Strait Islander children aged 2–14 were overweight or obese, compared with 25% of their non-Indigenous counterparts.[xix]
One in five (20%) Aboriginal and Torres Strait Islander children aged 2–14 were overweight and one in ten (10%) were obese. At age 15–17, 35% were overweight or obese. About one in five (21%) were overweight, while about one in seven (14%) were obese.[xx]
Of Aboriginal and Torres Strait Islander boys aged 2–14, 18% were overweight and 10% were obese. At age 15–17, 21% were overweight and 17% were obese. Among girls aged 2–14 and those aged 15–17, 21% were overweight and 11% were obese.[xxi]
Children with obesity are more likely to be obese as adults and have an ‘increased risk of developing both short and long-term health conditions, such as Type 2 diabetes and cardiovascular disease’.[xxii]
Mental health
The likelihood of probable serious mental illness has been found to be consistently higher among Aboriginal and Torres Strait Islander children compared to their non-Indigenous peers.[xxiii]
National Coronial Information System data show that Aboriginal and Torres Strait Islander children aged 4–17 accounted for 19.2% of all child deaths due to suicide between 2007–15. [xxiv] Specifically, there were:
- one to three deaths in the 4–9 year age range
- one to three deaths in the 10–11 year age range
- 12 deaths in the 12–13 year age range
- 45 deaths in the 14–15 year age range
- 62 deaths in the 16–17 year age range. [xxv]
The AIHW collects hospital data on intentional self-harm. Children who engage in intentional self-harm, with or without suicidal intent, often only experience hospitalisation because they cannot manage their injury without medical intervention. Approximately 8% of hospitalisations for intentional self-harm between 2007–08 and 2016–17 involved Aboriginal and Torres Strait Islander children.[xxvi] Of the 2,928 hospitalisations for Aboriginal and Torres Strait Islander children, 17 (<1%) were for children aged 3–9, 859 (29%) were for children aged 3–14 and 2,052 (70%) were for children aged 15–17.[xxvii]
In its Concluding Observations (2019), the Committee on the Rights of the Child called on the Australian Government to prioritise mental health service delivery to Aboriginal and Torres Strait Islander children, including addressing the underlying causes of children’s suicide and poor mental health.[xxviii]
Sexual health
The fertility rates of Aboriginal and Torres Strait Islander teenagers are approximately 5.8 times the rate for non-Indigenous teenagers (52 per 1,000 females compared to nine per 1,000 females).[xxix]
The Committee on the Rights of the Child in its Concluding Observations (2019) specifically called for the Australian Government to strengthen its measures to prevent teenage pregnancies among Aboriginal and Torres Strait Islander girls, including by providing culturally sensitive and confidential medical advice and services. [xxx]
The levels of sexually transmitted infections (STIs) in children, especially those from Aboriginal and Torres Strait Islander communities, are particularly concerning. The rates of infection within these communities are recognised as being the highest of any identifiable population in Australia.[xxxi]
For example, 2016 data from the Northern Territory, shows there were 161 notified cases of chlamydia in Aboriginal children under 16 years compared to three cases in non-Indigenous children; 186 notified cases of gonorrhoea in Aboriginal children under 16 years compared to one case in a non-Indigenous child; 26 notified cases of syphilis in Aboriginal children under 16 years with no notified cases for non-Indigenous children; and 240 notified cases of trichomoniasis in Aboriginal children under 16 years with no notified cases for non-Indigenous children.[xxxii]
Aboriginal Medical Services play a crucial role in providing health services for Aboriginal and Torres Strait Islander children. Research has suggested that ‘one of the most productive ways forward with regards to improving knowledge and increasing safe sex practice among young Aboriginal people is through community-controlled organisations’.[xxxiii]
[i] Reconciliation Australia, Share Our Pride, Our shared history (2019) <http://shareourpride.reconciliation.org.au/sections/our-shared-history/>.
[ii] Australian Institute of Aboriginal and Torres Strait Islander Studies, Indigenous Australian Languages, 2019 (14 March 2019) <https://aiatsis.gov.au/explore/articles/indigenous-australian-languages>.
[iii] United Nations Committee on the Rights of the Child, Concluding Observations on the Combined Fifth and Sixth Periodic Reports of Australia, 82nd Sess, UN Doc CRC/C/AUS/CO/5-6 (30 September 2019) para 46(a).
[iv] Australian Institute of Health and Welfare, Trends in Indigenous Mortality and Life Expectancy 2001–2015 (Report, 1 December 2017) vii.
[v] United Nations Committee on the Rights of the Child, Concluding Observations on the Combined Fifth and Sixth Periodic Reports of Australia, 82nd Sess, UN Doc CRC/C/AUS/CO/5-6 (30 September 2019) para 36(a).
[vi] Australian Institute of Health and Welfare, Aboriginal and Torres Strait Islander adolescent and youth health and wellbeing 2018 (Report, 2018) xii.
[vii] Australian Institute of Health and Welfare, Aboriginal and Torres Strait Islander adolescent and youth health and wellbeing 2018 (Report, 2018) xii.
[viii] Australian Institute of Health and Welfare, Aboriginal and Torres Strait Islander adolescent and youth health and wellbeing 2018 (Report, 2018) 6.
[ix] Australian Bureau of Statistics, National Aboriginal and Torres Strait Islander Health Survey (2018) <www.abs.gov.au/websitedbs/D3310114.nsf/Home/Survey+Participant+Information+-+National+Aboriginal+and+Torres+Strait+Islander+Health+Survey>.
[x] Australian Bureau of Statistics, National Aboriginal and Torres Strait Islander Health Survey (2018) <www.abs.gov.au/websitedbs/D3310114.nsf/Home/Survey+Participant+Information+-+National+Aboriginal+and+Torres+Strait+Islander+Health+Survey>.
[xi] Mayi Kuwayu: The National Study of Aboriginal and Torres Strait Islander Wellbeing (2019) <https://mkstudy.com.au/>.
[xii] Department of Prime Minister and Cabinet, Closing the Gap Report: Prime Minister’s Report 2019 (Report, 2019) 10 <https://ctgreport.niaa.gov.au/>.
[xiii] Department of Prime Minister and Cabinet, Closing the Gap Report: Prime Minister’s Report 2019 (2019) 10 <https://ctgreport.niaa.gov.au/>.
[xiv] Australian Institute of Health and Welfare, Australia’s health 2018 (Report, 2018) 317 <www.aihw.gov.au/getmedia/7c42913d-295f-4bc9-9c24-4e44eff4a04a/aihw-aus-221.pdf.aspx?inline=true>.
[xv] Australian Institute of Health and Welfare, Australia’s health 2018 (Report, 2018) 31 <www.aihw.gov.au/reports/australias-health/australias-health-2018/contents/table-of-contents>.
[xvi] Australian Institute of Health and Welfare, Australia’s health 2018 (Report, 2018) 322 <www.aihw.gov.au/reports/australias-health/australias-health-2018/contents/table-of-contents>.
[xvii] Australian Institute of Health and Welfare, Australia’s health 2018 (Report, 2018) 321 <www.aihw.gov.au/reports/australias-health/australias-health-2018/contents/table-of-contents>.
[xviii] Australian Institute of Health and Welfare, Australia’s health 2018 (Report, 2018) 329 <www.aihw.gov.au/reports/australias-health/australias-health-2018/contents/table-of-contents>.
[xix] Australian Institute of Health and Welfare, A Picture of Overweight and Obesity in Australia 2017 (Report, 2017) 14 <https://www.aihw.gov.au/getmedia/172fba28-785e-4a08-ab37-2da3bbae40b8/aihw-phe-216.pdf.aspx?inline=true>.
[xx] Australian Institute of Health and Welfare, Overweight and obesity: an interactive insight: A web report (19 July 2019) <www.aihw.gov.au/reports-data/behaviours-risk-factors/overweight-obesity/overview>.
[xxi] Australian Institute of Health and Welfare, Overweight and obesity: an interactive insight: A web report (19 July 2019) <www.aihw.gov.au/reports-data/behaviours-risk-factors/overweight-obesity/overview>.
[xxii] Australian Bureau of Statistics, Children Who are Overweight or Obese (2009) 1 <www.ausstats.abs.gov.au/ausstats/subscriber.nsf/LookupAttach/4102.0Publication24.09.093/$File/41020_Childhoodobesity.pdf>.
[xxiii] Mission Australia, Youth Survey Report 2017 (2017) 4 <www.missionaustralia.com.au/publications/research/young-people>.
[xxiv] National Coronial Information System. Report prepared for the National Children’s Commissioner on Intentional Self-Harm Fatalities of Persons under 18 in Australia 2007–2015. Report prepared on 07/02/2018.
[xxv] National Coronial Information System. Report prepared for the National Children’s Commissioner on Intentional Self-Harm Fatalities of Persons under 18 in Australia 2007–2015. Report prepared on 07/02/2018.
[xxvi] Australian Institute of Health and Welfare, Data request Specification on self-harm prepared for the Australian Human Rights Commission 2007-2008 to 2016-17 (2018).
[xxvii] Australian Institute of Health and Welfare, Data request Specification on self-harm prepared for the Australian Human Rights Commission 2007-2008 to 2016-17 (2018).
[xxviii] United Nations Committee on the Rights of the Child, Concluding Observations on the Combined Fifth and Sixth Periodic Reports of Australia, 82nd Sess, UN Doc CRC/C/AUS/CO/5-6 (30 September 2019) para 38(a), (b).
[xxix] Australian Institute of Health and Welfare, Children’s Headline Indicators: Teenage Births (2018) <www.aihw.gov.au/reports/children-youth/childrens-headline-indicators/contents/indicator-14>.
[xxx] United Nations Committee on the Rights of the Child, Concluding Observations on the Combined Fifth and Sixth Periodic Reports of Australia, 82nd Sess, UN Doc CRC/C/AUS/CO/5-6 (30 September 2019) para 39(a).
[xxxi] Royal Commission and Board of Inquiry into the Protection and Detention of Children in the Northern Territory (Final Report, 2017) vol 3b, 82.
[xxxii] Royal Commission and Board of Inquiry into the Protection and Detention of Children in the Northern Territory (Final Report, 2017) vol 3b, 82.
[xxxiii] The Kirby Institute, Sexual Health and Relationships in Young Aboriginal and Torres Strait Islander People: Results from the first national study assessing knowledge, risk practices and health service use in relation to sexually transmitted infections and blood borne viruses (Report, 2014) 54.