NACCHO Aboriginal Torres Strait Islander Children’s Health : Download @AusHumanRights Children’s Rights Report 2019 — In Their Own Right : Our kids continue to face significant disadvantage across a range of domains

“ 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

Download full report 300 + Pages 

childrensrightsreport_2019_ahrc

Read over 380 Aboriginal Children’s Health articles published by NACCHO over the past 8 years

AHRC Press Release 

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 Gapa 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/&gt;.

[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&gt;.

[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/&gt;.

[xii] Department of Prime Minister and Cabinet, Closing the Gap Report: Prime Minister’s Report 2019 (Report, 2019) 10 <https://ctgreport.niaa.gov.au/&gt;.

[xiii] Department of Prime Minister and Cabinet, Closing the Gap Report: Prime Minister’s Report 2019 (2019) 10 <https://ctgreport.niaa.gov.au/&gt;.

[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&gt;.

[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.

NACCHO Aboriginal Children’s #FirstNationsEarlyYears #EarlyChildhood Health : NACCHO joins SNAICC #ECA and 30 other Organisations calling to make early learning a priority for Aboriginal and Torres Strait Islander children #RefreshtheCTGrefresh

We’ve known for several years that 15,000 additional early learning places are needed for Aboriginal and Torres Strait Islander children’s enrolment to be level with the general population.”

Geraldine Atkinson, SNAICC Deputy Chairperson

This is a problem we can solve – it requires the political will to make sure that every single First Nations child has access to, and participates in, quality early learning for at least three days per week in the two years before school.”

Samantha Page, ECA CEO

Download Position Paper 

SNAICC-ECA-Early-Years-Position-Paper-

Download Discussion Paper 

SNAICC-ECA-Discussion-Paper-

Read over 350 Aboriginal Children’s Health articles published by NACCHO in the past 7 years

More than thirty leading child welfare, education and research organisations have endorsed a new call by Early Childhood Australia (ECA) and SNAICC – National Voice for our Children to ensure all Aboriginal and Torres Strait Islander children receive quality early learning and family support.

Published today, the joint position paper, Working Together to Ensure Equality for Aboriginal and Torres Strait Islander Children in the Early Years, highlights the key issues that impede First Nations children from accessing early childhood education and care (ECEC), while further providing recommendations for improving outcomes.

The data we have tells us that our children are half as likely to attend a Child Care Benefit approved early childhood service than non-indigenous children.

Everyone who cares about child welfare in Australia is concerned that too many children are starting school with developmental vulnerability, and that two out of five Aboriginal and Torres Strait Islander children are vulnerable when they start school; that’s twice the rate of vulnerability overall.

The most important thing for our children to thrive is that we need ongoing support for culturally appropriate, community-controlled services, and help to improve the quality of those services and professional development for their staff.

“We can see from the great results in high-quality Aboriginal Child and Family Centres, that families feel welcome, the children love to come, and they make a good transition to school.”

– Geraldine Atkinson, SNAICC Deputy Chairperson

Children and families are already benefitting from evidence-based, targeted family support services, like Families as First Teachers, Home Instruction for Parents of Preschool Youngsters (HIPPY), Parents as Teachers (PAT) and Best Start (in WA).

“We want to see all First Nations families get this vital support in the early years because supporting parents in the home environment is as important as access to early learning services to improve outcomes for children.”

– Samantha Page, ECA CEO

The joint position paper by ECA and SNAICC urges the Commonwealth Government to work alongside state and territory governments to take these actions:

  1. Establish new early childhood development targets to close the gap in the AEDC domains by 2030, and an accompanying strategy—through the Closing the Gap refresh
  2. Commit to permanently fund universal access to high-quality early education for three- and four-year-olds, including additional funding to ensure that Aboriginal and Torres Strait Islander children get access to a minimum of three days per week of high-quality preschool, with bachelor-qualified teachers
  3. Invest in quality Aboriginal and Torres Strait Islander community-controlled integrated early years services, through a specific early education program, with clear targets to increase coverage in areas of high Aboriginal and Torres Strait Islander population, and high levels of disadvantage.

Further recommendations include:

  • COAG to fund a targeted program to support evidence-informed, culturally safe, integrated early childhood and family-focused programs, across the nurturing care spectrum, in early education and care services that work with high numbers of Aboriginal and Torres Strait Islander children.

The paper and its recommendations are endorsed by peak bodies, children‘s education and care service organisations and major children’s organisations who all that support the rights of Aboriginal and Torres Strait Islander children including: Save the Children, National Aboriginal Community Controlled Health Organisation (NACCHO); UNICEF, Brotherhood of St Laurence; Australian Council of Social Services (ACOSS); Murdoch Children’s Research Institute; Queensland Aboriginal and Torres Strait Islander Child Protection Peak (QATSICPP); Victorian Aboriginal Child Care Agency (VACCA) and many more.

See the full list of endorsing organisations in the position paper.

The broad range of support for these recommendations shows the high level of agreement and concern that action needs to be taken to make sure that Australia improves our support for First Nations children to give them the best start in life.

NACCHO #Aboriginal Health and #Immunisation @AIHW reports Aboriginal children aged 5 national immunisation rate of 94.6%

 ” Aboriginal and Torres Strait Islander people suffer a disproportionate burden from communicable diseases (diseases that can be transmitted from person to person), with rates of hospitalisation and illness due to these conditions many times higher than other Australians.1

Part 2  below presents results for children who were identified as Aboriginal and/or Torres Strait Islander on the AIR. “

 In 2015–16, Aboriginal and Torres Strait Islander children aged 5 had an even higher national immunisation rate of 94.6%. However, there was wider variation across PHN areas, ranging from 98.8% in the Gold Coast (Qld) to 89.4% in Western Victoria.”

Download Healthy Communities:

AIHW_HC_Report_Imm_Rates_June_2017

See Previous NACCHO Aboriginal Health and #WorldImmunisationWeek : @healthgovau Vaccination for our Mob

Part 1 Overview MORE INFO HERE

Immunisation is a safe and effective way to protect children from harmful infectious diseases and at the population level, prevent the spread of these diseases amongst the community.

Australia has generally high immunisation rates which have increased steadily over time, but rates continue to lag in some local areas.

This report focuses on local area immunisation rates for children aged 5 and shows changes in immunisation rates over time. It also presents 2015–16 immunisation rates for all children and Aboriginal and Torres Strait Islander children aged 1, 2 and 5.

Results are presented for the 31 Primary Health Network (PHN) areas. Where possible they are broken down into smaller geographic areas, including for more than 300 smaller areas and across Australian postcodes.

Further detailed rates are available in the downloadable Excel sheet and a new interactive web tool allows users to compare results over time by geography and age group.

This local-level information assists professionals to use their knowledge and context for their area, to target areas in need and develop effective local strategies for improvement.

The report finds:

  • Since 2011–12, childhood immunisation rates have improved nationally and across smaller areas, for all children and for Aboriginal and Torres Strait Islander children. Variation in rates still exists across local areas, however the gap between those areas with the highest and lowest rates is diminishing
  • Nationally 92.9% of all children aged 5 were immunised in 2015–16. All PHN areas achieved an immunisation rate of 90% or more, ranging from 96.1% in Western NSW to 90.3% in North Coast (NSW).

Summary

In 2015–16, childhood immunisation rates continued to improve nationally and in most local areas. Although rates vary across local areas, the gap in rates between the highest and lowest areas is diminishing.

This report focuses on immunisation rates for 5 year olds and presents results since 2011–12. It also provides the latest information for 1, 2 and 5 year olds for Australia’s 31 Primary Health Network (PHN) areas and smaller local areas.

From 2011–12 to 2015–16, there were notable improvements in rates for fully immunised 5 year olds. National rates increased from 90.0% to 92.9%. Rates increased for PHN areas too, as all areas reached rates above 90% in 2015–16.

Rates in smaller local areas (Statistical Areas Level 3, or SA3s) have also improved. In 2015–16, 282 of the 325 local areas had rates of fully immunised 5 year olds greater than or equal to 90%. This is up from 2011–12 when only 174 areas had rates in this range. Further, the difference in rates between the highest and lowest areas has decreased over time (Figure 1).

In 2015–16, the rate of fully immunised children varied across PHN areas for the three age groups:

  • 1 year olds – 95.0% to 89.8% (national rate 93.0%)
  • 2 year olds – 93.2% to 87.2% (national rate 90.7%)
  • 5 year olds – 96.1% to 90.3% (national rate 92.9%).

Part 2 Aboriginal and Torres Strait Islander children

Aboriginal and Torres Strait Islander people suffer a disproportionate burden from communicable diseases (diseases that can be transmitted from person to person), with rates of hospitalisation and illness due to these conditions many times higher than other Australians.1

This section presents results for children who were identified as Aboriginal and/or Torres Strait Islander on the AIR. These data are based on Medicare enrolment records.

For Aboriginal and Torres Strait Islander children, national immunisation rates in 2015–16 for 1 and 2 year olds were lower than the rates for all children (89.8% compared with 93.0% for 1 year olds, and 87.7% compared with 90.7% for 2 year olds).

In contrast, the national immunisation rate for Aboriginal and Torres Strait Islander children aged 5 years was higher than the rate for all children (94.6% compared with 92.9%).

Primary Health Network areas

In 2015–16, the percentages of fully immunised Aboriginal and Torres Strait Islander children varied across PHN areas for all three age groups as shown in Figure 6. The range in immunisation rates across PHN areas for the three age groups is outlined below.

  • 1 year olds – 94.2% in Tasmania to 76.1% in Perth North (WA)
  • 2 year olds – 93.4% in South Western Sydney (NSW) to 76.0% in Perth South (WA)
  • 5 year olds – 98.8% in Gold Coast (Qld) to 89.4% in Western Victoria.

Statistical Areas Level 4 (SA4s)

For Aboriginal and Torres Strait Islander children, Statistical Areas Level 4 (SA4s) were used instead of SA3s as the smallest geographic areas. There are larger populations in SA4s and this allows more reliable reporting for smaller population groups such as Aboriginal and Torres Strait Islander children.

Across more than 80 SA4s, the percentage of Aboriginal and Torres Strait Islander children fully immunised in 2015–16 varied considerably:

  • 1 year olds – ranged from 95.9% in Central Coast (NSW) to 72.4% in Perth–North West (WA)
  • 2 year olds – ranged from 96.0% in Coffs Harbour–Grafton (NSW) to 71.2% in Perth–South East (WA)
  • 5 year olds – ranged from 100% in Murray (NSW) to 87.6% in Perth–South East (WA).

Figure 6: Percentage of Aboriginal and Torres Strait Islander children fully immunised and numbers not fully immunised, by Primary Health Network area, 2015–16

# Interpret with caution: This area’s eligible population is between 26 and 100 registered children.

Notes

  • Components may not add to totals due to rounding.
  • Data are reported to one decimal place, however for graphical display and ordering they are plotted unrounded.
  • These data reflect results for children recorded as Aboriginal and Torres Strait Islander on the AIR. Levels of recording may vary between local areas.

Source Australian Institute of Health and Welfare analysis of Department of Human Services, Australian Immunisation Register statistics, for the period 1 April 2015 to 31 March 2016, assessed as at 30 June 2016. Data supplied 2 March 2017.

ADDED June14

Influenza Vaccination During Pregnancy

Vaccination remains the best protection pregnant women and their newborn babies have against influenza.

Despite influenza vaccination being available free to pregnant women on the National Immunisation Program, vaccination rates remain low with only 1 in 3 pregnant women receiving the influenza vaccine.

Influenza infection during pregnancy can lead to premature delivery and even death in newborns and very young babies. Pregnant women can have the vaccine at any time during pregnancy and they benefit from it all through the year.

Health professional:

Pregnant women:

 

NACCHO Aboriginal Children health crisis : With 19,000 kids in new #stolen generation “

  kids

” The almost 19,000 Aboriginal and Torres Strait Islander children in out of home care each year need the highest quality support if we are to break these cycles of harm.

As we come to recognise the devastating mental, physical and social impacts of trauma, grief and abuse across generations, and understand just how widespread this problem is for all children, the need to treat child abuse and neglect as a public health issue is clear.

This approach means better understanding the problem, its causes and impacts, and the strategies to best prevent and respond to it.

This approach must be supported by community determination, a strong research and evidence base, a trained and culturally competent workforce and effective interventions, including health promotion. ”

From the Conversation

Read 192 NACCHO Articles about Aboriginal Children

Read 35 NACCHO articles about NT Royal Commission Don Dale Kids

Child protection and out-of-home care have been the subject of multiple inquiries and reviews, and 2016 has been no exception. This year there have been four separate royal commissions into child protection and the related factors of family violence, child sexual abuse, juvenile detention and the systemic failures in these areas.

The Victorian Commission for Children and Young People recently released two reports examining the failure of both government and non-government organisations to implement policies and services for Aboriginal children that will safeguard their cultural connections.

The inter-generational issues that have stemmed from the forced removal of Aboriginal children from their families and communities – and the resultant trauma experienced by so many – have been the focus of concerted action and advocacy by Aboriginal leaders, peak bodies, organisations and community groups since the 1970s.

But in these most recent reports, we see familiar concerns. These include the widespread lack of implementation of the Aboriginal and Torres Strait Islander Child Placement Principle and the lack of cultural care planning for Aboriginal children in out-of-home care.

The Aboriginal and Torres Strait Islander Child Placement Principle (the principle) is often described and legislated as a “placement hierarchy”.

Under the principle, placement choices for Aboriginal and Torres Strait Islander children who can’t remain with their parents start with family and kin networks. That is followed by non-related carers in the child’s community, and then other Aboriginal caregivers and non-relative foster carers.

The principle emphasises five aspects:

  • prevention
  • partnership
  • placement
  • participation, and
  • connection.

These aspects of the principle are often overlooked, or not implemented, because they are not included in legislation.

Nationally, the impact of the principle has crudely been measured through figures from the Australian Institute of Health and Welfare which assess the Aboriginality of caregivers and their relationship to a child.

However, the reports from the Victorian Commission, together with similar audits in Queensland, have highlighted the reality behind the numbers. These reports show minimal practice compliance with the principle, and high levels of variability within and across jurisdictions.

For example, a number of children are not correctly identified as Aboriginal, which means there cannot be adherence to the principle for these children. Similarly, despite policy intent and available programs, there is minimal compliance with several practice aspects including the use of family decision making meetings and strategies to maintain cultural identity.

We’ve examined why this policy and practice disconnect exists when it comes to the safety and well being of Aboriginal children. There are several factors that act as barriers to implementation of the principle, not least of which is the increasing over-representation of Aboriginal children in child protection systems across Australia.


Adapted by Alwin Chong and Fiona Arney from the publication: ‘Enhancing the implementation of the Aboriginal and Torres Strait Islander Child Placement Principle: Policy and practice considerations.’ CC BY-ND

If we’re going to improve conditions for Aboriginal children in child protection and out-of-home care, we must focus on breaking inter-generational cycles of trauma. We also need to make sure children feel “culturally safe”. That means they don’t face challenges to or denials of their cultural identity; of who they are and what they need.

We must recognise the protective properties of cultural connection, rather than viewing culture as a risk factor, and engage communities in determining the solutions most appropriate for them.

In addition to the work being undertaken as part of the National Framework for Protecting Australia’s Children, major national grass roots initiatives are driving this change.

National Aboriginal and non-Aboriginal organisations – for example, SNAICC, the Aboriginal and Torres Strait Islander Healing Foundation, Winangay Resources, and the Australian Centre for Child Protection – are leading the Family Matters and Positive Futures initiatives to find alternative approaches to support Aboriginal children, their families and communities.

 

NACCHO MJA heath news: NAIDOC Week issue devoted to exploring the health status of Australia’s Aboriginal peoples

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Article by: Ruth Armstrong, Senior Deputy Editor – Medical Journal of Australia, Sydney, NSW.

This issue of the MJA, timed to coincide with NAIDOC Week, is devoted to exploring the health status of Australia’s Aboriginal and Torres Strait Islander peoples — particularly our children and young people. Children aged 0–14 years make up 35% of the Australian Indigenous population, write Eades and Stanley.

Data on their health and development are patchy but indicate a growing divide between Indigenous and other Australian children for several risk factors and conditions. Azzopardi and colleagues add a systematic review of the evidence for young people aged 10–24 years into the mix, finding gaps in the observational research for urban settings, mental health and injury, and confirming the well known dearth of interventional studies.

Two studies in this issue add to the scant evidence available by testing simple interventions that might lead to improvements, such as providing subsidised fruit and vegetable boxes to disadvantaged families in regional towns (Black and colleagues) and swimming pools in remote communities (Stephen and colleagues).

Turning our thoughts to the health needs of Indigenous children is always important but is particularly timely now. A federal election, with all its potential for policy upheaval, is just 2 months away. In the first article in our pre-election series, Arabena recognises an urgent need for better data to evaluate existing and future policies, and envisages a plan for health that takes Aboriginal and Torres Strait Islanders’ perspectives, wishes and culture into account, and brings an end to aspects of the health system that contribute to inequality, such as racism.

Independently of the election, the Australian Government is developing a new National Aboriginal and Torres Strait Islander Health Plan for the next decade. Kimpton, president of the Australian Indigenous Doctors’ Association, says the plan will have the best chance of success if it has at its heart some important principles: nurturing of the Indigenous health workforce; genuine, strong partnerships with Indigenous organisations; fostering culture as integral to health and wellbeing; and promoting Indigenous leadership, while involving the whole health system.

The solutions to many health problems for Indigenous children lie outside the health system, but making our health services accessible, culturally safe and appropriate places will lead to better outcomes for the families who inevitably need them. “Cultural competence” can be a daunting term for doctors. Thackrah and Thompson encourage us to look at our own culture of medicine and the practical realities of patients’ lives when trying to put this difficult concept into practice.

Amid all this thinking and soul searching, there are good examples of what works — innovative health promotion and education programs combining the nurturing effects of “country” with exchanges of new knowledge (Webb and colleagues), and thriving health services where Indigenous families can truly have their health needs met and that also serve as centres of outreach bringing sorely needed medical expertise to remote communities (McGilvray).

As Milroy reminds us in her response to a study that found many Aboriginal children had been exposed to traumatic, potentially health damaging experiences (Askew and colleagues), Indigenous children need access to the best possible health services right now and for years to come.

History tells us that policies fail, and services falter, when they are not developed in consultation with those for whom they are designed. On this point, Eades and Stanley concur: “… we believe that Australian services have failed to close the gap in child health because they have been developed without involving or engaging First Nations people”. At this important time in Australian history, we have yet another chance to get it right. Be it by public policy or individual action, we need to do all we can to make our health services places of healing for Aboriginal and Torres Strait Islander children and their families.