There are some incredible things happening out there in communities all around Australia. Our Report Card shines a bright light on what needs to be done to improve the health and wellbeing of Aboriginal and Torres Strait Islander children in their important early years of life.
It also brings together some of the great work that is already happening to make a difference
Dr Steve Hambleton (see full launch speech below)
Picture above: Romlie Mokak CEO AIDA, Justin Mohamed NACCHO chair, Senator Fiona Nash and AMA CEO Dr Steve Hambleton
WATCH LAUNCH on NACCHOTV and NITV
(Transcript from World News Australia Radio) Thea Cowie reports
The Aboriginal and Torres Strait Islander health report card highlights the impact early childhood experiences can have on genetic expression
DOWNLOAD THE REPORT HERE
Unfortunately there’s nothing new about inter-generational Indigenous disadvantage.
But Australian Medical Association national president Steve Hambleton says new developments in neuroscience, molecular biology and epigenetics provide a scientific explanation for the cycle of disadvantage.
“Now epigenetics, or the study of the way genes are switched on and off, we can now understand how those early life experiences become hard-wired into the body with lifelong effects on health and wellbeing. Early experiences can influence which of the person’s genes are activated and de-activated and consequently how the brain and body development occurs.”
The AMA report says repetitive stressful experiences early in life can cause changes in the function of genes that influence how well the body copes with adversity throughout life – including the development of emotional control, memory function and cognition.
The report cites research showing more than 20 per cent of Aboriginal and Torres Strait Islander families with children under 16 experience seven or more life stress events in a year.
Chairman of the National Aboriginal Community Controlled Health Organisation, Justin Mohamed, admits it’s daunting to think about the impact early childhood events can have on a genetic level.
“It’s very scary to think that an individual event or a multitude of events, or the environment that you were raised in, can actually switch off your potential of what you could be. And on the other side of the thing I think it’s very encouraging to think that well there might just be some minor adjustments which actually can switch on so you can actually reach your potential.”
Mr Mohamed says in many ways the science backs up what’s long been known.
But he hopes the evidence will help focus efforts and investment on the early years – the years he says really change lives.
“They want evidence, they want to see where they can make the best investment to get the best return. So I think that this report will show that well here’s some evidence. We know that if the right investment is made, the right rollout to frontline services, Aboriginal community controlled health services, that we can have really good turn around with the results.”
The Australian Indigenous Doctors’ Association chief executive officer, Romlie Mokak, says the report also highlights the importance of providing support to mothers- and fathers-to-be.
“Having all of that early education and support is really critical for fundamental things like having access pre-natally. When baby’s born the connect between having all of that clinical support and education, the right nutrition and supportive environments can improve birth weights. And it’s also about making sure that care continues once bub’s born.”
Recommendations from the AMA report include establishing a national plan for expanded maternal and child services including parenting and life skills education, expanding home visit services and building a strong sense of cultural identity and self-worth.
Mr Mokak acknowledges the report is just one of thousands written in an attempt to address Indigenous disadvantage.
But he hopes this one will receive the bipartisan support and funding needed to capitalise on its findings.
“The fact that the president of the AMA, Steve Hambleton, who’s so committed to this agenda, chairs the taskforce that produced the report says something. This is however many thousands of doctors in the country who are saying this is important business for the medical fraternity. The biggest call here I think is for us to think about a future beyond a political cycle. My hope would be that it fits in terms of aligning with government, the Opposition and the Greens and others to say this is an important agenda for us to keep supporting.”
The AMA Indigenous Health Report Card is one of the most significant pieces of work produced by the AMA. It gives us great pride. It matters. It makes a difference.
We have been producing these Report Cards for over a decade now, and each time we focus on a different aspect of Indigenous health – children’s health, primary care, funding, men’s health, or inequity of access.
We come at it from all angles.
We do not pretend to have all the solutions to the many health problems that confront Aboriginal peoples and Torres Strait Islanders. But the AMA recognises and acknowledges the problems and we want to help fix them. Our Report Cards are a catalyst for thinking, and hopefully a catalyst for action.
This year we are focusing on the early years of life. It is the right of every Australian child to have the best start in life – but in Australia today not every child benefits from this right. In their early years, children need to be safe, have adequate opportunities for growth and development, and have access to adequate health, child development, and education services.
Many of our children are missing out, but none more so than Aboriginal and Torres Strait Islander children.
There have been some improvements in recent years with many Aboriginal and Torres Strait Islander children making a successful transition to healthy adult life.
But there are still far too many who are being raised in community and family environments that are marked by severe early childhood adversity.
This adversity in early life can affect educational and social functioning in later life, and can increase the risk of chronic illness.
We are seeing improvements through government commitment and cooperation on closing the gap initiatives, but much more action is needed.
Epigenetics is all about how early life experiences become hard-wired into the body, with life-long effects on health and wellbeing.
Early experiences can influence which of a person’s genes are activated and de-activated and, consequently, how the brain and the body develop.
Building and providing stable and healthy life experiences in the early years can help break the cycle of adversity.
That is our task and our challenge.
Good nutrition, responsive care and psychosocial stimulation can have powerful protective benefits to improve longer-term health and wellbeing.
Strong culture and strong identity are also central to healthy early development.
The costs to individuals, families, and society of Aboriginal and Torres Strait Islander children failing to reach their developmental potential continue to be substantial.
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 among Aboriginal peoples and Torres Strait Islanders.
It is crucial for the momentum to be sustained by renewing the COAG National Partnership Agreements on Indigenous Health and on Indigenous Early Childhood Development for another five years.
The AMA makes several recommendations in the Report Card, including :
A national plan for expanded comprehensive maternal and child services;
The extension of the Australian Nurse Family Partnership Program of home visiting to more centres;
Support for families at risk with interventions to protect infants and young children from neglect, abuse and family violence;
Efforts to reduce the incarceration of Aboriginal people and Torres Strait Islanders; efforts to improve the access of Aboriginal people and Torres Strait Islanders to the benefits of the economy, especially employment and entrepreneurship;
Efforts to keep children at school;
Building a strong sense of cultural identity and self-worth; improving the living environment with better housing, clean water, sanitation facilities, and conditions that contribute to safe and healthy living; and better data, research and evaluation culturally appropriate measures of early childhood development and wellbeing.
We have also highlighted some examples of programs that are already being successful at improving the early years of Indigenous children.
There is the Darwin Midwifery Group Practice, the Aboriginal Family Birthing Program in South Australia, and the NSW Intensive Family Support Service are just a few.
Our governments – individually and through COAG – must examine these programs, learn from them, and replicate them where possible.
Our governments must also look at the Abecedarian approach to early childhood development.
This involves a suite of high quality teaching and learning strategies to improve later life outcomes for children from at-risk and under-resourced families.
It is being used to great effect at the Central Australian Aboriginal Congress in Alice Springs.
The AMA believes the Abecedarian approach has a strong track record of success and we urge all governments to have a closer look for possible widespread implementation.
There are some incredible things happening out there in communities all around Australia. Our Report Card shines a bright light on what needs to be done to improve the health and wellbeing of Aboriginal and Torres Strait Islander children in their important early years of life.
It also brings together some of the great work that is already happening to make a difference.
Importantly, it defines a challenge for all of us – governments, the medical profession, the r health and education sectors, and the broader community – to give these kids and their families a healthier life.
I now ask the Assistant Minister for Health, Senator Fiona Nash, to say a few words and officially launch our Report Card. Background. Some key factors impacting on Aboriginal and Torres Strait Islander health and wellbeing in the early years:
Pregnancy and Birth
Aboriginal and Torres Strait Islander women have a higher birth rate compared with all women in Australia (2.6 babies compared to 1.9), and are more likely to have children at a younger age: 52 per cent of the Aboriginal women giving birth in 2010 were aged less than 25 years, and 20 per cent were less than 20 years, compared with 16 per cent and 3 per cent, respectively, for the broader community [AIHW, 2012];
Aboriginal women remain twice as likely to die in childbirth as non-Aboriginal mothers, and are significantly more likely to experience pregnancy complications and stressful life events and social problems during pregnancy, such as the death of a family member, housing problems, and family violence [Brown, 2011];around half of Aboriginal and Torres Strait islander mothers who gave birth in 2010 smoked during pregnancy, almost four times the rate of other Australian mothers; and while infant mortality continues to fall, low birth weight appears to be increasing.
Infancy and early years
Aboriginal and Torres Strait Islander children are twice as likely to die before the age of five than other Australian children of that age group. However, the Closing the Gap target to halve this gap in mortality rates by 2018 will be reached if current trends continue; between 2008 and 2010, Aboriginal and Torres Strait Islander children less than five years of age were hospitalised at a rate 1.4 times greater than other children of the same age [AIHW 2013]; Aboriginal and Torres Strait Islander children suffer from nutritional anaemia at 30 times the rate of other children [Bar-Zeev, et. al., 2013]; and Aboriginal and Torres Strait Islander children between 2 and 4 years of age are almost twice as likely to be overweight or obese compared with all Australian children in that age range [Webster et. al., 2013].
Family Life
More than 20 per cent of Aboriginal and Torres Strait Islander families with children younger than 16 years have experienced seven or more life stress events in a year [Zubrick et al, 2006]. The greater the number of family life stress events experienced in the previous 12 months, the higher the risk of children having clinically significant social and emotional difficulties [FaHCSIA, 2013]; for Aboriginal and Torres Strait Islander children, risk factors such as: a close family member having been arrested, or in jail or having problems with the police, being cared for by someone other than their regular carers for more than a week; being scared by other people’s behaviour had the greatest impact on a child’s social and emotional difficulty scores; especially if these factors were sustained over a number of years [FAHCSIA 2013]; between 2006 and 2010, the injury death rate for Aboriginal and Torres Strait Islander children was three times higher than that for other children. In 2010–11, the rate of hospitalisation for injuries was almost 90 per cent higher for children from remote and very remote areas than for children in major cities. Overall, hospitalisation due to injury among Aboriginal and Torres Strait Islander children was almost double that of other children, with the greatest disparity relating to assault [AIHW, 2012];
Aboriginal and Torres Strait Islander children were almost eight times as likely to be the subject of substantiated child abuse and neglect compared with other Australian children [AIHW 2012].
Early Childhood Education and Schooling
Aboriginal and Torres Strait Islander children were almost twice as likely to be developmentally vulnerable than other Australian children, and to require special assistance in making a successful transition into school learning; the Closing the Gap target for all Aboriginal and Torres Strait Islander four-year-olds living in remote communities to have access to 15 hours of early childhood education per week was achieved in 2013; across the country, the proportion of Aboriginal and Torres Strait Islander children achieving the national minimum standards decreases as remoteness increases. For example, in 2012, only 20.3 per cent of Aboriginal and Torres Strait Islander year 5 students in very remote areas achieved national minimum standards in reading, compared with 76 per cent in metropolitan areas;
Only modest progress has been made in achieving the Closing the Gap target to halve the gap for Aboriginal and Torres Strait Islander students in NAPLAN reading, writing and numeracy assessment scores by 2018
