Health and socioeconomic inequalities of Australian children revealed

New report reveals health and socioeconomic inequalities of Australian children and youth including potential years of life lost, hospital emergency visits, participation in higher education.

Understandably, being healthy in childhood and as young people provides an important foundation for later life. However, data released by the Public Health Information Development Unit (PHIDU) at Torrens University Australia highlights the inequity in health status, the use of health services, health outcomes and socioeconomic status of young Australians (aged 0 to 24 years), according to the communities in which they live. The key findings of PHIDU’sChild and Youth Social Health Atlas of Australiainclude:

Health status and outcomes

Deaths of young people and potential years of life lost[1]

In Australia in 2018, there were 1,134 deaths of persons aged 15 to 24 years, of which over two thirds (71.8%) were male. The proportion of the youth population (15 to 24 years) who committed suicide over the period 2014 to 2018, at 35.9%, ishigher than in any other age group, with the proportion declining with age, to 28.9% in the 25 to 34 years age group and 17.0% in the 35 to 44 years age group.

This is the greatest contributor to potential years of life lost for this age group with deaths caused by being an occupant of a car injured in a transport accident being the second greatest contributor.

Rates of potential years of life lost per 1,000 people aged 15 to 24 years are consistently higher in regional areas across the nation than in their corresponding capital city.

Children and young people presenting at hospital emergency departments

Young people (aged 15 to 24 years) from the most disadvantaged areas were also more likely to attend a public hospital emergency department for a mental health condition – with a 61% higher rate of presentations to an emergency department for those living in the capital cities when compared with those in the least disadvantaged areas; and a rate 79% higher if living in regional areas.

For children aged from 0 to 14 years presenting to an emergency department for respiratory conditions (mainly asthma), there were large equity gaps for those in the capital cities (46% higher rate of presentations in the most disadvantaged when compared with the least disadvantaged areas) and regional areas (55%).

Variations in rates of presentation outside of the Major Cities areas are not consistent, being highly influenced by access to facilities providing these services.

In releasing the research, PHIDU Director, Professor John Glover, said: “The impact of presentations to emergency departments for all causes, and in recent years for mental health conditions, is well known and is putting an increasing strain on public hospital resources.”

Babies and their mothers

The Child and Youth Social Health Atlas of Australiaalso reveals women in the most disadvantaged areas of Australia were more likely to:

• ·not have had an antenatal visit in the first 10 weeks of their pregnancy, as recommended – in the capital cities, the proportion was 20% higher in the most disadvantaged areas, and in regional areas (i.e., areas outside of the capital cities) it was 13% higher;
• have had a baby of low birthweight (less than 2,500 grams) – in the capital cities the proportion was 34% higher, and in regional areas, 54% higher;
• have smoked cigarettes at some time during their pregnancy – in the capital cities, 5.8 times the rate of smoking in the least disadvantaged areas, and in regional Australia, 4.1 times.

It is of note that whereas the proportion of low birthweight babies has changed little over the past 12 years (in either the capital cities or regional areas), the rate of smoking during pregnancy has changed, and changed dramatically. The rate over the period 2016 to 2018 is down by 40% on that in the period 2003 to 2006, with similar declines in the capital cities and regional areas.

As shownhere, although the reductions in smoking occurred across the social spectrum, the largest declines were in the least disadvantaged areas, resulting in a wider equity gap (the difference in rates between the most and least disadvantaged areas).

Differences are also evident across the Remoteness Areas, with the proportion of low birthweight babies in the Very Remote areas 67% above that in the Major Cities; for smoking during pregnancy, the smoking rate in the Very Remote areas was nearly five (4.8) times that in the Major Cities, a range from 7.2% in Major Cities to 34.6% in the Very Remote areas. The clear implication from these data is of the poorer health status at the beginning of life for many babies in the most disadvantaged areas of Australia.

Socioeconomic status

Children in families where the mother has low educational attainment

The number of Australian children under 15 years in families where the mother has low educational attainment has markedly reduced, down by 44% from 2006 to 2016. However, one outcome has been a widening in the equity gap, to a proportion in the most disadvantaged areas of the capital cities that is now four times that in the least disadvantaged areas and that has almost doubled in regional areas (i.e. areas outside of the capital cities).

School leavers participating in higher education

In March 2019, 40% fewer young people from the most disadvantaged areas in the capital cities were enrolled at an Australian university, compared with the proportion in the least disadvantaged areas (proportions of school leavers of 20.2% and 33.7%, respectively). In regional areas (i.e. areas outside of the capital cities), participation in higher education was lower in all quintiles, and the equity gap was wider, with 57% fewer young people from the most disadvantaged areas enrolled at an Australian university.

The city/country divide was even more substantial, with 82% fewer young people from Very Remote Areas who finished school in 2018 being enrolled at a university in March 2019, when compared with those in the Major Cities (proportions of school leavers of 4.5% and 24.8%, respectively).

PHIDU’s Child and Youth Social Health Atlas of Australia, including interactive atlases to view maps for any area in Australia, are availablehere.

About the Public Health Information Development Unit (PHIDU):

PHIDU, based at Torrens University in Adelaide, promotes and manages the collection, dissemination and utilisation of national, state and local data for public health purposes. PHIDU at Torrens University is best known for its social health atlases of Australia that were pioneered by Professor Glover in the 1990s.https://phidu.torrens.edu.au/

[1]Data are for the period from 2014 to 2018; Potential years of life lost due to deaths before 75 years of age