Improving the health and wellbeing of Aboriginal and Torres Strait Islander children in Australia

Abstract

I completed my Masters of Applied Epidemiology during 2017-18 with the NHMRC funded Centre for Research Excellence in Improving Health Services for Aboriginal and Torres Strait Islander Children (CRE ISAC) located at the University of Western Australia. My projects focussed mostly on social epidemiology, with the exception of my outbreak.

Chapter two provides a case-control study of a point source outbreak of Salmonella Typhimurium, which occurred at a university residential college in April 2018. Epidemiological and environmental investigation identified the most likely source of the outbreak to be raw eggs used in coleslaw. Public health action was the provision of information on the safe handling of eggs to prevent further outbreaks.

Chapter three, public health data analysis, was a population-based birth cohort study using linked datasets with information on a cohort of Aboriginal and Torres Strait Islander children, and their mothers and siblings. The 2009 and 2012 Australian Early Development Census was used to assess developmental vulnerability across five domains of development in Aboriginal children born in Western Australia. Latent class analysis was used identify and describe profiles of risk for developmental vulnerability. Six distinct classes were identified.

My surveillance project, provided in chapter four, was the evaluation of the Western Australian population based data linkage Intellectual Disability Exploring Answers (IDEA) surveillance system. I evaluated the usefulness, simplicity, flexibility, data quality, acceptability, representativeness, timeliness, and stability of the IDEA system. This was completed by process observation, semi-structured interviews and data analysis. The IDEA system has successfully been used to understand prevalence rates and inform resource allocation. Advocacy organisations could play an important role in the sustainability of the system. Additional variables or enhanced surveillance for functional capacity could strengthen the system and provide information for people living with intellectual disability and their families.

Chapter five is my epidemiology project which was a cross-sectional study of 1554 clinical child health audits and associated systems assessments from 74 primary care services from 2012-2014. Composite process of care indicators (PoCIs) were developed for social and emotional wellbeing, child neurodevelopment and anaemia. Crude and adjusted logistic regression models were fitted clustering for health services. 32.0% (449) of records had a social and emotional wellbeing PoCI, 56.6% (791) had an anaemia PoCI and 49.3% (430) had a child neurodevelopment PoCI. The study found that the need for young Indigenous children aged 24-59 months to receive quality care for important social and health indicators should be a priority. Processes of care and organisational systems within primary care services are important for the optimal management of anaemia in Indigenous children.

The final chapter concludes with my lessons from the field. This provided me with an opportunity to deliver a count regression teaching opportunity to my peers. Show more