The general health of a cohort of Aboriginal children (0–7 years) in Sydney

In both urban and rural locations, the health of Indigenous children is worse than that of non-Indigenous Australian children.1 General data on the health of urban Indigenous children are scarce.2 Here we describe reports by parents about specific common childhood illnesses in urban Aboriginal children and parental responses to these illnesses.

The data were collected from a birth cohort of 149 Aboriginal children and their parents (Gudaga Study, recruited 2005–2007),3 using best practice methods for research in an Aboriginal community.4 During semi-annual structured interviews with an Aboriginal project officer, parents provided information about respiratory tract infections (“a cold, runny nose, cough, bronchitis, or chest infection”), gastrointestinal conditions (“vomiting and/or diarrhoea”), ear health (“problems with his/her ears”), asthma/wheeze, and tonsillitis that had been experienced by their child in the preceding month. The parent’s response to these conditions was coded as “gave medication” or “sought professional advice”; 96% of those who sought professional advice reported having seen their doctor or general practitioner. Parents were also asked to rate their own general health and that of their child on a 5-point Likert scale. Data were analysed according to the child’s age group at interview. We did not attempt to verify parental responses or to justify the responses reported.

The general characteristics of the cohort have been described elsewhere.3 About 65% of mothers were of Indigenous heritage, 22% were less than 20 years old when they first gave birth, 11% had post-school qualifications, and 58% had a partner.

Parents frequently reported the listed childhood illnesses, and that they had given medication or sought professional advice (Box). While ear health problems, asthma or wheeze, and tonsillitis were less frequently reported than respiratory tract infections and gastrointestinal problems, they were more likely to elicit a parental treatment response. The mean parental score for their children’s general health ranged between 3.6 (standard deviation [SD], 1.2) and 4.6 (SD, 0.7) across the 7 years each child was followed; scores for the parents’ own health ranged between 3.3 (SD, 1.2) and 3.7 (SD, 1.0). Child and own health scores at each interview were associated (linear mixed model, P < 0.001), and the overall means were correlated (Pearson’s r = 0.52; P < 0.001).

This is one of only a few reported studies to systematically track the prevalence of common childhood illnesses in a cohort of urban Aboriginal children, and to explore their general health and that of their parents. Although it was a small cohort study, its strength lies in its recruitment of a population of urban Aboriginal children, the high rates of follow-up, and the systematic description of a range of general child health problems across early childhood. The reported problems varied over time, reflecting the development of the survey and the children.

Our findings indicate that parents responded to their children’s health problems by seeking professional advice or giving medication. Although the poorer general health of Indigenous Australian adults is recognised,1,2 the correlation between parent-rated adult and child health scores highlights the importance of ongoing programs for improving the general health of Indigenous Australian families. National programs that support local organisations and community development, such as Close the Gap,5 require sustained support in both urban and rural communities.