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In 2017, Indigenous Australians currently experience disproportionate levels of education, living standards and employment than the rest of Australia. This Indigenous population also experience poorer health status ratings as a consequence from their disadvantaged lifestyles. Although, The Australian Government has begun to address the inequalities in health status between Australia’s population groups. Indigenous Australians are still expected to live 10-17 years less than other Australians, often due to potentially avoidable conditions. Among these statistics of the indigenous population, children are also contributing. As highlighted in Figure 1, although there is some geographic variation, indigenous children mortality rates are significantly higher than non-indigenous children rates are. The leading cause of Indigenous childrens deaths originate in the perinatal period as birth and pregnancy complications account for 42% of all child deaths; then 18% from Sudden Infant Death Syndrome; followed by 13% from injury. Indigenous Children’s morbidity levels are also higher due to more children suffering from chronic conditions, obesity, poor dental health and other diseases than non-indigenous children. Indigenous children aged 0–4 years were hospitalised for dental conditions at twice the rate of non-Indigenous children. Due to comprehensive disadvantages including limited access to education, health care s
ervices and other support services. Indigenous children have a worse health status than other Australian children. The government and many other community groups phased interventions to change the overall health status in Indigenous communities. It is important to provide the foundations for Indigenous children that they can utilise as adults and encourage into other generations.

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Health determinants affecting Indigenous child health

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Health determinants affecting Indigenous child health

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Body weight

In many Indigenous children, the first signs of excess body weight and obesity can emerge. As emphasised in Figure 2, Indigenous children (aged 2-14 years) are more likely than non-indigenous children to be underweight, less likely to be in the normal weight range, and more likely to be overweight or obese. Being overweight or obese is often associated with many health risks including heart diseases, Type 2 diabetes, some cancers, respiratory conditions and social problems. A high BMI rating in children can influence sleeping patterns for children, which can contribute to poor concentration and irritability levels at school and reduced physical activity. Thus, body weight can interfere with a child’s interaction with their friends, their self-esteem and stress levels.
Aboriginal people were a hunter/gathering population and their bodies are equipped with a survival advantages that was particularly efficient at maximising scarce nutrients, this is referred to a thrifty gene. Unfortunately, in modern lifestyles, due to the availability of large quantities of food, energy-dense foods and an inactive population. Indigenous people are 1.6 times more likely than non-Indigenous Australians to experience obesity. Therefore, they are more likely to endure health conditions associated with excess body weight.

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Eating habits

Establishing good eating habits during childhood is fundamental for the health, wellbeing and development of all children. Through the consumption of a variety of nutrients in foods, optimal development can be reached and the body can perform. Poor nutrition or imbalances during childhood can contribute to insufficient development to the body and its systems, body weight, obesity, malnutrition, and tooth decay. Only 15% of Indigenous Australians aged 2-14 years reported to have an adequate daily fruit and vegetable intake. Within this report, 78% of these indigenous children met the recommended fruit intake and 16% met the recommended vegetable intake (shown in Figure 3). Numerous factors contribute to the insufficient consumption of nutritious foods including food insecurities, financial constraints, and education. It is suggested that people living in poverty tend to maximise calories per dollar spent on food. Therefore consuming cheaper foods that are energy-dense and rich in fats as whole grains, fresh vegetables and lean meats are more expensive. In the last 12 months, 22% of people went without food due to food insecurities. Poor and inconsistent eating habits of Indigenous children can result in ineffective functioning and development of the body’s systems, anxiety, depression, decreased resistance to diseases.

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Tobacco smoking in the home

Smoking tobacco in the home has a detrimental effect on the health of all children, especially those children in Indigenous communities. Aboriginal adults are three times more likely to smoke than non-Indigenous adults are. Tobacco is also one of the leading contributors to the burden of diseaseamong Aboriginal people (contributing 12%). Given children, most commonly encounter passive smoke from their parents, family and friends. Indigenous children have a higher chance of experiencing passive smoking than other Australian children. Children are especially vulnerable to passive smoking as it can prompt the development of respiratory infections (such as bronchitis, bronchiolitis and pneumonia), increases the risk of slower lung growth, encourage coughing and breathlessness, and the children have an increased likelihood of becoming a smoker themselves. Those children exposed to passive smoking are at an increased risk of premature death and disease, which can influence all forms of their health.

Some Indigenous children may have already experienced the consequences from parents smoking tobacco in the home. During pregnancy, smoking or passive smoking can contribute to low birth weight and increases the risk of poor outcomes for babies.Low birth weight indicates the body’s systems are underdeveloped and the baby has an increased health risks and development problems, which can affect a person’s throughout their lifespan (including throughout childhood).

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Access to health care

Access to quality health care services is important for the maintenance of health, preventing and managing diseases or injuries. Unfortunately, in some remote Indigenous communities, health care services are inaccessible and limited. In 2012–13, 30% of Aboriginal people reported that despite needing to, they did not see a health care provider in the previous 12 months. This avoidance of dentists, doctors, counsellors, other health professionals and hospitals in particular affects Indigenous children. Children's access to health care is critical to their health and development, as they are more vulnerable and at risk to illnesses and other health complications. In many Indigenous communities, the children’s inability to access health care services has led to poor health. Children’s immune system is sometimes unable to respond to diseases and requires medical attention. Illnesses and injuries can leave a child feeling lethargic unable to participate in everyday activates resulting in decreased engagement in physical activity, isolation from friends and family members, and feeling of stress over their recovery.

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Kidney disease

Kidney diseases are a significant health problem among Indigenous people as it affects mortality and morbidity levels in an Aboriginal population. It is estimated to contribute 5% of the burden of disease for Indigenous Australians. Although most kidney diseases affect adults, childhood is a serious risk factor for kidney dysfunction. The high level of Kidney diseases among Indigenous Australians is associated with the following risk factors including high blood pressure, repeated infections in childhood, low birth weight, infant malnutrition, diabetes and poor education. These conditions are all quite common among Indigenous children. Kidney disease can affect an individual’s quality of life, and their health or it can cause death. The body systems in a patient are poorly functioning and they have to constantly be monitored throughout their treatment, which can often isolate an individual from their friends and family. They may experience high stress levels as they worry about their condition and my feel lack of control over their lives. The risk of developing Kidney disease can be minimised or eliminated through healthier nutrition, earlier detection and diagnosis of the condition, and an increased physical activity.

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The Indigenous Nutrition Services Program is driven by the community in an attempt to decrease the number of chronic conditions affecting Indigenous Australians. By establishing different methods, the program targets both Indigenous children and adults accordingly. The program offers the following:

·        Nutrition workshops

·        Food education

·        Advices parents with shopping choices

·        Cooking classes

·        State school workshops

·        A targeted healthy lifestyle program for young people

By increasing the nutrient information available for Indigenous parents, they can alter their food selection and cooking behaviours to benefit their children’s development. Along with this, children are also educated in schools to ensure an improvement in their nutrient consumption occurs. Children are transitioning though a vital period of growth (height, weight, brain development, development of motor skills) and they need a variation of nutrients as fuel. Education around the importance of specific nutrients should ensure a better development for Indigenous children, and reduce the risk of diseases and conditions that can result from a nutrient imbalance.

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Close the Gap

The Australian Government’s Close the gap initiative is a strategy, which aims to reduce the numerous disadvantages between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians. Addressing life expectancy, child mortality, access to health services, educational achievement, and employment. The government has made a commitment to the Aboriginal and Torres Strait Islander people to achieve health equality within a generation. To monitor the changes, measurable targets have been set to monitor the improvements within the Indigenous communities. Below are the objectives specific to Indigenous children:

-        Halve the gap in mortality rates for Indigenous children under five within a decade.

-        Ensure all Indigenous four years-olds in remote communities have access to early childhood education within five years.

-        Halve the gap for Indigenous students in reading, writing and numeracy within a decade.

The Close the Gap campaign focuses on improving the health of Indigenous children as they have the potential to carry on these changes to future generations.

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http://www.health.gov.au/internet/main/publishing.nsf/Content/indigenous-implementation-plan

http://closingthegap.pmc.gov.au/sites/default/files/ctg-report-2017.pdf

http://www.healthinfonet.ecu.edu.au/health-infrastructure/health-promotion

https://www.pmc.gov.au/sites/default/files/publications/Aboriginal%20and%20Torres%20Strait%20Islander%20HPF%202014%20-%20edited%2014%20Oct%202015.pdf

http://www.abc.net.au/news/2016-05-22/wa-communities-grow-impatient-over-lack-of-drinking-water/7435474

http://www.abc.net.au/radionational/programs/breakfast/water-quality-concerns-in-remote-indigenous-communities/8803078

http://www.healthinfonet.ecu.edu.au/key-resources/programsprojects?pid=3320

http://www.healthinfonet.ecu.edu.au/key-resources/programsprojects?pid=3280

https://www.health.act.gov.au/sites/default/files/KidsAtPlay/Factsheet%20%20Tap%20into%20water%20everyday%20%28430k%29.pdf