Preventive activities in children and young people
Health surveillance is the foundation for preventive activity in children and young people. This involves working with parents, nurses and others in the community to maintain awareness of risk and protective factors that affect family and child wellbeing.82 The parent held child health record has been demonstrated to improve health surveillance.83
Health inequality
To support the assessment and early identification of health issues in Aboriginal and Torres Strait Islander children, the Child Health Check (0–14) MBS Item 708 is now available. The health status of indigenous children remains poor with disparities in health status across different regions. For example, compared with non-Indigenous Australians, Aboriginal and Torres Strait Islander children are three times more likely to die before their first birthday; five times more likely to succumb to SIDS; twice as likely to be born premature or with low birth weight; and nearly four times as likely to be hospitalised with respiratory infection. Indigenous Australian mothers are eight times more likely than non-Indigenous mothers to receive inadequate antenatal care and rates of breastfeeding are lower in indigenous than non-indigenous communities.
There is a gradient in health and life outcomes for children and young people over the entire socioeconomic spectrum. There are large numbers in the middle range of the population and it is these numbers that are used by those who argue for universal interventions. On the other hand, the magnitude of the ill health experienced by those at the bottom end of the spectrum is used by others to argue for targeted interventions.84,85 Maternal smoking during pregnancy is more prevalent among women of low socioeconomic status (SES) and single mothers and is strongly associated with low birth weight. Mothers from lower socioeconomic backgrounds have fewer and less regular antenatal visits. Lower rates of breastfeeding and shorter duration of breastfeeding have been reported for mothers in a range of disadvantaged backgrounds, including single, low income, migrant, unemployed families, poorly educated parents and disadvantaged communities. Higher mortality rates in infancy and childhood, including deaths from hypoxia, SIDS, prematurity related disorders, accidental and nonaccidental injury are reported for low SES children and children living in disadvantaged neighbourhoods.85
© The Royal Australian College of General Practitioners
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