Preventive activities in children and young people

Prevention and health promotion in the early years, from conception to 5 years of age, is important for an individual’s lifelong health and wellbeing.¹ It may also be an opportunity to redress health inequalities.^2, 3 In adolescence, neurodevelopmental studies support the value of early intervention to prevent ongoing harm.

Many infants and children visit their general practitioner (GP) frequently, and adolescents visit at least once a year.⁵ This frequent contact provides opportunities for disease prevention and health promotion.

Evidence provides moderate support for the hypothesis that ‘accessible, family-centred, continuous, comprehensive, coordinated, compassionate and culturally effective care improves health outcomes for children with special healthcare needs’.⁶ There is also evidence that supports the beneficial impact of similar care for children without special healthcare needs.^7-8

What are the key equity issues and who is at risk?

• Low socioeconomic status (SES) is associated with increased childhood morbidity and mortality.⁹ This includes higher rates of death from neonatal hypoxia, sudden unexpected death in infancy (SUDI), prematurity-related disorders, and accidental and non-accidental injury;^10,11 hospitalisations related to asthma;¹² and risk of child abuse.¹³ Low SES is also associated with overweight and obesity in children.¹⁴
• While there has been a decline in infant mortality since the 1990s, infant mortality in Aboriginal and Torres Strait Islander peoples is more than twice that of non-Indigenous children,¹⁰ in part due to pregnancy, labour and delivery complications, and trauma and congenital malformations.¹⁵ Aboriginal and Torres Strait Islander infants have higher rates of death from SUDI.¹⁶ They are also more likely to be born premature or with low birth weight^17,18 and are more likely to be hospitalised before 1 year of age.¹⁹
• Aboriginal and Torres Strait Islander peoples and people from socioeconomically disadvantaged backgrounds are more likely to experience low immunisation rates.²⁰

What can GPs do?

• Refer to the general strategies for supporting patient education and health literacy in disadvantaged groups.
• Consider advocating for and supporting community-based strategies or policies for health promoting changes within the environments in which families live (eg school-based programs targeting nutrition and physical activity).^21–27
• Use resources supporting the provision of culturally competent care to adolescents from culturally diverse backgrounds.²⁸

Table 3.1

Age-related health checks in children and young people

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Table 3.2

Explanatory notes for Practice Points

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