Abstracts of theses and treatises
Atkinson D (1993) Growth in Aboriginal children in Western Australia in the 1980's: Geographic and seasonal variation, and the relationship between impaired growth and hospital morbidity. Unpublished Master of Public Health thesis, University of Western Australia, Perth, Western Australia.
Aboriginal children, in almost all studies, show a consistent pattern of substantially impaired growth in the first two years of life. Even in less remote areas studies have generally shown lesser, but still significant, growth impairment. Some reports show a secular trend for improving growth, however, this is not consistent and some of the more recent studies in the north of Western Australia show growth only a little better than was reported in the 1960's.This study describes geographic, seasonal and temporal variation in Aboriginal child growth in Western Australia in the 1980's, emphasising growth in the Kimberley. The relationship between impaired growth and hospital morbidity for a sample of these children was also examined.Nutritional Anthropometry data on Aboriginal children under five years of age collected by Community Health staff was linked to data from the Midwives' notification form by Arturo. Midwives data was then linked to hospital morbidity data for some of these children in this study. Nutritional indices were calculated using a computer package for the analysis of nutritional data from the Centres for Disease Control, and estimates of nutritional status at various ages up to two years were made.A total of 6723 Aboriginal children born between 1981 and 1986 in Western Australia were included in the study. For all regions except the Perth and Central regions a reasonable proportion of children were measured in all years and in the Kimberley a very high proportion of children were measured. There were considerable variations between regions in the pattern of growth observed, with growth in the Kimberley and the Goldfields worse than elsewhere in the State and growth in the South West of the State better. In the remote areas of the Kimberley children were, on average, about 1.3 standard deviations below the level of the reference population in the second year of life, while children in the South-West were about two thirds of a standard deviation below the reference between regions Aboriginal children in all regions outside the Perth area were more similar to Aboriginal children in other regions than they were to the reference population.Overall no significant trend for improved growth between children born in the earlier years of the study and those born in the later years was found, although children in the Goldfields region may have been improving over this time period.A highly statistically significant, and possibly quite important, seasonal variation in growth was observed for the Kimberley, with growth appearing to be substantially worse in the hotter summer months and better in the winter. This has been anecdotally thought to be the case in the north of the State, but has not previously been documented amongst young Western Australian Aboriginal children.Children in the central Kimberley who have very poor growth were documented to have very high levels of hospital morbidity, with the median child spending 15 days in hospital in the first two years of life and nearly one third of the children spending one month or more in hospital in this period. Up to 40 per cent of hospital usage by these children in their second year of life may be related to poor growth, suggesting that significant gains could be made if nutritional status was improved.Considerable resources have been devoted to collecting this nutritional information on Aboriginal children and insufficient attention has been paid to analysis. A less ambitious system of periodic surveys with greater attention to accuracy and more resources for analysis would be more useful for monitoring progress than on-going centralised data collection.The marked seasonal differences in growth documented for the north of the State need to be taken into account when planning programs to improve child health. Further research to document the geographical pattern of seasonal variation and to monitor progress is required.
For further information on this subject look in the Australian Indigenous HealthInfoNet Bibliography or return to the theses page.
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