Sadly we continue to see higher injury rates in indigenous children compared to non-indigenous children across the world; in some areas up to 8 times higher. A recent review looked over past research to try and uncover why preventable injury rates continue to be so high in these communities.
The review looked at a range of studies worldwide and collated their findings.
Higher rates of injury and mortality were documented for transport related injury, burns and scalds, suffocation, drowning and poisoning. Falls were the only injury that was not significantly higher in indigenous populations. The largest disparities were seen in the 0 -4 years age group except in poisoning injuries where indigenous 5 -9 year olds had higher rates of injury than other age groups.
Transport related injury
Higher rates of hospitalisation and death in indigenous children compared to non-indigenous children were found in nearly all the studies involved. The biggest disparity was found in the youngest age group (0-4 year olds) in both transport related crashes and pedestrian injuries.
Burns and Scalds
Burn injuries and deaths were found to be higher in indigenous populations in all the studies. Australian and New Zealand studies found greater inequalities in younger age groups than older children.
Once again, indigenous children had higher rates of injury than non-indigenous children. Canada reported that largest difference in injury rates.
Falls data collated in Australia and examined by 5 year age groups did not find any differences in inequalities by age group. No significant difference between indigenous and non-indigenous children was found in many of the studies.
Poisoning rates were higher in indigenous children, with the disparity greatest in the 5-9 year age group in Australia.
Rates of mortality from suffocation have been estimated at between 1.9 and 3 times higher in indigenous children.
Why do the inequalities exist?
It was difficult to draw conclusions as to the reasons the inequalities exist between indigenous and non-indigenous child injury.
Some of the difference was able to be explained by the mother’s socioeconomic status and educational attainment.
It has been long known that the disparities in health are born from the inequalities in society. There is a cycle of disadvantage observed in indigenous cultures that begun from colonisation and the policies that were enforced from that time on. Many indigenous communities live with poor education, high unemployment, low income, separation of families and overcrowded living conditions. These factors increase the risk and incidence of unintentional childhood death and injury. It is also possible that indigenous populations are exposed to a greater range of hazards in their living environments. Reduced access to and lower quality health care as well as transport cashes attribute to higher inequality in indigenous children with a high number of indigenous people living in remote areas.
Transport injuries in indigenous communities result from a range of issues including longer travelling distances, poorer quality roads, driver fatigue, failure to use seatbelts, alcohol and drug use, overcrowding of cars, unsafe cars and travelling at higher speeds. It has also been suggested that road safety measures might be less vigorously enforced in remote areas.
An issue highlighted by the study was that there are many difficulties in obtaining data (particularly indigenous status of child) and it is possible that due to poor recording the injury rates of indigenous children are underestimated.
A range of recommendations were made from the studies researched. Most included further research into indigenous communities to gain understanding in risk factors, barriers and attitudes towards health and also to design culturally appropriate prevention programs.
Other recommendations included targeting the injuries with the greatest inequalities, improving healthcare and access in remote areas, raise awareness and further enforce prevention measures. A multidisciplinary approach that accounts for the broader social and environmental determinants of indigenous health is suggested.
This review has highlighted again that Indigenous children worldwide have higher injury mortality and morbidity. The leading causes of inequalities were burns, poisoning and transport injuries. The greatest differences were found in younger age groups, mainly 0 to 4 year olds.
More recent studies still show significant disparities between indigenous and non-indigenous children when compared to studies from the 1980s showing little improvement has been made.
Due to the lack of evidence, there is still minimal knowledge on the underlying causes of indigenous inequality.
This information has come from :
Möller, H., Falster, K., Ivers, R. and Jorm, L. (2014). Inequalities in unintentional injuries between indigenous and non-indigenous children: a systematic review. Injury Prevention, 21(e1), pp.e144-e152.
Kidsafe SA has developed the Safety for our Little Fellas resources to help support staff and families in reducing childhood deaths and serious injuries in Indigenous communities. Please contact us for more information.