Child and Youth Social Health Atlas of Australia

Social determinants of health, health status, use of health services and health outcomes for children and young people in Australia, presented in maps (for small geographical areas), graphs (showing differences socioeconomic disadvantage of area and Remoteness Area) and data workbooks

Published: 2021

Introduction

Being healthy in childhood and as young people provides an important foundation for later life. This Child and Youth Social Health Atlas of Australia draws together data from other Social Health Atlases and unpublished data for those aged from 0 to 24 years. However, the data do not cover all aspects of the health and wellbeing of this population group. Some of the gaps are data as to visits of young children to general medical practitioners, or of young people to sexual health and other specialist services. The Atlas seeks to set the data on health status, use of health services and health outcomes alongside the demographic, social and economic characteristics of this population group in the communities where they live across Australia.

Key findings

Socioeconomic status

Children in families where the mother has low educational attainment

Policy context: A lack of successful educational experiences of parents may lead to low aspirations for their children; and may be related to parents’ attitudes, their ability to manage the complex relationships which surround a child’s health and education, and their capacity to control areas of their own lives [1,2,3,4].

The data: The proportion of children under 15 years in families where the mother has low educational attainment has been included in the Social Health Atlas since the 2006 Census. When the 2016 data for this indicator were compiled, it was encouraging to see the marked reduction in the number of children in these families, down by 44 per cent from 2006 to 2016. However, one outcome has been a widening in the equity gap, to a proportion in the most disadvantaged areas of the capital cities that is now four times that in the least disadvantaged areas and that has almost doubled in regional areas (i.e., areas outside of the capital cities). This concentration of people with many aspects of disadvantage is common across many indicators in the Atlas.

Children under 15 years without access to the Internet at home

Policy context: A household can be considered to be disadvantaged if it lacks the resources to participate fully in society [5]. Access to the outside world, through the Internet provides a means of communicating with friends and family, as well as services, employers and schools, thereby increasing educational, employment and other opportunities, including social interaction [6].

Socioeconomic characteristics of households continue to influence the rate of computer and Internet connectivity across Australia. Households which do not have children under 15 years, those that are located in non-metropolitan or regional areas of Australia and/or have lower household incomes are less likely to have a computer and/or access to the Internet [6].

The data: The research reveals 4.8% of Australian children under 15 years are living in homes without Internet access. The proportion of children under 15 years in families where the Internet was not accessed; however, the proportion varied by 6.7 times, from 1.2 per cent in the least disadvantaged areas of the capital cities to 7.9 per cent in the most disadvantaged areas. In regional areas (i.e., areas outside of the capital cities), the variation was smaller (4.5 times), although the proportions were higher, ranging from 3.1 per cent to 13.7 per cent.

Not surprisingly, the variation from Major Cities to Very Remote areas was greater, a difference in rates of 7.9 times (from 3.7 per cent to 29.4 per cent, respectively).

School leavers participating in higher education

Policy context: Education increases opportunities for choice of occupation and for income and job security, and also equips people with the skills and ability to control many aspects of their lives – key factors that influence wellbeing throughout the life course. Young people who complete Year 12 are more likely to make a successful initial transition to further education, training and work than early leavers [7].

The acquisition of a post-school qualification increases work and employment opportunities and also increases the likelihood of a financially secure future. Despite the Global Financial Crisis and the end of the mining boom impacting on the earning of early career graduates, Bachelor degree holders continued to enjoy a significant income premium over Year 12 holders [8].

The data: In March 2019, 40 per cent fewer young people from the most disadvantaged areas in the capital cities were enrolled at an Australian university, compared with the proportion in the least disadvantaged areas (proportions of school leavers of 20.2 per cent and 33.7 per cent, respectively). In regional areas (i.e., areas outside of the capital cities), participation in higher education was lower in all quintiles, and the equity gap was wider, with 57 per cent fewer young people from the most disadvantaged areas enrolled at an Australian university.

The city/country divide was even more substantial, with 82 per cent fewer young people from Very Remote Areas who finished school in 2018 being enrolled at a university in March 2019, when compared with those in the Major Cities (proportions of school leavers of 4.5 per cent and 24.8 per cent, respectively).

Health status and outcomes

Babies and their mothers

Policy context: Antenatal care is associated with positive child and maternal health outcomes, with regular antenatal care visits in the first trimester (before 14 weeks’ gestational age), leading to fewer interventions in late pregnancy and positive outcomes for child health [9]. The Australian Antenatal Guidelines recommend that the first antenatal visit occur within the first 10 weeks of pregnancy and that first-time mothers with an uncomplicated pregnancy attend 10 visits [10]. Although almost all mothers (99.9%) who gave birth in 2015 had at least one antenatal visit, although fewer than half (47%) did so in the first 10 weeks of pregnancy and 10% did not start antenatal care until after 20 weeks’ gestation [9].

The weight of a baby at delivery (birthweight) is widely accepted as a key indicator of infant health and can be affected by a number of factors, including the age, size, health and nutritional status of the mother, pre-term birth, and tobacco smoking during pregnancy [11]. A baby is defined as having a low birthweight if they are born weighing less than 2,500 grams. Low birthweight is generally associated with poorer health outcomes, including increased risk of illness and death, longer periods of hospitalisation after birth, and increased risk of developing significant disabilities [12].

Maternal smoking during pregnancy is a major risk factor that can adversely affect infant health, increasing the likelihood of low birth weight, pre-term birth, foetal and neonatal death, and SIDS [9].

The data: Women in the most disadvantaged areas of Australia were more likely

  • to not have had an antenatal visit in the first 10 weeks of their pregnancy, as recommended – in the capital cities, the proportion was 20 per cent higher than in the most disadvantaged areas, and in regional areas (i.e., areas outside of the capital cities) it was 13 per cent higher;
  •  

  • to have had a baby of low birth weight – in the capital cities the proportion was 74 per cent higher, and in regional areas, 54 per cent higher;
  •  

  • to have smoked cigarettes at some time during their pregnancy – in the capital cities, 5.8 times the rate of smoking in the least disadvantaged areas, and in regional Australia, 4.1 times.

It is of note that whereas the proportion of low birth weight babies has changed little over the past 12 years (in either the capital cities or regional areas), the rate of smoking during pregnancy has changed, and changed dramatically. The rate over the period 2016 to 2018 is down by 40 per cent on that in the period 2004 to 2006, with similar declines in the capital cities and regional areas. As shown here, although the reductions in smoking occurred across the social spectrum, the largest declines were in the least disadvantaged areas, resulting in a wider equity gap (the difference in rates between the most and least disadvantaged areas).

Differences are also evident across the Remoteness Areas, with the proportion of low birthweight babies in the Very Remote areas 67 per cent above that in the Major Cities; for smoking during pregnancy, the smoking rate in the Very Remote areas was nearly five (4.8) times that in the Major Cities, a range from 7.2 per cent in Major Cities to 34.6 per cent in the Very Remote areas.

The clear implication from these data is of the poorer health status at the beginning of life for many babies in the most disadvantaged and areas outside of Australia.

Deaths of young people

Policy context: The proportion of the youth population (15 - 24 years) who committed suicide over the period 2014 to 2018, at 35.9%, is higher than in any other age group, with the proportion declining with age, to 28.9% in the 25 to 34 years age group and 17.0% in the 35 to 44 years age group.

Just over one third (37.7%) of male deaths and around 31.6% of female deaths between 15 and 24 years were from intentional self-harm (suicide). The next highest proportion for females was deaths as an occupant of a car injured in a transport accident (17.0%), with a higher proportion for males (20.7%).

The age-specific death rates for Aboriginal and Torres Strait Islander males and females in New South Wales, Queensland, Western Australia, South Australia and the Northern Territory over the years 2014 to 2018 were 2.1 and 2.9 times higher than for non-Indigenous males and females, respectively. Note that this information is not available for Victoria, Tasmania and the Australian Capital Territory.

The data: Young people aged 15 to 24 years living in the most disadvantaged areas had a death rate that was 57 per cent above those in the least disadvantaged areas in the capital cities and 64 per cent higher in regional areas of Australia.

The city/country divide is even more evident, with deaths at these ages increasing substantially across the Remoteness Areas, with the rate in Inner Regional areas 69 per cent above that in Major Cities areas; in Outer Regional areas the gap was over double (2.2 times), in Remote Areas, almost three times (2.9 times) and in Very Remote areas it was over four times (4.4 times).

Children and young people presenting at emergency department clinics for mental health conditions

Policy context: Public hospital emergency departments are accessible 24 hours a day, seven days a week, to provide acute and emergency care to patients arriving either by ambulance or by other means. While some people require immediate attention for life threatening conditions or trauma, most require less urgent care.

An ED service event can be commenced by a doctor, nurse, mental health practitioner or other health professional, when investigation, care and/or treatment is provided in accordance with an established clinical pathway defined by the emergency department [13]. The data include both presentations at formal emergency departments and emergency occasions of service provided through other arrangements, particularly in smaller hospitals located in regional and remote areas. In particular, note the caveat at the link here.

The data: Young people aged 15 to 24 years from the most disadvantaged areas were more likely to attend a public hospital emergency department for a mental health condition – with a 61 per cent higher rate of presentations to an emergency department for those living in the capital cities when compared with those in the least disadvantaged areas; and a rate 79 per cent higher if living in regional areas.

For children aged from 0 to 14 years presenting to an emergency department for respiratory conditions (mainly asthma), there were large equity gaps for those in the capital cities (46 per cent higher rate of presentations in the most disadvantaged when compared with the least disadvantaged areas) and regional areas (55 per cent).

Variations in rates of presentation outside of the Major Cities areas are not consistent, being highly influenced by access to facilities providing these services, in particular in many regional and remote areas (see the comment re ‘caveats’ in the Policy context note, above).

The impact of presentations to emergency departments for all causes, and in recent years for mental health conditions, is well known and is putting an increasing strain on public hospital resources.

View References

View the Child and Youth Social Health Atlas of Australia

Maps

Single maps

The Single Map presents all indicators for all areas allowing users to explore and understand patterns and trends for a range of datasets.

Population Health Areas (PHA) map

Local Government Areas (LGA) map

Primary Health Networks with component PHAs map

Primary Health Networks with component LGAs map

Double maps

The Double Map enables users to select two different indicators to compare on two synchronised maps within the same view. The two indicators selected are also presented as a Scatterplot to assess potential correlations.

Population Health Areas (PHA) map

Local Government Areas (LGA) map

Primary Health Networks with component PHAs map

Primary Health Networks with component LGAs map

Area profile maps

The Area profile Map presents the indicators in a single view using a spine chart. In this way users can readily see how the selected area compares with the national average percentage or rate for each indicator.

Population Health Areas (PHA) map

Local Government Areas (LGA) map

Primary Health Networks with component PHAs map

Primary Health Networks with component LGAs map

*For the Area profile templates to show any data, you must select an area by highlighting it on the map. Learn more ...

Graphs

Monitoring inequality in Australia

The Inequality graphs present the Child and Youth Atlas Social Health Atlas of Australia indicators, where available, by Quintiles of Socioeconomic Disadvantage of Area, for Australia, States/ Territories, and the Capital cities and Rest of State/ Territory areas. For background information and an overview on interpreting the graphs, refer to the Inequality graphs: Introduction.

Graphs Australia NSW Vic Qld SA WA Tas NT ACT

Monitoring inequality in Australia: Primary Health Networks (PHN)

The Inequality graphs present the Child and Youth Atlas Social Health Atlas of Australia indicators, where available, by Quintiles of Socioeconomic Disadvantage of Area within Primary Health Networks (PHN), for each State/ Territory. For background information and an overview on interpreting the graphs, refer to the Inequality graphs: Introduction.

Graphs NSW Vic Qld SA WA Tas NT ACT

Remoteness

The Remoteness Graphs present the Child and Youth Atlas Social Health Atlas of Australia indicators, where available, by Remoteness Area, for Australia and the State/ Territory areas (excluding ACT). For information on the Remoteness classes or interpreting the graphs, refer to the Remoteness graphs: Introduction.

Graphs Australia NSW Vic Qld SA WA Tas NT

View Notes on the data