Jurisdictional, socioeconomic and gender inequalities in child health and development: analysis of a national census of 5-year-olds in Australia

doi:10.1136/bmjopen-2012-001075

BMJ Open. 2012; 2(5): e001075.

Published online 2012 September 4. doi: 10.1136/bmjopen-2012-001075

PMCID: PMC3437432

Jurisdictional, socioeconomic and gender inequalities in child health and development: analysis of a national census of 5-year-olds in Australia

Sally A Brinkman,^1,² Angela Gialamas,³ Azizur Rahman,³ Murthy N Mittinty,³ Tess A Gregory,¹ Sven Silburn,^1,⁴ Sharon Goldfeld,^5,⁶ Stephen R Zubrick,¹ Vaughan Carr,^7,⁸ Magdalena Janus,⁹ Clyde Hertzman,¹⁰ and John W Lynch^3,¹¹

¹Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, Perth, Australia

²Health Sciences, Curtin University, Perth, Australia

³School of Population Health, Discipline of Public Health, The University of Adelaide, Adelaide, Australia

⁴The Centre for Child Development and Education, Menzies School of Health Sciences, Darwin, Australia

⁵Centre for Community Child Health, Royal Childrens Hospital, Melbourne, Australia

⁶Murdoch Children's Research Institute, The University of Melbourne, Melbourne, Australia

⁷School of Psychiatry, Faculty of Medicine, The University of New South Wales, Sydney, Australia

⁸Schizophrenia Research Institute, Sydney, Australia

⁹Offord Centre for Child Studies, McMaster University, Hamilton, Canada

¹⁰Human Early Learning Partnership, The University of British Columbia, Vancouver, Canada

¹¹School of Social and Community Medicine, The University of Bristol, Bristol, UK

^{Correspondence to} Sally Anne Brinkman; Email: sallyb/at/ichr.uwa.edu.au

Received April 20, 2012; Accepted July 27, 2012.

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Abstract

Objectives

Early child development may have important consequences for inequalities in health and well-being. This paper explores population level patterns of child development across Australian jurisdictions, considering socioeconomic and demographic characteristics.

Design

Census of child development across Australia.

Setting and participants

Teachers complete a developmental checklist, the Australian Early Development Index (AEDI), for all children in their first year of full-time schooling. Between May and July 2009, the AEDI was collected by 14 628 teachers in primary schools (government and non-government) across Australia, providing information on 261 147 children (approximately 97.5% of the estimated 5-year-old population).

Outcome measures

Level of developmental vulnerability in Australian children for five developmental domains: physical well-being, social competence, emotional maturity, language and cognitive skills and communication skills and general knowledge.

Results

The results show demographic and socioeconomic inequalities in child development as well as within and between jurisdiction inequalities. The magnitude of the overall level of inequality in child development and the impact of covariates varies considerably both between and within jurisdiction by sex. For example, the difference in overall developmental vulnerability between the best-performing and worst-performing jurisdiction is 12.5% for males and 7.1% for females. Levels of absolute social inequality within jurisdictions range from 8.2% for females to 12.7% for males.

Conclusions

The different mix of universal and targeted services provided within jurisdictions from pregnancy to age 5 may contribute to inequality across the country. These results illustrate the potential utility of a developmental census to shed light on the impact of differences in universal and targeted services to support child development by school entry.

Keywords: Social Epidemology, Inequality, Public Health Policy, Child Health and Development, Australia

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