Abstract
BackgroundThe burden of mental health problems among Aboriginal and Torres Strait Islander children is a major public health problem in Australia. While socioeconomic factors are implicated as important determinants of mental health problems in mainstream populations, their bearing on the mental health of Indigenous Australians remains largely uncharted across all age groups.MethodsWe examined the relationship between the risk of clinically significant emotional or behavioural difficulties (CSEBD) and a range of socioeconomic measures for 3993 Indigenous children aged 4–17 years in Western Australia, using a representative survey conducted in 2000–02. Analysis was conducted using multivariate logistic regression within a multilevel framework.ResultsAlmost one quarter (24%) of Indigenous children were classified as being at high risk of CSEBD. Our findings generally indicate that higher socioeconomic status is associated with a reduced risk of mental health problems in Indigenous children. Housing quality and tenure and neighbourhood-level disadvantage all have a strong direct effect on child mental health. Further, the circumstances of families with Indigenous children (parenting quality, stress, family composition, overcrowding, household mobility, racism and family functioning) emerged as an important explanatory mechanism underpinning the relationship between child mental health and measures of material wellbeing such as carer employment status and family financial circumstances.ConclusionsOur results provide incremental evidence of a social gradient in the mental health of Aboriginal and Torres Strait Islander children. Improving the social, economic and psychological conditions of families with Indigenous children has considerable potential to reduce the mental health inequalities within Indigenous populations and, in turn, to close the substantial racial gap in mental health. Interventions that target housing quality, home ownership and neighbourhood-level disadvantage are likely to be particularly beneficial.
Highlights
The burden of mental health problems among Aboriginal and Torres Strait Islander children is a major public health problem in Australia
Aboriginal children were largely distributed in the more disadvantaged categories of most measures of socioeconomic status (SES), with few represented in the top category: only 6% of Aboriginal children had a primary carer with a post-secondary education, 5% lived in a family that could ‘save a lot’, and less than 1% lived in areas that fall into the top Socioeconomic Index for Areas (SEIFA) quintile
The strength and shape of the associations with mental health vary by SES measure, the most consistent gradients were found for housing quality and tenure
Summary
Mental health disorders have complex aetiologies, with a broad range of factors shown to variably influence them [3] across time and by place and lifecourse stage [4]. Among these factors socioeconomic status (SES) is consistently implicated as an important determinant in both adult [5,6,7,8,9] and child populations [10,11]. While this pattern has been observed from early childhood (0–5 years), the association is less consistent among young children, potentially owing to the difficulty in identifying mental illness in children of this age [10]
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