Health and Safety

About the Domain

The health and safety of children is a strong indicator of the value a society places on children. Being healthy and safe has a direct relationship with a child's wellbeing.

The Health and Safety domain examines 14 factors that strongly influence the life-long wellbeing of Western Australia's (WA's) children and young people. The measures reported here highlight all childhood age groups, from before birth to late adolescence.

The companion report Building Blocks contains information about programs which are effective in improving the wellbeing of children and young people in the Health and Safety domain.

  • Birth weight
    • Why this measure has been included

      A baby's weight at birth is generally considered to be a good proxy measure of neonatal health. Babies born in a healthy weight range, defined as 2,500g or more, are more likely to have good health overall and are less likely to be subject to significant disability compared with low birth weight babies (less than 2,500g). 1

      What is this measure?

      The measure examines the incidence of low birth weight babies in WA. The data used in this measure comes from the Australia's mothers and babies series of reports, which is published annually by the Australian Institute of Health and Welfare (AIHW).2 This is a comprehensive collection of perinatal statistics on births in Australia.

      Commentary

      Figure 1 shows that in 2008, 93.8 per cent of babies born in WA were 2500g or more. However, for babies born to Aboriginal mothers, the percentage was significantly lower at 85.2 per cent.

      The percentage of healthy-weight births in WA is close to the Australian average, with WA averaging 93.6 per cent between 2003 and 2008 and the national average being 93.7 per cent for both Aboriginal and non-Aboriginal mothers.

      However, when only Aboriginal mothers are considered, the WA percentage of 85.2 percent is consistently lower than the national average of 87.7 per cent. Between 2003 and 2008, the percentage of babies born at a healthy birth weight has not improved. During the same period the average percentage of babies at a healthy birth weight was 94.1 per cent for non-Aboriginal mothers.3 (See Figure 1 for trend data on Aboriginal births)

      The health of the mother both before and during pregnancy has a close relationship to the likelihood of a baby being born at a healthy weight. Mothers who are healthy, who have good nutrition during their teenage years and during pregnancy and who do not smoke or drink alcohol during their pregnancy are more likely to have a baby of a healthy weight.4

      In some cases, low birth weight is not a factor related to the health of the mother. Approximately half of multiple births result in low birth weight babies. The report Perinatal Statisticsin Western Australia 2008 published by the WA Department of Health stated that in 2008, 52.6 per cent of multiple-birth babies in WA were low birth weight.5 Australia-wide statistics for that year show 50.2 per cent of twins and 99.5 per cent of other multiple births were of low birth weight.6 Older mothers are also more likely to give birth to low birth weight babies.7

      At an international level, the Organisation for Economic Co-operation and Development (OECD) health data for 2008 showed that Australia, with 93.8 per cent of healthy birth weight babies, recorded a result that was similar to the OECD average of 93.7 per cent. However, if only the babies born to Aboriginal mothers are considered, the percentage drops to 87.7 per cent, well below the OECD average and lower than any OECD country.8

      Click here to download the PDF of this measure

       


      1 Laws PJ et al 2010, Australia's mothers and babies 2008, Perinatal statistics series no. 24, Cat no. PER 50, Australian Institute of Health and Welfare, p. 67.

      2 In 2008 this was published as Laws PJ, Li Z and Sullivan EA 2010, Australia's mothers and babies 2008, Perinatal statistics series no. 24, Cat no. PER 50, Australian Institute of Health and Welfare.

      3 Data from Midwives Notification System, (unpublished).

      4 United Nations Children's Fund 2007, Child poverty in perspective: An overview of child well-being in rich countries, Innocenti Report Card 7, 2007 United Nations Childrens Fund Innocenti Research Centre, Italy, p. 14.

      5 Le M & Tran B 2008, Perinatal Statistics in Western Australia 2008: Twenty-sixth Annual Report of the Western Australian Midwives' Notification System, Department of Health, Western Australia, p. 48.

      6 Laws PJ et al 2010, Australia's Mothers and Babies 2008, Perinatal statistics series no 24, Cat. No. PER 50, Australian Institute of Health and Welfare, p. 70.

      7 Laws PJ et al 2010, Australia's Mothers and Babies 2008, Perinatal statistics series no 24, Cat. No. PER 50, Australian Institute of Health and Welfare, p. 71.

      8 Organisation for Economic Co-operation, CO1.3 [website], viewed 30 September 2011, < http://www.oecd.org/dataoecd/4/37/46798664.pdf >.

  • Infant mortality
    • Why this measure has been included

      The infant mortality rate, which reflects the rate of survival of children in their first year of life, is used internationally, along with birth weight, as a key indicator of a country's overall infant health status.1 

      What is this measure?

      This measure looks at the infant mortality rate in WA and Australia. This information is drawn from the Australian Bureau of Statistics (ABS) data on deaths in Australia, based on information provided by each State's Registry of Births, Deaths and Marriages. Rates included here are provided as a three-year grouping to assist in reducing the volatility of the rate due to the small numbers involved.2

      Commentary

      Table 1 shows that in WA and Australia, the overall number of infant deaths is relatively low and has shown a downwards trend. The infant mortality rate in WA for 2007-09 is lower than the Australian average (3.0 per 1,000 in WA compared to 4.3 per 1,000 nationally).

      The ABS reports that in 2008, Australia's infant mortality rate was 4.1 infant deaths per 1,000 live births. This puts Australia in the lower third of OECD countries. Luxembourg had the lowest infant mortality rate in the OECD with a rate of 1.8 per 1,000 live births.3 

      In 2010, the WA Perinatal and Infant Mortality Committee released a report analysing perinatal and infant deaths between 2005 and 2007.4 Over this period there were 310 total infant deaths in WA. The report stated that the most prevalent causes of death were:

      • congenital abnormalities (30% of all deaths)
      • extreme prematurity (19.7%)
      • Sudden Infant Death Syndrome (SIDS) (14.2%)
      • neurological (12.3%).5 

      Notably, for all of these conditions other than neurological, the rate for Aboriginal mothers was higher to a statistically significant level.6

      The same report highlights an increased risk of perinatal and post-neonatal deaths for rural and regional areas. With the exception of the South West, all rates of perinatal deaths were significantly higher than for the metropolitan area and all rural areas exceeded the metropolitan rate for post-neonatal deaths.7 

      The ongoing decrease in infant mortality rates in WA is attributed to continuing advances in medical and obstetric care, increased public awareness of health issues for babies, antibiotics and vaccinations, and campaigns to address deaths through Sudden Infant Death Syndrome (SIDS) and accidents.8

      Click here to download the PDF of this measure


      1 Organisation for Economic Co-operation and Development Society at a Glance 2009:  Social Indicators, Organisation for Economic Co-operation and Development, p. 106.

      2 Australian Bureau of Statistics 2010, Deaths, Australia, 2009, cat. no. 3302.0 [website], viewed 10 January 2011, <http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/A932463DB3A44C73CA2577D60010A05B>

      3 Australian Bureau of Statistics 2010, Measures of Australia's Progress, 2010, cat. no. 1370.0 [website], viewed 26 September 2011,<http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/
      1370.0~2010~Chapter~International%20comparisons%20
      (4.1.9)>.  

      4 Perinatal and Infant Mortality Committee 2010, The 13th Report of the Perinatal and Infant Mortality Committee of Western Australia for Deaths in the Triennium 2005-07, Department of Health, Western Australia.  ‘Perinatal deaths' include stillbirths and neonatal deaths, where the child is born alive but dies within 28 days of birth.  'Infant deaths' includes all deaths of live-born babies up to one year old. 

      5 Perinatal and Infant Mortality Committee 2010, The 13th Report of the Perinatal and Infant Mortality Committee of Western Australia for Deaths in the Triennium 2005-07, Department of Health, Western Australia,  p. 41.

      6 Perinatal and Infant Mortality Committee 2010, The 13th Report of the Perinatal and Infant Mortality Committee of Western Australia for Deaths in the Triennium 2005-07, Department of Health, Western Australia,  p. 41.

      7 Perinatal and Infant Mortality Committee 2010, The 13th Report of the Perinatal and Infant Mortality Committee of Western Australia for Deaths in the Triennium 2005-07, Department of Health, Western Australia, p. 47.

      8 Perinatal and Infant Mortality Committee 2010, The 13th Report of the Perinatal and Infant Mortality Committee of Western Australia for Deaths in the Triennium 2005-07, Department of Health, Western Australia, p. 90.

       

  • Child health checks
    • Why this measure has been included

      There is a strong relationship between a child's early health and their wellbeing in later life.1 The WA Department of Health advises that all WA children aged 0 to six years can access seven child health and developmental assessments. These child health checks are free, evidence-based and delivered by child and school health nurses2 at critical points in the child's development to identify any health or developmental problems in the early stages.3

      What is this measure?

      This measure looks at the percentages of children who receive the seven health checks provided in WA, at the various ages prescribed. The data used has been provided by Child and Adolescent Community Health (CACH) services and is taken from the Community Health Care and Related Information System (HCARe) which reports on 'Occasions of Service' by service type as reported in the CACH Governance Report for 2009-10. 4

      CACH advises that this data is not available for regional WA, or by Aboriginality.

      In addition, at the time this data was reported in the 2009-10 Governance report, accurate live birth data was not available, therefore estimates were used based on the Department of Health Midwives' Notification System and the Epidemiology Branch population statistics.

      Commentary

      Nearly all (96% in 2008-09 and 99% in 2009-10) WA babies living in metropolitan areas were visited at home by a child health nurse for their first child health check. However, fewer than half of newborns (42% in 2008-09 and 46% in 2009-10) were visited within the optimal 10-day period (Table 2).

      Attendance at the second health check at six to eight weeks was high, with 92 per cent and 94 per cent of children receiving this contact in 2008-09 and 2009-10 respectively. The third health check at three to four months maintains a high attendance (between 79% and 81%), however, after this check, attendance declines sharply (Table 2).

      In 2008-09 only 31 per cent of children attended the 18 months check, and this decreased to 30 per cent in 2009-10. For the 3 to 3.5 year check only 11 per cent of children attended in 2008-09 and attendance decreased further to nine per cent in 2009-10 (Table 2).

      In 2008-09, 22,953 children received a school entry health assessment. The WA Department of Health has advised that this increased significantly in 2009-10 to 27,007 due to a two-year phased catch-up program to include Kindergarten and Pre-primary students5 (Table 3).

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      1 Council of Australian Governments 2009, Investing in the Early Years-A National Early Childhood Development Strategy, Commonwealth of Australia, p. 8.

      2 Child and school health nurses are registered nurses with post-graduate qualifications in child and family health.

      3Child and Adolescent Community Health, Our Services [website], viewed 28 September 2011, <http://pmh.health.wa.gov.au/general/CACH/services.htm>.

      4 Office of the Western Australian Auditor General, Universal Child Health Checks, Report 11 - November 2010, p. 6.  

      5 Email communication, WA Department of Health, 23 September 2011.

  • Immunisation
    • Why this measure has been included

      Immunisation against certain childhood diseases is effective in preventing child morbidity and mortality.1 It increases the protection for individual children and contributes to overall population health by reducing the rate at which those diseases circulate in the community.

      The National Immunisation Program Schedule2 is a comprehensive list of the recommended vaccinations for children at particular ages, with the intention of achieving widespread community immunity to certain transmissible childhood diseases, including diphtheria, measles, mumps and polio. Immunisation coverage of 90 per cent is required to interrupt the on-going transmission of vaccine-preventable disease in the community.3

      What is this measure?

      This measure counts those children who are fully immunised according to the appropriate schedule for their age (12 to 15 months, 24 to 27 months and 60 to 63 months).4 In Figure 3, Australian average figures are shown for comparison.

      Data has been supplied by the Australian Childhood Immunisation Register (ACIR), based on reporting by immunisation providers. The recording of whether a child is Aboriginal on the ACIR is voluntary and this may affect the level of reported immunisation coverage for Aboriginal children.

      Commentary

      The rate of immunisation in WA is lower than the rate for Australia overall at each of the first three immunisation stages. 

      Figure 2 shows that immunisation rates in WA have remained largely unchanged over the past five years, at slightly above or below the 90 per cent target for the first two recommended immunisation stages. Since 2005, WA has not met the target for the third immunisation. However, since the schedule was changed in 2008 to replace the 72-months vaccination with 60-months vaccinations, the rate of children fully vaccinated at 60 months has increased to reach 86.6 per cent in 2010.

      For Aboriginal children in WA, the rate of immunisation at 12 months is lower than for non-Aboriginal children, as shown in Figure 4. By the 24-month immunisation stage the gap narrows, yet falls away again at the third immunisation point.

      Compared internationally, WA has a lower rate of immunisation for DTP (Diptheria, Tetanus, Pertussis) than most OECD countries, and an average rate for measles.5 

      Click here to download the PDF of this measure

       


      1 Australian Institute of Health and Welfare 2009, A picture of Australia’s Children 2009, Cat. no. PHE 112, Australian Institute of Health and Welfare, p. 124.

      2 The National Immunisation Program Schedule can be found at  <http://health.gov.au/internet/immunise/publishing.nsf/Content/nips2>.

      3 Australian Institute of Health and Welfare 2009, A picture of Australia’s Children 2009, Cat. no. PHE 112, Australian Institute of Health and Welfare, p. 124.

      4 Note that the immunisation statistics are given a three month ‘window’ to ensure that delayed reporting to Australian Childhood Immunisation Register is still included.

      5 Organisation for Economic Co-operation and Development Health Data listing 2011 [website], viewed 30 September 2011, <http://www.oecd.org/dataoecd/52/42/49188719.xls>.

  • Smoke-free pregnancy
    • Why this measure has been included

      The effects of maternal smoking can persist throughout a child's life. There is strong evidence that smoking in pregnancy is associated with low birth weight, growth retardation in the fetus and increased risks of prematurity. There is also evidence of association with SIDS.1 2 

      What is this measure?

      The measure reports the incidence of smoking in pregnancy. Data on smoking in pregnancy in WA has been supplied by the Maternal and Child Health Unit, WA Department of Health, which maintains the WA Perinatal Collection.3 The comparative data for Australia has been calculated from the AIHW National Perinatal Collection.4

      Commentary

      Table 6 shows that the rate of smoking in pregnancy in WA declined from 2003 to 2008, and in 2008 it fell to just below the national average (16.2% nationally compared to 15.4% in WA).

      However, it is also clear that there is a significantly higher rate of smoking among Aboriginal pregnant women. Figure 5 shows that more than 50 per cent of Aboriginal women smoked in pregnancy in comparison to approximately 13 per cent of non-Aboriginal pregnant women.5

      Table 7 shows that non-Aboriginal women in regional areas were more likely to smoke in pregnancy than those in the metropolitan area.

      Some of the strategies aimed at decreasing the rate of smoking in the general population include ongoing campaigns to raise awareness on the effects of tobacco, significant increases in the price of tobacco and restrictions on the use of tobacco in public spaces through the Tobacco Products Control Act 2006.6 

      Click here to download the PDF of this measure


      1 Laws PJ et al 2010, Australia's mothers and babies 2008, Perinatal statistics series no. 24, Cat no. PER 50, Australian Institute of Health and Welfare, p. 67.

      2 Perinatal and Infant Mortality Committee 2010, The 13th Report of the Perinatal and Infant Mortality Committee of Western Australia for Deaths in the Triennium 2005-07, Department of Health, Western Australia, p. 46.

      3 Data from the Perinatal Collection is published annually as the Perinatal Statistics in Western Australia series under various authors.

      4 Data from the AIHW National Perinatal Collection is published annually as the Australia's Mothers and Babies series under various authors.

      5 Due to the relatively small numbers of Aboriginal women compared to the overall population, there is potential for small variations to cause large percentage variations and so interpretation of annual trend data is difficult.

      6 Tobacco Products Control Act 2006, sections 107A-107D contain the provisions regarding smoking in public places, see Tobacco Products Control Act 2006, (WA) [website], viewed 2 February 2012, <http://www.slp.wa.gov.au/legislation/statutes.nsf/main_mrtitle_983_homepage.html>

  • Alcohol-free pregnancy
    • Why this measure has been included

      The consumption of alcohol in pregnancy can have a negative effect on a baby's wellbeing. Drinking during pregnancy is linked to a range of conditions including low birth weight, alcohol-related birth defects, alcohol-related neurodevelopmental disorders and a number of conditions that are broadly classified as Fetal Alcohol Spectrum Disorder.1 

      Current research indicates that even low levels of alcohol use in pregnancy may have an adverse effect on the fetus and current National Health and Medical Research Council guidelines recommend that women do not drink at all during pregnancy.2

      What is this measure?

      At present there is no consistent data collection on alcohol use in pregnancy, although the Department of Health has indicated that it may commence collecting this information in the next three years.3 

      The National Drug Strategy Household Survey (NDSHS) 2010 data was collected from over 26,000 people across Australia aged 12 or over. The sample size for WA in 2010 was 2,473 persons overall, including 1,306 females.

      A Telethon Institute of Child Health Research (TICHR) study invited 10 per cent of women who gave birth between 1 January 1995 and 30 June 1997 to participate in research which involved completing a questionnaire 12 weeks after birth on health-related behaviours before, during and after pregnancy.  There were 4,839 valid responses.4

      Neither of these data sets is available by region or Aboriginality.

      Commentary

      According to the 2010 data collected by AIHW for the NDSHS and shown in Figure 6, around 50 per cent of pregnant women in both the WA and Australian samples did not drink at all during pregnancy. Comparison with results from previous surveys, particularly 2007, shows that the proportion of women abstaining from alcohol during pregnancy has increased in WA and all other jurisdictions except South Australia (Table 8).5  

      Approximately one in two women continue to consume alcohol on at least one occasion during pregnancy in both WA and Australia overall.

      The TICHR study found that 58.7 per cent of women drank alcohol at least once during pregnancy, with the majority of women that did drink (54.4%) averaging less than one standard drink per day. Around one in 20 (4.4%) pregnant women drank one standard drink or more per day during the pregnancy.6 

      The TICHR study also found that the amount of alcohol consumed on a typical occasion also decreased somewhat. Approximately one-third (32.3%) of respondents said they drank more than two and less than five standard drinks per occasion in the first three months prior to pregnancy. Drinking at this level decreased to 10.6 per cent in the first trimester of pregnancy and decreased further in the second and third trimesters.7 The study also found that for those women who continued to drink only one to two standard drinks per occasion, the frequency at which this occurred decreased.8

      The findings of the TICHR survey on the decreasing frequency of drinking are similar to another WA study based on surveys of 587 women who gave birth between September 2002 and July 2003 in two hospitals in the Perth metropolitan area. This study showed that nearly one-third (32.7%) of women did not drink before pregnancy, but during pregnancy this nearly doubled (64.8%). In addition, most respondents who did drink during pregnancy stated their drinking levels had decreased significantly. The amount respondents drank on any occasion halved from two standard drinks to one, and the number of occasions of drinking per week nearly halved from 1.7 days per week to one day per week.9

      Fetal Alcohol Syndrome (FAS) is a severe alcohol-related condition in children that can result from drinking alcohol during pregnancy, and is one of the conditions which fall under the classification of Fetal Alcohol Spectrum Disorder. FAS can result in learning difficulties, behavioural problems, mental illness and other wellbeing issues throughout the child's life and into adulthood.10 It is of particular concern in the Aboriginal community, as rates of occurrence in Aboriginal babies are reported to be significantly higher than in non-Aboriginal babies.11 

      While research indicates that, generally, fewer Aboriginal women than non-Aboriginal women consume alcohol, those that do tend to drink at more harmful levels, particularly women of childbearing age.12

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      1 National Health and Medical Research Council 2009, Australian Guidelines to reduce health risks from drinking alcohol, Commonwealth of Australia, pp. 70-71 & 75-76.

      2 See the National Health and Medical Research Council, Frequently asked questions on alcohol, <http://www.nhmrc.gov.au/your_health/healthy/alcohol/alcoholqa.htm>.

      3, Information provided to the Commissioner for Children and Young People, [email], 3 May 2011, Department of Health, Western Australia.

      4 Colvin L et al 2007, 'Alcohol Consumption During Pregnancy in Nonindigenous West Australian Women', Alcoholism:  Clinical and Experimental Research, vol 31, no 2, pp. 276-284.

      5 Results for the ACT, NT and Tas have been excluded due to small sample sizes in these jurisdictions.

      6 Colvin L et al 2007, 'Alcohol Consumption During Pregnancy in Nonindigenous West Australian Women', Alcoholism:  Clinical and Experimental Research, vol 31, no 2, p. 279.

      7 Colvin L et al 2007, 'Alcohol Consumption During Pregnancy in Nonindigenous West Australian Women', Alcoholism:  Clinical and Experimental Research, vol 31, no 2, p. 280.

      8 Colvin L et al 2007, 'Alcohol Consumption During Pregnancy in Nonindigenous West Australian Women', Alcoholism:  Clinical and Experimental Research, vol 31, no 2, p. 280.

      9 Giglia R and Binns C 2007, 'Patterns of alcohol intake in pregnant and lactating women in Perth, Australia', Drug and Alcohol Review, Sept 2007, vol 26 no 5, pp. 493-500.

      10 Alcohol and Pregnancy Project 2009, Alcohol and Pregnancy and Fetal Alcohol Spectrum Disorder: a Resource for Health Professionals (1st revision), Telethon Institute for Child Health Research, p. 7.

      11 Alcohol and Pregnancy Project 2009, Alcohol and Pregnancy and Fetal Alcohol Spectrum Disorder: a Resource for Health Professionals (1st revision), Telethon Institute for Child Health Research, p. 8.

      12 Zubrick S et al 2004, The Western Australian Aboriginal Child Health Survey:  The Health of Aboriginal Children and Young People, Telethon Institute for Child Health Research, p. 116.

  • Body Weight
    • Why we have included this measure

      Being overweight or obese increases a child's risk of a number of lifestyle diseases, including diabetes, heart disease, asthma, and some cancers, both in the short and long term.1 A healthy weight in childhood is particularly important as children who are overweight or obese tend to carry this into adulthood.2

      Children and young people who are overweight or obese can also experience discrimination, victimisation and teasing by their peers. This may contribute to poor peer relationships, school experiences and psychological wellbeing, particularly among older overweight and obese children.3

      The measure used here is Body Mass Index (BMI), which is internationally accepted as an indirect measure of overweight and obesity. BMI is calculated by dividing weight in kilograms by the square of height in metres.4

      What is this measure?

      This measure is concerned with the BMI of children and young people five to 17 years old.

      Figure 7 and Figure 8 include data taken from the WA Health and Wellbeing Surveillance System (HWSS).5 This survey is conducted monthly by phone interview and aggregated over the year. 

      For the five to 15 year-old age group, the BMI is calculated from parental responses about their child's height and weight, while BMI for the 16 to 17 years age group is calculated from the young person's own responses. 

      Table 10 shows estimates derived from the National Health Survey (NHS) 2007-08 that is conducted by the ABS.6 The NHS is an Australia-wide survey of over 20,000 people who are randomly selected and interviewed in person. In the 2007-08 survey, for the first time since 19957 the height and weight of respondents aged five years and over was measured in the interview and this was recorded in addition to the self-reported data. The estimates shown in Table 10 are based on the measured results.

      Of the two data sets that inform this measure, neither is available by region or by Aboriginality. 

      NHS estimates for respondents categorised as underweight are not available for individual states and territories.8 The estimates are included in category 'underweight/normal'. Similarly, the HWSS results for respondents categorised as underweight are included in category 'not overweight or obese'.

      Commentary

      In 2010, the HWSS found that based on responses from parents or carers more than three-quarters (77.7%) of WA children aged five to 15 years were not overweight or obese.

      The HWSS data for this measure for the past five years shows a slight change in the results for the age group five to 15 years, where the proportion of children considered not overweight or obese has increased from 73.6 per cent in 2004 to 77.7 per cent in 2010. In terms of gender differences, the survey results indicate a greater prevalence of overweight female children and a greater prevalence of obesity in male children, although these differences are not statistically significant (Table 9).

      For young people 16 and 17 years of age, the proportion who are not overweight or obese (based on self-assessment) decreased from 84.9 per cent in 2004 to 78.4 per cent in 2009.

      Based on results from the 2007-08 NHS, the ABS estimates that in WA 74.9 per cent of five to 17 year olds are not overweight or obese.9 This is similar to the result for Australia overall (75.3%).

      Approximately one in five of those in the five to 17 year age group in WA are considered overweight and around one in 20 are obese.10 Comparison with previous years is not possible as only self-reported measurements were collected.11

      Click here to download the PDF of this measure

       


      1 Australian Institute of Health and Welfare 2011, Headline Indicators for children's health, development and wellbeing 2011, Australian Institute of Health and Welfare, p. 41.

      2 Australian Bureau of Statistics 2009, 'Children who are overweight or obese', Australian Social Trends, Sep 2009 [website],viewed 22 September 2011,<http://www.ausstats.abs.gov.au/ausstats/subscriber.nsf/
      LookupAttach/4102.0Publication24.09.093/$File/41020_Childhoodobesity.pdf
      >.

      3 Australian Institute of Health and Welfare 2011, Headline Indicators for children's health, development and wellbeing 2011, Australian Institute of Health and Welfare, p. 41.

      4 Australian Institute of Health and Welfare 2011, Headline Indicators for children's health, development and wellbeing 2011,  Australian Institute of Health and Welfare, p. 42.

      5 Davis P & Joyce S 2011, The Health and Wellbeing of Children in Western Australia in 2010, Overview and Trends. Department of Health, Western Australia.

      6 Australian Bureau of Statistics 2009, National Health Survey: Summary of Results, 2007-2008 (Reissue),'Table 12: Health risk factors: Children aged 5 to 17 years', data cube: Excel spreadsheet, cat. no.4364.0, viewed 22 September 2011, <http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/
      4364.02007-2008%20(Reissue)?OpenDocument
      >.

      7 Australian Bureau of Statistics 1997, National Nutrition Survey: Selected Highlights, Australia, 1995, cat. no. 4802.0, viewed 10 January 2012, <http://www.abs.gov.au/ausstats/abs@.nsf/mf/4802.0>.

      8 Due to small sample size and corresponding high relative standard error rates.

      9 Included in this estimate is the proportion of respondents that qualify as 'underweight'.

      10 For a detailed discussion on the tendency for survey participants to over-estimate height and under-estimate weight, refer to Australian Bureau of Statistics 1995, How Australians Measure Up, cat. no. 4359.0, viewed 5 January 2012,  <http://www.ausstats.abs.gov.au/Ausstats/subscriber.nsf/
      Lookup/CA25687100069892CA256889001F4A36/$File/43590_1995.pdf
      >.

      11 The Australian Bureau of Statistics collected measured data for height and weight for the National Nutrition Survey of 1995 however these results have not been reflected here.

  • Physical activity
    • Why this measure has been included

      Physical activity may have positive effects on overall health and wellbeing. Maintaining an active lifestyle decreases the risk of a number of lifestyle-related diseases such as coronary heart disease, stroke and diabetes.1  

      What is this measure?

      This measure examines the reported weekly physical activity levels of children and young people five to 17 years old. WA data is sourced through the WA HWSS.2 The data for children and young people five to 15 years is reported by parents and data for those 16 to 17 years is self-reported. Children aged five to 15 years are considered to meet the requirement if they maintain seven sessions of physical activity per week for at least 60 minutes per session. Young people aged 16 to 17 years meet the requirement if they participate in at least five sessions to a total of 150 minutes per week.

      Commentary

      In 2006 around 45 per cent of children in WA between five and 15 years of age met the physical activity guidelines. After an increase from that rate in the following two years, when more than half of children met the guidelines, in 2010 the result was similar to 2006. Boys were significantly more likely to complete the recommended amount of physical activity compared with girls. In 2010, 59.1 per cent of boys aged between five and 15 years met the guidelines compared with 38.4 per cent of girls in this age group.3 (Figure 9)

      Figure 10 shows that in the same year, three-quarters (75.1%) of young people aged 16 and 17 years met the guidelines, which is the highest percentage since 2006.

      It is difficult to compare State data with national data due to the differences in the age groupings. However, the Victorian Child Health and Wellbeing Survey in 2006 found that 71.2 per cent of Victorian children aged five to 12 years met the daily guidelines.4 Similarly, the Tasmanian Child Health and Wellbeing Survey reported that 62 per cent of children aged five to 12 years were physically active for at least 60 minutes per day.5

      The Commissioner for Children and Young People WA's research into the wellbeing of children and young people in WA found that children and young people were interested in both structured and unstructured physical activity and recreation. The participants said that, as well as the physical health benefits, recreational activities provided an important opportunity for children and young people to develop confidence, competence and a sense of achievement. However, some participants noted that there were barriers to participating in activities such as lack of facilities, cost, lack of transport, age restrictions and safety concerns. This was particularly the case for children and young people in remote areas.6 

      Click here to download the PDF of this measure


      1 Davis P & Joyce S 2011, The Health and Wellbeing of Children in Western Australia in 2010, Overview and Trends,  Department of Health, Western Australia, p. 44.

      2 Annual series published as The Health and Wellbeing of Children in Western Australia:  Overviews and Trends  and  Health and Wellbeing of Adults in Western Australia:  Overviews and Trends, various years

      3 Davis P & Joyce S 2011, The Health and Wellbeing of Children in Western Australia in 2010, Overview and Trends, Department of Health, Western Australia, p. 46.

      4 Department of Education and Early Childhood Development 2009, The State of Victoria's Children 2008:  A report on how children and young people in Victoria are faring, Department of Education and Early Childhood Development, p. 51.

      5 Tasmanian Government 2009, Kids Come First Report 2009:  Outcomes for Children and Young People in Tasmania, Tasmanian Government,p. 47.

      6 Commissioner for Children and Young People Western Australia 2010, Speaking out about wellbeing,, Commissioner for Children and Young People Western Australia, pp. 12-13.

  • Treatment for a mental health disorder
    • Why this measure has been included

      Good mental health is an essential component of wellbeing and means that children and young people are more likely to have fulfilling relationships, cope with adverse circumstances and adapt to change.1 Poor mental health for children and young people is associated with behavioural issues, a diminished sense of self-worth and a decreased ability to cope. This can affect their quality of life, emotional wellbeing and capacity to engage in school and community activities.2

      When a person experiences a mental health problem or disorder in childhood or adolescence, it can be a precursor to ongoing mental health issues in adulthood and increases the likelihood of alcohol and drug use, smoking, poorer physical health and social skills, and lower educational attainment.3

      What is this measure?

      There is no adequate or reliable data which accurately reflects the extent of mental health issues among children and young people in the community.

      In information provided to the Commissioner for Children and Young People WA's Inquiry into the mental health and wellbeing of children and young people in Western Australia,4 the Infant, Child, Adolescent and Youth Mental Health Executive Group estimated that the Child and Adolescent Mental Health Service was only funded to provide a service to 20 per cent of the children and young people who required it.5

      Additionally, underfunding of many mental health services has resulted in stringent eligibility criteria being developed to manage demand.6 Underfunding has also resulted in lengthy waiting lists with a focus on 'crisis' response rather than comprehensive early intervention and treatment.7 In regional and remote areas of WA, mental health assessment, early intervention and treatment services are especially limited.8

      Commentary

      A number of studies have examined the prevalence of mental health problems and disorders in Australian children and young people. The Child and Adolescent component of the National Survey of Mental Health and Well-being, conducted in 1998, concluded that about 14 per cent of Australian children and young people between four and 17 years of age had a mental health problem.9 A 2009 report by Access Economics stated that almost one-quarter (24.3%) of Australian young people aged 12 to 25 years had some form of mental health illness. Illnesses included anxiety disorders, affective disorders, substance use disorders, personality disorders, childhood disorders, schizophrenia and eating disorders.10

      TICHR conducted the Western Australian Child Health Survey in 1995, which found that more than one in six children in WA aged four to 17 years had a mental health problem.11 The Western Australian Aboriginal Child Health Surveyin 2005 found that 24 per cent of Aboriginal children aged four to 17 years were at high risk of clinically significant emotional or behavioural difficulties.12

      The Raine Study, a longitudinal study of a cohort of children born in WA, reported that 11.5 per cent of children aged two years and 20 per cent of children aged five years had clinically significant behavioural problems, with more than six per cent having clinically significant mental health problems at both ages.13

      The 2011 Report of the Inquiry into the Mental Health and Wellbeing of Children and Young People in Western Australia, made 54 recommendations including that:

      • funding to the State's ICAYMHS be increased to meet the needs of those with mild, moderate and severe mental illnesses
      • the Mental Health Commission improve and maintain comprehensive data collection on the mental health of children and young people, including of mental health and wellbeing outcomes
      • funding be provided for the TICHR Child Health Survey to be conducted every three years.

      The latter two recommendations are aimed at increasing understanding concerning the extent and nature of mental health problems and disorders amongst children and young people, and to help in the planning of policy and services.14

      Click here to download the PDF of this measure

       


      1 Australian Research Alliance for Children and Youth 2008, The Wellbeing of Young Australians:  Report Card, Australian Research Alliance for Children and Youth, p. 4.

      2 Commissioner for Children and Young People Western Australia 2011, Report of the Inquiry into the mental health and wellbeing of children and young people in Western Australia, Commissioner for Children and Young People Western Australia, p. 28.

      3 Commissioner for Children and Young People Western Australia 2011, Report of the Inquiry into the mental health and wellbeing of children and young people in Western Australia, Commissioner for Children and Young People Western Australia, p. 28.

      4 Commissioner for Children and Young People Western Australia 2011, Report of the Inquiry into the mental health and wellbeing of children and young people in Western Australia, Commissioner for Children and Young People Western Australia.

      5 Infant Child and Youth Mental Health Executive Group 2009, New Strategic Directions for Child and Adolescent Mental Health Services 2010-2020 (Draft), p. 10.

      6 Commissioner for Children and Young People Western Australia 2011, Report of the Inquiry into the mental health and wellbeing of children and young people in Western Australia, Commissioner for Children and Young People Western Australia, pp. 45 & 52.

      7 Commissioner for Children and Young People 2011, Report of the Inquiry into the mental health and wellbeing of children and young people in Western Australia, Commissioner for Children and Young People, Western Australia, pp. 65-66.

      8 Commissioner for Children and Young People 2011, Report of the Inquiry into the mental health and wellbeing of children and young people in Western Australia, Commissioner for Children and Young People, Western Australia, p. 75.

      9 Sawyer M et al 2000, Mental Health of Young People in Australia:  Child and Adolescent Component of the National survey of Mental Health and Well-Being, Department of Health and Aged Care, Commonwealth of Australia, pp. xi.

      10 Access Economics 2009, The economic impact of youth mental illness and the cost effectiveness of early intervention, Access Economics, p.11.

      11 Zubrick S et al 1995, Western Australian Child Health Survey:  Developing Health and Wellbeing in the Nineties, Australian Bureau of Statistics and Institute for Child Health Research, Western Australia, p. 35.

      12 Zubrick, S, et al 2005, The Western Australian Aboriginal Child Health Survey: The Social and Emotional Wellbeing of Aboriginal Children and Young People, Curtin University of Technology and Telethon Institute for Child Health Research, p. 25.

      13 Robinson et al 2008, 'Pre- and post-natal influences on pre-school mental health: a large-scale cohort study', The Journal of Child Psychology and Psychiatry, 2008, 49 (10), pp. 1118-28.

      14 Commissioner for Children and Young People 2011, Report of the Inquiry into the mental health and wellbeing of children and young people in Western Australia, Commissioner for Children and Young People Western Australia, pp. 65-67.

  • Exposure to family and domestic violence
    • Why this measure has been included

      Research has consistently identified the negative effects of exposure to family and domestic violence on children and young people.1

      Some of the psychological and behavioural effects of exposure to family and domestic violence can include depression, anxiety, trauma symptoms, antisocial behaviour, mood problems, school difficulties and a higher likelihood of substance abuse.2 Other research has identified that possible consequences of exposure to family violence include eating disorders, early school leaving, suicide attempts and violence.3

      There is a growing body of evidence around the effects of witnessing family and domestic violence on children and young people. While the child themselves may not be the subject of the violent behaviour, the existence of violent behaviour in their household has been shown, for a significant proportion of children, to cause trauma. This can have effects on the child's coping mechanisms and sense of self, can cause a state of hyper-vigilance, and in some cases can manifest as post-traumatic stress disorder.4 Not all children witnessing domestic violence exhibit trauma symptoms;5 regardless, every child or young person has a right6 to live free from violence in any form.

      What is this measure?

      There is no adequate or reliable data which reflects the incidence of family and domestic violence in the community, in particular, children's exposure to it. Family and domestic violence is generally under reported.7 Hence, any data that is available is at best a proxy and indicative measure and cannot reflect the extent of exposure to family violence. The data in Table 15 is limited as a measure of children and young people's exposure to family violence and is at best a proxy and indicative measure.

      This measure compares police data on family and domestic incidents from 2006 and 2010. Rates are per 1,000 population, calculated against the ABS Estimated Resident Population for 2006 and 2010 respectively.8 In the tables, a 'crime' incident indicates police recorded one or more offences against at least one person involved in the incident, while a 'general' incident indicates there were no offences recorded.

      This data has been reported by WA Police district and, due to differing collection strategies, the data is not comparable with other states or nationally. It is not available by Aboriginality.

      All the reported incidents are those in which a family or domestic relationship exists between parties, but this does not necessarily indicate that the incident was family violence or a precursor to family violence.

      Commentary

      From current data it is difficult to know how many children are directly affected by family and domestic violence. The report Children's exposure to domestic violence in Australia examines current literature on the effects of family and domestic violence on children and infers that households where violence is reported are considerably more likely to have children present than non-violent households.9

      Table 15 shows that between 2006 and 2010 the overall rate of reported family and domestic incidents has increased. However, the rate of 'crime' incidents has decreased, while the rate of 'general' incidents has increased significantly.

      In 2006 the rate of 'crime' incidents was higher than 'general' incidents in eight of 14 districts. By 2010 this trend had shifted, and all districts recorded a higher rate of 'general' incidents than 'crime' incidents.

      WA Police advise that this reversal may in part be attributed to changes in legislation and policy around responses to family and domestic violence. Recent years have seen the consolidation of a cross-government collaborative approach to addressing family and domestic violence, including the establishment of models where WA Police and Department for Child Protection (DCP) officers are co-located, to allow a more immediate response.

      WA Police are also taking a more proactive approach to addressing family violence incidents, particularly promoting early intervention. In addition, WA Police have implemented improved recording of incidents and better education and training around appropriate responses to family violence. This increased focus on family violence has seen increased reports of potential family violence incidents, allowing police to intervene prior to offending behaviour occurring.10

      Rates of reported incidents, per 1,000 population, are considerably higher in the Kimberley, Pilbara, Goldfields-Esperance and Mid West-Gascoyne than in the metropolitan and southern districts.

      Click here to download the PDF of this measure


      1 The term 'exposure' is used here to reflect current research which shows that a child does not have to be a witness to actual physical violence to be affected by it and that family and domestic violence can take many forms. Richards K 2011, Children's exposure to domestic violence in Australia, Trends and issues in crime and criminal justice, No 419, Australian Institute of Criminology, June 2011, p. 1.

      1 Richards K 2011, Children's exposure to domestic violence in Australia, Trends and issues in crime and criminal justice, No 419, Australian Institute of Criminology, June 2011, p. 3.

      2 Richards K 2011, Children's exposure to domestic violence in Australia, Trends and issues in crime and criminal justice, No 419, Australian Institute of Criminology, June 2011, p. 3.

      3 Laing L 2000, Children, young people and domestic violence, Issues Paper no. 2, Australian Domestic and Family Violence Clearinghouse.

      4 Humphreys C 2007, Domestic violence and child protection: Challenging directions for practice, Issues Paper no. 13, Australian Domestic and Family Violence Clearinghouse.

      5 Article 19 of the United Nations Convention on the Rights of the Child

      6 A discussion of this can be found in Richards K 2011, Children's exposure to domestic violence in Australia, Trends and issues in crime and criminal justice No, 491, June 2011, Australian Institute of Criminology.

      7 Australian Bureau of Statistics 2007, Population by Age and Sex, Australia, 2006, 'Table - Population Estimates by Age and Sex, Western Australia by Geographical Classification [ASGC 2006], data cube: Excel spreadsheet, cat. no. 3235.0 [website], viewed 17 August 2011, <http://www.ausstats.abs.gov.au/Ausstats/subscriber.nsf/
      0/FDB4BC36AC4D8E09CA2573210018C32C/$File/32350_agesex_wa_%202006.xls
      >.

      8 Australian Bureau of Statistics 2011, Population by Age and Sex, Regions of Australia, 2010, 'Table - Population Estimates by Age and Sex, Western Australia by Geographical Classification [ASGC 2010], 2005 and 2010', datacube: Excel spreadsheet, cat. no. 3235.0 [website], viewed 17 August 2011 <http://www.ausstats.abs.gov.au/Ausstats/subscriber.nsf/
      0/23478B15D2FD9DACCA2578E10013A199/$File/32350ds0006_wa_2005_2010.xls
      >.

      9 Richards K 2011, Children's exposure to domestic violence in Australia, Trends and issues in crime and criminal justice, No 419, June 2011, p. 2.

      10 Western Australian Police 2011, Information provided to the Commissioner for Children and Young People, [email], 3 November 2011.

  • Substantiations of notifications of abuse or neglect of children and young people
    • Why this measure has been included

      National and international research consistently refers to the profound impact of trauma on children and young people who have been abused and/or neglected and the trauma of being removed from their parents and potentially other family members. This trauma, coupled with a lack of secure attachment, contributes to these children and young people being at high risk of mental health problems, including attention and social problems. There are also higher rates of suicide attempts by children and young people who have been abused or neglected when compared with the general population.1  2 

      What is this measure?

      This data reports on the numbers and rates of substantiations of a notification of abuse and neglect for children. Substantiations are recorded when the relevant department has received a child protection notification, investigates and concludes that there was reasonable cause to believe that a child has suffered significant harm or is likely to through abuse and/or neglect.

      Not all cases of abuse and neglect come to the attention of authorities. This data is therefore presented as a proxy measure, to show a proportion of those children affected by abuse or neglect.3

      This data is taken from Child protection Australia 2009-2010 and has beenextracted from the administrative systems of the state and territory departments responsible for child protection, according to nationally agreed definitions and counting rules.4

      The differences between states and territories in legislation, policies and practices in relation to child protection should be taken into account when interpreting the data for this measure.5 On 1 January 2009, WA introduced mandatory reporting provisions for sexual abuse; where doctors, nurses, midwives, teachers and police have a reasonable suspicion that a child is or has been a victim of sexual abuse, they must report.6 Other Australian jurisdictions have mandatory reporting of all forms of child abuse (ie physical, emotional and sexual abuse) and child neglect. Victorian and the Australian Capital Territory have mandatory reporting for suspected cases of child sexual abuse and physical abuse only.7

      It should also be noted that WA implemented a new client information system in March 2010 and was unable to report data for the 2009-10 financial year. Data for the period 1 January 2010 to 31 December 2010 was used as a proxy for 2009-2010 data. Data as at 31 December 2010 was used as a proxy for data at 30 June 2010.

      Commentary

      The Child protection Australia 2009-10 publication data at Table 16 indicates that in WA, the rate of children who are the subject of a substantiation of a notification of abuse or neglect was 2.9 per 1,000, which is the lowest rate of all jurisdictions. This compares to a national rate for the same period of 6.1 per 1,000. 

      From 2004-05 to 2009-10 in WA there was a slight increase (0.8 per 1,000) in substantiations of notifications of abuse or neglect. Nationally from 2004-05 to 2009-10 there was a slight decrease of 1.0 per 1,000.

      Across all jurisdictions in 2009-10, Aboriginal children and young people were more likely to be the subject of a substantiation of a notification than non-Aboriginal children and young people. Table 17 shows the rate ratio of substantiation of a notification. In WA, the rate ratio of Aboriginal children and young people who were the subject of a substantiation of a notification compared to non-Aboriginal children and young people was the highest of all states and territories at 12.7 per 1,000.8 The national rate ratio of Aboriginal to non-Aboriginal children substantiation of notifications was 7.7 per 1,000.

      In terms of the reasons for substantiations of notifications of neglect and abuse of children and young people, data published in Child protection Australia 2009-10 (reproduced in Table 18) indicates that in WA, neglect is most common, followed by emotional, physical and sexual abuse, which has a similar substantiation rate with a variance of 1.3 per cent. Other jurisdictions report emotional abuse as the most common reason for substantiations of notifications, except for the Northern Territory where, as with WA, neglect is most common.9 Males were more likely to be the subjects of substantiations of notifications of all types of abuse other than sexual abuse (Figure 11).

      Click here to download the PDF of this measure

       


      1 Sawyer et al 2007, 'The mental health and wellbeing of children and adolescents in home-based foster care', Medical Journal of Australia, 186 (4), pp. 181-184.

      2 Department of Community Services 2007, Mental Health of Children in Out- of-Home Care in NSW, Australia , Department of Community Services.

      3 This is in keeping with other jurisdictions such as Victoria.  See Department of Education and Early Childhood Development 2009, The State of Victoria's children 2008:  A report on how children and young people in Victoria are faring, DEECD, p. 83.

      4 Australian Institute of Health and Welfare 2011, Child protection Australia 2009-10, Cat. no. CWS 39, Australian Institute of Health and Welfare.

      5 Australian Institute of Health and Welfare 2011, Child protection Australia 2009-10, Cat. no. CWS 39, Australian Institute of Health and Welfare, p. 45.

      6 For further information on mandatory reporting in Western Australia see www.mandatoryreporting.dcp.wa.gov.au

      7 Australian Institute of Health and Welfare 2011, Child protection Australia 2009-10, Cat. no. CWS 39, Australian Institute of Health and Welfare, pp. 91-94.

      8 Rate ratios are calculated by dividing the un-rounded rate of Aboriginal children who were the subject of a substantiation notification by the un-rounded rate of non-Aboriginal children who were the subject of a substantiation notification.

      9 WA data for the period 1 January 2010 to 31 December 2010 was used as a proxy for 2009-10 data.  Data as at 31 December 2010 was used as a proxy for data at 30 June 2010.

  • Children and young people in out-of-home care
    • Why this measure has been included

      Out-of-home care refers to the care of children and young people less than 18 years of age who are unable to live with their families, usually due to child abuse and/or neglect. It involves the placement of a child or young person with alternate caregivers on a short— or long-term basis.

      International and national studies consistently show that children and young people in out-of-home care experience high levels of disadvantage and have exceptionally poor mental health and social competence relative to the general population. 12

      Studies have also found that children and young people who have been in out-of-home care have poor long-term outcomes compared to the general population. These children and young people are less likely to complete schooling to Year 12 level or its equivalent. They are also more likely to be unemployed, homeless, have involvement with the youth justice system, have alcohol and drug use problems and become teenage parents.3

      What is this measure?

      This measure is of the numbers of children who are in various forms of out-of-home care in WA and Australia. This data is taken from Child protection Australia 2009-2010 and has beenextracted from the administrative systems of the state and territory departments responsible for child protection, according to nationally agreed definitions and counting rules.4

      The differences between states and territories in legislation, policies and practices in relation to out-of-home care should be taken into account when interpreting the data for this measure.5 A description of the legislative and regulatory position of each state and territory is available in the Child protection Australia series of reports.6

      It should also be noted that WA implemented a new client information system in March 2010 and was unable to report data for the 2009-10 financial year. Data for the period 1 January 2010 to 31 December 2010 was used as a proxy for 2009-2010 data. Data as at 31 December 2010 was used as a proxy for data at 30 June 2010.

      In relation to types of care reported against for this measure:

      • 'Foster care' is where a family or an individual cares for other people's children in their own home. The carer must be authorised and reimbursed (or was offered reimbursement but declined) by the state or territory for the care of the child. When this is a member of the child or young person's family it is referred to as 'relative care'.7
      • 'Family group homes' is where a child or young person is placed a residential building that is typically run like a family home which has a limited number of children and are cared for around the clock by resident substitute parents.8
      • 'Residential care' is where placement is in a residential building whose purpose is to provide placements for children and where there are paid staff.910

      Commentary

      Table 19 shows that at 30 June 2010, the rate of children and young people in out-of-home care in WA was 5.1 per 1,000. This represents a rate increase of 1.3 per 1,000 children and young people from 30 June 2005, when the rate was 3.8 per 1,000.

      An increase was recorded across all jurisdictions between 30 June 2005 and 30 June 2010. The overall national increase was 2.1 per 1,000 children, from 4.9 per 1,000 on 30 June 2005 to 7.0 per 1,000 on the 30 June 2010.

      The rate of children and young people in out-of-home care in WA on the 30 June 2010 was the second lowest rate in Australia, with Victoria having the lowest rate at 4.4 per 1,000.11 As noted above, differences in legislation and policy in the different states and territories might affect the comparability of these figures.

      Table 20 shows that in all states and territories on 30 June 2010, the rate of Aboriginal children and young people in out-of-home care was higher than that of non-Aboriginal children and young people.12

      In WA, the rate of Aboriginal children and young people in out-of-home care was 40.0 per 1,000, which represents a rate ratio of Aboriginal to non-Aboriginal children of 13.5.13

      Nationally, the rate of Aboriginal children and young people in out-of-home care in 2010 was 48.4 per 1,000, which represents a rate ratio of Aboriginal to non-Aboriginal children of 9.7.

      In Table 21 it can be seen that children in care in WA are split approximately evenly between foster care and relative care. This is similar to the overall national proportions for children and young people in care.

      Table 22 shows the numbers of Aboriginal children and young people in out-of-home care by relationship to carer. Around three-quarters of Aboriginal children and young people in care are placed with relatives or other Aboriginal carers.

      Click here to download the PDF of this measure


      1 Wise S et al 2010, Care-system Impacts on Academic Outcomes: Research Report June 2010, Anglicare Victoria and Wesley Mission Victoria, p. 55.

      2 Osborn A & Bromfield L 2007, Young people leaving care, Child Protection Clearing House, Australian Institute of Family Studies.

      3 Mendes P 2009, 'Globalization, the Welfare State and Young People Leaving State Out-of-Home Care', Asian Social Work and Policy Review, Vol 3 (2), pp. 85-94.

      4 Australian Institute of Health and Welfare 2011, Child protection Australia 2009-10, Cat. no. CWS 39, Australian Institute of Health and Welfare.

      5 Australian Institute of Health and Welfare 2011, Child protection Australia 2009-10, Cat. no. CWS 39, Australian Institute of Health and Welfare p. 45.

      6 Australian Institute of Health and Welfare 2011, Child protection Australia 2009-10, Cat. no. CWS 39, Australian Institute of Health and Welfare, pp. 96-122.

      7 Department for Child Protection 2011, Interested in Foster Caring? [website], viewed 16 November 2011.
      <http://www.dcp.wa.gov.au/FosteringandAdoption/InterestedInFosterCaring/
      Pages/InterestedInFosterCaring.aspx>
      .

      8 Australian Institute of Health and Welfare 2011, Child protection Australia 2009-10, Cat. no. CWS 39, Australian Institute of Health and Welfare p.132.

      9 Australian Institute of Health and Welfare 2011, Child protection Australia 2009-10, Cat. no. CWS 39, Australian Institute of Health and Welfare p. 133.

      10 In May 2011, the Department for Child Protection commenced operation of a residential secure care centre for children and young people who are at risk to themselves or at risk to others.

      11WA data for the period 1 January 2010 to 31 December 2010 was used as a proxy for 200-10 data. Data as at 31 December 2010 was used as a proxy for data at 30 June 2010.

      12 WA data for the period 1 January 2010 to 31 December 2010 was used as a proxy for 2009-10 data. Data as at 31 December 2010 was used as a proxy for data at 30 June 2010.

      13 Rate ratios are calculated by dividing the un-rounded rate of Aboriginal children who were in out-of-home care by the un-rounded rate of non-Aboriginal children who were in out-of-home care. The resulting number is a measure of how many Aboriginal children were in out-of-home care for every one non-Aboriginal child who was in out-of-home care.

  • Hospitalisations from injury and accident
    • Why we have included this measure

      Injuries and accidents are major causes of hospitalisation for children and young people in Australia. Injuries can potentially have long-lasting and debilitating effects on the child or young person and can also impact on the family where a disability results. Many injuries are preventable through public health strategies.1

      What is this measure?

      This measure reports on the incidence and cause of hospitalisation for injury among children and young people. The data shows the number of periods of care in hospital for each cause of injury between 2005 and 2009. Each of these is termed a 'hospital separation', that is, a person discharged from hospital and returning for treatment of the same injury is counted as two separations. This data is widely used as an effective measure of injury and accident occurrence in the community.

      The data was provided by the Epidemiology Branch, Public Health Division, WA Department of Health.

      Commentary

      In WA between 2005 and 2009 there were 43,573 hospital separations for injury and accident for children and young people (Figure 12). The leading cause of injury was falls (30.4%), followed by transport accidents (15.2%), accounting for nearly half of injury hospitalisations. One-third of hospitalisations for injury are accounted for by other unintentional injuries.2

      Specifically by age group:

      • For the four years and under age group, the most prevalent cause was falls (33.7%), followed by accidental poisoning (10.9%) and fire, burns and scalds (6.2%).
      • For those five to 12 years of age, falls were again the leading category accounting for four in ten injuries (40.8%), followed by transport accidents (16.0%). 
      • For young people between 13 and 17 years of age, transport accidents are the most prevalent cause of injury (22.7%), followed by falls (17.5%) and intentional self-harm (7.4%).

      This compares with the Australia-wide figures for 2006-07 for children aged 0 to 14 years, in which 40 per cent of injury separations were accounted for by falls, and 14 per cent by transport accidents.3  

      Rates of hospitalisation show that males are significantly more likely than females to be hospitalised for an injury. On crude rates (not adjusted for age), males have a rate of around 28 hospitalisations per 1,000, while females have a rate of 17 per 1,000. Australia-wide figures are similar with boys being 60 per cent more likely to be hospitalised from injury than girls.4

      Young Aboriginal people are nearly twice as likely as young non-Aboriginal people to be hospitalised. The crude rate for young Aboriginal people is 44 per 1,000, nearly double that for young non-Aboriginal people at 24. Similar trends are evident in Australian and Victorian data.5 6 A report from the WA Department of Health suggests this is in part attributable to the effects of drug and alcohol misuse, socio-economic disadvantage, remoteness of residence, discrimination and lack of culturally-secure health facilities.7

      Click here to download the PDF of this measure


      1 Australian Institute for Health and Welfare 2009, A picture of Australia's children 2009, Australian Institute for Health and Welfare, p. 102.

      2 Australian Institute for Health and Welfare 2009, A picture of Australia's children 2009, Australian Institute for Health and Welfare, p. 102.

      3 The category 'Other unintentional injuries' totals all causes of accident and injury not already represented. Because this is an aggregate category comprising a number of causes of accident and injury it has not been included in this commentary. Also not included is category 'medical complications'.

      4 Australian Institute of Health and Welfare 2009, A picture of Australia's children 2009, Australian Institute of Health and Welfare pp. 104 & 105.

      5 Australian Institute of Health and Welfare 2009, A picture of Australia's children 2009, Australian Institute of Health and Welfare pp. 104 & 105.

      6 Australian Institute of Health and Welfare 2009, A picture of Australia's children 2009, Australian Institute of Health and Welfare, p. 105.

      7 Department of Education and Early Childhood Development 2008, The state of Victoria's children 2008, Department of Education and Early Childhood Development, p. 80.

      8 Ballestas T et al 2011, The Epidemiology of Injury in Western Australia, 2000-2008, Department of Health, Western Australia, p. 128.

  • Deaths from injury and accident
    • Why this measure has been included

      Injury or accident is the leading cause of death for children aged between one and 14 years in all industrialised countries, including Australia.1  

      What is this measure?

      This measure shows the rate, number and percentage of children and young people who have died as a result of injury or accident. The rate has been calculated over five years (2002-2007) while the number and percentages have been totalled over ten years (1998 to 2007 inclusive) as annual numbers are low and the inclusion of individual years may compromise the confidentiality of the data.

      Data has been supplied by the Epidemiology Branch, Public Health Division, WA Department of Health.

      Commentary

      The overall number and rates of children and young people dying is low. The average death rates in Figure 13 show a consistent trend in terms of age groups. Children in the middle years age group (five to 12 years) are least likely to suffer injuries or accidents resulting in death. Infants and young children (0 to four years) are almost twice as likely to die as a result of injury or accident, while the adolescent age group (13 to 17 years) is over three times as likely to die. The reasons for this may be partly explained by the most prevalent causes of death for each group.

      From 1998 to 2007, transport accidents were the most significant cause of death for children and young people, followed by other unintentional injuries, accidental drowning and intentional self-harm (Table 24).

      Approximately two-thirds of all deaths are males.2 Specifically by age group from 1998 to 2007:

      1. Among children aged four years and under, 33.3 per cent of deaths are the result of accidental drowning and 25 per cent are caused by transport accidents (Table 25).
      2. Among children aged five to 12 years, the most prevalent causes of death are transport accidents at 47.3 per cent and accidental drowning at 13.4 per cent (Table 25).
      3. Among young people aged 13 to 17 years, transport accidents account for 55.7 per cent of deaths and intentional self-harm representing 23.3 per cent (Table 25).

      Aboriginal children and young people aged 0 to 17 years are considerably over-represented in deaths from an injury or accident compared with all children and young people. Deaths from injury or accident among this group are approximately 30 per cent of total deaths from injury and accident, while Aboriginal children and young people represent approximately six per cent of the general population in this age group.3

      The leading causes of death for children and young people in WA match those reported in Victoria from 2005-06 (the latest figures).4 Tasmania reported in 2006 on children 14 years and under and noted that road transport, accidental drowning and assault were the leading causes of death from injury or accident in this age group.5 Queensland also reported on deaths for people aged 17 years and under between 2007 and 2009 and transport was once again the leading cause of death, followed by drowning and intentional self-harm.6 In all jurisdictions the proportion of male deaths is significantly higher than those of females. Victoria and Queensland also both reported that the rate of Aboriginal deaths was disproportionately high.7 8

      Click here to download the PDF of this measure

      1 Australian Institute for Health and Welfare 2009, A Picture of Australia's Children 2009, Australian Institute for Health and Welfare, p. 102.

      2 Original data has not been reproduced for confidentiality reasons.

      3 Original data has not been reproduced for confidentiality reasons.

      4 Department of Education and Early Childhood Development 2008, The State of Victoria's Children 2008,  Department of Education and Early Childhood Development, p. 82.

      5 Tasmanian Government 2009, Kids Come First Report 2009: Outcomes for Children and Young People in Tasmania, Tasmanian Government, p. 50.

      6 Commissioner for Children and Young People and Child Guardian 2010, Snapshot 2010: Children and young people in Queensland, Commissioner for Children and Young People and Child Guardian, pp. 72&73.

      7 Department of Education and Early Childhood Development 2008, The State of Victoria's Children 2008, Department of Education and Early Childhood Development p. 82.

      8 Commissioner for Children and Young People and Child Guardian 2010, Snapshot 2010: Children and young people in Queensland, Commissioner for Children and Young People and Child Guardian, pp. 72&75.