The hospitalisation rate for Indigenous babies less than 12 months old is eight times higher than the rate for other Australian infants, a report on hospitalisation and injury among Aboriginal and Torres Strait Islander children and young people has found.
According to the extensive report from the Australian Institute of Health and Welfare, the most common cause of hospitalisation due to injury among Indigenous infants was a fall (38%), which was also true for other Australian infants (53% of hospitalisations).
The second most common cause of injury among Indigenous infants who were hospitalised was due to other unintentional causes (28%), followed by assault (17%). In comparison, assault cases comprised 3% of hospitalisations among other Australian babies.
The report details injuries that led to hospitalisation of Aboriginal and Torres Strait Islander youngsters under the age of 24 between 2011 and 2013. There were of 18,537 Indigenous youth hospitalised due to injury and poisoning over this period, the report found.
Rates of injury among Indigenous children and young people increased with remoteness, the report found, with 51% of young people hospitalised due to injury in remote areas being Indigenous, despite making up just 36% of the overall population in those areas.
Assault was the leading cause of hospitalisation for Indigenous people aged 15–17 and 18–24 years. The rate of assault injury among Indigenous children and young people overall, at 457 cases per 100,000, was six times higher than that of other Australians. The rate of assault injury among Indigenous girls and young women was more than 17 times higher than other Australians, and 22 times higher for Indigenous women aged 18–24 years.
“Many factors contribute to the relatively high rates of hospitalised injuries in Aboriginal and Torres Strait Islander children and young people,” the report found.
“These include the ongoing effects of colonisation, social disadvantage, drug and alcohol misuse, poor safety standards and unsafe roads and living environments. Indigenous children and young people may also be at higher risk of injury due to overcrowding at home, economic deprivation and high levels of exposure to domestic violence.”
The most frequent causes of injuries requiring hospitalisation for Indigenous youth were falls, assault, transport crashes and intentional self-harm. Falls were also the most frequent cause of injury for other Australian youth, followed by transport crashes, assault and intentional self-harm.
However, Indigenous children experience significantly higher rates of injury due to burns, assault and self-harm at a greater range of ages, the report found.
Dr Mahiban Thomas, a maxillofacial and oral surgeon at the Northern Territory’s Royal Darwin hospital, said the report echoed his own findings.
Thomas has kept a database of all surgeries for facial fractures he has carried out over the past eight years, and said he had operated on 34 Indigenous children under the age of 18 in that time. Of those, 26 were assault and domestic violence-related facial fractures, while five were due to motor vehicle accidents. There was one sport-related fracture, one related to a fall, and one due to an unknown cause.
Of 29 non-Indigenous youth Thomas had operated on over the period, 12 facial fractures were sports-related, nine were due to an assault and domestic violence, five were due to motor vehicle accidents and three due to falls.
“The non-Indigenous people I treat for facial trauma are often those who have misfielded a cricket ball or who have a footy injury,” Thomas said. “The rest of my patients who are young and Indigenous have an extremely low rate of sporting injuries and are more likely to be injured due to assaults and interpersonal violence.”
Thomas said he had been working as a surgeon at the hospital for 11 years, and that in that time he had tried to prevent Indigenous people in particular from being injured through assault.
“We often sit down and work backwards with people to raise situational awareness and try to determine what led to them being harmed, and we had a program where we would get a mental health practitioner to work with a person following their surgery to help them get away from dangerous situations and become more situationally aware,” he said.
“Unfortunately we lost funding for that program, it was very expensive. But people with facial fractures have a 15% chance of getting another one, and that is higher for Indigenous people, so the counselling was an important preventative mechanism.”
Thomas, who has been working as a surgeon in Darwin for 11 years, said the situation had left him feeling “helpless”.
“They are beautiful people, Indigenous people, they are absolutely beautiful. And these problems arise partly out of them feeling they do not have a place in society. I vehemently enjoy my work and want to help them. But I feel helpless.”
Australia Institute of Health and Welfare spokesperson Professor James Harrison said he hoped the report would help researchers and policymakers identify areas that warranted following up and taking action on.
“There are certainly some particularly worrying findings in the more remote parts of Australia for Indigenous people in particular, so we really need to target interventions in those areas,” Harrison said.