Australian children living in areas with a relatively high risk of social exclusion also experience relatively poor health outcomes, argues this bulletin.
The Australian Institute of Health and Welfare (AIHW) and the University of Canberra’s National Centre for Social and Economic Modelling (NATSEM) have collaborated to explore links between the risk of social exclusion and health outcomes in Australian children at the small-area level.
Social exclusion is a broad concept that is used to describe social disadvantage and lack of opportunity. NATSEM developed the child social exclusion (CSE) index for 0–15 year olds using data predominantly from the 2006 Census. The index aims to capture the risk of social exclusion experienced by Australian children at the small-area level (mostly Statistical Local Areas—SLAs). It is made up of five domains related to social exclusion: socioeconomic circumstances, education, connectedness, housing and health service access.
This project linked the CSE index with data on children’s health outcomes in the form of potentially preventable hospitalisations (PPHs) and avoidable deaths among 0–14 year olds.
The findings show that Australian children living in small areas with a high risk of child social exclusion have, on average, worse health outcomes than children living in other areas. This is the case in remote as well as in non-remote areas.
PPH rates were associated with the risk of child social exclusion:
- Areas with a relatively high risk of child social exclusion also had relatively high average rates of PPH.
- PPH rates were much higher in the areas that had the highest risk of child social exclusion than in all other areas.
- A high risk of child social exclusion was associated with high PPH rates for children both in remote and non-remote areas.
- Children living in Remote and Very remote areas had higher rates of PPH than would be expected based on the CSE index alone.
Areas with a relatively high risk of child social exclusion also had relatively high rates of avoidable deaths. The estimated annual rate of avoidable deaths among the 20% of children who lived in the areas with the highest risk of child social exclusion was 32 per 100,000 children. This is more than twice as high as the 15 avoidable deaths per 100,000 children that occurred among the 20% of children who lived in the areas with the lowest risk of child social exclusion.
The findings suggest that geographical modelling of disadvantage at the small-area level may be a valuable tool to help focus policy programs aimed at improving the health and wellbeing of Australia’s children. Characteristics of areas with unexpectedly good or poor health outcomes given their score on the CSE index can be used to identify other factors that, like remoteness, have an association with children’s health outcomes that is independent of social exclusion.