In the past decade, there has been increasing awareness of the commonalities between the social determinants of criminal behaviour and the social determinants of health, including factors such as poverty, child maltreatment, education and environmental health. The description ‘multiple and complex’ has been used to describe the breadth and depth of the needs of vulnerable populations that span a wide range of social and health issues. One significant health issue for people in the criminal justice system (CJS) is hearing impairment (HI). It has been suggested that involvement in the CJS may be a consequence of hearingrelated social problems such as low educational standards, unemployment, alcohol and other substance abuse. Other reports have also suggested that people with HI are more likely to encounter ‘language and learning challenges’, which might lead to ‘challenging behaviours’ that increase the risk of CJS engagement.
Objectives: The study looks to quantify the relative contribution of HI and other markers of social wellbeing and engagement as predictors of youth-offending.
Importance of study: These types of studies are important to inform effective prevention and early intervention strategies for juvenile delinquency including in the NT where Aboriginal children comprise about 40% of all NT children and are over-represented in both child protection notifications (80%) and in youth detention centres.
Study type: Retrospective cohort study and statistical analysis.
Methods: This was a retrospective cohort study of 1533 Aboriginal children (born between 1996 and 2001) living in remote Northern Territory communities. The study used linked individual-level information from health, education, child protection and youth justice services. The outcome variable was a youth being “found guilty of an offence”. The key explanatory variable, hearing impairment, was based on audiometric assessment. Other variables were: child maltreatment notifications, Year 7 school enrolment by mother, Year 7 school attendance and community ‘fixed- effects’. The Cox proportional hazards model was used to estimate the association between HI and youth offending; and the Royston R2 measure to estimate the separate contributions of risk factors to youth offending.
Results: The proportion of hearing loss was high in children with records of offence (boys: 55.6%, girls: 36.7%) and those without (boys: 46.1%; girls: 49.0%). In univariate analysis, a higher risk of offending was found among boys with moderate or worse HI (HR: 1.77 [95% CI: 1.05–2.98]) and mild HI (HR: 1.54 [95% CI:1.06–2.23]). This association was attenuated in multivariable analysis (moderate HI, HR: 1.43 [95% CI:0.78–2.62]; mild HI, HR: 1.37 [95% CI: 0.83–2.26]). No evidence for an association was found in girls. HI contributed 3.2% and 6.5% of variation in offending among boys and girls respectively. Factors contributing greater variance included: community ‘fixed-effects’ (boys: 14.6%, girls: 36.5%), child maltreatment notification (boys: 14.2%, girls: 23.9%) and year 7 school attendance (boys: 7.9%; girls 12.1%). Enrolment by mother explained substantial variation for girls (25.4%) but not boys (0.2%).
Conclusion: There was evidence, in univariate analysis, for an association between HI and youth offending for boys however this association was not evident after controlling for other factors. Our findings highlight a range of risk factors that underpin the pathway to youth-offending, demonstrating the urgent need for interagency collaboration to meet the complex needs of vulnerable children in the Northern Territory
- The researchers believe the findings of this study will have important implications for the recent Australian Government’s ‘Closing the Gap Refresh’ and the NT Government’s Reform Implementation Plan in response to the Royal Commission into the Protection and Detention of Children in the Northern Territory.
- The analysis in this report finds that the pattern and magnitude of association differs between boys and girls. For boys, both ‘moderate or worse HI’ and ‘mild HI’ were associated with higher risk of offending in the univariate analysis, although in both categories, the association was attenuated in the multivariable model. No evidence for an association was found in either the univariate, or the multivariable model for girls.
- The study demonstrates that the prevalence of HI among Aboriginal children with a record of an offence is high, which corroborates the results of a previous study on HI among adult inmates in Darwin and Alice Springs prisons.
- The high rates of hearing problems among NT Aboriginal prisoners raises concern about their ability to communicate with corrections staff, a situation that can be exacerbated for those for whom English is not their first language.
- These findings point to opportunities for early intervention to disrupt the pathway into the youth justice system, and provide a clear message for governments, policy makers, and community service providers about the urgent need for interagency collaboration to meet the ‘multiple and complex needs’ of vulnerable children in the Northern Territory.