Centre for Population Health Research, Curtin Health Innovation Research Institute, Curtin University, Perth, Australia.
BMC Public Health. 2012 Sep 10;12:756. doi: 10.1186/1471-2458-12-756.
The 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.
We 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.
Almost 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.
Our 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.
精神健康问题在澳大利亚原住民和托雷斯海峡岛民儿童中是一个主要的公共卫生问题。虽然社会经济因素被认为是主流人群精神健康问题的重要决定因素，但它们对所有年龄段的澳大利亚原住民的精神健康的影响在很大程度上仍然未知。
我们使用 2000-02 年进行的一项代表性调查，研究了西澳大利亚 3993 名 4-17 岁原住民儿童的一系列社会经济指标与临床显著情绪或行为困难（CSEBD）风险之间的关系。分析是在多层次框架内使用多变量逻辑回归进行的。
近四分之一（24%）的原住民儿童被归类为 CSEBD 高风险。我们的研究结果普遍表明，较高的社会经济地位与原住民儿童心理健康问题风险降低有关。住房质量和所有权以及邻里劣势对儿童心理健康都有很强的直接影响。此外，原住民儿童家庭的情况（育儿质量、压力、家庭组成、过度拥挤、家庭流动性、种族主义和家庭功能）作为一个重要的解释机制，突显了儿童心理健康与照顾者就业状况和家庭经济状况等物质福利指标之间的关系。
我们的结果为澳大利亚原住民和托雷斯海峡岛民儿童的心理健康存在社会梯度提供了增量证据。改善有原住民儿童的家庭的社会、经济和心理条件，对于减少原住民群体内部的心理健康不平等，进而缩小心理健康方面的巨大种族差距，具有相当大的潜力。针对住房质量、住房所有权和邻里劣势的干预措施可能特别有益。
