The Sax Institute, PO Box K617, Haymarket, NSW, 1240, Australia.
Melbourne School of Population and Global Health, Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne, Australia.
Int J Equity Health. 2019 Jul 31;18(1):120. doi: 10.1186/s12939-019-1019-x.
Early childhood social and emotional development underpins later social, emotional, academic and other outcomes. The first aim of this study was to explore the association between child, family and area-level characteristics associated with developmental vulnerability, amongst Aboriginal and non-Aboriginal children in their first year of school. The second aim was to quantify the magnitude of the social and emotional developmental inequalities between Aboriginal and non-Aboriginal children and the extent to which differences in socioeconomic disadvantage and perinatal characteristics explained this inequality.
This retrospective cohort study used cross-sectoral data linkage to identify and follow participants from birth to school age. In this way, social and emotional development was examined in 7,384 Aboriginal and 95,104 non-Aboriginal children who were included in the Australian Early Development Census in their first year of full-time school in New South Wales (NSW) in 2009 or 2012 and had a birth registration and/or perinatal record in NSW. The primary outcome measures were teacher-reported social competence and emotional maturity as measured using the Australian version of the Early Development Instrument.
The mean age at the start of the school year for children in the study sample was 5.2 years (SD = 0.36 years). While 84% of Aboriginal children scored favourably - above the vulnerability threshold - for social competence and 88% for emotional maturity, Aboriginal children were twice as likely as non-Aboriginal children to be vulnerable on measures of social development (RR = 2.00; 95%CI, 1.89-2.12) and had 89% more risk of emotional vulnerability (RR = 1.89; 95%CI, 1.77-2.02). The inequality between Aboriginal and non-Aboriginal children was largely explained by differences in the socioeconomic and perinatal health characteristics of children and families. Thus, after adjusting for differences in measures of socioeconomic advantage and disadvantage (Model 2), the relative risk was attenuated to 1.31 (95% CI: 1.23-1.40) on the social competence domain and 1.24 (95% CI, 1.15-1.33) on the emotional maturity domain. Child, family and area-level characteristics associated with vulnerability were identified.
Most of the gap in early childhood social and emotional development between Aboriginal and non-Aboriginal children can be attributed to socioeconomic and early life health disadvantage. Culturally safe health and social policies addressing the socioeconomic and health inequalities experienced by Aboriginal children are urgently required.
儿童早期的社会和情感发展是后期社交、情感、学业和其他方面发展的基础。本研究的首要目的是探索与儿童、家庭和地区层面相关的特征与原住民和非原住民儿童在入学第一年的发展脆弱性之间的关联。其次是量化原住民和非原住民儿童在社会和情感发展方面的不平等程度，以及社会经济劣势和围产期特征差异在多大程度上解释了这种不平等。
本回顾性队列研究使用跨部门数据链接来识别和跟踪参与者从出生到学龄期。通过这种方式，2009 年或 2012 年新南威尔士州（NSW）全日制学校入学的第一年，对 7384 名原住民和 95104 名非原住民儿童使用澳大利亚早期发展普查（Australian Early Development Census）进行了社会情绪发展评估，这些儿童在 NSW 有出生登记和/或围产期记录。主要结局指标是教师报告的社会能力和情绪成熟度，使用澳大利亚版早期发展工具（Australian version of the Early Development Instrument）进行测量。
研究样本中儿童在学年开始时的平均年龄为 5.2 岁（标准差=0.36 岁）。尽管 84%的原住民儿童在社会能力方面表现出色（得分高于脆弱性阈值），88%的原住民儿童在情绪成熟度方面表现出色，但原住民儿童在社会发展方面出现脆弱性的可能性是非原住民儿童的两倍（RR=2.00；95%CI，1.89-2.12），情绪脆弱性的风险高 89%（RR=1.89；95%CI，1.77-2.02）。原住民和非原住民儿童之间的不平等在很大程度上可以用儿童及其家庭的社会经济和围产期健康特征的差异来解释。因此，在调整了社会经济优势和劣势的衡量指标（模型 2）后，社会能力领域的相对风险降低到 1.31（95%CI：1.23-1.40），情绪成熟度领域的相对风险降低到 1.24（95%CI，1.15-1.33）。确定了与脆弱性相关的儿童、家庭和地区层面的特征。
原住民和非原住民儿童在社会和情感发展方面的早期差距，大部分可以归因于社会经济和生命早期健康方面的劣势。迫切需要制定文化安全的卫生和社会政策，以解决原住民儿童所经历的社会经济和健康不平等问题。
