Research School of Finance, Actuarial Studies and Statistics, Australian National University, Canberra, 2601, Australia.
School of Demography, Australian National University, Canberra, 2601, Australia.
Int J Health Geogr. 2020 Oct 19;19(1):43. doi: 10.1186/s12942-020-00237-x.
Children's early development plays a vital role for maintaining healthy lives and influences future outcomes. It is also heavily affected by community factors which vary geographically. Direct methods do not provide a comprehensive picture of this variation, especially for areas with sparse populations and low data coverage. In the context of Australia, the Australian Early Development Census (AEDC) provides a measure of early child development upon school entry. There are two primary aims of this study: (i) provide improved prevalence estimates of children who are considered as developmentally vulnerable in regions across Australia; (ii) ascertain how social-economic disadvantage partly explains the spatial variation.
We used Bayesian spatial hierarchical models with the Socio-economic Indexes for Areas (SEIFA) as a covariate to provide improved estimates of all 335 SA3 regions in Australia. The study included 308,953 children involved in the 2018 AEDC where 21.7% of them were considered to be developmentally vulnerable in at least one domain. There are five domains of developmental vulnerability-physical health and wellbeing; social competence; emotional maturity; language and cognitive skills; and communication and general knowledge.
There are significant improvements in estimation of the prevalence of developmental vulnerability through incorporating the socio-economic disadvantage in an area. These improvements persist in all five domains-the largest improvements occurred in the Language and Cognitive Skills domain. In addition, our results reveal that there is an important geographical dimension to developmental vulnerability in Australia.
Sparsely populated areas in sample surveys lead to unreliable direct estimates of the relatively small prevalence of child vulnerability. Bayesian spatial modelling can account for the spatial patterns in childhood vulnerability while including the impact of socio-economic disadvantage on geographic variation. Further investigation, using a broader range of covariates, could shed more light on explaining this spatial variation.
儿童早期发展对于维持健康生活至关重要,并影响未来的结果。它也受到地域差异的社区因素的严重影响。直接方法无法全面了解这种变化,尤其是对于人口稀少且数据覆盖率低的地区。在澳大利亚的背景下,澳大利亚早期发展普查(AEDC)在儿童入学时提供了早期儿童发展的衡量标准。本研究有两个主要目的:(i)提供澳大利亚各地被认为在发展方面处于弱势的儿童的流行率估计值的改善;(ii)确定社会经济劣势在多大程度上解释了空间变化。
我们使用贝叶斯空间层次模型,并将社会经济指数区域(SEIFA)作为协变量,以提供澳大利亚所有 335 个 SA3 地区的改进估计值。该研究包括 2018 年 AEDC 中涉及的 308,953 名儿童,其中 21.7%的儿童在至少一个领域被认为在发展方面处于弱势。发展弱势的五个领域包括:身体健康和幸福感;社会能力;情绪成熟度;语言和认知技能;以及沟通和一般知识。
通过在一个区域纳入社会经济劣势,对发展弱势的流行率进行估计会有显著的改进。这些改进在所有五个领域都存在,语言和认知技能领域的改进最大。此外,我们的结果表明,澳大利亚的儿童发展弱势存在重要的地域维度。
抽样调查中人口稀少的地区会导致儿童弱势的相对较小流行率的直接估计不可靠。贝叶斯空间建模可以在考虑社会经济劣势对地理变化的影响的同时,解释儿童弱势的空间模式。进一步的研究,使用更广泛的协变量,可以更深入地了解解释这种空间变化。