Growth and morbidity in children in the Aboriginal Birth Cohort Study: the urban–remote differential

Abstract

Objectives: To describe the prevalence of markers of growth, chronic and infectious disease in peripubertal Aboriginal children living in the Darwin Health Region in the “Top End” of the Northern Territory, and to compare prevalence between children living in urban and remote areas. Design: Cross‐sectional survey nested in a prospective birth cohort. Subjects: 482 children living in the region who were recruited at birth (Jan 1987 to Mar 1990) and were followed up between 1998 and 2001, when aged 8–14 years. Main outcome measures: Selected parameters of growth and nutrition, infectious disease and potential markers of chronic adult disease were compared between children living at follow‐up in suburban situations in Darwin–Palmerston (urban) and those living in rural communities with an Aboriginal council (remote). Results: Remote children were shorter than urban children (mean height, 141.7 v 146.3 cm; P < 0.001), lighter (median weight, 30.3 v 37.1 kg; P < 0.001) and had lower body mass index (median, 15.3 v 17.9 kg/m2; P < 0.001) and haemoglobin level (mean, 125.1 v 130.9 g/L; P < 0.001). Some potential markers of adult chronic disease were higher in urban than remote children: systolic blood pressure (mean, 109.6 v 106.2 mmHg; P = 0.004), and levels of total cholesterol (4.3 v 4.0 mmol/L; P < 0.001), high‐density lipoprotein cholesterol (mean, 1.4 v 1.2 mmol/L; P < 0.001) and insulin (median, 7 v 4 mU/L; P = 0.007). Diastolic blood pressure, levels of red cell folate, serum glucose and low‐density lipoprotein cholesterol, and urinary albumin–creatinine ratio did not differ by location. The prevalence of visible infections was also higher in remote than urban children (P < 0.05). Conclusion: As some markers of health differ between peripubertal Aboriginal children living in urban areas and those in remote areas, results of surveys in remote areas cannot be generalised to urban Aboriginal populations.

Type 2 diabetes in Indigenous and non‐Indigenous children and adolescents in New South Wales

“…The high incidence of T2DM in Indigenous Australian children and adolescents, and those from other minority groups, supports consensus recommendations for screening high‐risk groups, including overweight children (BMI > 85th percentile), those from high‐risk ethnic backgrounds (Indigenous, Asian/Pacific and Hispanic), and those with signs of insulin resistance (acanthosis nigricans), or a family history of T2DM 21 . The high rate of early complications 5 , 6 , 8 , 23 and the more common occurrence of dyslipidaemia, hypertension and renal disease in Indigenous children make screening even more important 24 . As Indigenous and non‐Indigenous children and adolescents have similar rates of T1DM, both forms of diabetes should be considered in an Indigenous child presenting with diabetes, and testing for autoantibodies should be included in the diagnostic work‐up.…”

Town or country: which is best for Australia's Indigenous peoples?

“…Compared with the total Australian population, Indigenous people living in major cities appear to be exposed to factors that adversely affect life expectancy, and there appear to be factors predisposing to better life expectancy in very remote areas. There is evidence to support this latter observation 10 , 11 …”

Poor food and nutrient intake among Indigenous and non-Indigenous rural Australian children

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