BACKGROUND: This study describes trends in social inequities in first dose measles-mumps-rubella (MMR1) vaccination coverage in Western Australia (WA) and New South Wales (NSW). Using probabilistically-linked administrative data for 1.2 million children born between 2002 and 2011, we compared levels and trends in MMR1 vaccination coverage measured at age 24 months by maternal country of birth, Aboriginal status, maternal age at delivery, socio-economic status, and remoteness in two states. RESULTS: Vaccination coverage was 3-4% points lower among children of mothers who gave birth before the age of 20 years, mothers born overseas, mothers with an Aboriginal background, and parents with a low socio-economic status compared to children that did not belong to these social groups. In both states, between 2007 and 2011 there was a decline of 2.1% points in MMR1 vaccination coverage for children whose mothers were born overseas. In 2011, WA had lower coverage among the Aboriginal population (89.5%) and children of young mothers (89.3%) compared to NSW (92.2 and 92.1% respectively). CONCLUSION: Despite overall high coverage of MMR1 vaccination, coverage inequalities increased especially for children of mothers born overseas. Strategic immunisation plans and policy interventions are important for equitable vaccination levels. Future policy should target children of mothers born overseas and Aboriginal children.
Arzu Arat, Hannah Catherine Moore, Sharon R Goldfeld et al.
The paper uses a child-centred approach to analyse Australia’s child immunisation laws. These laws condition enrolment to early education centres on the child being fully immunised and provide financial incentives to parents, encouraging them to comply with the national immunisation protocol. The paper seeks to contribute to the debates in public health about the utility of human rights and the definition of the ‘public’ by problematising the marginalisation of children from this space. Navigating between the positionalities of individuals and collectives in two terrains, namely, human rights and public health, the paper examines how children and their rights are conceptualised in the development of immunisation policies, and asks what these laws tell us about children’s positionality, lives and bodies in society. It argues that the current child immunisation laws commodify children’s bodies, physically and figuratively, as a means to protect the entire population from infectious diseases. This reproduces children and childhood as means to an end, seeing childhood as a vehicle to adulthood. Utilising a child-centred approach can advance a different approach to public health matters concerning children, safeguarding their rights in this domain and in turn changing their public visibility.
Introduction: Childhood immunisation is a safe and effective way to protect children and communities from serious diseases. In Australia childhood immunisation is generally well accepted with high coverage rates however pockets of low coverage exist. Authors conducted five previous studies in New South Wales which found socio-economic disadvantage, gender inequity, health service access barriers and under-utilisation of immunisation data, rather than ideological opposition, contributed to children's incomplete vaccination. Material and Methods: Common findings across those five studies were identified. Additional literature was reviewed using a number of lenses, underpinned by a social determinants of health framework. Results: The lensed approach allowed further exploration of the impact of financial stress, poor mental health, drug and alcohol problems, domestic violence, assumed gender roles, lack of culturally acceptable health care for Indigenous families, geography and changes to immunisation policies on families and how this may have contributed to pockets of low immunisation coverage. Social and structural inequities were revealed. These often contributed to conflicting priorities that meant children's immunisations fell behind. Discussion: Strategies to address inequities may include reorientation of existing community based child health services to include flexible options such as drop in clinics, outreach services, home visiting and ensuring Indigenous families have access to culturally safe and acceptable services. Assistance with transport would further improve access to services. Better use of immunisation data can aid in the identification of pockets of low coverage and monitor and evaluate service effectiveness. Conclusions: Greater awareness of social and structural barriers and their impact on families can inform the design of tailored strategies that address the needs of disadvantaged children and families. Without efforts to overcome the inequities that contribute to low immunisation coverage, the status quo persists, leaving children and communities at risk of vaccine preventable diseases.
Susan L Thomas, Katarzyna T. Bolsewicz, Julie Leask et al.
Importance: Current guidelines recommend screen time limitations for young children in favor of their ongoing development and well-being. Distinguishing momentary patterns of screen use in relation to childhood well-being will further inform screen time recommendations to better reflect contemporary childhood digital experiences. Objective: To investigate the associations between momentary children's screen use, parent-child interactions, emotions, and externalizing behavior. Design, Setting, and Participants: In this ecological momentary assessment (EMA) study, parent-reported methodology was used to measure children's screen-based experiences. Reporting on the last hour, assessments were provided up to 3 times per weekday and 5 times per weekend day, across a 2-week period from May to November 2024. Parents completed momentary assessments in their everyday environments, capturing typical fluctuations in children's habits, emotions, and behaviors. Participants identified as parents of children in the first 3 years of formal schooling. Exposure: Children's use of screens including screen use, duration, activities, and solo vs co-use details. Main Outcomes and Measures: Children's momentary affect, externalizing behaviors, and parent-child interactions were measured using subsets of items from the Positive and Negative Affect Schedule Short form, the Strengths and Difficulties Questionnaire, and the Child Parent Relationship Scale-Short form, respectively. Results: A total of 934 momentary assessments from 42 parents (mean [SD] age, 38.7 [4.9] years; 33 female [79%]) of children (mean [SD] age, 6.4 [1.2] years; 24 male [57%];) were included in analyses. Multilevel modeling indicated screen use duration was associated with lower levels of both positive affect (b = -0.16; 95% CI, -0.30 to -0.02; estimating screen time b = -0.05; 95% CI, -0.08 to -0.01) and negative affect (b = -0.12; 95% CI, -0.24 to -0.01; estimating screen time b = -0.10; 95% CI, -0.15 to -0.06). Interactive activities (b = 0.26; 95% CI, 0.04-0.47) and co-use (b = 0.17; 95% CI, 0-0.34) were significantly associated with positive affect. Parent-child interactions negatively estimated screen use duration (b = -0.07; 95% CI, -0.13 to -0.02). Conclusions and Relevance: Results of this study suggest that the associations between children's digital experiences and well-being are complex and bidirectional. The momentary associations found in this study provide evidence for moving beyond duration-focused recommendations toward context-sensitive guidelines that consider the dynamic nature of children's digital experiences.
Jacquelyn A. S. Harverson, Jeromy Anglim, Louise E. Paatsch et al.
No single conceptual framework currently captures the overall well-being of children experiencing maternal incarceration. To address this gap, we examined whether an existing, population-based child well-being framework, developed by the Australian Research Alliance for Children and Youth’s (ARACY), is able to account for factors known to influence the well-being of children in the context of maternal incarceration. Using a meta-narrative method, our synthesis of 97 documents revealed that the domains in the ARACY framework account for the overall well-being of children experiencing maternal incarceration; contextual factors specific to these children were not well represented. These factors include those that shape what well-being looks like for children experiencing maternal incarceration, those that are common to these children but not directly related to maternal incarceration, and those directly related to maternal incarceration itself. Therefore, while population-based frameworks like ARACY’s can serve as a useful tool to improve understanding of the well-being outcomes of children experiencing maternal incarceration, such frameworks should not be used for policy and practice translation without consideration of these unique contextual factors. Failure to do so may lead to inadequate support targets and indicators that poorly measure meaningful change for this population. Based on our findings, we suggest policy and practice efforts prioritise understanding well-being from different cultural perspectives, address pre-existing disadvantage, and implement multisystemic interventions tailored to individual children’s needs. Future research should develop robust prevention and intervention strategies that account for implementation challenges while deepening the theoretical and empirical understanding of these children’s unique well-being needs.
Corrie Williams, Tara Renae McGee, Robyn Garland et al.
Abstract ‘Well-being’ and ‘child well-being’ are broad terms with little consensus amongst numerous definitions. Applications of the term, particularly for children aged birth to six, are vague due to the lack of conceptual clarity. The aim of this scoping review is to synthesise the recent literature on young children’s well-being, drawing on perspectives across disciplines to propose relevant considerations for promoting child well-being in Early Childhood Education and Care (ECEC) contexts. Using Arksey and O’Malley’s methodological framework for scoping studies, 55 articles gathered and published between 2018 and 2024 were reviewed. Two key themes emerged from qualitative analysis of the articles: (1) ambiguity in conceptualisations of the concept stemming from varied discourses guiding definitions and different approaches towards supporting and assessing child well-being; and (2) increasing consensus on the need for multidimensional conceptualisations. Main considerations for applying understandings of child well-being to ECEC were proposed, including: contemplating education as contributing towards the goal of child well-being and well-being as necessary for effective learning; adopting a balanced and multidimensional approach towards promoting children’s well-being in the present and in the future; and recognising that children’s well-being is influenced by and supported within dynamic contexts, systems and processes.
Lynn Lee-Pang, Penny A. Levickis, Lisa Murray et al.
This study on literacy learning in innovative learning environments (ILEs) and traditional one teacher classrooms, focused on Asian English-as-an-additional-language (EAL) students, contrasting them with English-only speaking students. There were 147 Years 5/6 primary school children in the study. Of these, 71 were Asian-EAL children, with 43 in ILEs and 28 in traditional classrooms. English-only students comprised 36 in ILEs and 40 in traditional classrooms. Parallel measures of vocabulary size, listening comprehension and reading comprehension were given to all students at two time points during one school year, about six months apart. Few studies have used quantitative measures to determine if ILEs influence academic literacy outcomes. The Asian-EAL students in ILEs performed similarly on the study measures as their peers in more traditional classrooms. The English-only students in ILEs performed worse than their peers in traditional classrooms, but there was no increase in this difference over the course of the study.
John Everatt, Jo Florence Fletcher, Ting Ma et al.
School environments can create healthy settings to foster children’s health and well-being. School gardening is gaining popularity as an intervention for healthier eating and increased physical activity. We used a systematic realist approach to investigate how school gardens improve health and well-being outcomes for school-aged children, why, and in what circumstances. The context and mechanisms of the specific school gardening interventions (n = 24) leading to positive health and well-being outcomes for school-aged children were assessed. The impetus of many interventions was to increase fruit and vegetable intake and address the prevention of childhood obesity. Most interventions were conducted at primary schools with participating children in Grades 2 through 6. Types of positive outcomes included increased fruit and vegetable consumption, dietary fiber and vitamins A and C, improved body mass index, and improved well-being of children. Key mechanisms included embedding nutrition-based and garden-based education in the curriculum; experiential learning opportunities; family engagement and participation; authority figure engagement; cultural context; use of multi-prong approaches; and reinforcement of activities during implementation. This review shows that a combination of mechanisms works mutually through school gardening programs leading to improved health and well-being outcomes for school-aged children.
Timothy P. Holloway, Lisa Dalton, Roger Hughes et al.
As survival rates for children born extremely preterm (EP, <28 weeks' gestation) have increased with advances in perinatal and neonatal care, their long-term functioning and quality of life assume more importance. Outcomes in early childhood provide some information, but outcomes at school-age are more informative of life-long functioning. Children born EP at school-age have substantially higher rates of intellectual impairment, poorer executive, academic and motor function, more neurodevelopmental disability, and poorer health-related quality of life than do contemporaneous term-born controls. Because the rates of adverse outcomes remain unacceptably high, and particularly since some outcomes may be deteriorating rather than improving over time, new strategies to ameliorate these problems, targeting periods before, during and after birth, and throughout the lifespan, are a priority.
Lex William Doyle, Alicia Jane Spittle, Peter J. Anderson et al.
OBJECTIVES: Children's additional health and developmental needs are often first identified by teachers when they begin school. This study estimates the Grade 3 literacy and numeracy outcomes of children with teacher-identified additional needs emerging in the first year of school, including the added burden conferred by socioeconomic disadvantage. METHODS: Population linked data (n = 42,619) were analysed from the Australian Early Development Census, which include teacher reports on children's health and development at school entry, and the National Assessment Program-Literacy and Numeracy, a direct assessment of reading and numeracy skills at Grade 3. Linear regression analyses were used to estimate associations between emerging needs and learning outcomes, adjusted for sociodemographic characteristics. The combined effect of emerging needs and low maternal education (an indicator of socioeconomic disadvantage) on academic outcomes was examined by estimating the relative excess risk due to interaction (RERI). RESULTS: Emerging health and developmental needs at school entry were associated with lower reading (b = -26.86, 95% CI = -29.19, -24.52) and numeracy (b = -24.39, 95% CI = -26.43, -22.35) outcomes at Grade 3. The combined effect of emerging needs and socioeconomic disadvantage was greater than expected when their individual effects are summed (RERI = 0.38, 95% CI 0.22, 0.55 for reading and RERI = 0.27, 95% CI 0.10, 0.43 for numeracy). CONCLUSION: In the current study, emerging health and developmental needs identified by teachers at the outset of schooling were associated with poorer literacy and numeracy skills at Grade 3, and family socioeconomic disadvantage appeared to further amplify this effect. Meeting the needs of these children will require timely and coordinated supports across the health and education systems, particularly for those children who are also disadvantaged.
Meredith O’Connor, Shiau Yun Chong, Jon Quach et al.
