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Open Access Highly Accessed Research article

Socioeconomic disparities in the mental health of Indigenous children in Western Australia

Carrington CJ Shepherd12*, Jianghong Li12, Francis Mitrou2 and Stephen R Zubrick2

Author Affiliations

1 Centre for Population Health Research, Curtin Health Innovation Research Institute, Curtin University, Perth, Australia

2 Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Perth, Australia

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BMC Public Health 2012, 12:756  doi:10.1186/1471-2458-12-756

Published: 10 September 2012

Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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.

Keywords:
Socioeconomic; Social disparities; Social gradient; Aboriginal; Mental health; Indigenous; Inequality; Australia