Demographics
Detailed demographics are reported at Table 1.
Table 1
2019 KHC respondent characteristics by Indigenous identification
Demographics | Missing data | First Nations children | Non-Indigenous children |
Mean (SD) | Proportion of cohort % (95% CI) | Mean (SD) | Proportion of cohort % (95% CI) |
Age in months at time of KHC health screen | n = 15 | 69.1 (4.7) | | 69.5 (4.1) | |
Gender | Male | n = 15 | | 50.7 (42.6–58.7), n = 74 | | 51.0 (49.7–52.3), n = 2,739 |
Female | | 49.3 (41.3–57.4), n = 72 | | 49.0 (47.7–50.3), n = 2,631 |
First Nations children accounted for 2.6% (n = 146) of 2019 KHC participants for whom Indigenous identification was reported (n = 5,516). Children were an average of 5 years 9 months at the time of the health screen. There was no significant difference in the gender profile of First Nations and non-Indigenous children.
The mean ICSEA score for First Nations and non-Indigenous children was above the national median of 1000, at 1054 (SD, 50) and 1089 (SD, 48) respectively. Significantly more First Nations than non-Indigenous children were in the most socio-educationally disadvantaged ICSEA quintile (42.5%, 95% CI, 34.7–50.6% (n = 62) compared to 17.5%, 95% CI, 16.5–18.5% (n = 940)) (Fig. 1). Similarly, a smaller proportion of First Nations children were in the most socio-educationally advantaged quintile compared to non-Indigenous children (8.2%, 95% CI, 4.6–13.5% (n = 12) compared to 23.0%, 95% CI, 21.9–24.1% (n = 1235)).
Figure 1: 2019 KHC respondent socio-educational disadvantage by Indigenous identification
†Quintile 5: ICSEA ≥ 1130; Quintile 4: ICSEA 1107 to 1129; Quintile 3: ICSEA 1072 to 1106; Quintile 2: ICSEA 1042 to 1071; Quintile 1: ICSEA < 1042. Missing: n = 15
Physical activity and screen time measures
Both First Nations and non-Indigenous children were physically active for at least 60 minutes on most days of the week (Table 2). A higher proportion of First Nations children were physically active at this level on every day of the week compared to non-Indigenous children.
Averaged across the week, daily screen time was 2.2 and 1.9 hours respectively for First Nations and non-Indigenous children. Weekend screen time averaged 3.1 hours for First Nation children and 2.7 hours for non-Indigenous children compared to 1.9 and 1.6 hours respectively on weekdays.
Table 2
2019 KHC respondent modifiable risk factors by Indigenous identification
Risk factor | Missing data | First Nations children | Non-Indigenous children |
Mean (SD) | Proportion of cohort % (95% CI) | Mean (SD) | Proportion of cohort % (95% CI) |
Physical activity |
| Days in typical week with ≥ 60 minutes | n = 86 | 6.0 (1.4) | | 5.7 (1.6) | |
≥ 60 minutes every day in typical week | | 56.6 (48.5–64.8), n = 81 | | 44.3 (43.0-45.7), n = 2,351 |
Screen time |
| Weekdays |
| | Total screen time per day | n = 178 | 1.9 (1.3) | | 1.6 (1.2) | |
| Mean daily screen time > 2 hours | | 30.5 (23.4–38.4), n = 43 | | 23.7 (22.6–24.9), n = 1,237 |
Weekends |
| Total screen time per day | n = 186 | 3.1 (1.9) | | 2.7 (1.7) | |
Mean daily screen time > 2 hours | | 60.4 (52.2–68.3), n = 84 | | 55.0 (53.6–56.4), n = 2,863 |
All days |
| Total screen time per day | n = 279 | 2.2 (1.3) | | 1.9 (1.2) | |
Mean daily screen time > 2 hours | | 41.9 (33.9–50.3), n = 57 | | 36.2 (34.9–37.6), n = 1,851 |
Health outcomes |
Table 3 sets out health and development outcomes by Indigenous identification. Three quarters of children were in the healthy weight range in both the First Nations and non-Indigenous cohorts.
Table 3
2019 KHC respondent health and development outcomes by Indigenous identification
Health outcome | Missing data | First Nations children | Non-Indigenous children |
Proportion of cohort % (95% CI) | Proportion of cohort % (95% CI) |
BMI category † |
| Healthy weight | n = 384 | 74.6 (66.7–81.5), n = 97 | 77.4 (76.2–78.5), n = 3,882 |
Overweight | 15.4 (10.0-22.3), n = 20 | 12.4 (11.5–13.3), n = 621 |
Obese | 9.2 (5.1–15.1), n = 12 | 7.5 (6.8–8.3), n = 377 |
Respiratory problems |
| Chest wheeze/whistle (ever) | n = 79 | 36.1 (28.6–44.2), n = 52 | 23.2 (22.0-24.3), n = 1,229 |
Chest wheeze/whistle (in past 12 months) | n = 81 | 24.5 (18.0–32.0), n = 35 | 13.0 (12.1–13.9), n = 689 |
Parents’ Evaluation of Developmental Status (PEDS) pathway scores |
| Pathway A | n = 39 | 15.1 (10.0-21.5), n = 22 | 11.8 (10.9–12.7), n = 629 |
Pathway B | 25.3 (18.8–32.8), n = 37 | 22.1 (21.0-23.2), n = 1,179 |
Pathway C–D (non-predictive concerns) | 23.3 (17.0-30.6), n = 34 | 16.1 (15.1–17.1), n = 858 |
Pathway E (no concerns) | 36.3 (28.8–44.3), n = 53 | 50.1 (48.8–51.4), n = 2,678 |
†Underweight excluded from table due to small numbers preventing adequate de-identification of data (included in analysis)
More than one-third of First Nations children had ever had a wheeze/whistle in the chest compared to less than one quarter of non-Indigenous children. Likewise, a significantly higher proportion of First Nations children had respiratory problems in the 12-month period preceding the KHC.
The proportion of children with developmental concerns was not significantly different for either cohort. However, only 36 per cent of First Nations children were identified as having no developmental concerns compared to more than half of non-Indigenous children.
Table 4 sets out SDQ ‘total difficulties’ and ‘high-risk subscale’ wellbeing scores, all of which were within the expected range for both cohorts of children.
Table 4
2019 KHC respondent Strengths and Development Questionnaire (SDQ) high-risk wellbeing scores by Indigenous identification
SDQ measure | Missing data | Expected range | First Nations children | Non-Indigenous children |
Mean (SD) | Mean (SD) |
Total difficulties | n = 53 | 0–13 | 10.5 (6.7) | 7.6 (5.0) |
Emotional difficulties | n = 52 | 0–3 | 2.4 (2.3) | 1.7 (1.8) |
Conduct problems | n = 50 | 0–2 | 1.8 (1.7) | 1.4 (1.4) |
Hyperactivity and inattention | n = 51 | 0–5 | 4.5 (2.7) | 3.3 (2.4) |
Peer problems | n = 51 | 0–2 | 1.8 (1.9) | 1.3 (1.6) |
Prosocial | n = 52 | 6–10 | 8.1 (1.7) | 8.2 (1.7) |
Health outcome associations with screen time
Exposure to more than two hours of screen time per day was associated with a range of unfavourable health outcomes in non-Indigenous children; screen time was not significantly associated with any of the health outcomes examined through this study for First Nations children (Table 5).
Table 5
Association between screen time over two hours per day (across all days of the week) and health outcomes by Indigenous identification
Health measures | Outcome | Comparison | Odds Ratio (95% CI) |
First Nations children | Non-Indigenous children |
BMI† | Overweight/obese | Healthy weight | 1.4 (0.6–3.1) | 1.5 (1.3–1.7) |
Respiratory | Chest wheeze/whistle (in past 12 months) | No chest wheeze/whistle (in past 12 months) | 1.0 (0.5–2.4) | 1.2 (1.0-1.4) |
Development | PEDS predictive concerns (any number) | No PEDS predictive concerns | 1.0 (0.5–2.1) | 1.5 (1.3–1.7) |
Wellbeing | ‘High-risk’ or ‘slightly raised’ range SDQ Total difficulties score | Expected range SDQ Total difficulties score | 1.1 (0.5–2.3) | 1.5 (1.3–1.8) |
†Underweight children were excluded from OR analysis due to the small proportion in this BMI category within each cohort
Non-Indigenous children who had an average of more than two hours of screen time per day were 1.5 times more likely to be overweight/obese, have at least one clinically significant developmental concern, or to have wellbeing measures outside of the ‘close to average’ range. They were also 1.2 times more likely to have had a wheeze/whistle in the chest in the 12 months before the KHC than children who had two hours or less daily screen time.