Transforming health for a more equitable future

Aboriginal children presenting to Emergency Departments (ED) are more likely to be critically unwell and need urgent care than non-Aboriginal children, new data has revealed.

A study looking at presentations of Aboriginal children to SCHN facilities between 2015 – 2020 has shown Aboriginal children are 2.2 times more likely to present to ED via ambulance compared to non-Aboriginal children and also have a higher chance of needing resuscitation and emergency response, accounting for 7.3 per cent of ED presentations, compared to just 5.2 per cent in the non-Indigenous population.

The study highlights not just the inequalities that exist for Aboriginal children but also the need for consideration of the social determinants of Aboriginal health in order to Close the Gap.

In the last year, SCHN has taken a number of positive steps towards improving health for Aboriginal children and their families, implementing several new programs and introducing new positions that focus on addressing Aboriginal health disparities and promoting safe, reliable and equitable healthcare for all.

Across SCHN, the Aboriginal workforce has grown by 20 staff in clinical and non-clinical roles, ranging from new graduate nurses, to cardiac concierge, through to the Aboriginal Health Outcomes and Equity Project Manager.

The Aboriginal Health Outcomes and Equity Project Manager is the first role of its kind at SCHN and aims to ensure the constant delivery of high-quality, equitable services to Aboriginal children.

“I am focused on better understanding the experiences of our Aboriginal patients and families in order to change the story for the health of Aboriginal children. By understanding what it is that our Aboriginal patients and families need, be it culturally or from a health service perspective, we can respect, support and enable optimal health outcomes,” Natasha Larter, Aboriginal Health Outcomes and Equity Project Manager, said.

“Seeing Aboriginal children arrive to our ED critically unwell, and knowing that they are 2.3 times more likely to die in our ED is distressing. It’s the voices of our patients and families that ultimately will change these statistics, and we must listen to them if we want to contribute to closing the gap.”

Natasha’s work is being supported by innovations in technology that are enabling Aboriginal families to be offered support sooner.

With the implementation of the SCHN Aboriginal Health Dashboard, clinicians have access to real time data about Aboriginal patients admitted to all area of the hospitals (including ED) and whether they have been seen by an Aboriginal Health Worker.

The new system aims to ensure every Aboriginal family is seen by an Aboriginal Health Worker within 24 hours of their admission, helping to give families the cultural and social support they need as early as possible.

While providing the very best care for Aboriginal patients and families in the hospital setting is a priority, there is also a significant effort being made to extend care to outreach settings, to improve early intervention and help improve health outcomes before children need hospital care. This is being achieved through community outreach clinics, programs and initiatives like the PEACH (Providing Enhanced Access to Health Services) project.

Led by SCHN Chief Investigator Professor Karen Zwi and Diversity Health Manager Daniela Feuerlicht, in partnership with South Eastern Sydney and Western Sydney LHDs, the PEACH project is implementing technological solutions (like automated clinician alerts) to enable earlier, supported and integrated access to healthcare services for vulnerable children and families who are referred to SCHN.

“The advantage of addressing Aboriginal health as part of a children’s hospital network is that we have a wide range of services and, therefore, an opportunity to intervene early in the life course.”

“What we do at SCHN is likely to alter a child’s health and affect the rest of their life. A reduction in chronic disease and mental health conditions means improved school performance, better job opportunities and reversing the cycle of disadvantage,” Professor Zwi said.

The SCHN Aboriginal Health Strategic Plan is providing a useful framework across increased employment of Aboriginal staff, culturally appropriate and highly accessible services for patients and families and research that drives positive change. 

There is still more to do though to help Close the Gap; and this work is everyone’s responsibility.

Thursday, 17 March, marks National Close the Gap day, a time to reaffirm our commitment to advocating for health equality and taking meaningful action in support of improving the health of Aboriginal children and their families.