Health of Southern Tasmanian 4- to 6-year-old children in out-of-home care compared to peers

Marie Rauter, Anagha Jayakar, Tom Clemens, Zaharenia Galanos, Louise Newbery, Andrew Whelan - Journal of Paediatrics and Child Health

Abstract

Aim

To compare the health of 4- to 6-year-old children in out-of-home care (OOHC) in Southern Tasmania with their peers.

Methods

Demographic and health data collection and prospective health assessment of all 4- to 6-year olds in OOHC in Southern Tasmania on 30 August 2011 was undertaken. Data were compared to Tasmanian and/or Australian peers.

Results

A total of 109 of 129 children aged 4 to 6 years were included in the study. Time in OOHC was on average 38 (range 0–76) months. Premature birth (18%), low birthweight (20%) and congenital malformations (10%) were more common compared to peers. Antenatal exposure to illicit or abused substances (71%), alcohol (51%) and cigarettes (79%) were very high. Vertically acquired hepatitis C was diagnosed in 2% with 33% exposed. Immunisation completion was 78% compared to 92.9% of Tasmanian peers. Obesity (11% vs. 6% Tasmanian children), hearing impairment (7% vs. 1% Tasmanian children) and dental caries (61% vs. 45% Tasmanian children) were all higher than peers. Hospitalisation due to injury was more than twice that of Tasmanian peers (32.1 vs. 12.6 per 1000 per year). Developmental delay was 50% on screening. Emotional or behavioural difficulties were seen in 54%.

Conclusions

Children in OOHC have high health needs. Comprehensive health assessments offer an opportunity to better identify and manage these needs. High hepatitis C exposure in utero was unexpected. This study highlights the need for comprehensive health screening assessments for all children in OOHC. OOHC clinic data can be helpful in planning broad interventions for children in OOHC.