A Deakin University-Flinders University research team who reviewed all research on Aboriginal child health, development and wellbeing in Australia has found major gaps in knowledge, with significant implications for health service policy and delivery.
Naomi Priest, Public Health Research Fellow at Deakin University, examined 214 studies from the late 1950s to 2005 and attempted to capture all epidemiological research regarding the health, development and wellbeing of Aboriginal and Torres Strait Islander children in Australia.
"The review maps the aspects of health, development and wellbeing the studies covered, including areas such as physical health, mental health and social functioning, and the geographic location of the studies," said Ms Priest.
"74.8% of research in this area was in physical health, with very limited research on mental health (2.8%) or social functioning (0.9%) of children."
"It also suggests that much of the research has come from a Western biomedical understanding of health and illness, rather than the more holistic view of child health and wellbeing held by Aboriginal peoples," said Dr Tamara Mackean, a descendant of the Wongai people, co-investigator and Vice President of the Australian Indigenous Doctors Association.
In addition, the review identified that the overwhelming majority of studies were in remote or very remote areas (66.5%) compared to studies conducted in major cities (11.6%).
Regional areas were considered by slightly more studies (15.4%). This is a distinct contrast to where most Aboriginal people live in Australia, with 30% living in major cities, 43% in regional areas and 27% in remote areas.
The review also examined whether Aboriginal and Torres Strait Islander involvement was reported in the research process, other than as subjects.
"One of the findings that emerged from the review was the fact that 71.5 % of the studies did not mention whether Aboriginal people had been involved in the research," Ms Priest said.
"This raises serious questions about both the ethics of the research process, as well as the quality and appropriateness of the research results. "These results would suggest that Aboriginal peoples and communities were not consulted about many of the research projects and it is not clear whether they even gave permission for much of the research.
"It is also highly likely that the research did not consider what was important to Aboriginal communities in terms of the health, development and wellbeing of their children.
"The implications for policy are that we need to ensure that Aboriginal perspectives regarding children's health, development and wellbeing are placed at the centre of all research and service delivery initiatives.
"In addition, an appropriate emphasis beyond only physical health and beyond remote communities is needed.
"The importance of Aboriginal children's mental health and wellbeing, and how this can be promoted and protected, needs to be incorporated into research and service delivery in urban, rural and remote areas.
"The unique needs of urban Aboriginal children must not be forgotten if we are to significantly address the health inequities experienced by Aboriginal children in Australia."