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Relationships between Psychosocial Resilience and Physical Health Status of Western Australian Urban Aboriginal Youth.

ABSTRACT: Psychosocial processes are implicated as mediators of racial/ethnic health disparities via dysregulation of physiological responses to stress. Our aim was to investigate the extent to which factors previously documented as buffering the impact of high-risk family environments on Aboriginal youths' psychosocial functioning were similarly beneficial for their physical health status.We examined the relationship between psychosocial resilience and physical health of urban Aboriginal youth (12-17 years, n = 677) drawn from a representative survey of Western Australian Aboriginal children and their families. A composite variable of psychosocial resilient status, derived by cross-classifying youth by high/low family risk exposure and normal/abnormal psychosocial functioning, resulted in four groups- Resilient, Less Resilient, Expected Good and Vulnerable. Separate logistic regression modeling for high and low risk exposed youth revealed that Resilient youth were significantly more likely to have lower self-reported asthma symptoms (OR 3.48, p<.001) and carer reported lifetime health problems (OR 1.76, p<.04) than Less Resilient youth.The findings are consistent with biopsychosocial models and provide a more nuanced understanding of the patterns of risks, resources and adaptation that impact on the physical health of Aboriginal youth. The results support the posited biological pathways between chronic stress and physical health, and identify the protective role of social connections impacting not only psychosocial function but also physical health. Using a resilience framework may identify potent protective factors otherwise undetected in aggregated analyses, offering important insights to augment general public health prevention strategies.

SUBMITTER: Hopkins KD

PROVIDER: S-EPMC4696679 | biostudies-other | 2015

REPOSITORIES: biostudies-other

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Project description:BACKGROUND:Most Australian Aboriginal children are on track with their development, however, the prevalence of children at risk of or with a developmental or behavioural problem is higher than in other children. Aboriginal child development data mostly comes from remote communities, whereas most Aboriginal children live in urban settings. We quantified the proportion of participating children at moderate and high developmental risk as identified by caregivers' concerns, and determined the factors associated with developmental risk among urban Aboriginal communities. METHODS:Study methods were co-designed and implemented with four participating urban Aboriginal Community Controlled Health Services in New South Wales, Australia, between 2008 and 2012. Caregiver-reported data on children <?8?years old enrolled in a longitudinal cohort study (Study of Environment on Aboriginal Resilience and Child Health: SEARCH) were collected by interview. The Parents' Evaluation of Developmental Status (PEDS) was used to assess developmental risk through report of caregiver concerns. Odds ratios (OR) were calculated using multinomial logistic regression to investigate risk factors and develop a risk prediction model. RESULTS:Of 725 children in SEARCH with PEDS data (69% of eligible), 405 (56%) were male, and 336 (46%) were aged between 4.5 and 8?years. Using PEDS, 32% were at high, 28% moderate, and 40% low/no developmental risk. Compared with low/no risk, factors associated with high developmental risk in a mutually-adjusted model, with additional adjustment for study site, were male sex (OR 2.42, 95% confidence intervals 1.62-3.61), being older (4.5 to <?8?years versus <?3?years old, 3.80, 2.21-6.54), prior history of ear infection (1.95, 1.21-3.15), having lived in 4 or more houses versus one house (4.13, 2.04-8.35), foster care versus living with a parent (5.45, 2.32-12.78), and having a caregiver with psychological distress (2.40, 1.37-4.20). CONCLUSION:In SEARCH, 40% of urban Aboriginal children younger than 8?years were at no or low developmental risk. Several factors associated with higher developmental risk were modifiable. Aboriginal community-driven programs to improve detection of developmental problems and facilitate early intervention are needed.

Project description:ObjectiveIn caregivers of urban Aboriginal children, to determine the frequency of major stressful life events, the proportion who meet criteria for resilience, and factors that are associated with resilience.DesignCross-sectional survey.SettingFour Aboriginal Community Controlled Health Services located in urban or regional areas in New South Wales, Australia.Participants574 caregivers of Aboriginal children participating in the Study of Environment on Aboriginal Resilience and Child Health.Primary outcome measureResilience, defined as having experienced three or more stressful life events in the last 12 months, and having scores of ?21 on the Kessler 10 Psychological Distress scale.ResultsOver half (315, 55%) of the caregivers reported three or more stressful life events-the most common being a close family member who was hospitalised with a serious medical problem (259, 45%). Of the participants who experienced three or more stressful life events, almost three-quarters (227, 72%) met the criteria for resilience. Using multivariable analysis, two factors were independently associated with resilience: not having a physical health problem that limited normal activities (adjusted OR (aOR) 4.3; 95%?CI 2.0 to 9.0), and not having problems caused by alcohol within the home (aOR 5.3; 95%?CI 2.2 to 12.8). Having a child whose behaviour placed a great deal of burden on the family was associated with less resilience (aOR 0.25; 95%?CI 0.09 to 0.68).ConclusionsCaregivers of urban Aboriginal children experienced a large number of stressful events, the most common being the poor health of close family members, but most exhibited resilience. Resilience was associated with stable family environments and good physical health. The high number of stressful life events that caregivers experience is reflective of broader inequalities that Aboriginal communities face. The availability of easily accessible and long-term health and support services may go some way to reducing this inequality and improving social and emotional well-being for Aboriginal families.

Project description:OBJECTIVES:To determine prevalences of underweight and overweight as well as low and high waist-to-height ratio (WHtR) in three prospective follow-ups and to explore tracking of these measures of nutritional status from childhood to adolescence and adulthood. The influence of socioeconomic status, remoteness, maternal body mass index (BMI) and birth weight on weight status was assessed. DESIGN:Longitudinal birth cohort study of Indigenous Australians. SETTING:Data derived from three follow-ups of the Aboriginal Birth Cohort study with mean ages of 11.4, 18.2 and 25.4 years for the participants. PARTICIPANTS:Of the 686 Indigenous babies recruited to the study between 1987 and 1990, 315 had anthropometric measurements for all three follow-ups and were included in this study. PRIMARY AND SECONDARY OUTCOME MEASURES:BMI categories (underweight, normal weight, overweight and obesity),WHtR categories (low and high), sex, areal socioeconomic disadvantage as defined by the Indigenous Relative Socioeconomic Outcomes index, urban/remote residence, maternal BMI and birth weight. Logistic regression was used to calculate ORs for belonging to a certain BMI category in adolescence and adulthood according to BMI category in childhood and adolescence. RESULTS:Underweight was common (38% in childhood and 24% in adulthood) and the prevalence of overweight/obesity increased with age (12% in childhood and 35% in adulthood). Both extremes of weight status as well as low and high WHtR tracked from childhood to adulthood. Underweight was more common and overweight was less common in remote and more disadvantaged areas. Birth weight and maternal BMI were associated with later weight status. There were significant sex differences for prevalences and tracking of WHtR but not for BMI. CONCLUSIONS:Socioeconomic factors, remoteness and gender must be addressed when assessing nutrition-related issues in the Indigenous communities due to the variation in nutritional status and its behaviour over time within the Indigenous population.

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Relationships between Psychosocial Resilience and Physical Health Status of Western Australian Urban Aboriginal Youth.

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