Hearing is fundamental for developing speech and language, to learn, laugh and play. In Australia, approximately two thirds of children will have been affected by otitis media (OM) before their first birthday.
Globally, children in resource-poor settings have the highest documented rates of recurrent acute otitis media (AOM). Shockingly, Aboriginal & Torres Strait Islander children have some of the highest rates of OM in the world.
If left untreated, OM can cause hearing loss and has been linked with educational and economic disadvantage as well as increased incarceration rates.
A recently published Western Australian study – the first of its kind – reported on the rate of hospitalisation for OM in a total birth cohort that examined differences between Aboriginal and non-Aboriginal children and between levels of socio-economic disadvantage.
The study found Aboriginal and Torres Strait Islander children were 10 times more likely to be hospitalised for OM than non-Aboriginal children but less likely to undergo surgery for grommets. Those Aboriginal & Torres Strait Islander children that did have grommet surgery were predominantly between the ages of 5 and 15 years, suggesting a delay in assessment for OM and access to surgery.
Additionally, among non-Aboriginal children, the most socio-economically deprived had the highest rates of OM-related hospitalisations, and all children living in rural or remote areas were at increased risk of hospitalisation for OM but less likely to have grommet surgery.
In contrast, the study found that all children belonging to the highest socio-economic group had the highest grommet surgery rates, despite having the lowest overall OM-related hospitalisations. Furthermore, the surgeries were generally performed in private metropolitan hospitals in children under 5 years.
OM-related hospitalisation data presented in the study represent the ‘tip of the iceberg’ and the severe and chronic clinical end of the spectrum. Most importantly, the study findings shine a light on the disproportionate provision of services to more advantaged families when the greatest burden is among socio-economically deprived families.
The researchers provide a compelling case for the urgent need to reduce the burden of OM among Aboriginal children and non-Aboriginal children from low socio-economic backgrounds. They argue that efforts must focus on addressing the social determinants of health – particularly the reduction of poverty and increased availability of services in rural and remote areas.
Learn more by reading the study.