Urban Aboriginal and Torres Strait Islander children's exposure to stressful events: a cross-sectional study

Objectives: To determine the frequency and types of stressful events experienced by urban Aboriginal and Torres Strait Islander children, and to explore the relationship between these experiences and the children's physical health and parental concerns about their behaviour and learning ability. Design, setting and participants: Cross-sectional study of Aboriginal and Torres Strait Islander children aged <= 14 years presenting to an urban Indigenous primary health care service in Brisbane for annual child health checks between March 2007 and March 2010. Main outcome measures: Parental or carer report of stressful events ever occurring in the family that may have affected the child. Results: Of 344 participating children, 175 (51%) had experienced at least one stressful event. Reported events included the death of a family member or close friend (40; 23%), parental divorce or separation (28;16%), witness to violence or abuse (20;11%), or incarceration of a family member (7; 4%). These children were more likely to have parents or carers concerned about their behaviour (P < 0.001) and to have a history of ear (P < 0.001) or skin (P = 0.003) infections. Conclusions: Children who had experienced stressful events had poorer physical health and more parental concern about behavioural issues than those who had not. Parental disclosure in the primary health care setting of stressful events that have affected the child necessitates appropriate medical, psychological or social interventions to ameliorate both the immediate and potential lifelong negative impact. However, treating the impact of stressful events is insufficient without dealing with the broader political and societal issues that result in a clustering of stressful events in the Aboriginal and Torres Strait Islander population.