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Hearing health the forgotten factor in Aboriginal disadvantage

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Rachel Siewert 17 Oct 2011

Senator Rachel Siewert, Australian Greens spokesperson for Aboriginal and Torres Strait Islander Health.  While delivering the recent Lionel Murphy Lecture, Attorney-General Robert McClelland described the over-representation of Aboriginal people in Australia’s criminal justice system as a ‘national shame’.  During this speech he covered a number of important topics, including the imperative 'justice reinvestment', but he failed to adequately address the underlying determinants of Aboriginal incarceration.

Such an omission reflects the long term failure of the policies of successive Governments to address the factors that contribute to Aboriginal disadvantage.  The WA Police Commissioner Karl O'Callaghan has discussed the dramatic overrepresentation of Aboriginal youth in some WA crime statistics, rightly pointing out the need to deal with the systemic social issues that contribute to these alarming figures.

One often-overlooked factor linked to disadvantage amongst Aboriginal and Torres Strait Islander people is hearing loss, despite a substantial body of evidence which links hearing health, educational outcomes and interaction with the justice system.

A reason this issue could frequently be overlooked is its inherent complexity. 

This widespread hearing loss is most often linked to a condition called otitis media. There are a range of reasons why it affects Aboriginal children to such an extent.  Otitis media is a middle ear infection which affects most children at one time or another.

For the majority of Australians, it is short term condition which passes without any lingering health effects, but that is often not the case for many Aboriginal children.
It is reported that the condition affects 90% of Aboriginal babies in the Northern Territory.  It strikes at an earlier age and is significantly more severe than national averages or accepted public health levels. Addressing the factors which cause otitis media to affect Aboriginal children to such an extent, requires long term commitment and investment which doesn’t fit nicely into to a three-year election cycle.

It has been estimated that Aboriginal children experience ear disease for an average of 2.5 years, compared to an average of 3 months for non-Aboriginal Children, making the chance of hearing loss significantly higher. It also means that children are facing barriers to learning during their formative years, to the detriment of vital language skills and education.   In addition to learning and development, these hearing problems have been linked to a range of negative outcomes around employment and training opportunities and the potential for involvement with the criminal justice system.

Research findings by the Northern Australian Aboriginal Justice Association indicated strong links between poor educational outcomes and the likelihood that a person will be charged with a criminal offence.

The extent to which hearing impairment occurs within the Aboriginal prisoners is yet to be fully investigated, but the levels are estimated to be very high.   Audiometic screening conducted by the Northern Territory Correctional Services found that over 90% of inmates in both Darwin and Alice Springs prisons have a significant hearing loss.

Testing of 150 women at Bandyup Women's Prison in Western Australian found significant hearing loss in 46% of Aboriginal women, compared to 10% in the rest of the prison population.  As well as making contact with the criminal justice system more likely, hearing and communication problems have the potential to seriously compromise the legal process itself.
Communication and language barriers make dealing with police, lawyers, and judges so much harder.

Addressing these justice outcomes involves better awareness and understanding of hearing health issues and better investment in assistive technology, above and beyond continuing efforts to target hearing loss itself.

Far and away, the best processes to assist people with hearing impairment and reduce the long term prevalence of the condition is one which, from the outset is developed with a wide range of parties in full consultation with Aboriginal people and communities.  Such links have been documented in the Senate Community Affairs Reference Committee report Hear Us- Hearing in Australia and the House of Representative’s Doing Time, Time for Doing report on juvenile justice.  Despite these reports and their respective recommendations, action to address the issues raised has been painfully slow.

While the prevalence of hearing health problems among Aboriginal and Torres Strait Islander people has been long acknowledged, there is no specific strategy in place to address it. This seems inconceivable given the commitment to ‘Close the Gap’.

A recent Aboriginal Children’s Hearing Health Forum in Canberra discussed these issues and took what I hope will be the first steps towards the formation and delivery of a National Aboriginal and Torres Strait Islander Hearing Policy, which would hopefully be supported across the political spectrum.

Such action deals directly with an important underlying cause of Aboriginal and Torres Strait Islander disadvantage, but will also have downstream effects in the key areas of education and involvement with the criminal justice system.

Participants from the forum are committed to working together to see action taken to improve hearing health and education outcomes.  Those involved are health experts, educators and business people with strong links to the community.

With a strong foundation and collaborative approach, such a group has the potential to identity national policy needs, advocate for change, consolidate existing research and undertake new studies.

This goodwill must now be matched with a commitment from state and Federal governments to look beyond the next election and make important investments in long term policies.

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