Ear disease and the associated hearing loss are significant health problems for Indigenous children (Morris et al. 2005; Khoo 2009; NAHSWP 1989). Children in many Indigenous communities suffer from chronic ear disease, in particular otitis media, at rates that well exceed the 4% threshold at which a disease is regarded as a major public health problem (WHO 1998). Ear disease, particularly where it leads to hearing loss, is a large contributor to poor educational achievement and higher unemployment and, as a consequence, greater contact with the criminal justice system later in life (AHMAC 2012; AIHW 2012a; SCARC 2010).
While the roots of this disease essentially lie in disadvantage and poverty, a number of environmental factors, individual genetics and microbial genomic factors also contribute (Couzos et al. 2007; Burns & Thomson 2013). Preventing ear disease in Indigenous children by tackling these factors is a high priority (AHMAC 2012; NAHSWP 1989).
While the social and biological bases of ear disease are reasonably well understood, many programs and strategies for its prevention do not appear to have worked effectively (Bowes & Grace 2014). In some cases, programs to prevent ear disease and associated hearing loss have been implemented without sufficient planning and high quality evidence (Khoo 2009). However, recent health services delivered under the Stronger Futures in the Northern Territory (SFNT) strategy have shown some success in reducing hearing loss, the prevalence of otitis media, and the severity of hearing impairment (AIHW 2014).
This resource sheet reviews past and current programs, research and strategies (both government and non-government) for the prevention and treatment of ear disease in Indigenous children. While the focus of the document is on preventing ear disease, programs aimed at treating infection and minimising hearing loss are also reviewed.