Targeting hearing loss in Aboriginal and Torres Strait Islander communities

Hearing loss is a significant health problem faced by Aboriginal and Torres Strait Islander people, mostly caused by chronic otitis media (middle-ear infection) during childhood.
 
Aboriginal and Torres Strait Islander children experience some of the highest rates of chronic otitis media in the world, with studies showing they are five times more likely to be diagnosed than non-Indigenous children.
 
Hearing loss and otitis media rates among Aboriginal and Torres Strait Islander children are considered a ‘public health crisis’ by the World Health Organization (WHO). The Australian Medical Association (AMA) released its November 2017 report, A national strategic approach to ending chronic otitis media and its lifelong impacts in Indigenous communities, to raise awareness of the national problem. The report also addresses the scourge of chronic otitis media in Aboriginal and Torres Strait Islander communities, despite the fact it has almost been eradicated in many parts of the world.
 
The National Aboriginal Community Controlled Health Organisation (NACCHO) and the RACGP’s National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people (National Guide) illustrates that the long-term consequences of chronic otitis media include delay in speech and language development, contributing to learning difficulties, behavioural problems and problems progressing through school.
 
According to Dr Tim Senior, Medical Advisor for RACGP Aboriginal and Torres Strait Islander Health, member of the National Guide Project Reference Group and a GP at Tharawal Aboriginal Corporation in NSW, all of these outcomes are preventable through early diagnosis.  
 
‘Effective screening and diagnosis for otitis media by healthcare providers is crucial,’ he told newsGP. ‘Knowledge of referral pathways to support hearing loss prevention, or treatment and restoration of hearing loss is also important.’
 
The prevalence of otitis media among Aboriginal and Torres Strait Islander children is the result of the environments in which people live – the social determinants of health. These include overcrowded households, poor hygiene and nutrition, and housing without basic facilities such as working taps, mirrors or basins that drain.
 
There is also an increased risk for children with a family history of ear infections and for children who live in a household with people who smoke.  
 
Dr Senior believes that education plays a significant role in the early diagnosis of otitis media among Aboriginal and Torres Strait Islander communities.
 
‘While prevention of hearing loss requires action in housing and education, medical services clearly have a role in providing treatment, and patient and community education in a culturally appropriate way to offer preventive care, including screening and immunisation and smoking cessation advice,’ he said.
 
The National Guide advocates that rates of hearing loss in the Aboriginal and Torres Strait Islander population could be reduced if ear infections are managed in childhood, through newborn hearing screening and availability of preventive guidelines in Aboriginal Community Controlled Health Services, with the hope this will lead to earlier identification and intervention to prevent hearing loss in later life.
 
The National Guide covers further information on hearing loss in these chapters:

• Hearing loss
• The health of young people
• Child health

Aboriginal-and-Torres-Strait-Islander-health hearing-loss national-guide