Koolungar (Children) Moorditj (Strong) Healthy Skin Project Part II: Skin Health in Urban-Living Australian Aboriginal Children

Abstract

Background: Although essential for overall health and wellbeing, little is known about skin health in urban-living Australian Aboriginal children. This co-designed, research-service project aimed to describe skin health and document skin disease frequency in urban-living Aboriginal children and young people (CYP, i.e., 0–18 years) in Western Australia (WA) and investigate housing associations for skin infections. Methods: Cross-sectional studies were conducted at Aboriginal Community Controlled Health Organizations in Bunbury and Perth, WA, over 2 weeks in September–October 2022. Aboriginal CYP were eligible to participate. Questionnaire responses and examination findings were analyzed. Results: Of the 164 CYP recruited, 149 (91%) were urban-living Aboriginal CYP. Fifty-three percent (78/148) of caregivers described a dermatological concern in their child; with high caregiver diagnostic accuracy for impetigo (96%), tinea (92%), and atopic dermatitis (AD) (89%). AD (18%, 26/147), head lice (18%, 27/147), tinea (12%, 18/147) and impetigo (7%, 10/147) were most prevalent. Social housing predicted current head lice (odds ratio [OR] 4.63; 95% confidence interval [CI] 1.72–12.50), current tinea (OR 3.15; 95% CI 1.06–9.36) and ever impetigo (2.39; 95% CI 1.09–5.27). Crowded living conditions predicted ever impetigo (OR 6.28; 95% CI 2.03–19.37); whereas frequent bathing (p value 0.032) and regular swimming in a chlorinated pool (OR 0.12; 95% CI 0.02–0.95) were protective. Conclusions: We report high caregiver diagnostic accuracy for skin conditions. AD is prevalent, with undertreatment, frequent impetiginization, and sleep disturbance indicating barriers to care. Healthcare providers must advocate for improved housing, as the link between skin infections and socioeconomic disadvantage impacts overall health for urban-living Aboriginal CYP.