Australia’s largest long-term study of the health and wellbeing of urban Aboriginal Children

Children and young people

The Study of Environment on Aboriginal Resilience and Child Health (SEARCH) is a unique resource for understanding the causes of ill health in urban Aboriginal children, and for developing and implementing strategies to improve their health.

SEARCH is owned and led by Aboriginal people. It functions as a long term, co-creative partnership between the Aboriginal Health & Medical Research Council, Aboriginal Community Controlled Health Services (ACCHSs) in NSW, the Sax Institute, and leading researchers from across Australia.

What is SEARCH

Since 2008, SEARCH has been following over 1,600 Aboriginal children in urban and regional NSW to provide critical information about their ongoing health, from obesity and chronic disease, to hearing and speech development.

SEARCH is the only platform of its kind, and is providing a holistic, ever-growing picture of the health and wellbeing of urban Aboriginal communities – evidence that is being used by communities to drive real improvements in health services.

How SEARCH works

SEARCH is collecting a wealth of information on the health and wellbeing of Aboriginal children. Using a community-led approach, partnering ACCHSs set the research priorities and decide how data is collected, interpreted and used. To date, 70 researchers from over 25 institutions have used the cohort data to publish papers, making SEARCH the most widely published individual source of data about Aboriginal health in Australia.

SEARCH has a strong track record of supporting Aboriginal researchers and community members to undertake undergraduate and higher degree courses and training in research and health promotion. SEARCH leaders provide mentorship and expertise along the research journey for both Aboriginal and non-Aboriginal researchers.

As we embark on the next ten years of the study, SEARCH will continue to work collaboratively with communities. And together, we can use this rich data source to help inform innovative programs and advocate for policy changes to support the future health of Aboriginal children and their families in urban and regional NSW.

SEARCH focus areas:

  • Ear health and child development
    According to SEARCH data, one in three participating children have been diagnosed with middle ear disease, and 10% of Aboriginal children have significant hearing problems. As a result of these findings, the NSW Ministry of Health provided funding for children at participating ACCHs, along with some additional ACCHs, to receive specialist services. To date, more than 8,000 extra speech and hearing services and 300 ENT surgeries have been provided to NSW Aboriginal children.
  • Mental health
    While the majority of children participating in SEARCH have good mental health, research shows that one in three SEARCH children are at high risk of experiencing mental health issues. SEARCH is working with select local health districts to test community-led mental health interventions to help support Aboriginal child and adolescent mental health.
  • Obesity and chronic disease
    SEARCH data indicates that food and nutrition insecurity is the third most significant factor affecting Aboriginal child health and wellbeing, and is related to higher rates of obesity and chronic disease. SEARCH is now embarking on an Aboriginal-led food security program to promote healthy and sustainable diets and reduce food stress in urban Aboriginal households.
  • Housing
    Nearly one in two families in social housing are struggling with poor dwelling conditions, and SEARCH has shown a connection between poor housing conditions and gastrointestinal disease in urban Aboriginal children. SEARCH is bringing these findings to the attention of decision makers in both the housing and health sectors.

Contact us

If you have any questions about SEARCH, please contact us at SEARCH@saxinstitute.org.au

More information about SEARCH

Focusing on Aboriginal community identified health priorities, the Study of Environment on Aboriginal Resilience and Child Health (SEARCH) is a cohort study of Aboriginal young people, from urban and large regional centres in New South Wales, Australia.

In Phase 1 (2008-2011) parents/caregivers and their children were invited to participate in SEARCH at the time of presentation to one of the four participating ACCHSs at Mount Druitt, Campbelltown, Wagga Wagga and Newcastle.

The following data was collected in Phase 1 and repeated in Phase 2 (2013-2020):

  • Questionnaire data (including physical health, environmental, and social and emotional well-being questions)
  • Height, weight, waist circumference and blood pressure measures
  • Complete audiometry, otoscopy/pneumatic otoscopy and tympanometry (children only)
  • Speech and language assessments (children aged 1-7 years)
  • Parents/caregivers complete the Parental Evaluation of Developmental Status (children aged 1-7 years)

Approval for data linkage was sought from parents/caregivers in both Phases, allowing routinely collected State and Commonwealth data to be combined with the survey, clinical, and ear, speech and development data collected to examine health service use and how it relates to good health in Aboriginal children.

In Phase 2 (2015-2020), parents/caregivers and their children of the SEARCH cohort were invited to be followed up at one of the four participating ACCHSs. They provided important information about how the health of the children has changed over time, and what predicts good health this cohort, including measures of a broad range of health outcomes and of potential determinants.

Building upon the knowledge and partnerships from SEARCH, the Centre of Research Excellence (CRE) in Partnership Pathways to Better Care and Outcomes for Aboriginal Young People was funded in 2017. The Centre’s mission is to better understand where and how to intervene in order to support Aboriginal children and towards a healthy start to their adult lives. With the addition of a new partner, Orange AMS, the CRE utilised mixed methods research and systematic reviews to co-produce a suite of interventions in the areas of mental health, ear health, child development and early prevention of chronic disease that are culturally appropriate, sustainable, and aim to improve health outcomes for Aboriginal children and adolescents in our partner communities.

In 2020, the ACCESS project (Aboriginal Community Controlled Ear-health Support System: developing, embedding and evaluating best practice models of care) received funding to develop, implement and evaluate an Aboriginal Child Health Navigator program in three ACCHSs spanning urban and regional NSW. ACCESS will not only support families of children with otitis media (OM) and hearing loss to access local services, but will also work with families, services and communities to address the underlying social determinants of health: the modifiable drivers of OM and hearing loss. It is expected that ACCESS will have direct benefits in terms of enhanced ACCHS models of care, better OM outcomes and likely long-term developmental, educational and vocational benefits.

The idea for a study arose in the early years of the Coalition for Research to Improve Aboriginal Health (CRIAH) — a joint venture between the Aboriginal Health and Medical Research Council and the Sax Institute.

Community leaders said they were interested in long-term research of child and family wellbeing that looked at health holistically and included interventions in important areas. The result was SEARCH.

Aboriginal community priorities have determined the direction of SEARCH and include: speech and language development; housing, neighbourhood and environment; ear health and hearing; social and emotional wellbeing; resilience; and overweight and cardiovascular disease.

SEARCH’s first phase was funded with a competitive grant from the National Health and Medical Research Council (NHMRC) and support from: the Australian Government Department of Education, Employment and Workplace Relations; the Centre for Aboriginal Health, NSW Ministry of Health; beyondblue; the Australian National University; and Rio Tinto Aboriginal Foundation.

Phase 2, which is currently underway, has been funded once more by the NHMRC as well as the Australian Primary Health Care Research Institute (APHCRI). We are pleased to have beyondblue, the Sydney Children’s Hospitals Network and the NSW Ministry of Health as partners in this phase.

The data from SEARCH is so important – this has given us important information about the things we were concerned about and now we are doing something about it.

Darryl Wright, CEO Tharawal Aboriginal Corporation

ACCHS partners

Working as part of SEARCH are four Aboriginal Community Controlled Health Services: Tharawal Aboriginal Corporation, Western Sydney Aboriginal Health Service (interim services are being provided by WentWest), Awabakal Newcastle Aboriginal Cooperative Ltd, Riverina Medical and Dental Aboriginal Corporation