Growth and morbidity in children in the Aboriginal Birth Cohort Study: The urban-remote differential

Objectives: To describe the prevalence of markers of growth, chronic and infectious disease in peripubertal Aboriginal children living in the Darwin Health Region in the "Top End" of the Northern Territory, and to compare prevalence between children living in urban and remote areas. Design: Cross-sectional survey nested in a prospective birth cohort. Subjects: 482 children living in the region who were recruited at birth (Jan 1987 to Mar 1990) and were followed up between 1998 and 2001, when aged 8-14 years. Main outcome measures: Selected parameters of growth and nutrition, infectious disease and potential markers of chronic adult disease were compared between children living at follow-up in suburban situations in Darwin-Palmerston (urban) and those living in rural communities with an Aboriginal council (remote). Results: Remote children were shorter than urban children (mean height, 141.7 v 146.3 cm; P <0.001), lighter (median weight, 30.3 v 37.1 kg; P <0.001) and had lower body mass index (median, 15.3 v 17.9 kg/m²; P <0.001) and haemoglobin level (mean, 125.1 v 130.9 g/L; P <0.001). Some potential markers of adult chronic disease were higher in urban than remote children: systolic blood pressure (mean, 109.6 v 106.2 mmHg; P = 0.004), and levels of total cholesterol (4.3 v 4.0 mmol/L; P <0.001), high-density lipoprotein cholesterol (mean, 1.4 v 1.2 mmol/L; P <0.001) and insulin (median, 7 v 4 mU/L; P = 0.007). Diastolic blood pressure, levels of red cell folate, serum glucose and low-density lipoprotein cholesterol, and urinary albumin-creatinine ratio did not differ by location. The prevalence of visible infections was also higher in remote than urban children (P <0.05). Conclusion: As some markers of health differ between peripubertal Aboriginal children living in urban areas and those in remote areas, results of surveys in remote areas cannot be generalised to urban Aboriginal populations.