- Title
- Structural and social inequities contribute to pockets of low childhood immunisation in New South Wales, Australia
- Creator
- Thomas, Susan; Bolsewicz, Katarzyna; Leask, Julie; Clark, Katrina; Ennis, Sonya; Durrheim, David N.
- Relation
- Vaccine: X Vol. 12, Issue December 2022, no. 100200
- Publisher Link
- http://dx.doi.org/10.1016/j.jvacx.2022.100200
- Publisher
- Elsevier BV
- Resource Type
- journal article
- Date
- 2022
- Description
- Introduction: Childhood immunisation is a safe and effective way to protect children and communities from serious diseases. In Australia childhood immunisation is generally well accepted with high coverage rates however pockets of low coverage exist. Authors conducted five previous studies in New South Wales which found socio-economic disadvantage, gender inequity, health service access barriers and under-utilisation of immunisation data, rather than ideological opposition, contributed to children’s incomplete vaccination. Material and Methods: Common findings across those five studies were identified. Additional literature was reviewed using a number of lenses, underpinned by a social determinants of health framework. Results: The lensed approach allowed further exploration of the impact of financial stress, poor mental health, drug and alcohol problems, domestic violence, assumed gender roles, lack of culturally acceptable health care for Indigenous families, geography and changes to immunisation policies on families and how this may have contributed to pockets of low immunisation coverage. Social and structural inequities were revealed. These often contributed to conflicting priorities that meant children’s immunisations fell behind. Discussion: Strategies to address inequities may include reorientation of existing community based child health services to include flexible options such as drop in clinics, outreach services, home visiting and ensuring Indigenous families have access to culturally safe and acceptable services. Assistance with transport would further improve access to services. Better use of immunisation data can aid in the identification of pockets of low coverage and monitor and evaluate service effectiveness. Conclusions: Greater awareness of social and structural barriers and their impact on families can inform the design of tailored strategies that address the needs of disadvantaged children and families. Without efforts to overcome the inequities that contribute to low immunisation coverage, the status quo persists, leaving children and communities at risk of vaccine preventable diseases.
- Subject
- childhood immunisation; equity; SDG 16; Sustainable Development Goals; access; indigenous; socio-economic; public health; SDG 1; SDG 3; SDG 5; SDG 10
- Identifier
- http://hdl.handle.net/1959.13/1458189
- Identifier
- uon:45395
- Identifier
- ISSN:2590-1362
- Rights
- ©2022 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
- Language
- eng
- Full Text
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Goal 10: Reduced Inequalities
Goal 5: Gender Equality
Goal 1: No Poverty
Goal 16: Peace, Justice and Strong Institutions
Goal 3: Good Health and Well-Being
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