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Purpose: Australian population data regarding the number and sociodemographic characteristics of children affected by a parent's cancer are not currently available. Moreover, predictions that this population is increasing have not been tested. This study provides data on the number and sociodemographic characteristics of parents with cancer and their young children (aged 0-11 years) in the state of Western Australia, and investigates whether long-term trends in this population have increased over time.Methods: Linked administrative data were used to describe parents with malignant cancer and their children aged 0-11 years at the time of diagnosis between 1982 and 2015 in Western Australia. Parents and children were described overall and by year of diagnosis and sociodemographic characteristics. A Poisson regression was used to investigate trends in the number of children affected, accounting for population growth. Incidence counts of parental cancer characteristics were included.Results: Between 1982 and 2015, 15,938 parents were diagnosed with a malignant cancer, affecting 25,901 children. In 2015, 0.28% of children in Western Australia experienced a parent's diagnosis. The number of children affected increased over time; however, this was accounted for by population growth. The majority of families lived in regional areas and were of high socioeconomic status. Older children and older parents most frequently experienced parental cancer. Skin and breast cancer were the most common diagnoses.Conclusions: A substantial number of families are affected by parental cancer. Results can guide intervention development and delivery to children of different developmental stages, and inform decisions regarding resource allocation and health service accessibility. [ABSTRACT FROM AUTHOR]

Children with adverse childhood experiences (ACEs) can have difficulty adapting to the school context and may therefore be more likely to be suspended. We examined the association between ACEs and suspensions using linked administrative data on children born in Western Australia from July 2003–June 2004 who attended a government school during 2009–2012 (N = 15,109). During pre-primary to grade 3, 378 children (2.5%) were suspended; 60% of these children had ACEs. Multilevel multinomial logistic regressions revealed that children with early childhood ACEs had around 2-times greater odds of being suspended once or multiple times, compared to children without ACE exposure. Children with school-age ACEs also had greater odds of single or multiple suspensions (1.87-times and 2.92-times greater, respectively). The odds of suspension increased 4–7% with each additional ACE exposure. Results highlight the need for early and intensive wraparound services for children with ACEs, to address the maintaining factors for behavioural issues. • Administrative data on adverse childhood experiences and suspensions were merged. • Children with adverse childhood experiences had higher odds of being suspended. • Adverse childhood experiences had a dose-response relationship with suspensions. • Suspensions were strongly predicted by parent convictions and child maltreatment. [ABSTRACT FROM AUTHOR]

OBJECTIVE: This study examined the association between chronic illness and school readiness, by using linked administrative population data. METHODS: The sample included children born in 2003-2004 who were residing in Western Australia in 2009 and had a complete Australian Early Development Census record (N = 22 890). Health and demographic information was also analyzed for 19 227 mothers and 19 030 fathers. The impact of child chronic illness on 5 developmental domains (social, emotional, language, cognitive, and physical) at school entry was analyzed. Analyses examined the association between child developmental outcomes and chronic illness generally, single or multiple chronic illness diagnosis, and diagnosis type. Logistic regression models estimated odds ratios for each outcome, adjusted for child, parent, and community sociodemographic variables. RESULTS: In the adjusted models, children with a chronic illness had an increased risk of being classified as developmentally vulnerable on all domains, compared with children without a chronic illness (20%-35% increase in risk). There was no increased risk for children with multiple chronic illness diagnoses over those with a single diagnosis (all Ps > .05). There was no evidence of a disease-specific effect driving this risk. CONCLUSIONS: Regardless of the number or type of conditions, chronic illness in young children is a risk factor for reduced school readiness. These effects were seen for health conditions not traditionally considered detrimental to school readiness, such as chronic otitis media. Thus, the implications of a broader range of chronic health conditions in early childhood on school readiness need to be considered. [ABSTRACT FROM AUTHOR]

Objective: We examined the impact of long-term mental health outcomes on healthcare services utilisation among childhood cancer survivors in Western Australia using linked hospitalisations and community-based mental healthcare records from 1987 to 2019., Method: The study cohort included 2977 childhood cancer survivors diagnosed with cancer at age < 18 years in Western Australia from 1982 to 2014 and a matched non-cancer control group of 24,994 individuals. Adjusted hazard ratios of recurrent events were estimated using the Andersen-Gill model. The cumulative burden of events over time was assessed using the method of mean cumulative count. The annual percentage change in events was estimated using the negative binomial regression model., Results: The results showed higher community-based service contacts (rate/100 person-years: 30.2, 95% confidence interval = [29.7-30.7] vs 22.8, 95% confidence interval = [22.6-22.9]) and hospitalisations (rate/1000 person-years: 14.8, 95% confidence interval = [13.6-16.0] vs 12.7, 95% confidence interval = [12.3-13.1]) in childhood cancer survivors compared to the control group. Childhood cancer survivors had a significantly higher risk of any event (adjusted hazard ratio = 1.5, 95% confidence interval = [1.1-2.0]). The cumulative burden of events increased with time since diagnosis and across age groups. The annual percentage change for hospitalisations and service contacts significantly increased over time ( p < 0.05). Substance abuse was the leading cause of hospitalisations, while mood/affective and anxiety disorders were common causes of service contacts. Risk factors associated with increased service events included cancer diagnosis at age < 5 years, leukaemia diagnosis, high socioeconomic deprivation, and an attained age of < 18 years., Conclusions: The elevated utilisation of healthcare services observed among childhood cancer survivors emphasises the need for periodic assessment of psychiatric disorders, particularly in high-risk survivors, to facilitate early management and optimise healthcare resources., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: The long-term effects of childhood cancer are unclear in the Australian context. We examined hospitalization trends for physical diseases and estimated the associated inpatient care costs in all 5-year childhood cancer survivors (CCS) diagnosed in Western Australia (WA) from 1982 to 2014., Methods: Hospitalization records for 2,938 CCS and 24,792 comparisons were extracted from 1987 to 2019 (median follow-up = 12 years, min = 1, max = 32). The adjusted hazard ratio (aHR) of hospitalization with 95% confidence intervals (CI) was estimated using the Andersen-Gill model for recurrent events. The cumulative burden of hospitalizations over time was assessed using the mean cumulative count method. The adjusted mean cost of hospitalization was estimated using the generalized linear models., Results: We identified a higher risk of hospitalization for all-cause (aHR, 2.0; 95% CI, 1.8-2.2) physical disease in CCS than comparisons, with the highest risk for subsequent malignant neoplasms (aHR, 15.0; 95% CI, 11.3-19.8) and blood diseases (aHR, 6.9; 95% CI, 2.6-18.2). Characteristics associated with higher hospitalization rates included female gender, diagnosis with bone tumors, cancer diagnosis age between 5 and 9 years, multiple childhood cancer diagnoses, multiple comorbidities, higher deprivation, increased remoteness, and Indigenous status. The difference in the mean total hospitalization costs for any disease was significantly higher in survivors than comparisons (publicly funded $11,483 United States Dollar, P < 0.05)., Conclusions: The CCS population faces a significantly higher risk of physical morbidity and higher cost of hospital-based care than the comparisons., Impact: Our study highlights the need for long-term follow-up healthcare services to prevent disease progression and mitigate the burden of physical morbidity on CCS and hospital services., (©2023 American Association for Cancer Research.)

Background: Currently, there is mixed evidence regarding the effects on children when a parent is chronically ill. Research has also primarily been conducted with adolescent samples. This study investigated developmental vulnerabilities in young children of parents with chronic illness., Methods: This study used linked administrative data. The study population included children born in Western Australia during 2003-2004 (n=19 071; mean age 5.5 years). The outcome measure was a score in the bottom 25% on any of the five developmental domains (physical, social, emotional, communicative and cognitive) of the Australian Early Development Census (2009 collection). Parental chronic illnesses were identified from hospital and cancer registry records, during the period from 1 year prior to the child's birth and until the end of 2009., Results: Higher odds of developmental vulnerabilities in physical, social, emotional and communication domains were observed for daughters of chronically ill mothers. Sons of chronically ill mothers had increased odds of language and cognitive difficulties. Risk level increased with each additional year of exposure to maternal chronic illness. Results also indicated increased odds of developmental vulnerabilities for children of mothers experiencing multiple compared with single chronic conditions; however, results were not statistically significant (all p>0.05). No association between fathers' chronic illness and children's developmental outcomes was found., Conclusions: Maternal chronic illness is associated with an increased risk of poor developmental outcomes for children, particularly daughters. Healthcare services have an important role to play in linking families into appropriate family-centred services to best support the needs of chronically ill mothers., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.)