In this socially disadvantaged population, otitis media tends to affect children early in life, tends to be persistent and is often asymptomatic (Kong and Coates 2009 Lehmann et al. 2005), with a recent survey reporting that almost all (90%) children have a history of otitis media (Leach et al. The prevalence of otitis media among Aboriginal children living in remote communities in the Northern Territory (NT) of Australia is among the highest reported worldwide (Morris et al. Middle ear disease (otitis media) is a common, usually transient, childhood disease and is the most common cause of hearing loss in children (Australian Institute of Health and Welfare (AIHW) 2014 Kong and Coates 2009 Leach and Morris 2017 Snodgrass and Groves 2017), however for Aboriginal Australian children living in remote communities, it is a major public health issue (Leach 1999 Morris et al. The association between HI and criminal activity was also proposed in a submission to the Inquiry into Hearing Health in Australia (2010), which stated that while HI may not directly cause criminal behaviour, it does have an impact on self-concept, educational attainment and social skills which in turn increase the risk of criminal activity (Australian Government Senate Community Affairs References Committee 2010). Other reports have also suggested that people with HI are more likely to encounter ‘language and learning challenges’, which might lead to ‘challenging behaviours’ (Glickman 2019 Vernon and Greenberg 1999) that increase the risk of CJS engagement. It has been suggested that involvement in the CJS may be a consequence of hearing-related social problems such as low educational standards, unemployment, alcohol and other substance abuse (Howard et al. One significant health issue for people in the criminal justice system (CJS) is hearing impairment (HI). The description ‘multiple and complex’ has been used to describe the breadth and depth of the needs of vulnerable populations that span a wide range of social and health issues (Rosengard et al. In the past decade, there has been increasing awareness of the commonalities between the social determinants of criminal behaviour and the social determinants of health, including factors such as poverty, child maltreatment, education and environmental health (Caruso 2017).
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