Project Overview

Justice-involved young people in Australia often have multiple and complex health issues. They experience high rates of mental illness, cognitive disability, substance-related harm, infectious disease, and non-communicable disease. These health conditions frequently co-occur, and are typically set against a backdrop of trauma, marginalisation, and entrenched disadvantage. Aboriginal and Torres Strait Islander children are over-represented in the youth justice system by a factor of 18, and in detention by a factor of 24. 
Justice system contact provides an important opportunity to identify young people with complex health and social needs, and to address population-level health inequities. Yet research has consistently shown that detention is associated with increased risk of morbidity and mortality, particularly in the days and weeks immediately post-release. In Australia and internationally, justice-involved young people die at a much higher rate than their peers, most often due to preventable causes such as suicide, drug overdose, injury, and violence. Despite their extreme vulnerability, little is known about their health needs after they transition out of the youth justice system and this lack of information has likely compounded health inequities. Information on their health needs and healthcare trajectories before and after youth justice contact is urgently needed to guide evidence-informed policy, practice, and justice reform responses. 
In response to this evidence gap, and in collaboration with the Australian Institute of Health and Welfare (AIHW) and the Australasian Youth Justice Administrators (AYJA), this NHMRC-funded project has linked nationwide youth justice records from 1 July 2000 to 30 June 2019 with hospital and emergency department records, Medicare and Pharmaceutical Benefits Scheme (PBS) records, and the National Death Index up to 31 December 2019. The combined dataset contains de-identified records for 88,110 young people across Australia. It is globally unique. Approximately one third of the cohort identifies as Aboriginal and/or Torres Strait Islander. The project is supported by a national project advisory committee with strong Aboriginal and Torres Strait Islander representation.

Aims

The broad aims of the NHMRC-funded project within which this PhD project is embedded include: 
1. Describe patterns of use of primary care, federally subsidised mental health care, ED and hospital services, and pharmaceuticals (including psychotropic and pain medications); 
2. Estimate all-cause and cause-specific crude mortality rates (CMRs) in the cohort, and in subgroups defined by sex and Indigenous status; 
3. Calculate all-cause and cause-specific standardised mortality ratios (SMRs) in the entire cohort, and in subgroups defined by sex and Indigenous status; 
4. Identify static and time-varying risk and protective factors for all-cause and cause-specific mortality. 
5. Through expert consensus (a Delphi panel), generate practice-based and consumer-informed evidence regarding candidate interventions to improve health outcomes and reduce preventable morbidity and mortality in justice-involved youth. 

The successful PhD candidate will work with their supervisory team to develop aims that are specific to their PhD and align with their interests and expertise. This may include, for example, a focus on particular health issues (e.g., mental illness, self-harm, overdose, injury, hepatitis C, cancer), patterns of healthcare use (e.g., primary care, frequent ED attendance, adherence to psychotropic medications), and/or preventable mortality. Appropriately skilled candidates have the option of developing a mixed-methods PhD, involving consultation and engagement with project stakeholders including service providers and young people.

Objectives

Using globally unique, nationally linked health and justice data, the overall objective of this project is to inform policies that will improve the health and wellbeing of justice-involved young people across Australia.

Significance 

Addressing the complex health needs of justice-involved young people in Australia is important to reducing health inequalities, Closing the Gap, and improving the health of the next generation of Australians. This rich dataset provides exceptional and unprecedented opportunities to document the health trajectories of justice-involved young people nationally and inform efforts to improve these outcomes.

The data for this project have already been obtained and cleaned and are available for analysis via the Sax Institute’s Secure Unified Research Environment (SURE). Costs of SURE access and associated data storage will be covered by the project. The project team has high-level expertise in the analysis of linked, multi-sectoral administrative data, world-leading expertise in justice health research, and strong connections with decision makers across Australia and internationally. This project is eminently feasible and has real potential to lead to meaningful improvements in health services and outcomes for justice-involved young people across Australia.

An internship may be available for this project. The successful candidate will have an opportunity to work with the Australian Institute of Health and Welfare (AIHW) which is using these linked data to develop and pilot a mechanism for routinely monitoring the health of justice-involved young people in Australia. This work is being overseen by the National Youth Justice Health Advisory Group, which is chaired by Professor Kinner.

• Future Students

• Faculty of Health Sciences

• Higher Degree by Research

• Australian Citizen
• Australian Permanent Resident
• New Zealand Citizen
• Permanent Humanitarian Visa
• International Student

• Merit Based

The annual scholarship package, covering both stipend and tuition fees, amounts to approximately $70,000 per year.

In 2024, the RTP stipend scholarship offers $35,000 per annum for a duration of up to three years. Exceptional progress and adherence to timelines may qualify students for a six-month completion scholarship.

Selection for these scholarships involves a competitive process, with shortlisted applicants notified of outcomes by November 2024.

1

All applicable HDR courses.

The successful applicant will have high-level skills in quantitative methods, ideally including hands-on experience working with linked administrative data. Candidates with training in epidemiology, health services research, public health, and/or biostatistics are encouraged to apply. The successful candidate will have exceptional written and oral communication skills, a strong interest in health equity, and a demonstrated track record of engaging effectively with academic, government, community, and lived-experience stakeholders. Aboriginal and Torres Strait Islander candidates are strongly encouraged to apply.

 

Please send your CV, academic transcripts and brief rationale why you want to join this research project via the HDR Expression of Interest form to the project lead researcher, listed below. 

You must be enrolled in a Higher Degree by Research Course at Curtin University by March 2025.

Project Lead: Professor Stuart Kinner