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This study aims to compare the impact of Australian onshore and offshore immigration detention centres (IDCs) on detainees’ health and health-care events.

It uses data extracted from the Australian Government’s quarterly health reports from 2014 to 2017. These reports contain a range of data about the health and well-being of detainees, including complaints/presenting symptoms and number of appointments and hospitalisations. To compare onshore and offshore data sets, the authors calculated the rate of health events per quarter against the estimated quarterly onshore and offshore detention population. They ran a series of two-proportion z-tests for each matched quarter to calculate median z- and p-values for all quarters. These were used as an indicator as to whether the observed differences between onshore and offshore events were statistically significant.

The results suggest that adults detained onshore and offshore have substantial health needs, however, almost all rates were far higher in offshore detention, with people more likely to raise a health-related complaint, access health services and be prescribed medications, often at two to three times the rate of those onshore.

This paper adds to a modest body of literature that explains the health of people detained in Australian IDCs. To the best of the authors’ knowledge, this is the first paper to explore health service utilisation and a range of other variables found in the Australian Government’s quarterly health reports. These findings bolster the evidence which suggests that detention, and particularly offshore detention is particularly harmful to health.

A narrative has developed in recent years to link ageing without children to support needs in later life. Social care has long been viewed as a private, familial responsibility, whilst health care is a societal, public good. Childlessness is framed negatively in terms of increased demands on care services and wider family networks. As governments tackle the issue of how to fund and deliver an equitable and sustainable long-term care sector, this paper aims to argue that it is more critical than ever to evaluate views of childlessness in the context of ageing.

Policy-oriented commentary paper.

If the focus on childlessness and ageing is through a lens of a potential care deficit, this continues to frame ageing without children as a risk and does little to challenge increasing reliance on unpaid care. Research and policy need to explore how to make access to social care more equitable and reduce expectations of unpaid care. They also need to increasingly emphasise exploration of aspects of later life beyond the issue of care, for example, by more of a focus on communities, what matters to people to age well and lives that extend beyond traditional views of nuclear families.

This paper uses the UK as a contextual example to argue that the research and policy communities have a role to play in evaluating their constructions of childlessness and ageing and questioning whether they do little more than legitimise government’s unwillingness to take responsibility for social care.