Table 1.

Normative and Queensland SUDI Study Social Vulnerability Framework indicators by family-weighted composite score method.

	Normative Social Vulnerability Indicators	Queensland SUDI Study Indicators	Family-weighted composite score method
Income and material resources	Family income below poverty line Family has Australian Government healthcare/concession card
	Limited material resources and financial hardshipa In past 12 months any of: Couldn't afford to buy groceries or clothing Couldn't pay rent/mortgage Pawned/sold possessions Assistance from welfare organizations	Proxy measure due to data availability. Any of: Insufficient food in home Inadequate food/clothing for children Infant fed cow's milk/powder as alternative to formula Difficulty paying rent/mortgage or problems securing accommodation Poor housing quality, lack of amenities, housing filthy, infestations Inability to afford other essentials (e.g., medications, whitegoods)	Binary
Employment	Under and precarious employment Neither parent full-time, one only part-time, casual, or unstable work	Proxy measure due to data availability.Low status parental occupationsb ( ≤ 25th percentile).	Continuous measure 1 (lowest)-−0.25
	Unemployment Neither parent employed <12 months	Both parents recorded as ‘unemployed' or no occupation listed on birth/death records	Binary
	Long-term unemployment Neither parent employed ≥12 months	Long-term parental unemployment noted in case records	Binary
Education and skills	Early school leaver Parents didn't complete high school
	Very early school leaver Parents didn't complete junior high school
	No advanced or vocational education Parents have no formal education beyond high school and no vocational training
	Poor basic skills Parents have poor literacy/English competence
Housing	Homelessness Sleeping rough, couch surfing, homeless shelters	Recent history of homelessness	Binary
	Marginal homelessness Insecure accommodation e.g., boarding houses, caravans, makeshift dwellings	Recent history of insecure forms of accommodation	Binary
	Overcrowding Australian Bureau of Statistics definition based on number of bedrooms and relationships between residents in dwellingc	Any of: Multiple families in one residence Entire family sharing one room (no other space available), living areas functioning as bedrooms More than 2 children sharing a bedroom, or pubescent children of opposite sex sharing a bedroom	Binary
	Transience and mobility Multiple moves during pregnancy during infant's life	Either of: >2 changes of address during pregnancy and after birth Transience noted in case records	Binary Longitudinal indicator
	Public housing Living in public/community housing
Health and healthcare	Chronic illness, condition or disability	Parent/s have a chronic illness, condition or disability	Weighted for family type and increasing prevalence
		One or more siblings has a chronic illness, condition or disability	Weighted for family type and increasing prevalence
	Mental ill-health	Mental ill-health in parents	Weighted for family type and increasing prevalence
	Alcohol misuse	Recent alcohol misuse history by parents	Weighted for family type and increasing prevalence
	Substance use	Recent substance abuse history or drug diversion therapy by parents	Weighted for family type and increasing prevalence
	Infant and child mortality	Previous liveborn sibling death	Binary
		Previous stillbirth	Weighted for increasing prevalence
	Multiple miscarriages or terminations	Multiple terminations or miscarriages	Weighted for increasing prevalence
	Limited access to primary care	Data available for mother and infant only. Any of: Hospitalization for ambulatory care-sensitive conditions (ACSC)d Emergency presentation for primary or dental care Missed appointments (including did not wait) Infant failure to thrive Recurrent parasitic infections in infant or siblings Inadequate antenatal care e	Weighted for increasing prevalence
Crime and threats to safety	Criminal offending	Parents charged with criminal offense <12 months	Weighted for family type and increasing prevalence
	Long term criminal offending	Parents consistent criminal offending in adulthood (≥12 months)	Weighted for family type and increasing prevalence Longitudinal indicator
	Victim of crime	Parents victim of crime <12 months	Weighted for family type and increasing prevalence
	Domestic and family violence	Domestic violence present in current or previous relationships	Binary Longitudinal indicator
	Child abuse and neglect Child in family experienced or at risk of physical, sexual or emotional abuse or neglect	Infant or sibling known to child protection services ≤ 3 years	Binary
	Engagement in risky behaviors	Parent/s currently or previously engaged in sex work	Binary Longitudinal indicator
Transport and access to services	Could not access services due to a lack of transport	Any of: Difficulty running the family car (i.e., fuel, registration) Difficulty attending medical appointments or important events due to a lack of transport Difficulties accessing public transport	Binary
	Does not have access to car in household
	Geographic isolation Geographic distance imposes a high restriction upon accessibility to goods, services and opportunities for interaction	Living in an area where Accessibility and Remoteness Index of Australia (ARIA+)f classification = remote or very remote or outer regional	Binary Weighted for remoteness classification
Family and social relationships	Limited social support Mother's social support index (condensed)g	Proxy measure due to data availability. Parent/s experience any of: Fractious and unsupportive familial relationships Involuntary separation of family due to incarceration of partner or partner working away without extended family support	Binary
	Multiple partners Parents have children to multiple different partners	Parents have one or more children to one or more previous partners	Weighted for family type and increasing prevalence
	Child not in the care of biological parents	Children in informal care arrangements and/or children placed in care of child protection agencies	Binary Longitudinal indicator
	Stressful life events Life events index (condensed)h	Proxy measure due to data availability. In previous 12 months ≤ 2 of: Tumultuous parental and extended family relationships Recent separation, divorce or separation/reconciliation pattern Recent re-partnering Child custody disputes Recent change in care arrangements Recent imprisonment or court appearance Death of a family member Recent move Recent job loss or demotion Major change in health of a family member	Weighted for increasing prevalence
Intergenerational disadvantage	Parental history of child abuse and neglect	Parents known to child protection services as children	Weighted for family type and increasing prevalence
	Parental history of juvenile offending	Parents history of juvenile offending noted in case records	Weighted for family type and increasing prevalence

= N/A in Queensland SUDI Study dataset.

^aFinancial hardship indicators are an abridged version of the hardship items used in Australian longitudinal population-based surveys (26, 27).

^bThe Australian Socioeconomic Index 2006 (AUSEI06) was applied to parental occupation data coded using the Australian and New Zealand Standard Classification of Occupations (28). The higher of the two occupational statuses represented the family's occupational status.

^c(29).

^dACSCs are avoidable with the application of public health interventions and early disease management, delivered in a primary care setting and are a marker for access to timely and effective primary care (17).

^eThe Kotelchuck Adequacy of Prenatal Care Utilization Index was used to categorize antenatal care as “adequate,” “intermediate,” or “inadequate” based on gestation at entry into antenatal care, number of visits and gestation at delivery (30).

^fThe Accessibility/Remoteness Index of Australia (ARIA+) divides Australia into classes of remoteness based on relative access to services (31).

^gStandardized tool for measuring maternal social support (32).

^hStandardized tool for measuring stressful life events (33).