207. Ear disease and skin infections are major health issues currently facing Aboriginal and Torres Strait Islander children. 208. Hearing loss that occurs as a result of ear infection is prevalent in Aboriginal and Torres Strait Islander children and is linked to delays in speech and language development.181 This can have a lasting impact on educational and workforce outcomes. 209. Skin infections are also common in some communities and can have longterm health consequences. The underlying causes of skin infections are primarily related to socio-economic disadvantage, including overcrowded housing, lack of access to basic sanitation and poor levels of education.182 210. Limited access to primary health care can result in delayed diagnosis, treatment and management of health conditions. (b) Fetal Alcohol Spectrum Disorder 211. During 2017, the Australian Government Department of Health undertook consultations across Australia to inform the development of the National Fetal Alcohol Spectrum Disorder Strategy 2018–2028, replacing the Fetal Alcohol Spectrum Disorder Action Plan (2013–2017). The FASD Strategy has not yet been released. 212. The Commission is concerned that a serious impediment to developing effective health and policy responses to FASD is the current lack of accurate information about its incidence and prevalence. 213. Data gaps relating to children with FASD should be considered as part of the national children’s data framework referred to in Recommendation 10 above. Recommendation 30: The Australian Government releases the National Fetal Alcohol Spectrum Disorder Strategy 2018–2028. (c) Childhood obesity 214. Childhood obesity rates have almost doubled since the 1980s and obesity is now a major public health issue in Australia.183 215. Children with obesity are more likely to be obese as adults and have an ‘increased risk of developing both short and long-term health conditions, such as Type 2 diabetes and cardiovascular disease’.184 37