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4704.0 - The Health and Welfare of Australia's Aboriginal and Torres Strait Islander Peoples, 2008  
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Contents >> Mothers and Children >> HEALTHY CHILD DEVELOPMENT

HEALTHY CHILD DEVELOPMENT

Breastfeeding

Breastfeeding has many positive effects on the survival, growth, development and health of infants. Many studies have shown that breastfeeding has a protective effect against conditions such as diarrhoea and respiratory infections and has benefits for children's growth, cognitive development and immunological functioning (Kramer 2001; Oddy et al. 2003 ; Lawton & Shortridge 1997: all cited in Zubrick et al 2004). Other studies have shown a protective effect against sudden infant death syndrome, asthma and other allergic diseases (Hoffman 1988; Oddy et al 1999; Merrett 1988).

The 2004-05 NATSIHS provides information on the breastfeeding status of infants and young children. In 2004-05, approximately 79% of Indigenous children aged 0-3 years in non-remote areas had been breastfed compared with 88% of non-Indigenous children. A higher proportion of non-Indigenous children (aged 0-3 years) than Indigenous children had been breastfed for 12 months or more (14% compared with 11%) (ABS 2006c).

Among Aboriginal and Torres Strait Islander children aged 0-3 years, 85% of those in remote areas and 79% of those in non-remote areas were currently breastfeeding or had previously been breastfed in 2004-05 (AIHW 2007a). The proportions of Indigenous infants aged less than 12 months who were breastfeeding in 2004-05 were particularly high in remote areas (85% of those aged less than six months and 82% of those aged 6-12 months (graph 6.8).

6.8 CURRENTLY BREASTFEEDING BY REMOTENESS, Indigenous children aged 0-3 years - 2004-05
Graph: 6.8 Currently breastfeeding, by remoteness and age of child, Indigenous children aged 0-3 years, 2004-05



Diet and nutrition

Poor diet and nutrition in the early years of life can affect childhood development, growth, functioning and health (Tomkins 2001). It is also a principal cause of many of the health conditions suffered by Aboriginal and Torres Strait Islander people. A diet high in carbohydrates and saturated fats, for example, is associated with high levels of obesity, Type 2 diabetes and renal disease, while consumption of fresh fruit and vegetables can be a protective factor against many of these diseases (NPHP 2001). Aboriginal and Torres Strait Islander families living in isolated areas, however, face particular challenges in providing their children with fresh, affordable food on a regular basis.

The National Health and Medical Research Council Dietary Guidelines recommend consuming a wide variety of nutritious foods, including a high intake of plant food such as fruit and vegetables, while also recommending moderating total fat and saturated fat intake (NHMRC 2003b). The daily food consumption guidelines for fruit and vegetable intake recommend:
  • one serve of fruit and two serves of vegetables for children aged 4-7 years
  • one serve of fruit and three serves of vegetables for children aged 8-11 years
  • three serves of fruit and three serves of vegetables for adolescents aged 12-18 years.

The 2004-05 NATSIHS collected information on the dietary behaviour of Indigenous people aged 12 years and over, including the number of daily serves of fruit and vegetables usually eaten by those living in non-remote areas. Among Indigenous children aged 12-14 years in non-remote areas, 24% met the recommended daily fruit intake of three or more serves, and 59% met the recommended daily vegetable intake of three or more serves. Among teenagers aged 15-17 years, 20% met the daily fruit consumption guidelines and 61% met the daily vegetable consumption guidelines (table 6.9). There were no significant differences between the proportion of Indigenous and non-Indigenous children whose fruit and vegetable consumption met the recommended daily guidelines.

6.9 CHILDREN'S USUAL DAILY INTAKE OF FRUIT AND VEGETABLES IN NON-REMOTE AREAS, by Indigenous status - 2004-05

12-14 years
15-17 years
Indigenous
Non-Indigenous
Indigenous
Non-Indigenous
%
%
%
%

Number of serves of fruit
Does not eat fruit
5.4
4.7
12.5
7.8
1 serve or less
40.8
39.1
41.8
40.4
2 serves
30.0
29.8
25.4
25.3
3 serves
15.9
15.3
12.9
15.6
4 or more serves
8.0
11.1
7.4
11.0
Total
100.0
100.0
100.0
100.0
Number of serves of vegetables
Does not eat vegetables
1.7
1.2
1.0
1.1
1 serve or less
20.4
22.6
25.2
23.9
2 serves
18.6
21.5
(a)12.8
(a)19.5
3 serves
29.0
27.9
34.4
30.0
4 or more serves
30.2
26.9
26.6
25.5
Total
100.0
100.0
100.0
100.0

(a) Difference between Indigenous and non-Indigenous data is statistically significant.
Source: AIHW analysis of 2004-05 NATSIHS and 2004-05 NHS



Immunisation

The Australian Childhood Immunisation Register (ACIR), managed by the Health Insurance Commission, holds information on childhood immunisation coverage. All children under seven years of age, enrolled in Medicare, are automatically included on the ACIR. Children who are not eligible to enrol in Medicare can be added to the ACIR when details of a vaccination are received from a doctor or immunisation provider. It should be noted that coverage estimates for Aboriginal and Torres Strait Islander children include only those who are identified as such and are registered on the ACIR. Children identified as Indigenous on the ACIR may not be representative of all Aboriginal and Torres Strait Islander children, and thus coverage estimates should be interpreted with caution.

Vaccination coverage rates for children aged one year, two years and six years at 31 December 2005 for New South Wales, Victoria, Western Australia, South Australia and the Northern Territory combined are shown in table 6.10. Aboriginal and Torres Strait Islander children had lower coverage compared with non-Indigenous children for all vaccines at 12 months of age (82% compared with 91%), while at two years of age the difference in vaccination coverage between Indigenous and non-Indigenous children was not as large (90% and 92% respectively). Immunisation rates at six years of age were similar for Indigenous and non-Indigenous children. This suggests that there may be a delay in the receipt of vaccines by Indigenous children, or in the transfer of data for Indigenous children to ACIR (AIHW 2007a).

6.10 VACCINATION COVERAGE ESTIMATES FOR CHILDREN AT 1, 2 AND 6 YEARS OF AGE, by Indigenous status - 31 December 2005(a)(b)

One year old
Two years old
Six years old
Indigenous
Non-Indigenous
Indigenous
Non-Indigenous
Indigenous
Non-Indigenous
%
%
%
%
%
%

Hepatitis B
93.9
94.8
97.9
95.9
. .
. .
DTP (diphtheria, tetanus and pertussis)
86.0
92.6
94.9
95.2
85.3
85.5
OPV (oral polio vaccine)
85.6
92.5
94.7
95.2
85.6
85.7
Hib (Haemophilius influenzae type b)
93.1
94.5
91.6
93.6
. .
. .
MMR (measles, mumps and rubella)
. .
. .
93.1
93.8
85.4
85.7
Total
82.2
91.1
89.9
92.1
84.3
84.6

. . not applicable
(a) Three-month cohorts, for cohorts born between 1 July and 30 September 2004, 1 July and 30 September 2003, and 1 July and 30 September 1999 respectively.
(b) Data for NSW, Vic., WA, SA and NT only as data on Indigenous status from other jurisdictions were incomplete.
Source: AIHW 2007a


The 2004-05 NATSIHS also provides information on the immunisation status of Indigenous children aged 0-6 years in non-remote areas of Australia. Among Indigenous children for whom immunisation records were available, 93% were fully immunised according to the recommended course of vaccinations at a specific age. In particular, 78% of Indigenous children in non-remote areas were fully immunised against diphtheria/tetanus, 74% against whooping cough, 82% against Hepatitis B, 78% against polio, 72% against Hib and 84% against measles, mumps and rubella (AIHW 2007a).


Selected environmental risk factors

Passive smoking

Exposure to environmental tobacco smoke, commonly referred to as passive smoking, has been shown to be a significant cause of morbidity and mortality, and children are the most vulnerable to its effects. For babies, passive smoking is one of the significant risk factors for sudden infant death syndrome (AMA 1999). Exposure to second hand smoking also increases children's risk of ear infections and respiratory illnesses, such as asthma (Strachan & Cook 1997). Children living with parents and relatives who smoke indoors are particularly at risk.

In 2004-05, an estimated 119,000 Aboriginal and Torres Strait Islander children lived with a regular smoker. This represents two-thirds (66%) of all Indigenous children aged 0-14 years. In comparison, around one-third (35%) of non-Indigenous children aged 0-14 years lived with a regular smoker. Regular smokers may or may not smoke at home indoors. Some 28% of Aboriginal and Torres Strait Islander children were living in households with a regular smoker who smoked at home indoors, three times the comparable rate for non-Indigenous children (9%) (table 6.11).

6.11 WHETHER LIVING WITH REGULAR SMOKER(S), by Indigenous status - Children aged 0-14 years - 2004-05

Regular smokers in household
Smokes indoors at home
Does not smoke indoors at home
No regular smokers in household
Total(a)
%
%
%
%

Indigenous
28.5
37.6
31.4
100.0
Non-Indigenous
9.2
26.2
64.6
100.0

(a) Includes children in households in which the smoker status of the resident adults was not known.
Source: ABS 2004-05 NATSIHS, AIHW 2007a


Exposure to risky/high risk drinker(s)

According to the 2004-05 NATSIHS, an estimated 27,900 Indigenous children (15%) were living in a household in which there was at least one risky/high risk drinker, compared with 11% of non-Indigenous children aged 0-14 years. The proportion of Indigenous children exposed to risky/high risk drinking within their household ranged from 10% of those in very remote areas to 18% of those in inner regional areas (graph 6.12).

6.12 LIVING IN A HOUSEHOLD WITH RISKY/HIGH RISK DRINKER(a), Indigenous children aged 0-14 years - 2004-05
Graph: 6.12 Living in a household with a riskyhigh risk drinker, by Remoteness Areas, Indigenous children aged 0-14 years, 2004-05



Health status of children

Long-term health conditions

The 2004-05 NATSIHS and 2004-05 NHS collected data on the prevalence of long-term health conditions among children 0-14 years of age, based on information provided by the person with main caring responsibility for the child. Similar proportions of Indigenous and non-Indigenous children had at least one long-term condition (44% compared with 42%) in 2004-05. The most common long-term health conditions reported for Indigenous children were respiratory diseases (19%), diseases of the ear (10%) and diseases of the eye (8%) (ABS 2006c).

While the same proportion of Indigenous and non-Indigenous children had respiratory disease(s) in 2004-05, Indigenous children were more likely than non-Indigenous children to have asthma (14% compared with 11%) and/or bronchitis (2% compared with 1%). Indigenous children were also more likely than non-Indigenous children to have ear/hearing problems, especially partial deafness (5% compared with 1%) and/or otitis media (4% compared with 2%) (table 6.13).

6.13 CHILDREN AGED 0-14 YEARS WITH A LONG-TERM HEALTH CONDITION, by Indigenous status and type of condition - 2004-05

Indigenous
Non-Indigenous
Type of condition
%
%

Diseases of the respiratory system
19.1
19.4
Asthma
(a)13.9
(a)11.4
Bronchitis
(a)2.2
(a)1.2
Chronic sinusitus
(a)2.2
(a)3.2
Diseases of the ear and mastoid
(a)9.5
(a)3.0
Deafness (complete/partial)
(a)4.5
(a)1.2
Otitis media
(a)4.4
(a)1.5
Diseases of the eye and adnexa
8.5
10.5
Short-sighted
(a)1.9
(a)3.5
Long-sighted
3.9
3.7
Diseases of the skin and subcutaneous tissue
2.8
3.1
Diseases of the nervous system
2.2
2.1
Diseases of the musculoskeletal system and connective tissue
1.9
1.8
Congenital malformations, deformations and chromosomal abnormalities
1.6
1.1
Diseases of the heart and circulatory system
1.5
1.3
Other(b)
(a)13.0
(a)9.7
Conditions not elsewhere classified
7.7
8.4
Total with a long-term condition(c)
44.0
41.2

(a) Difference between Indigenous and non-Indigenous data is statistically significant.
(b) Includes diseases of the digestive system, infectious and parasitic diseases, diseases of the blood and blood forming organs, diseases of the genitourinary system, neoplasms/cancer, mental and behavioural disorders and endocrine, nutritional and metabolic diseases.
(c) Sum of components may be more than total as persons may have reported more than one type of condition.
Source: ABS 2006c


Burden of disease and injury

The burden of disease and injury among Indigenous Australians was assessed using Disability Adjusted Life Years (DALYS) - the sum of years of life lost due to premature death and years lived with disability (Vos et al 2007). In 2003 it was estimated that the burden of disease and injury for Indigenous Australians aged 0-14 years was 20,187 DALYS, representing 21% of the total burden of disease and injury for all Indigenous Australians (95,976 DALYS). The leading causes of this burden were neonatal (20%), mental disorders (19%), acute and chronic respiratory infections (18%) and congenital anomalies (12%).

Four major risk factors (tobacco, alcohol, illicit drugs and unsafe sex) attributed around 5% of the total burden of disease among Aboriginal and Torres Strait Islander children in this age group. Tobacco was by far the largest contributor to the disease burden in this age group due to the association between smoking during pregnancy and the increased risk of having a low birthweight baby (Vos et al 2007).

Hospitalisations of infants and children

Hospitalisations data provide a measure of a population's use of health services, but are not a direct measure of health status (see box 7.7 in Chapter 7). The quality of Indigenous identification in hospitalisations data varies across jurisdictions, with 2005-06 data presented for the six jurisdictions with adequate Indigenous identification - New South Wales, Victoria, Queensland, Western Australia, South Australia and the Northern Territory (see box 7.9 in Chapter 7).

In 2005-06, Aboriginal and Torres Strait Islander infants (aged less than one year) were hospitalised at a rate 1.4 times that of other Australian infants. Conditions originating in the perinatal period were the leading cause of hospitalisation of Indigenous infants, followed by diseases of the respiratory system and infectious and parasitic diseases. For skin diseases, diseases of the respiratory system and infectious and parasitic diseases, Indigenous infant hospitalisation rates were around three to four times the rates for other infants (table 6.14).

6.14 REASONS FOR HOSPITALISATIONS OF INFANTS(a), by Indigenous status - 2005-06

Number
Rate(b)
Indigenous
Other(c)
Indigenous
Other(c)
Rate ratio(d)

Conditions originating in the perinatal period (P00-P96)
2 584
49 141
215.7
204.2
1.1
Diseases of the respiratory system (J00-J99)
2 416
15 056
201.7
62.6
3.2
Infectious and parasitic diseases (A00-B99)
1 174
8 344
98.0
34.7
2.8
Contact with health services (Z00-Z99)
622
13 197
51.9
54.8
0.9
Symptoms not elsewhere classified (R00-R99)
524
11 953
43.7
49.7
0.9
Congenital malformations (Q00-Q99)
427
7 731
35.6
32.1
1.1
Diseases of the skin (L00-L99)
227
1 144
18.9
4.8
4.0
Injury and poisoning (S00-T98)
219
2 636
18.3
11.0
1.7
Diseases of the digestive system (K00-K93)
172
4 382
14.4
18.2
0.8
Diseases of the genitourinary system (N00-N99)
121
2 560
10.1
10.6
0.9
Subtotal
8 486
116 144
708.4
482.6
1.5
Other(e)
343
9 568
28.6
39.8
0.7
Total(f)
8 838
125 813
737.8
522.7
1.4

(a) Data for NSW, Vic., Qld, WA, SA and NT combined. Excludes private hospitals in NT. Hospitalisations are based on state of usual residence.
(b) Per 1,000 population aged less than one year.
(c) Comprises hospitalisations of non-Indigenous infants and hospitalisations of infants whose Indigenous status was not stated.
(d) Rate for Indigenous persons divided by the rate for other persons.
(e) Includes diseases of the ear and mastoid process, endocrine, nutritional and metabolic diseases, diseases of the nervous system, diseases of the eye and adnexa, diseases of the circulatory system, diseases of the blood and blood forming organs, diseases of the musculoskeletal system, neoplasms, and mental and behavioural disorders.
(f) Includes hospitalisations for which no principal diagnosis was recorded.
Source: AIHW National Hospital Morbidity Database


In 2005-06, Aboriginal and Torres Strait Islander children aged 1-14 years were hospitalised at a rate 1.3 times that of other children of the same age. Diseases of the respiratory system were the leading cause of hospitalisation among Indigenous children, followed by injury and poisoning and infectious and parasitic diseases. Aboriginal and Torres Strait Islander children were hospitalised for skin diseases at more than three times the rate of other Australian children, and were hospitalised for infectious and parasitic diseases at around twice the rate of other children (table 6.15).

6.15 REASONS FOR HOSPITALISATIONS OF CHILDREN AGED 1-14 YEARS(a), by Indigenous status - 2005-06

Number
Rate(b)
Indigenous
Other(c)
Indigenous
Other(c)
Rate ratio(d)
no.
no.
%
%
%

Diseases of the respiratory system (J00-J99)
4 412
68 505
27.1
19.8
1.4
Injury and poisoning (S00-T98)
3 583
58 799
22.0
17.0
1.3
Infectious and parasitic diseases (A00-B99)
2 229
28 097
13.7
8.1
1.7
Diseases of the digestive system (K00-K93)
2 081
45 306
12.8
13.1
1.0
Diseases of the skin (L00-L99)
1 526
9 583
9.4
2.8
3.4
Symptoms not elsewhere classified (R00-R99)
1 349
22 554
8.3
6.5
1.3
Diseases of the ear and mastoid process (H60-H95)
1 204
25 026
7.4
7.2
1.0
Contact with health services (Z00-Z99)
1 099
20 410
6.8
5.9
1.1
Diseases of the genitourinary system (N00-N99)
661
11 367
4.1
3.3
1.2
Diseases of the nervous system (G00-G99)
577
12 910
3.5
3.7
1.0
Subtotal
18 721
302 557
115.1
87.4
1.3
Other(e)
2 593
59 350
15.9
17.1
0.9
Total(f)
21 321
362 008
131.1
104.5
1.3

(a) Data for NSW, Vic., Qld, WA, SA and NT combined. Excludes private hospitals in NT. Hospitalisations are based on state of usual residence.
(b) Per 1,000 population aged 1-14 years.
(c) Comprises both hospitalisations of non-Indigenous children and hospitalisations of children whose Indigenous status was not stated.
(d) Rate for Indigenous persons divided by the rate for other persons.
(e) Includes diseases of the nervous system, congenital malformations and deformations, diseases of the circulatory system, endocrine, nutritional and metabolic diseases, neoplasms, mental and behavioural disorders, diseases of the blood and blood forming organs, diseases of the eye and adnexa, pregnancy, childbirth and the puerperium and conditions originating in the perinatal period.
(f) Includes hospitalisations for which no principal diagnosis was recorded.
Source: AIHW National Hospital Morbidity Database



Infant and child mortality

Identification of Indigenous Australians is incomplete in all states and territories however current mortality data are considered to have a sufficient level of coverage to enable statistics on Aboriginal and Torres Strait Islander mortality to be produced for four jurisdictions - Queensland, Western Australia, South Australia and the Northern Territory (see Chapter 9).

For analysis of trends over time in Indigenous and child mortality from 1991-2005, only three jurisdictions have a sufficient level of coverage to enable statistics on Aboriginal and Torres Strait Islander mortality to be produced - Western Australia, South Australia and the Northern Territory. Ideally, the trends data would compare rates for Indigenous and non-Indigenous infant and child mortality. The 'not stated' category for Indigenous status, however, was only included from 1998 onwards (before which, deaths with Indigenous status 'not stated' were included with non-Indigenous deaths). Indigenous mortality rates have therefore been compared with the mortality rates for 'other' Australians (i.e. deaths of both non-Indigenous people as well as those for whom Indigenous status was not stated).

Due to the incompleteness of Indigenous identification in mortality data, the number of deaths registered as Indigenous is an underestimate of the actual number of deaths that occur in the Indigenous population. Identification of Indigenous Australians may also differ between death registrations, birth registrations and the Census. Identification may also vary over time, and at different rates in states and territories. Therefore trends in infant and child mortality rates for Aboriginal and Torres Strait Islander children should be treated with caution.

Infant mortality

Infant deaths are deaths of live-born babies who die before reaching their first birthday. For the period 2001-2005, the infant mortality rate for Aboriginal and Torres Strait Islander infants living in Queensland, Western Australia, South Australia and the Northern Territory combined was almost three times that of non-Indigenous infants (table 6.16). The leading causes of death for Indigenous infants were conditions originating in the perinatal period (mainly foetus and newborn babies affected by complications of placenta, cord and membrane, and foetus and newborn babies affected by maternal complications of pregnancy), symptoms, signs and ill-defined conditions (mainly sudden infant death syndrome), congenital malformations, respiratory diseases (mainly pneumonia), injury and poisoning (mainly accidental suffocation and strangulation in bed) and infectious and parasitic diseases (such as septicaemia, meningococcal infection and congenital syphilis).

Mortality rates for respiratory diseases and infectious and parasitic diseases were particularly high for Aboriginal and Torres Strait Islander infants. For these two conditions, mortality rates were 11 and 5 times the rates for non-Indigenous infants.

6.16 MAIN CAUSES OF INFANT DEATHS(a), by Indigenous status - 2001-2005

Number
Rate(b)
Indigenous
Non-Indigenous
Indigenous
Non-Indigenous
Rate ratio(c)

Conditions originating in the perinatal period (P00-P96)
204
955
562.9
218.8
2.6
Symptoms, signs and ill-defined conditions (R00-R99)
99
213
273.2
48.8
5.6
Congenital malformations (Q00-Q99)
57
451
157.3
103.3
1.5
Respiratory diseases (J00-J99)
36
38
99.3
8.7
11.4
External causes (Injury/poisoning) (V01-Y98)
20
67
55.2
15.4
3.6
Infectious and parasitic diseases (A00-B99)
16
36
44.2
8.2
5.4
All other causes(d)
28
144
77.3
33.0
2.3
Total
460
1 904
1 269.3
436.2
2.9

(a) Data for Qld, WA, SA and NT. Deaths are based on state of usual residence and year of registration of death. Excludes a total of 61 deaths for which Indigenous status was not stated.
(b) Per 100,000 population aged less than one year.
(c) Rate for Indigenous persons divided by the rate for non-Indigenous persons.
(d) Includes neoplasms, endocrine, nutritional and metabolic diseases, mental and behavioural disorders, diseases of the musculoskeletal system, diseases of the ear and mastoid process, diseases of the eye and adnexa, diseases of the circulatory system, diseases of the skin and subcutaneous tissues, diseases of the genitourinary system, diseases of the nervous system, diseases of the digestive system, diseases of the blood and blood forming organs.
Source: AIHW National Mortality Database


Trends in infant mortality

Infant mortality rates for Aboriginal and Torres Strait Islander infants decreased significantly in Western Australia, South Australia and the Northern Territory over the period 1991 to 2005. In Western Australia the infant mortality rate fell from 26 per 1,000 live births in 1991 to 12 per 1,000 live births in 2005, with corresponding decreases for South Australia (from 20 to 10 per 1,000 live births) and for the Northern Territory (from 25 to 16 per 1,000 live births). The mortality rate for other Australian infants also declined over this period, but to a lesser extent, so the difference between the two has decreased significantly (graphs 6.17, 6.18 and 6.19). Infant mortality rates in single years for each of these jurisdictions are presented in Chapter 9.

6.17 INFANT MORTALITY RATES - WESTERN AUSTRALIA, by Indigenous status - 1991-2005
Graph: 6.17 Infant mortality rates - Western Australia, by Indigenous status, 1991-2005


6.18 INFANT MORTALITY RATES - SOUTH AUSTRALIA, by Indigenous status - 1991-2005
Graph: 6.18 Infant mortality rates - South Australia, by Indigenous status, 1991-2005


6.19 INFANT MORTALITY RATES - NORTHERN TERRITORY, by Indigenous status - 1991-2005
Graph: 6.19 Infant mortality rates - Northern Territory, by Indigenous status, 1991-2005


Child mortality

In the period 2001-2005, the mortality rate for Aboriginal and Torres Strait Islander children aged 1-14 years in Queensland, Western Australia, South Australia and the Northern Territory combined, was almost three times the mortality rate for non-Indigenous children in these jurisdictions (table 6.20).

6.20 MAIN CAUSES OF DEATH FOR CHILDREN AGED 1-14 YEARS(a), by Indigenous status - 2001-2005

Number
Rate(b)
Indigenous
Non-Indigenous
Indigenous
Non-Indigenous
Rate ratio(c)

External causes (V01-Y98)
90
417
17.9
6.3
2.9
Diseases of the nervous system (G00-G99)
20
102
4.0
1.5
2.6
Diseases of the circulatory system (I00-I99)
18
43
3.6
0.6
5.6
Neoplasms (C00-D48)
16
194
3.2
2.9
1.1
Congenital malformations (Q00-Q99)
12
64
2.4
1.0
2.5
Symptoms, signs and abnormal findings (R00-R99)
12
45
2.4
0.7
3.5
Infectious and parasitic diseases (A00-B99)
10
39
2.0
0.6
3.4
Diseases of the respiratory system (J00-J99)
10
38
2.0
0.6
3.5
All other causes(d)
10
75
2.0
1.1
1.8
Total
198
1 017
39.5
15.3
2.6

(a) Data from Qld, WA, SA and NT. Data based on state of usual residence and year of registration of death. Excludes a total of 29 deaths of children for whom Indigenous status was not stated.
(b) Per 100,000 population aged 1-14 years.
(c) Rate for Indigenous children divided by the rate for non-Indigenous children.
(d) Includes endocrine, nutritional and metabolic diseases, mental and behavioural disorders, diseases of the musculoskeletal system, diseases of the ear and mastoid process, diseases of the eye and adnexa, diseases of the skin and subcutaneous tissues, diseases of the genitourinary system, diseases of the digestive system, diseases of the blood and blood forming organs, certain conditions originating in the perinatal period.
Source: AIHW National Mortality Database


External causes (such as transport accidents, assault and intentional self-harm) were the leading cause of death among Aboriginal and Torres Strait Islander children, and occurred at three times the rate for non-Indigenous children. Indigenous children died from infectious and parasitic diseases, diseases of the respiratory system and circulatory diseases at three to six times the rate of non-Indigenous children.

Trends in child mortality

Childhood mortality rates should be interpreted with caution due to the small number of deaths each year for Indigenous and other Australian children. The data indicate that the child mortality rate for Aboriginal and Torres Strait Islander children decreased significantly in the Northern Territory from 86 per 100,000 children in the period 1991-1993 to 52 per 100,000 children in the period 2003-2005. The child mortality rate for other Australian children decreased significantly in Western Australia and South Australia over this period - from 19 to 15 per 100,000 children in Western Australia - and from 19 to 13 per 100,000 children in South Australia (table 6.21).

6.21 CHILD MORTALITY RATES(a)(b), by Indigenous status - 1991-1993 to 2003-2005

1991-1993
1994-1996
1997-1999
2000-2002
2003-2005

Indigenous rate
WA
71.7
74.6
46.6
49.0
54.1
SA
40.0
32.0
33.8
36.5
28.8
NT
86.4
69.1
74.2
60.2
51.9
Other Australian rate(c)
WA
18.8
19.0
17.0
16.2
15.0
SA
19.2
18.7
16.8
14.6
13.2
NT
33.1
29.6
17.7
16.4
24.2
Rate ratio(d)
WA
3.8
3.9
2.7
3.0
3.6
SA
2.1
1.7
2.0
2.5
2.2
NT
2.6
2.3
4.2
3.7
2.1

(a) Deaths are based on year of registration of death.
(b) Per 100,000 population aged 1-14 years.
(c) Comprises deaths of non-Indigenous children and those for whom Indigenous status was not stated.
(d) Mortality rate for Indigenous children divided by the mortality rate for other Australian children.
Source: AIHW National Mortality Database






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