Suchergebnisse

ABSTRACTObjectivesAn accurate picture of infant mortality informs society of its social progress. It is a key indicator of how effective public health policies and programs are in caring for the most vulnerable in our society. Currently, at the population level, Victorian data on Aboriginal and Torres Strait Islander births and deaths are excluded from Australian vital statistics. The Victorian Aboriginal Mortality Study aimed to provide a more complete and accurate population profile of Aboriginal births in Victoria using population data linkage of Victorian statutory and administrative datasets. ApproachTwo population statutory datasets, the Victorian Perinatal Data Collection (VPDC) and Victorian Registry of Births, Deaths and Marriages (RBDM) were linked, using probabilistic matching with mother's name and surname, child's date of birth and sex, for all births that occurred in Victoria between 1988 and 2008, inclusive to more accurately ascertain births to mothers and fathers who identified as Aboriginal and/or Torres Strait Islander (hereafter respectfully 'Aboriginal').ResultsOver 1.34 million files, reporting births between 1988 and 2008, were linked. However, due to data integrity issues for Indigenous identification prior to 1998, the years between 1999 and 2008 only were used in the development of the birth cohort. Matching the VPDC with the RBDM resulted in identifying an additional 4,333 live births where mother and/or father identified as Aboriginal, representing an 87% increase in the number of births previously recorded as Aboriginal by the VPDC*. The largest increase (186%) in the number of births where mother and/or father identified as Aboriginal births was observed within the Victorian metropolitan areas. ConclusionThis is the first time that the VPDC and RBDM birth data were linked in Victoria. The matched birth information established a more complete population profile of Aboriginal and/or Torres Strait Islander births. These data will provide a more accurate baseline to enhance the Victorian and Australian governments' ability to plan services, allocate resources and evaluate funded activities aimed at eliminating disparity experienced by Aboriginal and/or Torres Strait Islander peoples. Importantly, it has established a more accurate denominator from which to calculate Aboriginal infant mortality rates for Victoria, Australia.
*Until 2009, the mother's Indigenous identification only was recorded in the VPDC

ABSTRACTObjectivesThe disparity between the infant mortality rates of Aboriginal and Torres Strait Islander (forthwith respectfully 'Aboriginal') and non-Aboriginal populations in Australia is well documented. However, major public health initiatives and campaigns aimed particularly at halving the Aboriginal infant mortality rate are hindered by the lack of comprehensive and accurate data. To date, infant and child mortality rates for Victorian born Aboriginal children have not been reported in national statistics. The aim of Victorian Aboriginal Child Mortality Study was to accurately measure the patterns and trends of Aboriginal infant mortality and to report the disparities between Aboriginal and non-Aboriginal infants born in Victoria, Australia between 1999 and 2008 inclusive. ApproachWe used best practice methodologies to link total population data and comprehensive mortality case review to classify and code the deaths to determine, for the first time, all-cause and cause-specific mortality for Aboriginal and non- Aboriginal infants born in Victoria from 1999 to 2008.ResultsBetween 1999 and 2009, Aboriginal infants were twice as likely to die in in the first year of life as non-Aboriginal infants. Infant cumulative mortality rates (CMR) were higher among Aboriginal births (9.1/1000 livebirths in 1999-2003 and 9.4/1000 livebirths in 2004-2008) than non- Aboriginal births (4.7/1000 livebirths in 1999-2003 and 4.5/1000 livebirths in 2004-2008). For Aboriginal infants there was an observed decrease in the rate of neonatal deaths, and conversely an increase in the postneonatal CMR (from 2.2/1000 livebirths in 1999-2003 and 3.8/1000 livebirths in 2004-2008). Among Aboriginal infants there was an increase in deaths attributed to prematurity (3.1/1000 livebirths in 1999-2003 and 4.3/1000 livebirths in 2004-2008) and sudden infant death syndrome (SIDS) (1.0/1000 livebirths in 1999-2003 and 1.7/1000 livebirths in 2004-2008). There were significantly more potentially preventable deaths among Aboriginal infants than in non-Aboriginal infants [infection (0.6/1000 Aboriginal livebirths vs 0.2/1000 non-Aboriginal livebirths, RR 2.5 95%CI 1.1-5.6) injury (0.6/1000 Aboriginal livebirths vs 0.1/ 1000 non-Aboriginal livebirths, RR 5.8 95%CI 2.5-13.5), and SIDS (1.4/1000 Aboriginal livebirths vs 0.28/1000 non-Aboriginal livebirths, RR 5.0 95%CI 2.9-8.6)]. ConclusionThis is the first time that all-cause and cause-specific mortality rates for Victorian born Aboriginal and non-Indigenous infants have been reported. The observed increasing disparities between Aboriginal and non- Indigenous infants, especially due to preventative causes, such as infection, injury and SIDS, in the post neonatal period, demand immediate action in partnership with Aboriginal communities. Collaborative action must focus on both access to primary health care and better living conditions.