2. Infant mortality
Why is infant mortality important?
Measures of infant mortality provide insight into the socio-demographic and lifestyle factors into which Australian children are born and how these affect both life and death chances. Child mortality also provides a key measure of the effectiveness of the health system in maternal and perinatal health including insight into how well the system is working and how it can be improved.
Social and economic factors are key determinants of infant and child mortality in both developed and developing countries (Collison et al. 2007; Marmot 2006). Infant and child mortality have been shown to be associated with indicators of parental disadvantage such as low income or joblessness, teenage motherhood, mother’s education and Indigenous status (Gracey & King 2009).
Australia has shown significant progress in reducing infant deaths with death rates halving between 1986 and 2010 (ABS 2013; ABS 2011a; AIHW 2012). Programs and resources directed at intensive care units, increased community awareness of the risk factors for sudden unexpected deaths in infancy (SUDI), and reductions in vaccine-preventable diseases through national childhood immunisation programs have been particularly successful.
Improvements in both access and quality of antenatal and maternal care should help to further reduce the infant mortality rate, especially for Indigenous babies. Issues currently targeted include maternal nutrition and reduction in risk behaviours such as drinking and smoking in pregnancy (AIHW 2012; Gracey & King 2009).
The Indigenous infant mortality rate has more than halved from 13.5 per 1,000 live births in 1998 to 6.0 per 1,000 in 2016, and the gap has narrowed significantly (by 84 per cent) over this period (Commonwealth Australia 2017). Further gains will be achieved by addressing the leading causes of Indigenous child death including conditions originating in the perinatal period (42 per cent of Indigenous child deaths), such as birth trauma, foetal growth disorders, complications of pregnancy, and respiratory and cardiovascular disorders (Commonwealth Australia 2017).
Do infant mortality rates vary across population groups?
The overall infant mortality rate for 2016 was 3.1 per 1,000 live births. The male infant mortality rate (3.4 per 1,000 live births) is slightly higher than the female infant death rate (2.8 per 1,000 live births). The Indigenous infant death rate (6.0 per 1,000 live births), was twice as high as the non-Indigenous infant death rate (3.0 per 1,000 live births).
In 2016, infant deaths were over twice as high in Remote and very remote areas (6.0 per 1,000 live births) compared with Major cities (2.9 per 1,000 live births). Infant deaths were also higher in the lowest socioeconomic areas compared to the highest socioeconomic areas (4.6 compared with 2.5 per 1,000 live births, respectively).
Has there been a change over time?
Over the period 2006 to 2016, the overall infant mortality rate has shown a downward trend (with some variability) from a high of 4.7 per 1,000 live births in 2006 to 3.1 per 1,000 live births in 2016. The difference between the male and female infant mortality rates has decreased over time: in 2006, the male rate was 1.3 times as high as the female rate (5.2 compared with 4.1 per 1,000 live births); in 2016, the rate for males was 1.2 times as high as that for females (3.4 compared with 2.8 per 1,000 live births).
The difference between the Indigenous and non-Indigenous infant mortality rates has also decreased, from 10.0 and 4.4 per 1,000 live births respectively in 2006, to 6.0 and 3.0 per 1,000 live births respectively in 2016. In part, the Indigenous infant mortality trend has changed due to an improvement in the quality of Indigenous identification (Commonwealth Australia 2017). Data on remoteness and socioeconomic position have not been available across all years from 2006 to 2016; however, the rates across all populations appear to be declining over time.
Infant mortality is measured as the number of deaths of infants less than 1 year of age in a given year, expressed per 1,000 live births in the same year.
Sudden infant death syndrome (SIDS) refers to the sudden and unexpected death of an infant aged less than 1 year during sleep that remains unexpected after a thorough investigation.
- Australian Bureau of Statistics (ABS) 2011a. Deaths, Australia, 2010. ABS cat. no. 3302.0. Canberra: ABS.
- ABS 2011b. The Health and Welfare of Australia’s Aboriginal and Torres Strait Islander Peoples, October 2010. Cat. 4704.0
- ABS 2013. Causes of Death, Australia, 2011. ABS cat. no. 3303.0. Canberra: ABS.
- Australian Institute of Health and Welfare 2012. A picture of Australia’s children 2012. Cat. no. PHE 167. Canberra: AIHW.
- Collison D, Dey C, Hannah G & Stevenson L 2007. Income inequality and child mortality in wealthy nations. Journal of Public Health 29(2):114–7.
- Commonwealth of Australia, Department of the Prime Minister and Cabinet 2017. Closing the gap: Prime Minister’s report 2017.
- Gracey M & King M 2009. Indigenous health part 1: determinants and disease patterns. The Lancet 2009 Vol. 374 :65-75.
- Marmot M 2006. Health in an unequal world. Clinical Medicine 6(6):559–72.