Profile of Children Who Died in the First 5 Years of Life in Western Australia, 1980‐2010

Abstract

Background In Western Australia (WA), mortality rates among children aged <5 years decreased over time but remains highest among infants aged <1 year. Furthermore, mortality rates among Aboriginal and Torres Strait Islander (hereafter Aboriginal) children are double that of their non‐Aboriginal peers. We describe the profile of Aboriginal and non‐Aboriginal WA‐born children who died before their 5th birthday. Methods Using data extracted from core population health datasets and linked by the Data Linkage Branch of the Western Australia Department of Health, we identified deaths and associated demographic, hospitalisation and developmental anomaly data. Mortality rate ratios (RR) were calculated using EpiBasic. Results Of 786,539 liveborn children in 1980‐2010, there were 5531 deaths in children aged <5 years (mortality rate=7.0 per 1000 live births). Aboriginal children were 3.5 times (95% CI=3.3‐3.8) more likely to die before their 5th birthday than non‐Aboriginal children, with the most pronounced differences among those born at 37‐41 weeks gestation (RR=4.0, 95% CI=3.6‐4.4). Approximately 53.4% of all liveborn children were hospitalised at least once while 5.3% had at least 1 developmental anomaly. Mortality rates among all children who had both hospital and developmental anomaly records were at least 3 times higher than those with neither. Conclusions Childhood mortality risk varies by gestational age, developmental anomaly and history of hospitalisation. Excess mortality among Aboriginal children likely reflects a different profile of chronic conditions among these children and inequalities in access to services. Deeper investigations into pathways to early mortality can inform future interventions.