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Can a mortality excess in remote areas of Australia be explained by indigenous status? A case study using neonatal
1Health Information Centre, 13th floor, Queensland Health Building, GPO Box 48, Brisbane, Queensland 4001. michael_coory@health.qld.gov.au
Objective:
To assess the extent to which indigenous status confounds the association between remoteness and neonatal mortality in Queensland.
Methods:
We used routine data from the Queensland Perinatal Data Collection. Poisson regression modelling was used to assess confounding.
Results:
Babies born to Indigenous mothers have mortality rates 2.42 times those of the rest of the population, regardless of whether they live in urban, rural or remote areas (95% CI 2.09-2.80). The babies of non-Indigenous women who live in remote areas have a low risk of neonatal death, similar to their rural and urban counterparts.
Conclusion:
In Queensland, the key demographic variable that determines neonatal mortality is indigenous status, not remoteness.
Implications:
Policymakers should not assume that an excess of a particular health problem in remote areas necessarily reflects equal disadvantage for all the Australians who live there.
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