Health of populations in northern Queensland aboriginal communities: change and continuity

We show that Australian Aborigines living in North Queensland have had an impressive decline in infant mortality over the past 50 years. Since the early 1970s, much of the decline can be attributed to preventive and curative medical services. On the other hand, the growth trajectory of infants and children has improved only slightly since the early 1970s, and mean and median weights are still well below international standards. In addition, there is no evidence that life expectancy at birth has improved significantly since the early 1970s. The pattern of declining infant mortality and stagnant life expectancy is accounted for by unchanging mortality at older ages. The major contributing causes are heart disease and accidents and violence. We suggest that the decline of infant mortality is the result of specific policy decisions made by the providers of preventive health services that infant health would be the focus of their efforts. The result was that many other aspects of health were not dealt with and adult mortality stagnated. We also suggest tentatively that the reduction in infant mortality coupled with persistent high rates of low birth weight and low weight for age at 1 year may be related to the high rates of young adult deaths from ischemic heart disease observed in Aboriginal populations.