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Excessive rates of childhood mortality in the Northern Territory, 1985-94
D T Silva1, A R Ruben, I Wronski
1Department of Public Health and Tropical Medicine, James Cook University of North Queensland, Townsville, Australia.
Insights
Childhood mortality in Australia's Northern Territory (NT) is higher for Aboriginal children, particularly from accidents and infections. Targeted safety interventions are crucial for reducing these preventable deaths.
Area of Science:
- Pediatric Mortality Studies
- Public Health Research
- Epidemiology
Background:
- Childhood mortality rates in the Northern Territory (NT) require specific investigation.
- Disparities in mortality between Aboriginal and non-Aboriginal children necessitate focused analysis.
Purpose of the Study:
- To determine the post-infant/childhood mortality rate (ages 1-14 years) in the Northern Territory.
- To compare mortality rates between Aboriginal and non-Aboriginal children in the NT.
Main Methods:
- Retrospective study design analyzing deaths over a 10-year period (1985-1994).
- Data collection focused on identifying causes of death in children aged 1-14 years in the NT.
Main Results:
- Aboriginal children faced significantly higher mortality risks: 2x for accidents, 11x for infections, and 3.2x overall compared to non-Aboriginal children.
- Leading causes included road traffic accidents (unrestrained occupants) for Aboriginal children and drowning (unfenced pools) for non-Aboriginal children aged 1-4.
- While overall mortality decreased, this reduction was not observed in Aboriginal children, highlighting persistent health inequities.
Conclusions:
- Children in the NT experience higher mortality rates than Australian averages, with Aboriginal children disproportionately affected.
- Implementing safety legislation for pool fencing, car seat restraints, and rural road safety could significantly reduce accidental child deaths.
- Addressing infection-related mortality is critical, especially for young Aboriginal children (1-4 years).
Objectives:
To estimate the post-infant/childhood mortality rate (1-14 years) in the Northern Territory (NT) of Australia.
Methods:
A retrospective study of post-infant death in the 10 years 1985-94 inclusive in the NT.
Results:
Two hundred and forty-four deaths were identified. Compared to a non-Aboriginal, an Aboriginal child was twice as likely to die from accidents, 11 times more likely to die from infection and 3.2 times more likely to die from all causes. Road traffic accidents were the leading cause of accident mortality in Aboriginal children. All children who died in collisions or rollovers were unrestrained. Drowning was the major cause of death amongst non-Aboriginal children aged 1-4 years; none of the residential pools in which drowning occurred had fencing which complied with the recommended Australian fencing standards. Mortality rates from infection were highest in Aboriginal children aged 1-4 years. The overall mortality rate decreased over the 10-year period with a significant reduction in non-Aboriginal but not in Aboriginal children.
Conclusions:
NT children aged 1-14 years have higher mortality rates than their Australian counterparts and these are significantly higher in Aboriginal compared to non-Aboriginal children. Legislation and enforcement of isolation pool fencing, car seat restraints and safer driving on rural roads could have a significant impact on reducing accident mortality.