Aboriginal and Torres Strait Islander Health Performance Framework (HPF) 2012

Tier 1—Deaths—1.22 All causes age-standardised death rate

The HPF was designed to measure the impact of the National Strategic Framework for Aboriginal and Torres Strait Islander Health (NSFATSIH) and will be an important tool for developing the new National Aboriginal and Torres Strait Islander Health Plan (NATSIHP).

Page last updated: 15 November 2012

Why is it important?:

The mortality rate of a population provides a summary measure of the overall health status of that population. However, it has some well-known limitations. There may be delays for many years before improvements in health status lead to reductions in mortality, and mortality statistics do not reflect the burden of illness in a population for diseases that do not necessarily result in death, such as arthritis and depression.

Despite these limitations, mortality rates are a useful measure with which to compare the overall health status of different populations and to monitor changes in overall health status of populations over time.

The all-causes mortality rate for Aboriginal and Torres Strait Islander peoples is several times higher than that for other Australians, indicating that the overall health status of Aboriginal and Torres Strait Islander peoples is worse than that of other Australians.

Findings:

During the period 2006–10, in those jurisdictions with adequate quality data (NSW, Qld, WA, SA, and the NT), 11,132 deaths were identified as those of Aboriginal and Torres Strait Islander peoples. After adjusting for age differences between the two populations, the all-cause mortality rate was 1.9 times as high for Aboriginal and Torres Strait Islander peoples than for non-Indigenous Australians (1151 versus 597 deaths per 100,000 population).

There was a 33% reduction in all-causes mortality rates for Aboriginal and Torres Strait Islander peoples between 1991–2010 in jurisdictions with adequate data quality for long-term trends (WA, SA and the NT). There was also a significant closing of the gap in mortality rates between Aboriginal and Torres Strait Islander peoples and other Australians over this period in both absolute and relative terms.

Current trends (2001–10), in the five jurisdictions with adequate data quality (NSW, Qld, WA, SA, and the NT), show a 5% decline in all-cause mortality rates, including a significant decline for males but not females.

Most deaths for Aboriginal and Torres Strait Islander peoples occur in the middle age groups. Most deaths for the non-Indigenous population occur in the older age groups. Approximately 66% of Aboriginal and Torres Strait Islander deaths occur before the age of 65. The Aboriginal and Torres Strait Islander mortality rate was 5 times as high in the 35–44 years age range as the non-Indigenous rate. In absolute terms, the greatest gap was in the 65–74 year age group. In the period 2006–10, mortality rates ranged from 962 deaths per 100,000 in NSW to 1541 in the NT.

In 2010, there was a gradient in death rates by remoteness for the total Australian population, with higher rates in very remote areas compared to urban areas, particularly for infants. It is not yet possible to undertake this analysis by Indigenous status due to the variation in quality of Indigenous identification by remoteness area. As Indigenous Australians make up nearly half of the resident population of very remote areas, the higher death rates for Indigenous Australians nationally are likely to have an impact on the overall population death rates for those living in very remote areas (ABS 2011a).

Mortality rates are also available for other countries where Indigenous peoples share a similar history of relatively recent European colonisation, such as New Zealand and the United States. In New Zealand, the age-standardised all-cause mortality rate for the Maori population was 635 per 100,000 in 2010, compared with 385 per 100,000 for other New Zealanders. In the United States, the age-standardised all-cause mortality rate for American Indians/Alaska Natives was 442 per 100,000 in 2009, which was lower than the age-standardised all-cause mortality rate for non-Indigenous persons over this period (509 per 100,000). Caution must be used in comparing data with other countries due to variations in data quality, methods applied for addressing data quality issues and definitions for identifying Indigenous peoples.

Implications:

The very high mortality rates for Aboriginal and Torres Strait Islander peoples, particularly in early childhood and the middle adult years, are an indication of the poor overall health status of Aboriginal and Torres Strait Islander peoples and reflect the high rates of chronic disease and injury.

There has been significant improvement in mortality rates for Aboriginal and Torres Strait Islander peoples in the past 20 years in the jurisdictions with adequate data for long-term analysis (WA, SA and the NT). There has also been a significant narrowing of the gap. The fact that improvements have occurred demonstrates that the severe health problems of Aboriginal and Torres Strait Islander peoples have been reduced to some extent and can be reduced further, and faster, with sustained and improved effort.

In December 2007, COAG agreed to a partnership between all levels of government to work with Aboriginal and Torres Strait Islander communities to achieve the target of closing the gap in Aboriginal and Torres Strait Islander disadvantage. To achieve this, COAG committed to six ambitious targets across a range of priority areas, one of which is to 'close the gap in life expectancy within a generation.' The National Indigenous Reform Agreement (NIRA) provides the overarching framework for working towards the six targets. The NIRA provides links to relevant National Agreements and Partnership Agreements established to address disadvantage across various social, economic and environmental dimensions. Through COAG, all governments have agreed to contribute to the $1.6 billion National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes with a focus on decreasing chronic disease.Top of page
Figure 73—Age-standardised all-cause mortality rates, by Indigenous status
Figure 73—Age-standardised all-cause mortality rates, by Indigenous status
Source: ABS and AIHW analysis of ABS Mortality Database
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Table 23—Age-standardised all-causes mortality rates, by Indigenous status, NSW, Qld, WA, SA and the NT, 2006–10

Number of deaths Indig.Number of deaths Non-Indig.Rate per 100,000(a) Indig.Rate per 100,000(a) Non-Indig.Rate ratioRate difference
NSW
2,903
231,732
962
598
1.6
363.4
Qld
3,031
125,074
1,089
597
1.8
491.9
WA
2,230
59,276
1,431
574
2.5
857.0
SA
710
61,226
1,060
615
1.7
445.4
NT
2,258
2,625
1,541
645
2.4
895.5
Total NSW, Qld, WA, SA & NT
11,132
479,933
1,151
597
1.9
554.0
(a) Age standardised
Source: ABS and AIHW analysis of ABS Mortality Database
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Figure 74—Age-specific all-cause mortality rates per 100,000 and rate ratios, by Indigenous status and sex, NSW, Qld, WA, SA and the NT, 2006–10

Males
Figure 74—Age-specific all-cause mortality rates per 100,000 and rate ratios, by Indigenous status and sex, NSW, Qld, WA, SA and the NT, 2006–10—Males
Females
Figure 74—Age-specific all-cause mortality rates per 100,000 and rate ratios, by Indigenous status and sex, NSW, Qld, WA, SA and the NT, 2006–10—Females
Source: ABS and AIHW analysis of ABS Mortality Database
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Figure 75—Age distribution of proportion of deaths, by sex and Indigenous status, NSW, Qld, SA and the NT, 2006–10

Aboriginal and Torres Strait Islander peoples

Figure 75—Age distribution of proportion of deaths, by sex and Indigenous status, NSW, Qld, SA and the NT, 2006–10—Aboriginal and Torres Strait Islander peoples


Non-Indigenous Australians


Figure 75—Age distribution of proportion of deaths, by sex and Indigenous status, NSW, Qld, SA and the NT, 2006–10—Non-Indigenous Australians
Source: AIHW and ABS analysis of National Mortality Database
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