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Aboriginal and Torres Strait Islander people have a shorter life expectancy compared to other Australians. The causes of Indigenous mortality, age at death and Indigenous perinatal (infant) mortality are explored in this page.
Aboriginal and Torres Strait Islander people are more likely to experience disability and reduced quality of life due to ill health, and to die at younger ages, than other Australians. While the available evidence clearly supports these facts, the exact magnitude of the differences between the Indigenous and non-Indigenous populations is difficult to establish conclusively. Incomplete recording of Aboriginal and Torres Strait Islander status in death records, and the experimental nature of population estimates, remain the major obstacles to producing a complete picture of Indigenous mortality in Australia. While these limitations prevent precise analysis of the data and present difficulties in the monitoring of mortality trends over time, the available statistics provide useful measures of Aboriginal and Torres Strait Islander health, and comparisons with the health of the total Australian population.
For the period 1996-2001, the life expectancy at birth for an Indigenous male was 59 years, and for an Indigenous female, 65 years. For the period 2002-2004, males in the total Australian population had a life expectancy of 78 years and females 83 years.
Death registrations from Queensland, South Australia, Western Australia and the Northern Territory are used to form a "quasi-national" picture of Indigenous mortality for the period 1999-2003. These four jurisdictions have been assessed by the ABS as having adequate coverage of Indigenous deaths.
During this time, there were 7,387 Indigenous deaths registered in these jurisdictions, accounting for 3.2% of all deaths in these four jurisdictions across this period. Death rates among Aboriginal and Torres Strait Islander people were higher than those recorded in the general population for almost all causes of death and for every age group.
For the period 1999-2003, for both Indigenous males and females, there were almost three times as many deaths for all causes as would be expected based on the rates of non-Indigenous Australians. Data from national surveys in 1994, 1995 and 2001 and 2004-05 show that Indigenous Australians were more likely than other Australians to smoke, consume alcohol at hazardous levels, be exposed to violence, and to be categorised as obese, all of which are significant health risk factors that could lead to mortality.
A higher proportion of Indigenous deaths than non-Indigenous deaths occur in age groups under 65 years. Over the period 1999-2003, 75% of Indigenous males and 65% of Indigenous females died before the age of 65, compared to only 26% of non-Indigenous males and 16% of non-Indigenous females.
The proportion of Indigenous deaths in each age group across the period 1999-2003 exceeded the proportion of Indigenous people represented in the total Australian population. The age-specific death rates for Indigenous males and females were greater than those for non-Indigenous males and females in all age groups. The death rate of Indigenous males and females aged 65 years and over was 1.4 times that of non-Indigenous males and females in the same age group. The difference was highest in the 35-44 year age group, with Indigenous males and females recording a rate more than five times that of non-Indigenous males and females the same age. The infant death rate across the period 1999-2003 was 3.1 times greater for Indigenous infants compared to non-Indigenous infants.
Infant mortality contributes to the younger average age at death of Indigenous people, with one in four infant deaths recorded as Indigenous in Queensland, Western Australia, South Australia and the Northern Territory.
Based on 1999-2003 death registrations, the three leading causes of death for Indigenous Australians living in Queensland, South Australia, Western Australia and the Northern Territory were diseases of the circulatory system, deaths due to external causes (predominantly accidents, self harm and assault) and neoplasms (cancer). Deaths due to these causes accounted for almost 58% of all identified Indigenous deaths in these jurisdictions. These were also the leading causes of death among the Australian population as a whole, accounting for about 74% of all deaths.
However, Indigenous males and females had higher death rates, and were more likely to die at much younger ages from these causes, than the general population.
In 1999-2003, diseases of the circulatory system accounted for 28% of Indigenous deaths. Over half (56%) of these deaths were attributable to ischaemic heart disease (heart attack, angina) (64% male and 46% female). Cerebrovascular disease (stroke) accounted for 11% of male Indigenous deaths and 18% of female Indigenous deaths attributed to circulatory system disease.
Over the period 1999-2003, Aboriginal and Torres Strait Islander people experienced higher rates of mortality from circulatory diseases, and were more likely to die from these diseases at younger ages, than the Australian population as a whole. Age-specific death rates were higher for Indigenous males and females than non-Indigenous males and females in every age group. The greatest relative differences in rates for males occurred in the 25-34 and 35-44 year aged groups, with Indigenous males recording a rate 9 and 10 times the rate for non-Indigenous males. Indigenous females recorded rates 12 and 13 times the rates for non-Indigenous females for the 35-44 and 45-54 year age groups.
In 1999-2003, deaths due to external causes, such as accidents, intentional self harm (suicide) and assault, accounted for 16% of all Indigenous deaths. There were three times more deaths from external causes than expected, based on all-Australian rates. The majority (72%) of these deaths were for males, and the main causes of deaths due to external causes for Aboriginal and/or Torres Strait Islander people were transport accidents (35%) and intentional self-harm (26%).
The 1999-2003 age-specific death rates due to external causes were higher among Indigenous males than among non-Indigenous males in all age groups, particularly in the age groups from 25-54 years. Death rates due to external causes for Indigenous females also exceeded those for non-Indigenous females in every age group. The greatest relative difference occurred in the 35-44 year age group.
In 1999-2003, neoplasms were responsible for 17% of all deaths identified as Indigenous. The majority of deaths in this category among Indigenous Australians (97%) were due to malignant neoplasms (cancer). A greater proportion of male Indigenous deaths (57%) were from malignant cancers than Indigenous female deaths (43%).
The main causes of Indigenous deaths from neoplasms were malignant cancers of the digestive organs (4%), which include cancers of the liver, stomach, intestine, gall bladder and pancreas, and respiratory and intrathoracic cancers (4%), such as cancers of the bronchus and lung, and larynx and trachea.
In the period from 1999-2003, death rates from neoplasms were higher for both Indigenous males and females than their non-Indigenous counterparts, for those aged 35 years and older.
The highest standardised mortality ratios (SMRs) for Indigenous males and females were for endocrine, nutritional and metabolic diseases, where there were 7 and 11 times more deaths, respectively, than expected. Most of these deaths were due to diabetes mellitus.
For more information of deaths from diabetes mellitus, see Ill-health conditions.
Multiple causes of death include all causes and conditions reported as the medical cause on the death certificate. Since 1997, the ABS has coded all causes of death reported on each death certificate, including the underlying, immediate and other associated causes of death. While it is often the case that more than one cause of death is reported on a death certificate, until recently, only the single underlying cause of death was used to produce statistics on mortality for the Australian population. However, it has been argued that some deaths would not occur without the influence of more than one cause, and that to understand mortality patterns of a population it is important to examine, where possible, all the causes which contribute to death. In particular, deaths due to chronic diseases, such as heart disease, kidney disease and diabetes, often occur with a number of concurrent, or coexisting, conditions present, and a single initiating condition is often difficult to isolate.
For example, in 1999-2003, while 8.2% of all Indigenous deaths were attributed to diabetes, only 0.4% of Indigenous male deaths and 0.8% of Indigenous female deaths were reported with an underlying cause of diabetes alone. However, diabetes mellitus was recorded as an associated cause for 17% of Indigenous male deaths and 26% of Indigenous female deaths resulting from ischaemic heart disease and as an associated cause for 20% of Indigenous male and 13% of Indigenous female deaths resulting from renal failure.
Over the period 1999-2003, in Queensland, Western Australia, South Australia and the Northern Territory, the national mortality rate for Indigenous infants was three times the rate for non-Indigenous infants (15 and 12 per 1,000 for Indigenous males and females compared to 5 and 4 per 1,000 live births for non-Indigenous males and females).
Infant mortality is a good marker of total population health. Developed nations tend to have lower rates of infant mortality per 1,000 live births compared with less developed nations. Good maternal and child health, access to prenatal and postnatal health facilities and maternal education are factors that contribute to lower rates of infant mortality.
For more information, see Mothers and babies.
For more general information, go to Deaths.