Australian Government: Australian Institute of Health and Welfare METeOR Home Page

National Indigenous Reform Agreement: PI 06-Under five mortality rate by leading cause, 2013

Identifying and definitional attributes

Metadata item type:Help on this termIndicator
Indicator type:Help on this termIndicator
Short name:Help on this termPI 06-Under five mortality rate by leading cause, 2013
METeOR identifier:Help on this term481154
Registration status:Help on this termIndigenous, Archived 13/12/2013
Description:Help on this term

Mortality rates for children aged less than five years, by leading causes of death (ICD-10 chapter level), by Indigenous status.

The Australian Bureau of Statistics (ABS) data for this indicator is for perinatal mortality, infant mortality, child 1-4 years mortality and child 0-4 years mortality.

Rationale:Help on this termHigh level of public interest. Key measure for the 'Closing the Gap' indicator of halving the gap in mortality rates for children under 5.
Indicator set:Help on this termNational Indigenous Reform Agreement (2013) Indigenous, Archived 13/12/2013
Outcome area:Help on this termIndigenous children have the same health outcomes as other Australian children Indigenous, Endorsed 21/07/2010
Quality statement:Help on this termNational Indigenous Reform Agreement: PI 06-Under five mortality rate by leading cause, 2013 QS Indigenous, Archived 25/06/2014

Collection and usage attributes

Population group age to:Help on this term

This indicator uses a number of different population group age bands:

  • For perinatal: 28 days of birth or less (refer to definition under computation)
  • For infants: Less than 1 year of age
  • For children aged 1-4 years: From 1 year of age to less than 5 years of age
  • For children aged 0-4 years: Less than 5 years of age.
Computation description:Help on this term

Rates are calculated for Indigenous and non-Indigenous.

Variability bands are to be calculated for rates (single year and national data for 5 years combined) using the standard method (see definition below).

For trends: Percentage change and statistical significance of change is to be calculated (required for CRC reporting).

Excludes deaths where Indigenous status was not stated.

Rate ratios and rate differences are calculated for Indigenous: non-Indigenous.

Note: Causes of death to be listed from highest to lowest Indigenous percentage for the most recent period (5 years combined).

Presentation:

Number, percentage; rate per 1,000 of all births (perinatal), rate per 1,000 live births (infant), rate per 100,000 population (children 1-4 years and children 0-4 years), rate ratio, rate difference and variability bands. 

Note: causes to be listed from highest to lowest Indigenous percentage.

Definitions:

'Standard method’ for variability band computation:

Rates derived from administrative data counts are not subject to sampling error but may still be subject to natural random variation, especially for small counts. A 95% confidence interval for an estimate is a range of values which is very likely (95 times out of 100) to contain the true unknown value. Where the 95% confidence intervals of two estimates do not overlap it can be concluded that there is a statistically significant difference between the two estimates. This is the standard method used in AIHW publications for which formulas can be sourced from Breslow and Day (1987) in the publication ‘Statistical methods in cancer research’. Typically in the standard method, the observed rate is assumed to have natural variability in the numerator count (e.g. deaths, hospital visits) but not in the population denominator count. Also, the rate is assumed to have been generated from a Normal distribution ("Bell curve"). Random variation in the numerator count is assumed to be centred around the true value - i.e. there is no systematic bias.

‘Perinatal mortality’ is defined as death of an infant within 28 days of birth (neonatal death) or of a fetus (unborn child) of at least 20 completed weeks of gestation or with a birth weight of at least 400 grams).

‘Leading causes of death’ are ICD-10 codes used for leading causes of death in the Aboriginal and Torres Strait Islander Health Performance Framework:

Perinatal mortality:

Main condition in the fetus/infant:

Other conditions originating in the perinatal period (P10-P15 and P50-P96); Disorders related to length of gestation and fetal growth (P05-P08); Congenital malformations, deformations and chromosomal abnormalities (Q00-Q99); Respiratory and cardiovascular disorders specific to the perinatal period (P20-P29); Infections specific to the perinatal period (P35-P39); Other conditions; Total deaths

Main condition in the mother, fetus and newborn affected by:

Complications of placenta, cord and membranes (P02); Maternal complications of pregnancy (P01); Maternal conditions that may be unrelated to present pregnancy (P00); Other complications of labour and delivery and noxious influences transmitted via placenta or breast milk (P03-P04); Total deaths

Infant mortality:

Certain conditions originating in the perinatal period (P00-P96); Congenital malformations, deformations and chromosomal abnormalities (Q00-Q99); Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99); Sudden infant death syndrome (R95);  Injury and poisoning (V01–Y99); Diseases of the respiratory system (J00-J99); Diseases of the circulatory system (I00-I99); Certain infectious and parasitic diseases (A00-B99); Other causes; All causes

Child 1-4 mortality:

Injury and poisoning (V01–Y99); Diseases of the respiratory system (J00-J99); Congenital malformations, deformations and chromosomal abnormalities (Q00-Q99); Diseases of the nervous system (G00-G99); Diseases of the circulatory system (I00-I99); Certain infectious and parasitic diseases (A00-B99); Certain conditions originating in the perinatal period (P00-P96); Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99); Other causes; All causes

Child 0-4 mortality:

Certain conditions originating in the perinatal period (P00-P96); Congenital malformations, deformations and chromosomal abnormalities (Q00-Q99); Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99); Injury and poisoning (V01–Y99); Diseases of the respiratory system (J00-J99); Diseases of the circulatory system (I00-I99); Diseases of the nervous system (G00-G99); Certain infectious and parasitic diseases (A00-B99); Other causes; All causes

Computation:Help on this term

Perinatal and infant mortality rates: 1000 x (Numerator ÷ Denominator).

Children 1-4 and 0-4 mortality rates: 100,000 x (Numerator ÷ Denominator).

Rate ratio: Indigenous rate divided by non-Indigenous rate.

Rate difference: Indigenous rate minus non-Indigenous rate.

Variability band: to be calculated using the standard method for estimating 95% confidence intervals as follows.

Crude rate:

Crude rate 18 pt

Where p = mortality rate

q = 1-p

n = denominator used to calculate mortality rate. 

Percentage change: Calculated by multiplying the average annual change over the period by the number of data points less 1. This is then divided by the rate for the first year in the series and multiplied by 100.

The average annual change in rates, rate ratios and rate differences are calculated using linear regression which uses the least squares method to calculate a straight line that best fits the data and returns an array that best describes the line. The simple linear regression line, Y = a + bX, or ‘slope’ estimate was used to determine the average annual change in the data over the period. The formula used to calculate the slope estimate and standard error of the slope in Microsoft Excel is:

LINEST (known_y’s, known_x’s, true) entered as an array formula (Ctrl, Shift, Enter).

Statistical significance of change: The 95% confidence intervals (CIs) for the standard error of the slope estimate (average annual change) are used to determine whether the apparent increases or decreases in the data are statistically significant at the p<0.05 level. The formula used to calculate the CIs for the standard error of the slope estimate is:

95% CI(x) = x ± 1.96 x SE(x)

where x is the average annual change (slope estimate).

If the upper and lower 95% confidence intervals do not include zero, then it can be concluded that there is statistical evidence of an increasing or decreasing trend in the data over the study period.

Definitions:

‘Perinatal mortality’ is defined in the ABS Perinatals Collection as death of a baby within 28 days of birth (neonatal death) or of a fetus (unborn child) of at least 20 completed weeks of gestation or with a birth weight of at least 400 grams.

Numerator:Help on this termPerinatal: Number of perinatal deaths (foetal and neo-natal)

Infant: Number of deaths among children aged less than 1 year

Children 1-4: Number of deaths among children aged 1-4 years

Children 0-4: Number of deaths among children aged 0-4 years
Numerator data elements:Help on this term
Data Element / Data SetBirth—birth status, code N
Data Source
ABS Perinatal Deaths Collection
Guide for use

Data source type: Administrative by-product data

Perinatal numerator data source
Data Element / Data SetData Element
Number of fetal and neonatal deaths
Data Source
ABS Perinatal Deaths Collection
Guide for use

Data source type: Administrative by-product data

Perinatal numerator data source
Data Element / Data SetPerson—age, total years N[NN]
Data Source
ABS Death Registrations Collection
Guide for use

Data source type: Administrative by-product data

Infant and child numerator data source
Data Element / Data SetPerson—date of birth, DDMMYYYY
Data Source
ABS Causes of Death Collection
Guide for use

Data source type: Administrative by-product data

Infant and child numerator data source
Data Element / Data SetPerson—date of death, DDMMYYYY
Data Source
ABS Causes of Death Collection
Guide for use

Data source type: Administrative by-product data

Infant and child numerator data source
Denominator:Help on this termPerinatal: Number of all births (including live births, and stillbirths of at least 20 completed weeks of gestation or with a birth weight of at least 400 grams).

Infant: Number of live births

Children 1-4: Population aged 1-4 years

Children 0-4: Population aged 0-4 years
Denominator data elements:Help on this term
Data Element / Data SetBirth—birth status, code N
Data Source
ABS birth registration data
Guide for use

Data Source type: Administrative by-product data

Perinatal and infant denominator data source
Data Element / Data SetPerson—estimated resident population of Australia, total people N[N(7)]
Data Source
ABS Estimated resident population (total population)
Guide for use

Data Source type: Estimated resident population (ERP) is derived from Census, Census Post Enumeration Survey (PES) and estimates of fertility, mortality, net migration etc.

Child 1-4 and 0-4 years denominator data source
Data Element / Data SetPerson—age, total years N[NN]
Data Source
ABS Estimated resident population (total population)
Guide for use

Data Source type: ERP is derived from Census, Census Post Enumeration Survey (PES) and estimates of fertility, mortality, net migration etc.

Child 1-4 and 0-4 years denominator data source
Data Element / Data SetPerson—estimated resident population of Australia, total people N[N(7)]
Data Source
ABS Indigenous experimental estimates and projections (2001 Census-based)
Guide for use

Data Source type: ERP is derived from Census, Census Post Enumeration Survey (PES) and estimates of fertility, mortality, net migration etc.

Child 1-4 and 0-4 years denominator data source
Data Element / Data SetPerson—age, total years N[NN]
Data Source
ABS Indigenous experimental estimates and projections (2001 Census-based)
Guide for use

Data Source type: ERP is derived from Census, Census Post Enumeration Survey (PES) and estimates of fertility, mortality, net migration etc.

Child 1-4 and 0-4 years denominator data source
Disaggregation:Help on this term

Current period: 2006-2010 (perinatal, infant, child 1-4 years, and child 0-4 years by cause) and 2007-2011 (infant, child 1-4 years, child 0-4 years all-cause):

For Indigenous and non-Indigenous (numbers, rates, percentage, rate ratios, rate differences, variability bands):

  • National by leading cause of death including total (ICD-10 chapter level and some sub-chapter level) by age group (perinatal, infant, child 1-4 years, and child 0-4 years).
  • National by age group (infant, child 1-4 years, and child 0-4 years): all-cause.

  • State/Territory (including national total) by age group (infant, child 1-4 years, and child 0-4 years): all-cause.

For Indigenous and non-Indigenous (numbers, rates, rate ratios, and rate differences):

  • State and territory (including national total) by age group (perinatal (fetal, neonatal and total perinatal), infant, child 1-4 years and child 0-4 years)
  • National by age group (infant, child 1-4 years, and child 0-4 years): all-cause.
  • State/Territory (including national total) by age group (infant, child 1-4 years, and child 0-4 years): all-cause.

Time series:

2006, 2007, 2008, 2009, 2010 (previously supplied), 2011 (all-cause) (deaths revised WA):

For Indigenous and non-Indigenous (numbers, rates, rate ratios, rate differences, variability bands, percentage change and statistical significance of change):

  • National by age group (perinatal, infant, and child 0-4 years)
Disaggregation data elements:Help on this term
Data Element / Data SetPerson—Indigenous status, code N
Data Source
ABS Perinatal Deaths Collection
Guide for use
Data source type: Administrative by-product data
Data Element / Data SetPerson—area of usual residence, geographical location code (ASGC 2009) NNNNN
Data Source
ABS Perinatal Deaths Collection
Guide for use
Data source type: Administrative by-product data
Data Element / Data SetPerson—Indigenous status, code N
Data Source
ABS Death Registrations Collection
Guide for use
Data source type: Administrative by-product data
Data Element / Data SetPerson—area of usual residence, geographical location code (ASGC 2009) NNNNN
Data Source
ABS Death Registrations Collection
Guide for use
Data source type: Administrative by-product data
Data Element / Data SetPerson—area of usual residence, geographical location code (ASGC 2009) NNNNN
Data Source
ABS Perinatal Deaths Collection
Guide for use
Data source type: Administrative by-product data
Data Element / Data SetPerson—underlying cause of death, code (ICD-10 2nd edn) ANN-ANN
Data Source
ABS Perinatal Deaths Collection
Guide for use
Data source type: Administrative by-product data
Data Element / Data SetPerson—area of usual residence, geographical location code (ASGC 2009) NNNNN
Data Source
ABS Causes of Death Collection
Guide for use
Data source type: Administrative by-product data
Data Element / Data SetPerson—underlying cause of death, code (ICD-10 2nd edn) ANN-ANN
Data Source
ABS Causes of Death Collection
Guide for use
Data source type: Administrative by-product data
Data Element / Data SetPerson—Indigenous status, code N
Data Source
ABS Causes of Death Collection
Guide for use
Data source type: Administrative by-product data
Comments:Help on this term

Most recent data available for 2013 CRC report is 2011 for infant and child all-cause mortality and 2010 for perinatal data and cause of death data.

Data are by reference year.

Single year data for children under 5 by leading cause of death are not required as the data are too small to identify trends. The CRC may reconsider this for future reports.

Disaggregation by Indigenous status will be based on data only from jurisdictions for which the quality of Indigenous identification is considered acceptable.

At this stage, only selected states and territories (NSW, Qld, WA, SA and NT) are considered of accepted quality for reporting Indigenous deaths for all ages. 

National rates should include these five states and territories only.

Disaggregation by state/territory is based on state/territory of usual residence of the deceased.

Indigenous child and particularly infant mortality data is subject to high variability due to small numbers of deaths among children 0 to 4 years.

Due to the small number of Indigenous deaths reported each year, 5 year combined data are recommended for reporting for the current reporting period. Disaggregation by leading causes of death is recommended to be reported at the national level only and not by state/territory due to small numbers.

Single year data will be used for time series.

Infant and child mortality:

Aggregated data (2007-2011) will be reported for all-cause mortality, and 2006-2010 for cause of death, for the current reporting period.

Single year data (2006, 2007, 2008, 2009, 2010 and 2011) will be reported for time series analyses (all-cause mortality and national level only for infants and child 0-4 years), noting that data provided for previous years will be used unless a resupply is provided.

Perinatal data:

Aggregated data (2006-2010, 2007-2011) will be reported for the current reporting period.

Single year data (2006, 2007, 2008, 2009, 2010 and 2011 - 2011 only for all cause total for infant and child mortality) will be reported for time series analyses (all-cause mortality and national level only for perinatals) noting that data provided for previous years will be used unless a resupply is provided.

To report trends, the COAG Reform Council will separately request percentage change and statistical significance testing for this indicator directly from the AIHW when ABS supplies the data.

Variability bands accompanying mortality data should be used for the purposes of comparisons over time and for national estimates at a point in time for Indigenous/non-Indigenous and cause of death comparisons. They should not be used for comparing mortality rates at a single point in time between jurisdictions as the variability bands and mortality rates do not take into account differences in under-identification of Indigenous deaths between jurisdictions. 

Baseline year for NIRA target (Halve the child mortality gap within a decade) is 2008; baseline year for this indicator is 2008; target year is 2018.

Projections from the 2011 Census will be available in mid-2014, at which point rates may need to be backcast to 2006 (the baseline for the associated target).

Perinatal data from the AIHW Perinatal Data Collection was reported for this indicator in the 2008-09 and 2009-10 reporting cycles, however it is no longer required.

Representational attributes

Representation class:Help on this termRate
Data type:Help on this termReal
Unit of measure:Help on this termPerson
Format:Help on this termN[N].N

Indicator conceptual framework

Framework and dimensions:Help on this termDeaths

Data source attributes

Data sources:Help on this term
Data SourceABS Perinatal Deaths Collection
Frequency
Annual
Data custodian

Australian Bureau of Statistics



Data SourceABS Death Registrations Collection
Frequency
Annual
Data custodian

Australian Bureau of Statistics



Data SourceABS Causes of Death Collection
Frequency
Annual
Quality statement
ABS causes of death collection, QS
Data custodian

Australian Bureau of Statistics



Data SourceABS birth registration data
Frequency
Annual
Data custodian

Australian Bureau of Statistics



Data SourceABS Estimated resident population (total population)
Frequency
Quarterly
Quality statement
ABS Estimated resident population (total population), QS
Data custodian
Australian Bureau of Statistics

Data SourceABS Indigenous experimental estimates and projections (2001 Census-based)
Frequency
Periodic
Quality statement
ABS Indigenous experimental estimates and projections, QS
Data custodian
Australian Bureau of Statistics

Accountability attributes

Reporting requirements:Help on this termNational Indigenous Reform Agreement.
Organisation responsible for providing data:Help on this termAustralian Bureau of Statistics (ABS).
Further data development / collection required:Help on this term

Specification: Long-term.

Improve the quality of Indigenous identification in deaths data.

 

Source and reference attributes

Steward:Help on this termNational Indigenous Reform Agreement Performance Information Management Group

Relational attributes

Related metadata references:Help on this term

See also National Healthcare Agreement: PB 09-Halve the mortality gap for Indigenous children under five within a decade, 2012 Health, Superseded 25/06/2013, Indigenous, Endorsed 11/09/2012

Has been superseded by National Indigenous Reform Agreement: PI 06-Under five mortality rate by leading cause, 2014 Indigenous, Archived 24/11/2014

Supersedes National Indigenous Reform Agreement: PI 09-Child under 5 mortality rate (and excess deaths), 2012 Indigenous, Archived 13/06/2013

Supersedes National Indigenous Reform Agreement: PI 10-Mortality rates (and excess deaths) by leading causes for children under 5, 2012 Indigenous, Archived 13/06/2013

My items Help on this term
Download Help on this term