National Indigenous Reform Agreement: PI 06-Under five mortality rate by leading cause, 2018
Identifying and definitional attributes
|Metadata item type:||Indicator|
|Short name:||PI 06-Under five mortality rate by leading cause, 2018|
|Registration status:||Indigenous, Archived 31/07/2018|
Mortality rates for children aged less than five, by leading causes of death (International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10)(2015 version) chapter level), by Indigenous status.
The Australian Bureau of Statistics (ABS) data for this indicator are for perinatal mortality, infant mortality (birth to less than 1 year), child 1–4 years mortality and child 0–4 years mortality.
It is the key component of measuring the 'Closing the Gap' target to ‘Halve the gap in mortality rates for Indigenous children under five within a decade (by 2018)'.
|Indicator set:||National Indigenous Reform Agreement (2018) Indigenous, Archived 31/07/2018|
|Outcome area:||Indigenous children have the same health outcomes as other Australian children Indigenous, Endorsed 21/07/2010|
|Quality statement:||National Indigenous Reform Agreement: PI 06-Under five mortality rate by leading cause, 2018; Quality Statement Indigenous, Archived 07/02/2019|
Collection and usage attributes
|Population group age to:|
This indicator uses a number of different population group age bands:
Rates are calculated for Indigenous and non-Indigenous Australians.
For children aged 1–4 and children aged 0–4:
Variability bands are to be calculated for rates (single year and national data for 5 years combined) using the standard method (see Definitions below).
Reporting is only for those jurisdictions which have adequate levels of Indigenous identification (New South Wales, Queensland, Western Australia, South Australia and the Northern Territory from 1998).
For trends: Percentage change and statistical significance of change are to be calculated (required for assessment of progress against targets).
Excludes deaths where Indigenous status was not stated.
Rate ratios and rate differences are calculated for comparisons between Indigenous and non-Indigenous Australians.
Note: Causes of death to be listed from highest to lowest Indigenous percentage for the most recent period (5 years combined).
Number, percentage, rate per 1,000 of all births (perinatal), rate per 1,000 live births (infant), rate per 100,000 population (children aged 1–4 and 0–4 ), rate ratio, rate difference and variability bands.
Note: Causes of death to be listed from highest to lowest Indigenous percentage.
This measure refers to ‘leading causes of death’. Data are provided for ‘selected causes of death’ according to the ICD-10 codes used for ‘leading causes of death’ in the Aboriginal and Torres Strait Islander Health Performance Framework:
Main condition in the fetus/infant:
Main condition in the mother, fetus and newborn affected by:
Child aged 1–4 mortality:
Child aged 0–4 mortality:
'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 (CI) 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% CIs 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 Australian Institute of Health and Welfare (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 (for example, 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, that is, there is no systematic bias.
Perinatal and infant mortality rates: 1000 x (Numerator ÷ Denominator).
Child aged 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% CIs as follows.
Where CI = confidence interval
CR = crude rate
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% 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% CIs 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.
‘Perinatal mortality’ is defined by the ABS 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 birthweight of at least 400 grams.
Perinatal: Number of perinatal deaths (fetal and neonatal)
Infant: Number of deaths among children aged less than 1 year
Child aged 1–4: Number of deaths among children aged 1–4 years
Child aged 0–4: Number of deaths among children aged 0–4 years
|Numerator data elements:|
Perinatal: Number of all births (including live births, and stillbirths of at least 20 completed weeks of gestation or with a birthweight of at least 400 grams).
Infant: Number of registered live births
Child aged 1–4: Population aged 1–4 years
Child aged 0–4: Population aged 0–4 years
|Denominator data elements:|
Current period: Five-year aggregate 2012–2016 supplied for perinatal, infant, child aged 1–4, and child aged 0–4 by all causes and by cause of death.
For Indigenous and non-Indigenous (numbers, rates, percentage, rate ratios, rate differences, variability bands):
For Indigenous and non-Indigenous (numbers, rates, rate ratios, and rate differences):
Single year data:
Up until the 2015-16 reporting cycle, causes of death and perinatal data lagged a year behind the all causes data.. Final revised cause of death data are also provided for 2013 and preliminary revised data are provided for 2014. Revised preliminary data for 2015 are yet to be available for reporting.
For Indigenous and non-Indigenous (numbers, rates, rate ratios, rate differences, variability bands, percentage change and statistical significance of change):
|Disaggregation data elements:|
Most recent data available for the 2018 National Indigenous Reform Agreement (NIRA) Report is 2016 for infant, child and perinatal mortality (both causes of death and all causes data). Data are by reference year.
Single year data for children under 5 by leading cause of death are not produced as the numbers are too small to identify trends. The body analysing progress against targets 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, data from only selected states and territories (New South Wales, Queensland, Western Australia, South Australia and the Northern Territory) are considered of accepted quality for reporting Indigenous deaths for all ages.
National rates should include these five jurisdictions only.
Disaggregation by state/territory is based on state/territory of usual residence of the deceased.
Indigenous child and particularly infant mortality data are subject to high variability due to small numbers of deaths among children aged 0 to 4.
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 in the numerator and three year average for the denominator.
Perinatal, infant and child mortality:
Aggregated data (2012–2016) will be reported for both all causes mortality and causes of death data.
Up until the 2015-16 reporting cycle, causes of death data for infants and children lagged a year behind the all causes data.
Single year data (2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014, 2015 and 2016) will be reported for time series analyses (all causes mortality and national level only). For the 2018 report, data re-supplied for 2013 (final revised) and 2014 (preliminary revised) for cause of death 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 the Council of Australian Governments' NIRA target (Halve the gap in mortality rates for Indigenous children under 5 within a decade) is 2008; baseline year for this indicator is 2006; target year is 2018.
Child aged 1–4 and child aged 0–4 mortality measures are derived from ERPs and projections based on the 2011 Census. The non-Indigenous population will be calculated based on 2011 Census based ERP total population minus 2011 Census based projections. First release total population ERP is to be used until rebased.
The term ‘Aboriginal and Torres Strait Islander people’ is preferred when referring to the separate Indigenous peoples of Australia. However, the term ‘Indigenous’ is used interchangeably with ‘Aboriginal and Torres Strait Islander’ in this indicator set to assist readability.
|Unit of measure:||Person|
Indicator conceptual framework
|Framework and dimensions:||Deaths|
Data source attributes
National Indigenous Reform Agreement.
|Organisation responsible for providing data:|
Australian Bureau of Statistics
|Further data development / collection required:|
Improve the quality of Indigenous identification in deaths data.
Source and reference attributes
Australian Institute of Health and Welfare
|Steward:||National Indigenous Reform Agreement Performance Information Management Group|
Breslow NE & Day NE 1987. Statistical methods in cancer research. Lyon: International Agency for Research on Cancer.
|Related metadata references:|
See also National Healthcare Agreement: PB b–Better health: halve the mortality gap for Indigenous children under five by 2018, 2017 Health, Superseded 30/01/2018
Has been superseded by National Indigenous Reform Agreement: PI 06-Under five mortality rate by leading cause, 2019 Indigenous, Archived 17/11/2019
Supersedes National Indigenous Reform Agreement: PI 06—Under five mortality rate by leading cause, 2017 Indigenous, Archived 06/06/2017