child and maternal health report

8/12/2019 Child and Maternal Health report

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Healthy Communities:Child and maternal health in 20092012

National Health Performance Authority


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Healthy Communities:Child and maternal health in 20092012

National Health Performance Authority


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National Health Performance AuthorityGPO Box 9848Sydney, NSW 2001 Australia

Telephone: +61 2 9186 9210www.nhpa.gov.au

National Health Performance Authority 2014

The National Health Performance Authority licenses use of this report under Creative Commons Attribution-Non Commercial-No Derivatives Licence 3.0, Australia and the terms of this notice.

You are permitted to make fair use of the report consistent with the terms of the licence. You must not make use of the report ina misleading or deceptive manner or in a manner that is inconsistent with the context of the report.

Permissions beyond the scope of the licence may be available at [email protected]

Disclaimer This report is produced for health research, health care and health advocacy purposes. This report is not intended to provideguidance on particular health care choices. You should contact your medical advisors on particular health care choices.

ISSN: 2201-8212Print ISBN: 978-1-74186-152-5Online ISBN: 978-1-74186-153-2

Suggested citation: National Health Performance Authority 2014, Healthy Communities: Child and maternal health in 20092012.

Further copies of this document can be downloaded from www.myhealthycommunities.gov.au

Published July 2014.

Please note that there is the potential for minor revisions of this report.Please check www.myhealthycommunities.gov.au for any amendments.


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iNational Health Performance Authority www.myhealthycommunities.gov.au Healthy Communities: Child and maternal health in 20092012

Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iii Key ndings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iii

Next steps . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vi

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 About this report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Why information on maternal and child health matters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 About the data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Fair comparisons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Key ndings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Infant and young child mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Low birthweight and smoking during pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Antenatal visits in the rst trimester . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

Health status and outcomes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Infant and young child mortality rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 Infant mortality rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Low-birthweight babies, all women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 Low-birthweight babies, Aboriginal and Torres Strait Islander women . . . . . . . . . . . . . . . . . . . . 24

Prevention . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 Smoking during pregnancy, all women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 Smoking during pregnancy, Aboriginal and Torres Strait Islander women . . . . . . . . . . . . . . . . 30

Use of health services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 Antenatal visits in the rst trimester, all women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34 Antenatal visits in the rst trimester, Aboriginal and Torres Strait Islander women . . . . . . . . . . 36

Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40

Acknowledgements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41

About the Authority . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42

Additional documentHealthy Communities: Child and maternal health in 20092012, Technical Supplement

Table of contents


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iiiNational Health Performance Authority www.myhealthycommunities.gov.au Healthy Communities: Child and maternal health in 20092012

Summary The numbers of infants and children who dieprematurely has fallen rapidly in recent years on

a population basis. Nevertheless, Australia hasinfant mortality rates three times higher than thebest-performing countries. 1 Even within Australia,there is a marked difference in infant and youngchild death rates between the areas where therates are lowest, and areas where they are highest.Identifying these differences may help to informimprovements in access to or delivery of servicesthat could in time lead to reductions in avoidable

deaths among infants and young children.

This is the rst report from the National HealthPerformance Authority (the Authority) thatpresents data at the local level for infant andyoung child mortality, low birthweight, smokingduring pregnancy and access to antenatal care.

There is a strong relationship between antenatalcare that commences within the rst 13 weeks(rst trimester) of pregnancy and positive childhealth outcomes. 2 Accordingly, in 2011 theCouncil of Australian Governments (COAG)identied the number of women with at least oneantenatal visit in the rst trimester as an importantindicator of access to care in communities.

COAG also agreed that infant and young childmortality rates, the proportion of babies born

with low birthweight and prevalence of smokingare important population health outcome measuresthat provide context for the interpretation of localhealth system performance.

For example, low-birthweight babies are at greaterrisk of poor health outcomes including death anddisability, particularly in the rst year of life, and havean increased risk in adulthood of diabetes type 2,

high blood pressure and cardiovascular disease.3

Measuring access to antenatal care and the healthoutcomes of children at the local level, including

premature death, low birthweight and smokingduring pregnancy, allows us to begin to identify thecommunities where programs such as antenatalservices are needed or have achieved success.Other factors such as the quality of antenatal careprovided and broader social determinants of healthalso impact on infant and child heath outcomes.

This report shows variation across local areas that

is not seen when reporting at national or state andterritory level. Data in the report cover all children andmothers and, where the data are available, Aboriginaland Torres Strait Islander mothers and their babies.

Data are presented for the period fromJanuary 2009 to December 2012, for 61 localareas across Australia called Medicare Localcatchments. For measures regarding Aboriginaland Torres Strait Islander mothers and theirbabies, data are presented for the period fromJanuary 2007 to December 2011.

Key ndingsInfant and young child mortality rate

In 20102012, the national rate of infant and youngchild mortality was 4.4 deaths per 1,000 live births(1,344 deaths).

Across local areas, the infant and young childmortality rate was more than three times higher in the catchment with the highest rate comparedto the catchment with the lowest rate.


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The infant and young child mortality rate rangedas follows:

Highest: Northern Territory 9.2 deaths per1,000 live births

Lowest: Bayside (Vic) 2.6 deaths per1,000 live births

(Figure 3, page 7 and pages 18 to 19) .

To allow fairer comparisons, the Authoritycompared local areas across Australia that have

similar characteristics such as remoteness,socioeconomic status and distance to hospitals.

These catchments are grouped into one of sevenpeer groups (page vi) .

The report shows there are differences ininfant and young child mortality rates acrosscatchments in peer groups that have similargeographic characteristics.

Across the metropolitan catchments, the highestinfant and young child mortality rate was morethan double in the local area with the highest rate(6.1 deaths per 1,000 live births in Greater MetroSouth Brisbane) compared to the local area withthe lowest rate (2.6 deaths per 1,000 live bir thsin Bayside (Vic)).

There were also differences across similar

local areas within the same peer group, evenafter accounting for geographic andsocioeconomic characteristics.

Across lower-income metropolitancommunities ( Metro 2 peer group), the infantand young child mortality rate was more thandouble in Greater Metro South Brisbane(6.1 deaths per 1,000 live births) comparedto South Western Melbourne (2.9 deaths per

1,000 live births)

Across middle-income regional communities(Regional 2 peer group), the infant and young

child mortality rate was 86% higher in CountrySouth SA (6.5 deaths per 1,000 live births)compared to Goulburn Valley (Vic) (3.5 deathsper 1,000 live births) (Table 1, page 6) .

While this report shows higher rates in many regionaland rural areas compared to metropolitan areas,and in lower-income compared to higher-incomeareas, there are some areas that do not follow this

trend. These areas demonstrate what is possible toachieve for other similar areas.

For example, Nepean-Blue Mountains (NSW),Barwon (Vic) and Goulburn Valley (Vic) are middle-to lower-income regional areas that have infant andyoung child mortality rates similar to or better thanmany higher-income metropolitan communities(Figure 4, page 12) .

Low-birthweight babies

The national percentage of all liveborn singletonbabies that were of low bir thweight was 4.8%for babies born to all women in 20092011 and11.0% for babies born to Aboriginal and TorresStrait Islander women in 20072011.

Across local areas, the percentage of all live

births that were of low birthweight was morethan double in the catchment with the highestpercentage compared to the catchment with thelowest percentage.

The percentage of low-birthweight babies rangedas follows:

Highest: Northern Territory 7.7%

Lowest: Sydney North Shore & Beaches 3.3%



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Differences were found across similar localareas even after accounting for geographic and

socioeconomic characteristics.

Across middle-income metropolitan communitiesin the Metro 2 peer group, the percentage oflow-birthweight babies was 41% higher in SouthWestern Melbourne (5.2%) compared to Fremantle(WA) (3.7%).

The report also found that among Aboriginal and

Torres Strait Islander mothers there was a greaterproportion of low-birthweight babies comparedwith other mothers in Australia.

Across local areas, the percentage of low-birthweight babies to Aboriginal and Torres StraitIslander women ranged from 17.5% in Gippsland(Vic) to 6.7% in Frankston-Mornington Peninsula (Vic) (Figure 5, page 13 and pages 24 to 25) .

Smoking during pregnancy

The national percentage of women who smokedduring pregnancy was 13.9% for all women for20092011 and 51.7% for Aboriginal and TorresStrait Islander women for 20072011.

Across local areas, the percentage of womenwho smoked during pregnancy was 18 timeshigher in the catchment with the highestpercentage compared to the catchment withthe lowest percentage.

The percentage of women who smoked duringpregnancy ranged as follows:

Highest: Far West NSW 33.1%



There were differences found across similar localareas even after accounting for geographic and


Across high-income metropolitan communities(Metro 1 peer group), the percentage of womenwho smoked during pregnancy was more than vetimes higher in Australian Capital Territory (10.2%)compared to Sydney North Shore & Beaches (1.8%).

The percentage of Aboriginal and Torres Strait

Islander women who smoked during pregnancyranged from 66.4% in Goulburn Valley (Vic) to29.4% in Macedon Ranges & North WesternMelbourne (Figure 5, page 13 and pages30 to 31) .

Antenatal visits in the rst trimester

In 20102011, the national percentage of womenwho had at least one antenatal visit in the rst

trimester of pregnancy was 67.2% for all womenand 50.3% for Aboriginal and Torres StraitIslander women.

Across local areas, the percentage of women whohad at least one antenatal visit in the rst trimesterwas more than double in the catchment with thehighest percentage compared to the catchmentwith the lowest percentage.

The percentage of women who had at least oneantenatal visit in the rst trimester ranged as follows:

Highest: Western Sydney 87.7%

Lowest: Grampians (Vic) 36.6%


Differences were found across similar localareas even after accounting for geographic and



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Across higher-income regional communities(Regional 1 peer group), the percentage of

women who had at least one antenatal visit inthe rst trimester of pregnancy was double inNepean-Blue Mountains (NSW) (85.5%) comparedto Frankston-Mornington Peninsula (Vic) (41.7%).

While this report shows higher rates in many regionaland rural areas compared to metropolitan areas,and in lower-income compared to higher-incomeareas, there are some that do not follow this trend.

These areas demonstrate what is possible toachieve for other similar areas.

For example, Western Sydney is a lower-incomemetropolitan area that has a lower rate of smokingduring pregnancy than most higher-incomemetropolitan communities, and has the highest rateof antenatal visits in the rst trimester than all othermetropolitan communities for all women, and thesecond-highest rate for Aboriginal and Torres StraitIslander women.

The percentage of Aboriginal and Torres StraitIslander women who had at least one antenatal visitin the rst trimester ranged from 80.5% in Nepean-Blue Mountains (NSW) to 21.8% in Grampians (Vic).

State and territory differences in denitions andmethods used for data collection affect the

comparability of data relating to smoking duringpregnancy, low-birthweight babies and antenatalvisits in the rst trimester across state and territory

jurisdictions and lower levels of geography withinthese jurisdictions.

Next steps This is the rst report from the Authority thatpresents data at the local level for infant andchild mortality rates, low birthweight, smoking

About the peer groups To enable fairer comparisons, the Authorityallocated each Medicare Local catchmentto one of seven peer groups, based onsocioeconomic status, remoteness anddistance to hospitals.

Metro 1: High urban density, highersocioeconomic status

Metro 2: Medium urban density, mediumsocioeconomic status

Metro 3: Low urban density, lowersocioeconomic status

Regional 1: Outer urban areas, middlesocioeconomic status

Regional 2: Mostly non-metro urban andregional areas, middle socioeconomicstatus

Rural 1: Distant from metro cities, withdiverse socioeconomic status

Rural 2: Mostly large remote areas, middleor lower socioeconomic status.

To nd more information about peer groups,see Healthy Communities: Child and maternal

health in 20092012, Technical Supplementat www.myhealthycommunities.gov.au

during pregnancy and access to antenatal careacross Australia.

Future reports will allow trends to be monitoredacross local communities and may explore otherfactors that contribute to poorer health outcomesfor infants and young children.


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Introduction

About this report The National Health Performance Authority (the Authority) bases its performance reports onindicators agreed by the Council of AustralianGovernments (COAG). This report focuses on thefollowing indicators:

Infant and young child mortality rate

Proportion of babies with low birthweight

Prevalence of smoking

Number of women with at least one antenatalvisit in the rst trimester.

The report provides information broken downby 61 Medicare Local catchments. The nationalnetwork of Medicare Local organisations wasestablished between 2011 and 2012 to improve theresponsiveness, coordination and integration of localhealth services. These organisations are due to bereplaced in 2015 with Primary Health Networks.

Data are presented for the period from January2009 to December 2012. For some measuresregarding Aboriginal and Torres Strait Islandermothers and their babies, data are presented forthe period from January 2007 to December 2011.

Presentation of the ndings in this report aims tohelp clinicians, health managers, administrators

and the public see how rates of infant and childmortality, low birthweight, maternal smoking andantenatal care differ across local areas. They arealso intended to provide Medicare Locals, PrimaryHealth Networks and Local Health Networkswith information they need to plan and delivercommunity and hospital care.

Why information on maternal and

child health mattersInfant and child mortality is a broad measureof the overall health of a population. In Australia, infant mortality rates have declined by 33%from 2005 to 2012, from 4.9 deaths to 3.3 deathsper 1,000 l ive births. 4 Australia is currently ranked14 of 30 OECD countries for which infantmortality rates were reported for 2012. Australiahad an infant mortality rate (3.3 deaths per

1,000 live bir ths) three times higher than that ofthe best-performing country, Iceland (1.1 deathsper 1,000 l ive births), and twice that of Slovenia(1.6 deaths per 1,000 live births). 1

Figure 1: Infant and young child deaths measured in this report

Birth 28 days 1 year

At least 20 weeks or 400 grams 0 to 27 days 28 days to


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Infant and young child mortality rates arereported as the number of deaths among children

aged less than 5 years per 1,000 live births duringthe three calendar years from 1 January 2010 to31 December 2012. The number of infant andyoung child deaths are reported as the averagenumber of deaths per year during the same timeperiod. The majority of these deaths (84%) occurin infancy (before 1 year of age).

In this report, infant mortality rates are reported

as the number of deaths of liveborn infants agedless than 1 year per 1,000 live births during thethree calendar years from 1 January 2010 to31 December 2012. In 20102012, 70% of infantand young child deaths occurred before 28 daysof life (neonatal death) (Figure 1, page 1) .

Three years of data were combined to createstable estimates for reporting mortality rates atthe local area level.

In 2011, there were 297,126 women who gavebirth to 299,588 liveborn and 2,220 stillborn

babies in Australia. Of these women, 11,729 wereidentied on the National Perinatal Data Collection

(NPDC) as being Aboriginal and Torres StraitIslander women who gave birth to 11,737 livebornand 158 stillborn babies. 5

The leading causes of infant and young childmortality in Australia are shown below in Figure 2 .

Low-birthweight babies are dened in thisreport as liveborn singleton babies who weigh less

than 2,500 grams at birth. A babys birthweight isa key indicator of health status and may reect thehealth of a mother during her pregnancy, includingher smoking status and the quality of antenatalcare received. 3

In this report, the percentage of babies whowere of low birthweight is the number of livebornsingleton babies who weighed less than 2,500grams at birth, divided by the total number of livesingleton babies born.

Figure 2: Most common causes and percentage of infant and young child deaths by category, in Australia,20102012

Source: National Health Performance Authorit y analysis of Australian Bureau of Statistics Causes of Death Collection 20102012.

Infant and young child deaths

0 to


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For the measures presented in this report, theNPDC data are attributed to the local area where

the mother usually resided, rather than the placewhere the birth occurred and exclude Australiannon-residents, residents of external territories andwomen who could not be allocated to a MedicareLocal catchment because their Statistical Local

Area of usual residence was not stated or wasnot valid.

Results for smoking during pregnancy exclude

women whose smoking status during pregnancywas not stated.

Results for antenatal visits in the rst trimesterexclude women whose gestation at the rstantenatal visit was not stated.

State and territory differences in denitions andmethods used for collection of data related tosmoking during pregnancy and antenatal visits inthe rst trimester affect the comparability of thesedata across state and territory jurisdictions andlower levels of geography within these jurisdictions.In particular, as data on smoking during pregnancyare not available for women who gave birthin Victoria in 2007 or 2008, the percentage of

Aboriginal and Torres Strait Islander women whogave birth and smoked during pregnancy duringthe ve calendar years from 1 January 2007 to 31

December 2011 does not include Aboriginal and Torres Strait Islander women who usually residedand gave birth in Victoria in 2007 or 2008. In WAand ACT, rst antenatal visits that occur outside ofthe hospital may not be included.

Results for each measure in this report arepresented on maps from pages 17 to 37 and on www.myhealthycommunities.gov.au

Fair comparisons To enable fairer comparisons, the Authority hasallocated each Medicare Local catchment to oneof seven peer groups, based on socioeconomicstatus, remoteness, and distance to hospitals:three in metropolitan areas, two in regional areas,and two in rural areas (page vi) .

For further information see Healthy Communities:Child and maternal health in 20092012, TechnicalSupplement at www.myhealthycommunities.gov.au

The data presented on Aboriginal and TorresStrait Islander mothers and their babies areinuenced by the quality and completeness of

Aboriginal and Torres Strait Islander identication,which may vary across local areas.


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Infant and young child mortality in this reportrefers to the death of a liveborn child before the

age of 5 years. The majority of these deaths (84%)occur in infancy (before 1 year of age).

In 20102012, the national rate of infant and youngchild mortality was 4.4 deaths per 1,000 live births(1,344 deaths).

Variation across local areas

Across local areas, the infant and young child

mortality rate was more than three times higher in the catchment with the highest rate comparedto the catchment with the lowest rate.

The infant and young child mortality rate rangedas follows:

Highest: Northern Territory 9.2 deaths per1,000 live births

Lowest: Bayside (Vic) 2.6 deaths per1,000 live births


The percentage of infant deaths compared withyoung child deaths also varied across local areas.Of the 59 local areas reported, infant deaths accounted for the vast majority (90% or more) of allinfant and young child deaths in ve Medicare Localcatchments Central Coast NSW, Eastern Sydney,Macedon Ranges & North Western Melbourne,Inner East Melbourne and Northern Sydney.

In contrast, infant deaths accounted for less than75% of all infant and young child deaths in SouthWest WA, Great South Coast (Vic), Frankston-Mornington Peninsula (Vic) and Country South SA.

Variation across peer groups

There were differences found in infant and youngchild mortality rates across local areas with similargeographic characteristics.

Across metropolitan areas , the infantand young child mortality rate was more than

double in the lower-income urban catchmentof Greater Metro South Brisbane (6.1 deathsper 1,000 live births, Metro 2) comparedto the wealthier inner-city catchment of Bayside(Vic) (2.6 deaths per 1,000 live births, Metro 1)

Across regional areas , the infant and youngchild mortality rate was almost double in thelower-income catchment of Country SouthSA (6.5 deaths per 1,000 live births, Regional2) compared to the wealthier catchment ofNepean-Blue Mountains (NSW) (3.3 deaths per1,000 live births, Regional 1)

Across rural areas , the infant and young childmortality rate was almost double in the Rural2 catchment of Northern Territory (9.2 deathsper 1,000 live births) compared to 4.9 deathsper 1,000 live births in Country North SA(Rural 1) and Goldelds-Midwest (WA) (Rural 2).

Variation within peer groups

There were differences across similar local areaseven after accounting for broad geographic andsocioeconomic circumstances. For example:

Within the Metro 2 peer group, the infant andyoung child mortality rate was more thandouble in Greater Metro South Brisbane

(6.1 deaths per 1,000 live births) comparedto South Western Melbourne (2.9 deaths per1,000 live bir ths).

Within the Regional 2 peer group, the infantand young child mortality rate was 86% higherin Country South SA (6.5 deaths per 1,000live births) compared to Goulburn Valley (Vic)(3.5 deaths per 1,000 live births) (Table 1,page 6) .

Key ndings: Infant and young child mortality


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While this report shows higher rates of infant andyoung child deaths in regional and rural compared

to metropolitan areas and in lower-incomecompared to higher-income areas, there are someareas that do not follow this trend. These areasdemonstrate what can be achieved for othersimilar areas.

Peer group Highest rate Lowest rate DifferenceMetro 1 4.2 2.6 62% (1.6 times higher)

Metro 2 6.1 2.9 110% (2.1 times higher)

Metro 3 5.0 3.3 52% (1.5 times higher)

Regional 1 5.8 3.3 76% (1.8 times higher)Regional 2 6.5 3.5 86% (1.9 times higher)

Rural 1 7.3 4.9 49% (1.5 times higher)

Rural 2 9.2 4.9 88% (1.9 times higher)

Table 1: Highest and lowest infant and young child mortality rates across Medicare Local catchments,by peer group , 20102012

For example, Nepean-Blue Mountains (NSW),Barwon (Vic) and Goulburn Valley (Vic) are middle-

to lower-income regional areas that have infantand child mortality rates similar to or better thanmany higher-income metropolitan communities.

Aboriginal and Torres Strait Islander infant and young child mortalityInfant and young child mortality rates for Aboriginal and Torres Strait Islander children havedeclined over the past decade with 42% of the decline in infant mortality rates due to a decreasein sudden infant deaths syndrome (SIDS) and 25% due to a fall in deaths from certain conditionsoriginating in the perinatal period. 7 External causes (injury and poisoning) account for just over halfof all deaths of Aboriginal and Torres Strait Islander infant and young children.

The recent Australian Government report on Closing the Gap (2014) showed that changes in the Aboriginal and Torres Strait Islander infant and young child mortality rate are currently withinrange to meet the target of halving the gap in mortality rates by 2018. 8 However, between 2006and 2010 Aboriginal and Torres Strait Islander infant and young child mortality rates were stilldouble the non-Indigenous rate, as were infant mortality rates (8 deaths per 1,000 live birthscompared with 4 deaths per 1,000 live births). Aboriginal and Torres Strait Islander infant mortalityrates also varied across states and territories, from 6 deaths per 1,000 live births in SA, to13 deaths per 1,000 live births in the NT.* 9

* Reliable data on child mortality for Aboriginal and Torres Strait Islander people are available for NSW, Qld, WA, SA and the NT.


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Low birthweight, all womenNationally, the percentage of liveborn babies* oflow birthweight was 4.8% for babies born to allwomen in 20092011 and 11.0% for babies bornto Aboriginal and Torres Strait Islander women in20072011.


Across local areas, the percentage of all livebirths that were of low birthweight was morethan double in the catchment with the highestpercentage compared to the catchment with thelowest percentage.

The percentage of all live births that were of lowbirthweight ranged as follows:

Highest: Northern Territory 7.7%

Lowest: Sydney North Shore & Beaches 3.3%(Figure 4, page 12 and pages 22 to 23) .


There were differences in the percentage of babiesborn of low birthweight across local areas withsimilar geographic characteristics.

Across metropolitan areas , the percentage ofall liveborn babies of low birthweight was 73%higher in the lower-income urban catchment ofNorthern Adelaide (5.7%, Metro 3) comparedto the wealthy inner-city catchment of SydneyNorth Shore & Beaches (3.3%, Metro 1)

Across regional and rural areas , the percentageof all liveborn babies of low birthweight washigher in most lower-income catchments(Regional 2 and Rural 2) compared to higher-

income catchments (Regional 1 and Rural 1).

Key ndings: Low birthweight and smokingduring pregnancy

Variation within peer groups There were differences across similar catchmentseven after accounting for geographic andsocioeconomic circumstances.

Within the Metro 2 peer group, the percentageof all live births that were of low birthweight was41% higher in South Western Melbourne (5.2%)compared to Fremantle (WA) (3.7%)

Within the Regional 2 peer group, thepercentage of all live births that were of lowbirthweight was 27% higher in Country SouthSA, New England (NSW) and Tasmania (5.6%)compared to South West WA (4.4%) (Table 2,page 9) .

Smoking during pregnancy,all womenNationally, the percentage of women who smokedduring pregnancy was 13.9% for all women for20092011 and 51.7% for Aboriginal and TorresStrait Islander women for 20072011.


Across local areas, the percentage of women whosmoked during pregnancy was 18 times higher in

the catchment with the highest compared to thecatchment with the lowest percentage.

The percentage of women who smoked duringpregnancy ranged as follows:

Highest: Far West NSW 33.1%



* Multiple births are excluded for the results for low birthweight in this report.


19/54


Variation across peer groups There were differences in the percentage ofwomen who smoked during pregnancy acrosslocal areas with similar geographic characteristics.

Across metropolitan areas , the percentageof women who smoked during pregnancywas 12 times higher in the lower-incomeurban catchment of Northern Adelaide (22.4%,Metro 3) compared to the wealthier inner-city

catchment of Sydney North Shore & Beaches(1.8%, Metro 1)

Across regional areas , the percentage ofwomen who smoked during pregnancy washigher in most lower-income catchmentscompared to higher-income catchments.For example, the percentage of womenwho smoked during pregnancy was almostdouble at 26.5% in Wide Bay (Qld) (Regional2) compared to 14.0% in Barwon (Vic) andIllawarra-Shoalhaven (NSW) (Regional 1).

However across rural areas this trend of lowerrates of smoking during pregnancy in higher-income areas compared to lower-income areaswas not apparent.


There were differences across similar catchmentseven after accounting for geographic andsocioeconomic circumstances.

Within the Metro 1 peer group, the percentageof women who smoked during pregnancy wasmore than ve times higher in AustralianCapital Territory (10.2%) compared to SydneyNorth Shore & Beaches (1.8%)

Within the Metro 2 peer group, the percentageof women who smoked during pregnancy wasthree times higher in Southern Adelaide-Fleurieu-Kangaroo Island (SA) (14.5%)

compared to South Eastern Sydney (4.7%)(Table 3) .

Table 2: Highest and lowest percentage of low-birthweight babies of all women across Medicare Localcatchments, by peer group , 20092011

Table 3: Highest and lowest percentage of smoking during pregnancy among all women across MedicareLocal catchments, by peer group , 20092011

Peer group Highest percentage Lowest percentage DifferenceMetro 1 4.4% 3.3% 33% (1.3 times higher)

Metro 2 5.2% 3.7% 41% (1.4 times higher)

Metro 3 5.7% 4.7% 21% (1.2 times higher)Regional 1 4.9% 4.3% 14% (1.1 times higher)Regional 2 5.6% 4.4% 27% (1.3 times higher)

Rural 1 7.5% 5.0% 50% (1.5 times higher)


Peer group Highest percentage Lowest percentage Difference

Metro 1 10.2% 1.8% 467% (5.7 times higher)Metro 2 14.5% 4.7% 209% (3.1 times higher)


Regional 1 18.8% 14.0% 34% (1.3 times higher)

Regional 2 26.5% 15.5% 71% (1.7 times higher)Rural 1 33.1% 19.5% 70% (1.7 times higher)



20/54


* The results do not include data for Aboriginal and Torres Strait Islander women who usually resided in Victoria and gave birth in Victoria in 2007 and 2008.

Low birthweight, Aboriginal andTorres Strait Islander women


Across local areas, the percentage of live births to Aboriginal and Torres Strait Islander women thatwere of low birthweight was 2.6 times higher inthe catchment with the highest compared to thecatchment with the lowest percentage.

The percentage of live births to Aboriginal and

Torres Strait Islander women that were of lowbirthweight ranged from:

Highest: Gippsland (Vic) 17.5%

Lowest: Frankston-MorningtonPeninsula (Vic) 6.7%



Across the three metropolitan peer groups,there was no apparent trend of lower rates oflow-birthweight babies in higher-income areascompared to lower-income areas. Similarly, notrend was seen across regional areas or acrossrural areas.


There were differences across similarcatchments after accounting for geographic andsocioeconomic circumstances. Within the Metro 2 peer group, the percentage

of all live births that were babies of lowbirthweight born to Aboriginal and TorresStrait Islander mothers was twice as high inBentley-Armadale (WA) (14.3%) compared toMetro North Brisbane (7.1%)

Within the Regional 2 peer group, thepercentage of all live births that were babies of

low birthweight born to Aboriginal and TorresStrait Islander mothers was more than twiceas high in Gippsland (Vic) (17.5%) compared toWide Bay (Qld) (7.6%) (Table 4) .

Smoking during pregnancy, Aboriginal and Torres StraitIslander women

Variation across local areas Across local areas, the percentage of Aboriginaland Torres Strait Islander women who smokedduring pregnancy* was more than double inthe catchment with the highest compared to thecatchment with the lowest percentage.

The percentage of Aboriginal and Torres StraitIslander women who smoked during pregnancy

ranged as follows:Highest: Goulburn Valley (Vic) 66.4%

Lowest: Macedon Ranges & North WesternMelbourne 29.4%



There were differences in the percentage of

Aboriginal and Torres Strait Islander womenwho smoked during pregnancy across regionalpeer groups with higher rates of smoking duringpregnancy in almost all lower-income areascompared to middle-income areas.

Across metropolitan areas and across rural areas,this trend of lower rates of low-birthweight babiesin higher-income areas compared to lower-incomeareas was not apparent.


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Table 5: Highest and lowest percentage of smoking during pregnancy among Aboriginal and Torres StraitIslander women across Medicare Local catchments, by peer group , 20072011*

Table 4: Highest and lowest percentage of low-birthweight babies of Aboriginal and Torres Strait Islanderwomen across Medicare Local catchments, by peer group , 20072011



Within the Metro 3 peer group, the percentageof Aboriginal and Torres Strait Islander womenwho smoked during pregnancy was morethan double in Northern Adelaide (62.0%)compared to Macedon Ranges & NorthWestern Melbourne (29.4%)

Within the Regional 2 peer group, thepercentage of Aboriginal and Torres StraitIslander women who smoked during

pregnancy was almost double in Goulburn Valley (Vic) (66.4%) compared to Grampians(Vic) (34.7%) (Table 5) .

* The results do not include data for Aboriginal and Torres Strait Islander women who usually resided in Victoria and gave birth in Victoria in 2007 and 2008.






Rural 1 13.6% 9.1% 49% (1.5 times higher)Rural 2 13.3% 10.3% 29% (1.3 times higher)





Regional 1 48.9% 42.0% 16% (1.2 times higher)Regional 2 66.4% 34.7% 91% (1.9 times higher)




22/54


* Women who usually resided in the Australian Capital Territory and gave birth in New South Wales were not counted in the results for the AustralianCapital Territory Medicare Local catchment for antenatal visits in the rst trimester, smoking during pregnancy and low birthweight.

# Interpret with caution. In WA and ACT, rst antenatal visits that occur outside of the hospital may not be included.Notes: Jurisdicti onal differences in denitions and methods used for data collection affect the comparabil ity of these data across jurisdictions and lower levelsof geography within jurisdictions. For data limitations and exclusions, see this reports Technical Supplement.

Sources: Customised data repor t prepared for the NHPA from the AIHW National Perinatal Data Collection 20092011 (birthweight, smoking during pregnancy) and20102011 (antenatal visits) and NHPA analysis of ABS Death Registrations Collection 20102012 and ABS Bir th Registrations Collection 20102012.

Figure 4: Percentage of all women who had at least one antenatal visit in the rst trimester , by measures ofchild and maternal health, by Medicare Local catchment , 20092012

Medicare Local catchments

Infant &young child

mortality rateper 1,000

Antenatalvisit in rsttrimester

Smokingduring

pregnancyLow birth-

weight

Western Sydney ...................................Nepean-Blue Mountains (NSW) ............Sydney North Shore & Beaches ............Northern Sydney ..................................Central Adelaide & Hills .........................Central Coast NSW ..............................Western NSW .......................................Northern Adelaide .................................Eastern Sydney ....................................New England (NSW) .............................Murrumbidgee (NSW) ...........................North Coast NSW .................................Hunter (NSW) .......................................Metro North Brisbane ...........................Illawarra-Shoalhaven (NSW) ..................Country North SA .................................

Country South SA .................................West Moreton-Oxley (Qld) .....................Inner East Melbourne ............................Bayside (Vic) .........................................Sthn Adelaide-Fleurieu-Kangaroo Is. .....Far West NSW ......................................Perth South Coastal .............................Northern Territory ..................................Inner West Sydney ................................Eastern Melbourne ...............................Great South Coast (Vic) ........................Southern NSW .....................................Lower Murray (Vic/NSW).......................Sunshine Coast (Qld) ............................South West WA ....................................South Eastern Sydney ..........................

Tasmania ..............................................Inner NW Melbourne .............................

Townsville-Mackay (Qld) ........................Barwon (Vic) .........................................Northern Melbourne .............................Darling Downs-SW Qld .........................Gippsland (Vic) .....................................Hume (Vic/NSW)...................................Central Qld ...........................................Bentley-Armadale (WA) .........................South Western Melbourne ....................Gold Coast (Qld) ...................................Greater Metro South Brisbane ..............Goldelds-Midwest (WA) .......................Loddon-Mallee-Murray (Vic/NSW) .........Central & NW Qld .................................South Western Sydney .........................

South Eastern Melbourne .....................Perth North Metro .................................Far North Qld ........................................Fremantle (WA) .....................................Perth Central & East Metro ...................Macedon Ranges & NW Melb ...............Kimberley-Pilbara (WA) .........................

Australian Capital Territory* ...................Frankston-Mornington Peninsula (Vic) ...Goulburn Valley (Vic) .............................Wide Bay (Qld)......................................Grampians (Vic) ....................................

87.7%85.5%85.5%85.1%84.7%83.0%82.7%82.3%81.2%81.2%79.9%79.7%77.1%75.6%75.4%75.2%

74.9%74.2%72.7%72.7%72.5%72.1%72.0% #

71.2%70.5%69.3%68.5%68.5%67.9%67.8%67.3% #

67.1%67.1%64.1%63.9%63.7%63.1%62.3%61.2%59.5%58.8%58.5% #

58.3%57.8%56.3%55.9% #

55.5%55.2%55.0%

54.0%53.9% #

53.5%50.4% #

50.1% #

49.8%45.2% #

45.2% #

41.7%41.3%40.9%36.6%

8.0%14.8%

1.8%2.2%

10.8%15.8%23.2%22.4%

2.5%22.7%18.2%18.2%16.9%13.0%14.0%26.7%

25.6%19.6%

3.9%5.5%

14.5%33.1%18.8%27.0%

6.3%11.3%19.1%19.2%22.3%15.6%17.1%

4.7%22.2%

6.8%19.5%14.0%

9.5%23.9%21.2%19.2%22.1%12.8%11.1%12.6%13.7%21.2%20.9%27.6%14.4%

15.4%8.5%

27.3%7.4%9.6%

10.7%25.4%10.2%18.5%24.4%26.5%15.5%

4.8%4.4%3.3%3.6%4.8%4.9%4.9%5.7%3.5%5.6%4.7%4.8%4.7%4.6%4.3%5.6%

5.6%4.9%4.3%4.0%4.7%7.5%4.3%7.7%4.2%4.7%5.0%5.2%5.8%4.9%4.4%4.0%5.6%4.4%5.2%4.4%4.9%4.6%5.5%5.0%5.0%5.1%5.2%4.2%4.7%5.8%5.2%7.6%4.7%

5.1%4.7%6.2%3.7%4.6%4.9%6.5%4.3%4.3%5.4%5.3%5.2%

4.43.32.83.13.43.95.73.43.06.15.75.04.84.74.34.9

6.54.33.32.63.95.33.99.23.63.74.34.05.75.84.93.04.74.25.03.63.35.34.04.17.33.62.95.06.14.95.18.15.0

4.83.08.53.43.23.96.73.84.73.56.24.4

0% 10% 20% 30% 40% 50% 60% 70% 80% 90%


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* Women who usually resided in the Australian Capital Territory and gave birth in New South Wales were not counted in the results for the AustralianCapital Territory Medicare Local catchment for antenatal visits in the rst trimester, smoking during pregnancy and low birthweight.

# Interpret with caution. In WA and ACT, rst antenatal visits that occur outside of the hospital may not be included. Data on smoking during pregnancywere not available for Aboriginal and Torres Strait Islander women who usually resided in Victoria and gave birth in Victoria in 2007 and 2008.Notes: Jurisdictional differences in denitions and methods used for data collection affect the comparability of these data across jurisdictions and lower levels

of geography within jurisdictions. For data limitations and exclusions, see this reports Technical Supplement. Source: Customised data report prepared for the NHPA from the AIHW National Perinatal Data Collection 20072011 (birthweight, smoking during pregnancy)

and 20102011 (antenatal visits).

Medicare Local catchments

Antenatalvisit in rsttrimester

Smokingduring

pregnancyLow birth-

weight

Nepean-Blue Mountains (NSW) ............Western Sydney ...................................Central Coast NSW ..............................North Coast NSW .................................Illawarra-Shoalhaven (NSW) ..................Murrumbidgee (NSW) ...........................Western NSW .......................................New England (NSW) .............................Perth South Coastal .............................

Tasmania ..............................................Hunter (NSW) .......................................West Moreton-Oxley (Qld) .....................Far West NSW ......................................Southern NSW .....................................Country South SA .................................Northern Adelaide .................................

Hume (Vic/NSW)...................................Lower Murray (Vic/NSW).......................South Western Sydney .........................Country North SA .................................Sunshine Coast (Qld) ............................Central Adelaide & Hills .........................Inner West Sydney ................................

Australian Capital Territory* ...................Northern Territory ..................................Sthn Adelaide-Fleurieu-Kangaroo Is. .....Gippsland (Vic) .....................................Darling Downs-SW Qld .........................Metro North Brisbane ...........................Northern Melbourne .............................South West WA ....................................

Townsville-Mackay (Qld) ........................Far North Qld ........................................Loddon-Mallee-Murray (Vic/NSW) .........Central Qld ...........................................Kimberley-Pilbara (WA) .........................Central & NW Qld .................................Gold Coast (Qld) ...................................Macedon Ranges & NW Melb ...............Goulburn Valley (Vic) .............................Goldelds-Midwest (WA) .......................Wide Bay (Qld)......................................Greater Metro South Brisbane ..............Grampians (Vic) ....................................Bentley-Armadale (WA) .........................Perth North Metro .................................Perth Central & East Metro ...................Barwon (Vic) .........................................Bayside (Vic) .........................................

Eastern Melbourne ...............................Eastern Sydney ....................................Frankston-Mornington Peninsula (Vic) ...Fremantle (WA) .....................................Great South Coast (Vic) ........................Inner East Melbourne ............................Inner NW Melbourne .............................Northern Sydney ..................................South Eastern Melbourne .....................South Eastern Sydney ..........................South Western Melbourne ....................Sydney North Shore & Beaches ............

80.5%74.7%73.5%70.0%69.9%68.1%67.9%66.6%65.3% #

64.5%64.2%60.8%60.8%60.6%57.1%57.1%

57.1%56.8%55.3%55.0%52.9%51.9%50.9%50.8% #

49.8%48.8%48.1%46.8%45.5%44.8%44.4% #

42.5%41.6%41.2%38.7%38.7% #

38.5%38.1%37.9%36.2%32.8% #

28.6%27.6%21.8%21.6% #

19.9% #

19.0% #

NPNP

NPNPNPNPNPNPNPNPNPNPNPNP

46.4%49.4%42.0%52.5%46.9%52.1%53.1%55.1%48.3%52.7%48.9%53.9%60.8%55.6%64.6%62.0%

51.8% #56.6% #

47.0%62.2%42.8%55.3%49.0%53.7%52.2%56.7%52.1% #

60.4%47.1%35.7% #

51.8%51.5%55.6%54.4% #

52.4%52.9%53.1%35.0%29.4% #

66.4% #

46.7%50.4%43.5%34.7% #

52.5%44.3%51.4%

NPNP

NP35.1%

NP47.6%

NPNPNPNP

43.4% #

34.4%NPNP

10.3%11.6%

9.9%10.6%

7.8%7.8%8.9%

11.5%10.8%

8.3%10.3%

8.0%12.4%14.7%10.7%13.5%

10.9%13.6%

9.7%13.0%

8.1%10.6%13.1%11.6%13.0%

8.9%17.5%

9.3%7.1%

10.0%14.0%10.9%10.3%12.1%

9.1%13.3%12.3%

8.3%7.0%9.7%

12.5%7.6%9.1%

11.9%14.3% 11.9%12.9%13.0%

NP

NP8.0%6.7%

13.0%16.4%

NP13.5%

NP7.2%7.2%

NPNP

0% 10% 20% 30% 40% 50% 60% 70% 80% 90%

Figure 5: Percentage of Aboriginal and Torres Strait Islander women who had at least one antenatalvisit in the rst trimester , by measures of child and maternal health, by Medicare Localcatchment , 20072011


24/54


Key ndings: Antenatal visits in the rst trimester

All womenIn 20102011, the national percentage of womenwho had at least one antenatal visit in the rsttrimester of pregnancy was 67.2% for all womenand 50.3% for Aboriginal and Torres StraitIslander women.


Across local areas, the percentage of women whohad at least one antenatal visit in the rst trimesterin 20102011 was more than double in thecatchment with the highest percentage comparedto the catchment with the lowest percentage.

The percentage of women who had at least oneantenatal visit in the rst trimester ranged as follows:

Highest: Western Sydney 87.7%




There were differences in the percentage ofwomen who had at least one antenatal visit inthe rst trimester across local areas with similargeographic characteristics.

Across rural areas , the percentage of women whohad at least one antenatal visit in the rst trimester

was 41% higher in the Rural 1 catchment ofCountry North SA (75.2%) compared to the Rural 2catchment of Far North Queensland (53.5%).

However, across metropolitan areas and acrossregional areas this trend of higher rates of womenwho had at least one antenatal visit in the rsttrimester in higher-income areas compared tolower-income areas was not apparent, with some

local areas demonstrating what can be achievedfor other similar areas.

For example:

Across metropolitan areas , the percentage ofwomen who had at least one antenatal visit inthe rst trimester was 37% higher in the lower-income urban catchment of Western Sydney(87.7%, Metro 3) compared to wealthier inner-city catchment of Inner North West Melbourne(64.1%, Metro 1)

Across regional areas, the percentage ofwomen who had at least one antenatal visit in

the rst trimester was almost double in thelower-income catchment of Western NSW(82.7%) compared to the wealthier catchment ofFrankston-Mornington-Peninsula (Vic) (41.7%).



Within the Metro 1 peer group, the percentageof women who had at least one antenatal visitin the rst trimester was 33% higher in SydneyNorth Shore & Beaches (85.5%) compared toInner North West Melbourne (64.1%)

Within the Regional 1 peer group, thepercentage of women who had at least oneantenatal visit in the rst trimester was double in Nepean-Blue Mountains (NSW) (85.5%)compared to Frankston-Mornington-Peninsula(Vic) (41.7%) (Table 6, page 15) .


25/54


Table 6: Highest and lowest percentage of all women who had at least one antenatal visit in the rst trimesteracross Medicare Local catchments, by peer group , 20102011

Aboriginal and Torres StraitIslander women


Across local areas, the percentage of Aboriginaland Torres Strait Islander women who had atleast one antenatal visit in the rst trimester in20102011 was almost four times higher inthe catchment with the highest compared to thecatchment with the lowest percentage.

The percentage of Aboriginal and Torres StraitIslander women who had at least one antenatalvisit in the rst trimester ranged as follows:

Highest: Nepean-Blue Mountains (NSW) 80.5%




There were differences in the percentage of Aboriginal and Torres Strait Islander womenwho had at least one antenatal visit in therst trimester across local areas with similargeographic characteristics.

Across regional areas , the percentage of Aboriginal and Torres Strait Islander womenwho had at least one antenatal visit in therst trimester was almost four times higher in the wealthier catchment of Nepean-Blue Mountains (NSW) (80.5%, Regional 1)compared to the lower-income catchment of

Grampians (Vic) (21.8%, Regional 2) Across rural areas , the percentage of

Aboriginal and Torres Strait Islander womenwho had at least one antenatal visit in therst trimester tended to be higher in the Rural1 peer group compared to the Rural 2 peergroup. The percentage was 58% higher inFar West NSW (60.8%, Rural 1) compared toCentral & North West Queensland (38.5%,

Rural 2).

However, across metropolitan areas this trendof higher rates of Aboriginal and Torres StraitIslander women who had at least one antenatalvisit in the rst trimester in higher-income areascompared to lower-income areas was notapparent, with some local areas demonstratingwhat can be achieved for other similar areas.






Rural 1 75.2% 58.8% 28% (1.3 times higher)Rural 2 71.2% 53.5% 33% (1.3 times higher)

Note: Results for Medicare Local catchments that are to be interpreted with caution are not included.


26/54


For example, across metropolitan areas , thepercentage of Aboriginal and Torres Strait Islander

women who had at least one antenatal visit in therst trimester was almost three times higher inthe lower-income urban catchment of WesternSydney (74.7%, Metro 3) compared to GreaterMetro South Brisbane (27.6%, Metro 2).


There were differences across similar catchmentseven after accounting for geographic and

socioeconomic circumstances. Within the Metro 2 peer group, the percentage

of Aboriginal and Torres Strait Islander womenwho had at least one antenatal visit in therst trimester was almost double in Central

Adelaide & Hills (51.9%) compared to GreaterMetro South Brisbane (27.6%)

Table 7: Highest and lowest percentage of Aboriginal and Torres Strait Islander women who had at least one antenatal visit in the rst trimester across Medicare Local catchments, by peer group , 20102011

Within the Regional 2 peer group, thepercentage of Aboriginal and Torres Strait

Islander women who had at least one antenatalvisit in the rst trimester was more than threetimes higher in North Coast NSW (70.0%)compared to Grampians (Vic) (21.8%) (Table 7) .

Peer group Highest percentage Lowest percentage DifferenceMetro 1* - - -




Regional 2 70.0% 21.8% 221% (3.2 times higher)Rural 1 60.8% 38.7% 57% (1.6 times higher)


* Data were only available for two Medicare Local catchments in this peer group.Note: Results for Medicare Local catchments that are to be interpreted with caution are not included.


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17

Health status and outcomesChild and maternal health in 20092012


28/54

National Health Performance Authoritywww.myhealthycommunities.gov.auHealthy Communities:Child and maternal health in 2009201218

111

113114

115

116

117

118

211

212

213

214 215

216

217

306

307 308

309

310

311

404

405

506

507

508

601

701

501

502

503504

505

506

401

402

403

404

405

201

202 203

204 205

206 207

208

209

210

211

214

215

216

217

117

801

CANBERRA

ROCKINGHAMMELBOURNE

GEELONG

PERTH

i.

vi.

ii.

iii.

iv.

v.

ADELAIDE

Results for Medicare Local catchmentswere ranked from highest to lowest andthen split into ve equal-sized groups. 1 The range within each of the

ve groups was as follows:

L o w e s t

g r o u p

H i g h e s t

g r o u p

Medicare Localcatchment boundary

Numbers on map areMedicare Local reference codes

211

ii. Adelaide andsurrounding areas

i. Perth andsurrounding areas

iii. Melbourne andsurrounding areas

iv. Canberra andsurrounding areas

1. Each Medicare Local has been assigned to a quintile group.2. For more information on peer groups and the calculation of peer group results refer to this reports Technical Supplement.Notes: Deaths are attributed to the Medicare Local catchment in which the infant or young child usually resided, irrespective of where they died.

Births are attributed to the Medicare Local catchment in which the mother usually resided, irrespective of where the birth occurred. Sources: National Health Performance Authority analysis of Australian Bureau of Statistics Death Registrations Collection 20102012 and Australian Bureau ofStatistics Birth Registrations Collection 20102012.

Data can be downloaded from www.myhealthycommunities.gov.au

Years of data: 20102012

Infant and young child mortality rate

During 20102012, the infant and young child mortality rate varied across Medicare Local catchments

and across peer groups, ranging from 2.6 deaths per 1,000 live births in Bayside (Vic) to 9.2 deathsper 1,000 live births in the Northern Territory.

Number of deaths among infants and youngchildren aged less than 5 years per 1,000 livebirths, 20102012

5.4 9.2

4.8 5.3

4.0 4.7

3.4 3.9

2.6 3.3


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National Health Performance Authority www.myhealthycommunities.gov.au

National overviews

Healthy Communities: Child and maternal health in 20092012 19

Health status and outcomes

0 2 4 6 8 10Metro 1 3.3Bayside .................................. 202 Sydney Nth Shore & Beaches . 108 Eastern Sydney....................... 101 Northern Sydney ..................... 107 Inner East Melbourne .............. 206 Inner West Sydney .................. 102

Australian Capital Territory ....... 801 Inner NW Melbourne ............... 201

2.62.83.03.13.33.6

3.84.2

0 2 4 6 8 10Metro 2 4.1South Western Melbourne ...... 203 Perth North Metro ................... 502 South Eastern Sydney ............ 103 Perth Central & East Metro ...... 501 Central Adelaide & Hills ........... 402 Fremantle ............................... 503 Bentley-Armadale ................... 504 Eastern Melbourne .................. 207 Sthn Adelaide-Fleurieu-Kang. Is. 403 Metro North Brisbane .............. 301 Gold Coast ............................. 303 Greater Metro South Brisbane . 302

2.93.03.03.23.43.43.63.73.94.75.06.1

0 2 4 6 8 10Metro 3 4.3Northern Melbour ne ................ 205 Northern Adelaide ................... 401 Macedon Ranges & NW Melb . 204 West Moreton-Oxley ............... 305 Western Sydney...................... 105 South Eastern Melbourne........ 208 South Western Sydney ........... 104

3.33.43.94.34.44.85.0

0 2 4 6 8 10Regional 1 4.3Nepean-Blue Mountains .......... 106 Barwon ..................... .............. 210 Central Coast NSW ................. 109 Perth South Coastal ................ 505 Illawarra-Shoalhaven ............... 110

Frankston-Mornington Peninsula 209 Hunter .................................... 111 Sunshine Coast ...................... 304

3.33.63.93.94.3

4.74.85.8

0 2 4 6 8 10Regional 2 5.0Goulburn Valley .................... ... 215 Southern NSW ..................... ... 117 Gippsland ............................... 217 Hume ..................................... 216 Great South Coast .................. 212 Grampians .................... .......... 211

Tasmania ................................ 601 South West WA ...................... 506 North Coast NSW ................... 113 Loddon-Mallee-Murray ............ 214 Darling Downs-SW Qld ........... 306

Murrumbidgee ........................ 116 Western NSW ......................... 115 New England .......................... 114 Wide Bay ................................ 307 Country South SA ................... 404

3.54.04.04.14.34.44.74.95.05.15.3

5.75.76.16.26.5

0 2 4 6 8 10Rural 1 5.6Country North SA ................... 405

Townsville-Mackay .................. 310 Far West NSW ........................ 118 Lower Murray ......................... 213 Central Qld ............................. 308

4.95.05.35.77.3

0 2 4 6 8 10Rural 2 7.9Goldelds-Midwest ................. 507 Kimberley-Pilbara .................... 508

Central & NW Qld ................... 309 Far North Qld ................... ....... 311 Northern Territory .................... 701

4.96.7

8.18.59.2

102

103

104

105

106

107 108

109

110

111

101

113

301

302

303

304

305

306

307

SYDNEY

BRISBANE

NEWCASTLE

SUNSHINECOAST

GOLDCOAST

WOLLONGONG

Fair comparisons

To compare Medicare Locals more fairly, eachMedicare Local catchment has been grouped

into one of seven peer groups 2, based onremoteness and socioeconomic status.

This allows:

Medicare Local catchments to be comparedwithin the same metropolitan, regional orrural peer group, and

Medicare Local catchments to be comparedwith the average for their peer group.

It also allows variation to be seen across peergroups that may be associated with remotenessand socioeconomic status.

v. Sydney andsurrounding areas

vi. Brisbane andsurrounding areas

Peer groups Map

Ref.

More information can be found at www.myhealthycommunities.gov.au and in this reports Technical Supplement.


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507





1. Each Medicare Local has been assigned to a quintile group.2. For more information on peer groups and the calculation of peer group results refer to this reports Technical Supplement.Notes: Deaths are attributed to the Medicare Local catchment in which the infant usually resided, irrespective of where they died.

Births are attributed to the Medicare Local catchment in which the mother usually resided, irrespective of where the birth occurred. Sources: National Health Performance Authority analysis of Australian Bureau of Statistics Death Registrations Collection 20102012 and Australian Bureau ofStatistics Birth Registrations Collection 20102012.

Data can be downloaded from www.myhealthycommunities.gov.au


Infant mortality rate

During 20102012, the infant mortality rate varied across Medicare Local catchments and across

peer groups, ranging from 2.3 deaths per 1,000 live births in Sydney North Shore & Beachesand Bayside (Vic) to 7.6 deaths per 1,000 live births in the Northern Territory.

Number of deaths among infants aged lessthan 1 year per 1,000 live births, 20102012

4.6 7.6

3.8 4.5

3.3 3.7

2.9 3.2

2.3 2.8Not availablefor publication


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National overviews



0 2 4 6 8 10Metro 1 2.9Bayside .................................. 202 Sydney Nth Shore & Beaches . 108 Eastern Sydney....................... 101 Northern Sydney ..................... 107 Inner East Melbourne .............. 206 Inner West Sydney .................. 102

Australian Capital Territory ....... 801 Inner NW Melbourne ............... 201

2.32.32.72.83.03.2

3.23.7

0 2 4 6 8 10Metro 2 3.6Perth North Metro ................... 502 South Western Melbourne ...... 203 Perth Central & East Metro ...... 501 Fremantle ............................... 503 South Eastern Sydney ............ 103 Central Adelaide & Hills ........... 402 Bentley-Armadale ................... 504 Sthn Adelaide-Fleurieu-Kang. Is. 403 Eastern Melbourne .................. 207 Metro North Brisbane .............. 301 Gold Coast ............................. 303 Greater Metro South Brisbane . 302

2.42.42.62.62.72.93.03.23.34.14.45.5

0 2 4 6 8 10Metro 3 3.6Northern Melbour ne ................ 205 Northern Adelaide ................... 401 Macedon Ranges & NW Melb . 204 West Moreton-Oxley ............... 305 Western Sydney...................... 105 South Eastern Melbourne........ 208 South Western Sydney ........... 104

2.72.93.63.73.84.04.4

0 2 4 6 8 10Regional 1 3.6Nepean-Blue Mountains .......... 106 Barwon ..................... .............. 210 Frankston-Mornington Peninsula 209 Perth South Coastal ................ 505 Illawarra-Shoalhaven ............... 110

Central Coast NSW ................. 109 Hunter .................................... 111 Sunshine Coast ...................... 304

2.62.83.23.53.5

3.74.04.8

0 2 4 6 8 10Regional 2 4.1Goulburn Valley .................... ... 215 Great South Coast .................. 212 South West WA ...................... 506 Grampians .................... .......... 211 Southern NSW ..................... ... 117 Gippsland ............................... 217 Hume ..................................... 216

Tasmania ................................ 601 Loddon-Mallee-Murray ............ 214 North Coast NSW ................... 113 Darling Downs-SW Qld ........... 306

Western NSW ......................... 115 Country South SA ................... 404 Murrumbidgee ........................ 116 Wide Bay ................................ 307 New England .......................... 114

2.82.93.13.33.43.53.74.14.34.34.3

4.54.64.95.05.3

0 2 4 6 8 10Rural 1 4.6Country North SA ................... 405

Townsville-Mackay .................. 310 Central Qld ............................. 308 Far West NSW ........................ 118 Lower Murray ......................... 213

3.84.06.1NPNP

0 2 4 6 8 10Rural 2 6.5Goldelds-Midwest ................. 507 Kimberley-Pilbara .................... 508

Central & NW Qld ................... 309 Far North Qld ................... ....... 311 Northern Territory .................... 701

3.75.7

6.97.07.6

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BRISBANE

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GOLDCOAST

WOLLONGONG

Fair comparisons



This allows:






Peer groups Map

Ref.

NP Not available for publication.More information can be found at www.myhealthycommunities.gov.au and in this reports Technical Supplement.


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402






Low-birthweight babies, all women

During 20092011, the percentage of liveborn babies of low birthweight varied across Medicare Local

catchments and across peer groups, ranging from 3.3% in Sydney North Shore & Beaches to 7.7% inNorthern Territory.

Percentage of live births that were of lowbirthweight, all women, 20092011

1. Each Medicare Local has been assigned to a quintile group.2. For more information on peer groups and the calculation of peer group results refer to this reports Technical Supplement.Notes: Multiple births and stillbirths are excluded. Births are attributed to the Medicare Local catchment in which the mother usually resided, irrespective of

where the birth occurred. Data exclude births to Australian non-residents, residents of external territories and women who could not be allocated to aMedicare Local catchment because their Statistical Local Area of usual residence was not stated or was not valid. Source: Customised data report prepared for the National Health Performance Authority from the Australian Institute of Health and Welfare National Perinatal

Data Collection 20092011.Data can be downloaded from www.myhealthycommunities.gov.au

5.6 7.7%

5.0 5.5%

4.8 4.9%

4.4 4.7%

3.3 4.3%


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Results for Medicare Localcatchments were ranked from

highest to lowest and then splitinto ve equal-sized groups. 1 The range within each of theve groups was as follows:

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402






Low-birthweight babies, Aboriginal and TorresStrait Islander women

During 20072011, the percentage of liveborn babies of low birthweight born to Aboriginal and TorresStrait Islander women varied across Medicare Local catchments and across peer groups, ranging from6.7% in Frankston-Mornington Peninsula (Vic) to 17.5% in Gippsland (Vic).

Percentage of live births that were of lowbirthweight, Aboriginal and Torres StraitIslander women, 20072011

1. Each Medicare Local has been assigned to a quintile group.2. For more information on peer groups and the calculation of peer group results refer to this reports Technical Supplement.Notes: Multiple births and stillbirths are excluded. Births are attributed to the Medicare Local catchment in which the mother usually resided, irrespective of

where the birth occurred. Data exclude births to Australian non-residents, residents of external territories and women who could not be allocated to aMedicare Local catchment because their Statistical Local Area of usual residence was not stated or was not valid. Source: Customised data report prepared for the National Health Performance Authority from the Australian Institute of Health and Welfare National Perinatal

Data Collection 20072011.Data can be downloaded from www.myhealthycommunities.gov.au

13.1 17.5%

11.7 13.0%

10.1 11.6%

8.2 10.0%

6.7 8.1%Not available

for publication


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0% 4% 8% 12% 16% 20%Metro 1 10.3%Inner NW Melbourne ............... 201 Inner West Sydney .................. 102

Australian Capital Territory* ..... 801 Eastern Sydney....................... 101 Northern Sydney ..................... 107 Sydney Nth Shore & Beaches . 108

Bayside .................................. 202 Inner East Melbourne .............. 206

13.5%13.1%11.6%

8.0%NPNP

NPNP

0% 4% 8% 12% 16% 20%Metro 2 10.2%Bentley-Armadale ................... 504 Fremantle ............................... 503 Perth Central & East Metro ...... 501 Perth North Metro ................... 502 Central Adelaide & Hills ........... 402 Greater Metro South Brisbane . 302 Sthn Adelaide-Fleurieu-Kang. Is. 403 Gold Coast ............................. 303 South Eastern Sydney ............ 103 Metro North Brisbane .............. 301 South Western Melbourne ...... 203 Eastern Melbourne .................. 207

14.3%13.0%12.9%11.9%10.6%

9.1%8.9%8.3%7.2%7.1%

NPNP

0% 4% 8% 12% 16% 20%Metro 3 10.3%Northern Adelaide ................... 401 Western Sydney...................... 105 Northern Melbour ne ................ 205 South Western Sydney ........... 104 West Moreton-Oxley ............... 305 South Eastern Melbourne........ 208 Macedon Ranges & NW Melb . 204

13.5%11.6%10.0%

9.7%8.0%7.2%7.0%

0% 4% 8% 12% 16% 20%Regional 1 9.7%Barwon ..................... .............. 210 Perth South Coastal ................ 505 Nepean-Blue Mountains .......... 106 Hunter .................................... 111 Central Coast NSW ................. 109

Sunshine Coast ...................... 304 Illawarra-Shoalhaven ............... 110 Frankston-Mornington Peninsula 209

13.0%10.8%10.3%10.3%

9.9%

8.1%7.8%6.7%

0% 4% 8% 12% 16% 20%Regional 2 10.5%Gippsland ............................... 217 Great South Coast .................. 212 Southern NSW ..................... ... 117 South West WA ...................... 506 Loddon-Mallee-Murray ............ 214 Grampians .................... .......... 211 New England .......................... 114 Hume ..................................... 216 Country South SA ................... 404 North Coast NSW ................... 113 Goulburn Valley .................... ... 215

Darling Downs-SW Qld ........... 306 Western NSW ......................... 115

Tasmania ................................ 601 Murrumbidgee ........................ 116 Wide Bay ................................ 307

17.5%16.4%14.7%14.0%12.1%11.9%11.5%10.9%10.7%10.6%

9.7%

9.3%8.9%8.3%7.8%7.6%

0% 4% 8% 12% 16% 20%Rural 1 11.4%Lower Murray ......................... 213 Country North SA ................... 405 Far West NSW ........................ 118

Townsville-Mackay .................. 310 Central Qld ............................. 308

13.6%13.0%12.4%10.9%

9.1%0% 4% 8% 12% 16% 20%

Rural 2 12.2%Kimberley-Pilbara .................... 508 Northern Territory .................... 701

Goldelds-Midwest ................. 507 Central & NW Qld ................... 309 Far North Qld ................... ....... 311

13.3%13.0%

12.5%12.3%10.3%

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Fair comparisons



This allows:






Peer groups Map

Ref.

* In 20072011, there were eight liveborn babies of Aboriginaland Torres Strait Islander women who usually resided in the

Australian Capi tal Territory and gave birth in New Sou th Wales

who were not counted in the result for the Australian Capital Territory Medicare Local catchment.NP Not available for publication.More information can be found at www.myhealthycommunities.gov.au and in this reports Technical Supplement.


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Numbers on map areMedi

child and maternal health report

Documents