Through lack of insight, foresight and hindsight: spatial patterns and determinants of infant mortality in sparsely populated regions of Australia

Abstract

The infant mortality rate is accepted as a measure of the health of a community and the adequacy of medical services. Australia has an overall low infant mortality rate, but this hides considerable local variability. Generally, the southeastern regions of Australia have lower than expected infant mortality, and consistently higher than expected numbers of infant deaths occur in those areas in the far north and remote centre. Very high infant death rates are spatially congruent in isolated Australia with variables which reflect the socioeconomic status, housing conditions and demographic status of local areas. A detailed analysis of the Alice Springs region suggests that infant death rates in such isolated areas are elevated substantially by the large numbers of deaths of Aboriginal infants. The greatest differences between Aboriginal and non Aboriginal infant death rates occur in the post neonatal period, which suggests that the standards of care of infants vary widely. The evidence indicates that the mere provision of health services does not ensure that they will be utilized by the most vulnerable groups in the population. Modern medical technology has little to offer infants who are located in an unprotected environment. There has been a failure to appreciate fully the implications for preventive strategy of the effects of underprivileged status, of different cultural patterns of child rearing and their likely influence upon child health. It seems likely that a programme to encourage social change is needed, and that rapid improvement cannot be anticipated Show more