Journal article
Disparities in severe neonatal morbidity and mortality between Aboriginal and non-Aboriginal births in Western Australia: A decomposition analysis
Journal of Epidemiology and Community Health, Vol.75(12)
2021
Abstract
Background The health disadvantages faced by Australian Aboriginal peoples are evidenced in early life, although few studies have focused on the reasons for population-level inequalities in more severe adverse outcomes. This study aimed to examine the scale of disparity in severe neonatal morbidity (SNM) and mortality between Aboriginal and non-Aboriginal births and quantify the relative contributions of important maternal and infant factors.
Method A retrospective cohort study with singleton live births (≥32 weeks’ gestation) was conducted using Western Australia linked whole population datasets, from 1999 to 2015. Aboriginal status was determined based on the mothers’ self-reported ethnic origin. An Australian validated indicator was adapted to identify neonates with SNM. The Oaxaca-Blinder method was employed to calculate the contribution of each maternal and infant factor to the disparity in SNM and mortality.
Results Analyses included 425 070 births, with 15 967 (3.8%) SNM and mortality cases. The disparity in SNM and mortality between Aboriginal and non-Aboriginal births was 2.9 percentage points (95% CI 2.6 to 3.2). About 71% of this gap was explained by differences in modelled factors including maternal area of residence (23.8%), gestational age (22.2%), maternal age (7.5%) and antenatal smoking (7.2%).
Conclusions There is a considerable disparity in SNM and mortality between Aboriginal and non-Aboriginal births in Western Australia with the majority of this related to differences in maternal sociodemographic factors, antenatal smoking and gestational age. Public health programmes targeting these factors may contribute to a reduction in early life health differentials and benefit Aboriginal population health through the life course.
Details
- Title
- Disparities in severe neonatal morbidity and mortality between Aboriginal and non-Aboriginal births in Western Australia: A decomposition analysis
- Authors/Creators
- A.A. Adane (Author/Creator) - The Kids Research Institute AustraliaH.D. Bailey (Author/Creator) - The Kids Research Institute AustraliaR. Marriott (Author/Creator) - Murdoch UniversityB.M. Farrant (Author/Creator) - The Kids Research Institute AustraliaS.W. White (Author/Creator) - Division of Obstetrics and GynaecologyC.C.J. Shepherd (Author/Creator) - The Kids Research Institute Australia
- Publication Details
- Journal of Epidemiology and Community Health, Vol.75(12)
- Publisher
- BMJ Publishing Group
- Identifiers
- 991005542541807891
- Copyright
- © 2021 The Authors
- Murdoch Affiliation
- Ngangk Yira Aboriginal Health Research Centre
- Language
- English
- Resource Type
- Journal article
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- Collaboration types
- Domestic collaboration
- Citation topics
- 1 Clinical & Life Sciences
- 1.72 Obstetrics & Gynecology
- 1.72.748 Neonatal Intensive Care
- Web Of Science research areas
- Public, Environmental & Occupational Health
- ESI research areas
- Social Sciences, general