Can a mortality excess in remote areas of Australia be explained by indigenous status? A case study using neonatal mortality in Queensland.
OBJECTIVE
To assess the extent to which indigenous status confounds the association between remoteness and neonatal mortality in Queensland.


METHODS
We used routine data from the Queensland Perinatal Data Collection. Poisson regression modelling was used to assess confounding.


RESULTS
Babies born to Indigenous mothers have mortality rates 2.42 times those of the rest of the population, regardless of whether they live in urban, rural or remote areas (95% CI 2.09-2.80). The babies of non-Indigenous women who live in remote areas have a low risk of neonatal death, similar to their rural and urban counterparts.


CONCLUSIONS
In Queensland, the key demographic variable that determines neonatal mortality is indigenous status, not remoteness.


CONCLUSIONS
Policymakers should not assume that an excess of a particular health problem in remote areas necessarily reflects equal disadvantage for all the Australians who live there.
Coory
Michael
M
Health Information Centre, 13th floor, Queensland Health Building, GPO Box 48, Brisbane, Queensland 4001. michael_coory@health.qld.gov.au
D005313:Fetal Death / Q000208:ethnology*; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D016012:Poisson Distribution; D011793:Queensland / Q000453:epidemiology; D012423:Rural Health / Q000706:statistics & numerical data; D014504:Urban Health / Q000706:statistics & numerical data