Placing Aboriginal and Torres Strait Islander mortality in an international context

Objective: To assess whether the patterns of mortality observed among Indigenous Australians were seen in other countries or sub-populations. Previous reports have indicated that the life expectancy of Indigenous Australians compares unfavourably with that of Indigenous groups in other developed countries, and is similar to that in some developing countries. However, in contrast to many developing countries, low life expectancy of Indigenous Australians is the result of relatively high and early adult mortality, rather than high infant mortality. Methods: Using routinely available administrative data on age-specific mortality and estimated life expectancy at birth, we compared data for Indigenous Australians (from the Northern Territory, Western Australia and South Australia combined) with corresponding data for 200 countries world-wide, as well as for several population groups of interest, including African Americans, Native Americans, Canadian Natives and New Zealand Maori. Results: Patterns of mortality among Indigenous Australians were markedly different to those of most other populations with available data, with the exception of the Russian Republic. The age-specific mortality rates for Russian males in 1990-95 were almost identical to those of Indigenous males in 1995-97. The similarities among females were less pronounced, but stronger than for any other country. Conclusion and implications: The dramatic fall in Russian life expectancy has been studied extensively and several important social and contextual factors have been identified. These factors are also relevant for the Indigenous population, and this may help to explain the similar mortality patterns of the two groups.