NACCHO Aboriginal Health : @AIHW Reports 1.#Indigenous life expectancy 2001-2015 and 2.Life expectancy varies by where you live

“The Australian Institute of Health and Welfare has released a new report : Trends in Indigenous mortality and life expectancy 2001-2015

This report examines Indigenous mortality and life expectancy during the period 2001 to 2015, based on evidence from the Enhanced Mortality Database.

The study observed increases in life expectancy during the study period for both Indigenous males and females across most jurisdictions. Life expectancy however increased faster among non-Indigenous than among Indigenous males and females.

 As a result, there was little change in the life expectancy gap

Are we Closing the Gap ? ”.

Download the AIHW report HERE and Summary Part 2 below

aihw-ihw-174.pdf

Report 2 Life expectancy varies by where you live

Healthy Communities: Life Expectancy and Potentially Avoidable Deaths in 2013–2015

This report provides updated information for life expectancy and potentially avoidable deaths in 2013–2015 across Australia, by Primary Health Network and smaller local areas.

Life expectancy at birth indicates the average number of years that a new born baby could expect to live, assuming that the current age-specific death rates are experienced throughout his/her life. It is a broad measure of population health.

Potentially avoidable deaths are deaths below the age of 75 from specific conditions that are potentially preventable through primary or hospital care. These conditions are classified using nationally agreed definitions. Rates of potentially avoidable deaths per head of population can be a useful indicator of how well health systems are performing.

Across PHN areas, the lowest average life expectancy for males and females was for those living in the Northern Territory–75.7 years and 78.5 years, respectively.”

From My Healthy Communities Website

Download

AIHW_HC_Report_Avoidable_deaths_life_expectancy_November_2017

Report 1 Trends in Indigenous mortality and life expectancy 2001-2015

In 2008, the Council of Australian Governments (COAG) committed to six ‘Closing the Gap in Indigenous disadvantage’ targets (COAG 2008).

These were revised to seven targets with the addition of a school attendance target in 2014 and a further revision to the early childhood education target in 2015 (Commonwealth of Australia 2015, 2016).

Two key health targets within the COAG ‘Closing the Gap’ are:

  • closing the life expectancy gap within a generation (by 2031)
  • halving the gap in death rates for Indigenous children under 5 within a decade (by 2018).

Assessing progress against these two ‘Closing the Gap’ targets requires robust measures of mortality and life expectancy, in particular, the levels, patterns and trends of mortality to assess whether efforts are on track to meet the targets.

Official mortality and life expectancy estimates are produced by the ABS on a regular basis.

ABS estimates of life expectancy for Indigenous Australians are based on linking Census data with mortality records for the 13 months following the Census, and are produced at the national level as well as for four individual jurisdictions (New South Wales, Queensland, Western Australia and the Northern Territory).

In Australia, all deaths are likely to be registered, however not all Indigenous deaths are recorded as Indigenous during the registration process. Information on a deceased person’s Indigenous status is provided to jurisdictional registrars of births, deaths and marriages from a variety of sources, including the family and friends of the deceased person, the funeral director, the doctor certifying the death, the coroner or a health worker.

There is no consistency in how Indigenous status is reported by these sources.

The quality of Indigenous identification in death data therefore reflects the quality of the information provided by these various sources. The quality of Indigenous identification on death records often varies between jurisdictions, and can affect not only the reliable estimation of the true levels, patterns and trends in Indigenous mortality and life expectancy, but also the reliable estimation of the gap in mortality and life expectancy between Indigenous and non-Indigenous Australians.

Robust estimates of Indigenous mortality and life expectancy cannot therefore be reliably estimated without adjustments to Indigenous status information on the death data.

This means that the effectiveness of ‘Closing the Gap’ initiatives to improve Indigenous mortality and life expectancy cannot be reliably determined while there are inconsistencies in Indigenous identification in death data across jurisdictions.

To find solutions to meet these challenges, AIHW developed the EMD project which was later endorsed and supported by the COAG to add to similar efforts being made by Australian, state and territory statistical agencies and departments, and the research community.

The difference in life expectancy between two populations is the result of differences between the two populations in their age-specific death rates. Understanding the factors that contribute to Indigenous life expectancy is important in understanding the life expectancy gap.

These components include the levels, patterns and trends in Indigenous death rates, including the distribution of Indigenous deaths by age and sex.

Equally important is knowledge of the levels, trends and components of non-Indigenous life expectancy, including the levels, age-sex patterns and trends in non-Indigenous mortality, and how these components are changing in relation to Indigenous mortality.

The focus of this report is therefore not only on the levels, patterns, trends and the gap in mortality and life expectancy between Indigenous and non-Indigenous Australians, but also on the various contributors to the life expectancy gap.

1.2 Objectives

The aims of the EMD project are:

  1. to enhance the quality of Indigenous status information on death data by linking registered death data with comparative data sets that contain information on deaths and Indigenous identification, comparing Indigenous status information across the linked data sets, and using the result of the comparison to develop algorithms for enhancing Indigenous status on death data
  2. to use the enhanced death data to develop life tables for jurisdictions with small Indigenous populations for which official life expectancy estimates are currently unavailable
  3. to explore the mortality patterns underlying the trends and the gap in life expectancy between Indigenous and non-Indigenous Australians, to assist with monitoring the ‘Closing the Gap’ key health targets.

2.5 Conclusion

Enhancement of Indigenous identification in the Enhanced Mortality Database has enabled the estimation of alternative mortality measures for the six jurisdictions considered, as well as for Australia as a whole.

A number of mortality measures and indicators—namely, the median age at death, age-specific death rates, the cumulative proportions of deaths occurring by specified ages, and age-standardised death rates—have all shown that mortality has declined, if only slightly, in most age groups for both Indigenous males and females across the six jurisdictions considered.

The analysis also provides information on which areas of mortality must be further monitored and targeted. For instance, on average, death occurs much earlier for Indigenous males and females than non-Indigenous males and females. Some of the key findings from the study include the following:

  • Mortality appeared to have declined during the reference period for both Indigenousmales and females: the median age at death for both Indigenous males and femalesincreased during the period 2001–2005 to 2011–2015, while the age-standardised deathrates declined for both Indigenous males and females (tables 2.2 and 2.3).
  • In terms of absolute decline in mortality, non-Indigenous males experienced a muchbigger absolute decline in mortality than Indigenous males, while Indigenous femalesexperienced a much bigger absolute decline in mortality than non-Indigenous females:

–consequently, the rate difference between Indigenous and non-Indigenous malesincreased during the period 2001–2005 to 2011–2015 while the rate differencebetween Indigenous and Indigenous females decreased (Table 2.4).

  • In terms of relative decline in mortality, non-Indigenous females experienced a slightlyhigher percentage decline in mortality (13.5%) than that experienced by Indigenousfemales (12.9%). Non-Indigenous males, however, experienced both a bigger absolutedecline in mortality as well as a bigger percentage mortality decline (17.7%) compared toIndigenous males (4.3%):

–as a result, the rate ratio between Indigenous and non-Indigenous males increasedduring the period 2001–2005 to 2011–2015 while the rate ratio between Indigenousand Indigenous females remained stable (Table 2.4).

  • The age-standardised death rate declined marginally (4.3%) for Indigenous males, from13.8 per 1,000 population in 2001–2005 to 13.2 in 2011–2015 and more substantially forIndigenous females (12.1%) from 11.6 in 2001–2005 to 10.2 in 2011–2015.
  • On the other hand, the age-standardised death rate declined by 17.7 per cent fornon-Indigenous males, from 7.9 per 1,000 population in 2001–2005 to 6.5 in 2011–2015,and by 13.5 per cent for Indigenous females, from 5.2 in 2001–2005 to 4.5 in2011–2015.
  • The age-standardised death rate also declined for Indigenous males and females in alljurisdictions, except in Queensland and South Australia where the age-standardiseddeath rate increased for Indigenous males, and Victoria, where the age-standardiseddeath rate increased for Indigenous females.
  • The biggest gap in mortality between Indigenous males and females on the one hand,and non-Indigenous males and females on the other, occurred at two points along theage spectrum: at infancy and from about age 45 onwards.

Trends in Indigenous mortality and life expectancy 2001–2015

Life expectancy

Life expectancy is a statistical measure of how long a person can expect to live, depending on the age they have already reached. It is the number of years of life remaining to a person at a particular age if current death rates do not change. Life expectancy can be determined for any age.

Thus, life expectancy at age 20 or 65 refers to the probable years of life remaining for a group of people at age 20 or 65 if they experienced the prevailing mortality rates for the rest of their lives. The most commonly used estimate of life expectancy is life expectancy at birth. Life expectancy at birth reflects the mortality pattern that prevails across all age groups (Shryock & Siegel 1976).

Estimates of life expectancy are obtained from a life table. The life table is a summary measure of the age-specific death rates in a population. Because mortality differs between the two sexes, the life table is usually calculated for males and females separately. The quality of life table estimates is directly affected by the quality of the input death and population data.

The death data used to prepare the life tables in this report come from the Enhanced Mortality Database, created by linking the MED to comparative data sets that contain information on death and Indigenous status (see Appendix C on the methodology for enhancing the Indigenous status of death records).

Part 2

 

 

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