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Mortality

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Information current: 1st July 2024
Printed on: 16th September 2024
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The Australian Indigenous HealthInfoNet’s mission is to contribute to improvements in Aboriginal and Torres Strait Islander health by making relevant, high quality knowledge and information easily accessible to policy makers, health service providers, program managers, clinicians and other health professionals (including Aboriginal and Torres Strait Islander health workers) and researchers. The HealthInfoNet also provides easy-to-read and summarised material for students and the general community. The HealthInfoNet achieves its mission by undertaking research into various aspects of Aboriginal and Torres Strait Islander health and disseminating the results (and other relevant knowledge and information) mainly via the Australian Indigenous HealthInfoNet websites  (https://healthinfonet.ecu.edu.au), The Alcohol and Other Drugs Knowledge Centre (https://aodknowledgecentre.ecu.edu.au) and Tackling Indigenous Smoking (https://tacklingsmoking.org.au). The research involves analysis and synthesis of data and information obtained from academic, professional, government and other sources. The HealthInfoNet’s work in knowledge exchange aims to facilitate the transfer of pure and applied research into policy and practice to address the needs of a wide range of users.

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Table of contents

Mortality

In July 2020, the National Agreement on Closing the Gap was created in consultation with Aboriginal and Torres Strait Islander people. The initiative aims to close the gap in life expectancy between Aboriginal and Torres Strait Islander and non-Indigenous Australians by 2031 [40834]. Specific outcomes, targets and indicators aimed at policy direction and monitoring progress for mortality include life expectancy, all-cause mortality, leading causes of death and potentially avoidable mortality [42101]. The difference in health outcomes (health gap) between Aboriginal and Torres Strait Islander people and non-Indigenous Australians (including life expectancy and infant/child mortality) can be attributed to several factors including:

  • differences in the social determinants of health
  • differences in health risk factors
  • differences in access to appropriate health services (not covered in this report)[42101][35151].

There were 5,082 deaths in Australia in 2022 where the deceased person was identified as Aboriginal and/or Torres Strait Islander (Table 1) [47845]. See Appendix 1 for discussion of data limitations.

Table 1. Numbers and proportions (%) of Aboriginal and Torres Strait Islander deaths, Australia, 2022

Jurisdiction Number of deaths[1] Proportion of deaths in total jurisdiction population %
NSW 1,691 2.7
Vic 337 0.7
Qld 1,271 3.3
WA 733 4.2
SA 275 1.8
Tas 124 2.4
ACT 29 1.1
NT 617 46
Australia 5,082 2.7

Note:

  • Australian total includes other territories including Jervis Bay Territory, the Cocos (Keeling) Islands, Christmas Island and Norfolk Island.

Source: ABS, 2023 [47845]

In 2022, there were 975 deaths for which no Indigenous status was reported, representing 0.5% of registered deaths; it is very likely that some of these deaths were among Aboriginal and Torres Strait Islander people [47845].

Death rates

Crude and age standardised death rates, median age at death, age specific death rates and infant/child mortality rates for Aboriginal and Torres Strait Islander people are only available for NSW, Qld, WA, SA and the NT as they are the jurisdictions with adequate levels of identification and sufficient numbers of deaths for mortality analysis to be undertaken [47845]. The Aboriginal and Torres Strait Islander data for these measures are based on three year averages, calculated for each calendar year, and then averaged. The reported rate for 2022 is based on the three year averages for the 2020-2022 period.

In 2022, the age-standardised death rate for Aboriginal and Torres Strait Islander people was 10 per 1,000 population (Table 2) [47845]. Rates for Aboriginal and Torres Strait Islander people varied by jurisdiction, with the highest rate occurring in the NT (13 per 1,000) and the lowest in NSW (8.8 per 1,000).

Table 2. Number of deaths and age-standardised death rates, Aboriginal and Torres Strait Islander people, NSW, Qld, WA, SA and the NT, 2022

Jurisdiction Numbers Aboriginal and Torres Strait Islander people
NSW 1,691 8.8
Qld 1,271 9.8
WA 733 12
SA 275 10
NT 617 13
Total for the selected jurisdictions 4,587 10

Notes:

  • Rates are per 1,000 population.
  • Rates are based on three-year averages; for Aboriginal and Torres Strait Islander data, rates are calculated for each calendar year and then averaged to reduce variability in annual rates.

Source: ABS, 2023 (Derived from [47845])

In 2022, the crude death rate in NSW, Qld, WA, SA and the NT for Aboriginal and Torres Strait Islander people was 5.1 per 1,000. The rate for males was higher than that for females (5.5 per 1,000 and 4.7 per 1,000 respectively) [47845].

For 2015-2019, in NSW, Qld, WA, SA and the NT, 15,439 deaths (males: 8,458, females: 6,981) were identified as Aboriginal and/or Torres Strait Islander [42101]. The crude death rate for all Aboriginal and Torres Strait Islander people was 430 per 100,000, with the rate for males (472 per 100,000) higher compared with females (388 per 100,000). The age-standardised death rate for all Aboriginal and Torres Strait Islander people was 922 per 100,000, with NSW recording the lowest rate (710 per 100,000), followed by Qld (965 per 100,000); SA (974 per 100,000); WA (1,126 per 100,000) and the NT with the highest rate (1,356 per 100,000).

Expectation of life

In 2023, the ABS published revised estimates for expectation of life at birth for Aboriginal and Torres Strait Islander people [48095]. According to these estimates, Aboriginal and Torres Strait Islander males born in Australia in 2020-2022 could expect to live to 71.9 years, 8.8 years less than the 80.6 years expected for non-Indigenous males.Aboriginal and Torres Strait Islander females born in Australia 2020-2022 could expect to live to 75.6 years, 8.1 years less than the 83.8 expected for non-Indigenous females. Revised estimates were also published for Aboriginal and Torres Strait Islander people living in NSW, Qld, WA and the NT (Table 3).

Table 3. Expectation of life at birth in years, by Indigenous status and sex, selected jurisdictions, Australia, 2020-2022

Jurisdiction Aboriginal and Torres Strait Islander people Non-Indigenous people Difference
Males
NSW 73.8 80.6 6.8
Qld 72.9 80.2 7.4
WA 68.9 81.2 12.3
NT 65.6 79.1 13.5
Australia 71.9 80.6 8.8
Females
NSW 77.9 83.8 5.9
Qld 76.6 83.5 7.0
WA 72.6 84.3 11.7
NT 69.4 83.2 13.8
Australia 75.6 83.8 8.1

Notes:

  • These estimates are based on the average number of Aboriginal and Torres Strait Islander deaths registered in 2020, 2021 and 2022 adjusted for under/overidentification of Indigenous status in registrations. Final Aboriginal and Torres Strait Islander population estimates are based on the 2021 Census.
  • Australian estimates are based on deaths in all states and territories.
  • Differences are based on unrounded estimates.
  • Life expectancy estimates for Australia are calculated taking age-specific identification rates into account.

Source: ABS, 2023 [48095]

Life expectancy for Aboriginal and Torres Strait Islander people was lower across all age-groups compared with non-Indigenous people. Aboriginal and Torres Strait Islander females had a greater life expectancy across all age-groups compared with Aboriginal and Torres Strait Islander males (Table 4) [48095].

Table 4. Expectation of life at selected ages, by Indigenous status and sex, selected jurisdictions, Australia, 2020-2022

Age Aboriginal and Torres Strait Islander people Non-Indigenous people Difference
Males
0 71.9 80.6 8.8
1 71.3 79.9 8.6
5 67.4 75.9 8.6
25 48.1 56.3 8.2
50

65

85

 26.4

15.5

4.4

 32.5

19.3

4.7

 6.1

3.9

0.3
Females
0 75.6 83.8 8.1
1 75.0 83.0 8.0
5 71.0 79.1 8.0
25 51.4 59.2 7.8
50

65

85

 28.5

16.7

4.5

 34.9

21.1

4.8

 6.4

4.4

0.3

Notes:

  • These estimates are based on the average number of Aboriginal and Torres Strait Islander deaths registered in 2020, 2021 and 2022 adjusted for under/overidentification of Indigenous status in registrations. Final Aboriginal and Torres Strait Islander population estimates are based on the 2021 Census.
  • Australian estimates are based on deaths in all states and territories.
  • Differences are based on unrounded estimates.
  • Life expectancy estimates for Australia are calculated taking age-specific identification rates into account.

Source: ABS, 2023 [48095]

Life expectancy for Aboriginal and Torres Strait Islander people varied considerably by remoteness of residence [48095]. Aboriginal and Torres Strait Islander males living in major cities had a life expectancy of 72.5 years in 2020-2022, compared with 67.3 years for those living in remote and very remote areas. For females, the figures were 76.5 years for major cities and 71.3 years for remote and very remote areas (Table 5).

Table 5. Expectation of life at birth in years, by Indigenous status and remoteness, Australia, 2020-2022

Remoteness Aboriginal and Torres Strait Islander people Non-Indigenous Difference
Males Females Males Females Males Females
Major cities 72.5 76.5 81.0 84.0 8.5 7.5
Inner and outer regional 72.8 76.7 79.6 83.2 6.8 6.5
Remote and very remote 67.3 71.3 79.7 83.7 12.4 12.4

Notes:

  • These estimates are based on the average number of Aboriginal and Torres Strait Islander deaths registered in 2020, 2021 and 2022. adjusted for under-identification and over-identification of Indigenous status in registrations. Aboriginal and Torres Strait Islander population estimates are based on the 2021 Census.
  • Differences are based on unrounded estimates.
  • Life expectancy estimates for Australia are calculated taking age-specific identification rates into account.

Source: ABS, 2023 [48095]

The life expectancy data for 2020-2022 are not comparable to previous Census data due to changes in the identification of Indigenous status [48095]. Due to this, the Overview does not provide trend analysis data for life expectancy.

Median age at death

In 2022, the median age at death[2] for Aboriginal and Torres Strait Islander people in NSW, Qld, WA, SA and the NT was 62.3 years [47845]. The median age of death varied across the selected jurisdictions, with NSW having the highest median age of death for both males and females (62.3 years and 67.9 years respectively) (Table 6). The lowest median age of death for males was reported for WA (55.9 years) and for females, in the NT (61.3 years).

Table 6. Median age at death (in years), Aboriginal and Torres Strait Islander people, by sex, NSW, Qld, WA, SA and the NT, 2022

Jurisdiction Aboriginal and Torres Strait Islander people
Males Females Persons
NSW 62.3 67.9 64.6
Qld 60.9 65.6 63.2
WA 55.9 61.9 59
SA 57.7 64.7 60.5
NT 56.7 61.3 59.2
Total for the selected jurisdictions 60.1 65.1 62.3

Notes:

  • Information is not available for the other jurisdictions because of the relatively small numbers of deaths recorded.
  • Median age of death is the age below which 50% of deaths occur.

Source: ABS, 2023 [47845]

Age-specific death rates

In 2022, in NSW, Qld, WA, SA and the NT, the death rate for Aboriginal and Torres Strait Islander people for all ages was 512 per 100,000 [47845]. The age-specific death rates increased with age from 5-14 years, with the highest rate reported in the 75 years and over age-group (8,237 per 100,000), followed by the 65-74 years age-group (2,741 per 100,000) and 55-64 years age-group (1,421 per 100,000). The lowest rate was in the 5-14 years age-group (19 per 100,000).

Infant mortality

The infant mortality rate (IMR) is the number of deaths of children aged less than one year in a calendar year per 1,000 live births in the same calendar year [47845]. In NSW, Qld, WA, SA and the NT in 2022, the Aboriginal and Torres Strait Islander IMR was 5.2 per 1,000 live births, with rates highest for males (5.6 per 1,000) compared with females (4.7 per 1,000) [47845]. The highest IMR was in the NT (15 per 1,000), followed by Qld and WA (both 5.4 per 1,000), and NSW (3.5 per 1,000). The lowest rate was in SA (2.0 per 1,000).

In the five-year period 2018-2022, in NSW, Qld, WA, SA and the NT, 532 infant deaths represented 84% of all deaths among 0-4 year old Aboriginal and Torres Strait Islander children (633 deaths) (Derived from [48392]). For the selected jurisdictions combined, the IMR for Aboriginal and Torres Strait Islander infants was 5.5 per 1,000, with the highest rate in the NT (14 per 1,000), followed by Qld (5.9 per 1,000), WA (5.2 per 1,000), NSW and SA (both 3.9 per 1,000).

Child mortality

For 2018-2022, in NSW, Qld, WA, SA and the NT there were 101 deaths among Aboriginal and Torres Strait Islander children aged 1-4 years (Derived from [48392]). The child mortality rate was 148 per 100,000 for 0-4 year olds. For the selected jurisdictions, the NT had the highest child mortality rate (312 per 100,000), followed by Qld (161 per 100,000), WA (156 per 100,000), SA (125 per 100,000) and NSW (104 per 100,000).

Causes of death

Ischaemic heart disease (IHD) was the leading specific cause of death for Aboriginal and Torres Strait Islander people living in NSW, Qld, WA, SA and the NT in 2022 [47832]. IHD accounted for 537 deaths, representing 12% of all deaths for Aboriginal and Torres Strait Islander people (total 4,587 for selected jurisdictions) (Derived from [47832]). The other leading specific causes of death were diabetes: 329 deaths (7.2%), chronic lower respiratory diseases: 293 deaths (6.4%) and cancer of trachea, bronchus and lung: 271 deaths (5.9%).

In 2022, for Aboriginal and Torres Strait Islander males living in NSW, Qld, WA, SA and the NT, the leading causes of death were IHD: 318 deaths, intentional self-harm: 160 deaths, diabetes: 144 deaths, cancer of trachea, bronchus and lung: 137 deaths, and chronic lower respiratory diseases: 134 [47832]. For females, the leading causes of death were IHD: 219 deaths, diabetes: 185 deaths chronic lower respiratory diseases: 159 deaths, cancer of trachea, bronchus and lung: 134 deaths and dementia (including Alzheimer’s disease): 95 deaths.

For 2018-2022, age-standardised death rates for Aboriginal and Torres Strait Islander people living in NSW, Qld, WA, SA and the NT show that the leading cause of death was IHD (120 per 100,000) [47832]. The next leading causes of death were chronic lower respiratory diseases (80 per 100,000) and diabetes (77 per 100,000). For 2018-2022, the leading cause of death for both Aboriginal and Torres Strait Islander males and females living in NSW, Qld, WA, SA and the NT was IHD (157 per 100,000 and 89 per 100,000 respectively). The next leading causes of death for males were chronic lower respiratory diseases (85 per 100,000) and diabetes (76 per 100,000), and for females, diabetes (78 per 100,000) and chronic lower respiratory diseases (76 per 100,000).

For 2018-2022 age-specific rates, from 15 years of age and above, for underlying causes of death among Aboriginal and Torres Strait Islander people living in NSW, Qld, WA, SA and the NT, indicated that intentional self-harm[3] was the leading cause of death for those aged 15-24 years (41 per 100,000), 25-34 years (48 per 100,000) and 35-44 years (52 per 100,000) [47832]. The leading cause of death for the 45-54 years, 55-64 years and 65-74 years age-groups was IHD at rates of 123 per 100,000; 184 per 100,000 and 323 per 100,000 respectively. For Aboriginal and Torres Strait Islander people aged over 75 years, dementia (including Alzheimer’s disease), was the leading cause of death at 962 per 100,000 deaths.

Maternal mortality

Maternal deaths refer to deaths of women during pregnancy or up to 42 days after delivery [43321]. Direct maternal deaths refer to those resulting from obstetric complications (including in pregnancy, labour, and in the first six weeks after delivery) from interventions, omissions, and incorrect treatment. Indirect maternal deaths refer to those resulting from a previously existing disease, or a disease that developed during pregnancy, that were not a direct result of obstetrics but aggravated by pregnancy. Coincidental deaths refer to deaths from unrelated causes (accidental and/or incidental) that occur during the pregnancy or up until six weeks after delivery.Maternal mortality ratios (MMRs) are calculated by dividing the number of maternal deaths (direct and indirect) by the number of women who gave birth to babies weighing at least 400 grams or who reached at least 20 weeks gestation; this result is then multiplied by 100,000 [43321].

In Australia between 2012-2021[4], 21 of the 181 maternal deaths reported were of Aboriginal and Torres Strait Islander women (Indigenous status was not reported in 16 of the total deaths) [43321]. Of these 21 Aboriginal and Torres Strait Islander maternal deaths, 10 were direct and 11 were indirect. The MMR for Aboriginal and Torres Strait Islander women was 17 deaths per 100,000 women who gave birth.

Between 2006-2020[5], there were 28 maternal deaths among Aboriginal and Torres Strait Islander women with the leading causes of death being cardiovascular diseases (CVD) (7 deaths: 25% of maternal deaths) and sepsis (6 deaths: 21%) [47117].

Avoidable deaths

Potentially avoidable deaths refers to deaths that could have been prevented with timely and effective health care, including early detection and effective treatment [42142]. They are calculated using the population data for Australians less than 75 years of age. For Aboriginal and Torres Strait Islander people, chronic disease and injury caused the highest proportion of avoidable deaths [42101].

In 2018-2022, there were 8,371 deaths from avoidable causes among Aboriginal and Torres Strait Islander people living in NSW, Qld, WA, SA and the NT at an age-standardised rate of 324 per 100,000 [48392]. The highest rate was in the NT (510 per 100,000) followed by WA (420 per 100,000), SA (375 per 100,000), Qld (299 per 100,000) and NSW the lowest (253 per 100,000).

More detailed information is available for 2015-2019 when there were 7,366 deaths (males: 4,322; females: 3,044) from avoidable causes among Aboriginal and Torres Strait Islander people aged 0-74 years living in NSW, Qld, WA, SA and the NT [42101]. The 7,366 deaths represented 60% of Aboriginal and Torres Strait Islander people who died during this period. Males were more likely to die from avoidable ca uses than females (crude rate 243 per 100,000 and 172 per 100,000 respectively). The age-specific avoidable mortality rate was relatively high for children under one year of age (374 per 100,000 live births), falling to the lowest rate for children aged 5-14 years (11 per 100,000 estimated resident population (ERP)) and 1-4 years (18 per 100,000 ERP), before increasing from the 15-24 years age-group through to the 65-74 years age-group (Table 7).

Table 7. Numbers and age-specific rates for avoidable deaths, Aboriginal and Torres Strait Islander people, NSW, Qld, WA, SA and the NT, 2015-2019

Age-group (years) Aboriginal and Torres Strait Islander people
Number Rate per 100,000
Less than 1 335 374
1-4 60 18
5-14 92 11
15-24 492 71
25-34 690 132
35-44 982 251
45-54 1,457 402
55-64 1,678 691
65-74 1,580 1,383
All ages – crude rate 7,366 208
All ages – age-standardised rate 7,366 314

Source: AIHW, 2022 [42101]

For 2015-2019, age-standardised rates for avoidable deaths were highest in the NT (513 per 100,000), followed by WA (441 per 100,000), and lowest in NSW (222 per 100,000). Aboriginal and Torres Strait Islander people living in remote areas had the highest avoidable mortality rate (467 per 100,000), 2.1 times higher than those living in major cities (227 per 100,000) and 1.7 times higher than those living in regional areas (269 per 100,000) (Derived from [42101]).

In 2015-2019, the most common conditions contributing to avoidable deaths among Aboriginal and Torres Strait Islander people aged 0-74 years living in NSW, Qld, WA, SA and the NT were IHD (21%), diabetes (12%), suicide and self-inflicted injuries (11%), chronic obstructive pulmonary disease (COPD) (8.8%) and cancer (8.0%) [42101].

[1] In 2022, information from the cause of death process including the Medical Certificate of Cause of Death and coronial information was made available to the ABS by the NSW Registry of Births, Deaths and Marriages as a secondary source for determining the Indigenous status of the deceased. Use of this additional source has led to improved recording of Indigenous status [47845].

[2] The median age at death is the age below which 50% of people die.

[3] Care needs to be taken in interpreting figures relating to intentional self-harm due to a revision process for coroner certified deaths and coding. Also, as noted above changes in methodology for NSW [47832].

[4] Data not available from WA for 2012-2017.

[5]  Data not available for WA for all years. This time period is used due to the small number of maternal deaths among Aboriginal and Torres Strait Islander women.

References

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