Painting a true picture of Indigenous birth numbers

When a baby is born in Victoria, certain information is collected and catalogued. But not many of us know that, up until 2009, the information collected at the birth has been about the baby’s mother, leaving the father largely out of the picture.

According to authors of a new study due to be released later this month, the omission has had the direct and dramatic effect of underestimating the number of births where either or both the mother or father identify as Aboriginal.  

The landmark study conducted by the Onemda VicHealth Koori Health Unit in the University of Melbourne’s School of Population and Global Health provides - for the first time – an accurate and complete identification and analysis of births and deaths of children up to the age 18 in Victoria over the past 20 years. 

The study has been funded by the Australian Research Council, the state and federal governments, the Lowitja Institute, and the RE Ross Trust.

“Current data in Victoria under-reports the number of Aboriginal births, deaths and hospitalisations, and the severity of ill health and preventable mortality for this population,” says Jane Freemantle, a Principal Research Fellow in the Centre for Health and Society in the Melbourne School of Population and Global Health. She is also co-author – with Bree Heffernan and Dulce Iskandar – of The History of Indigenous Identification in Victorian Health Datasets, 1980–2011.

“I estimate that in Victoria over the past 10 years alone, we have underestimated the births to mothers or fathers who identify as Aboriginal or Torres Strait Islander by up to a staggering 120 per cent,” she says.

According to Associate Professor Freemantle, these data potentially distort the size of the gap between birth and death outcomes for the Aboriginal and non-Aboriginal population, including the key indicators of low birth weight, pre-term birth, teenage pregnancy, and causes of perinatal and child mortality. 

“It has had significant implications for funding of health services, maternal and child health programs and evidence-based interventions to prevent avoidable infant and childhood deaths,” she says.

“Our research findings will provide a more accurate picture of the distribution of Victoria’s Aboriginal birth population and particularly the areas of greatest need in maternal and perinatal health.

“In essence, the true Aboriginal birth population within Victoria is closer to 2 per cent, rather than the 0.6 per cent currently being cited.”

By linking population data from a number of statutory and administrative datasets, including the Victorian Perinatal Data Collection Unit and the Registry of Births, Deaths and Marriages, and undertaking a comprehensive analysis of deaths of all Victorian children born between the 20-year period 1988 and 2008, the project has been able to definitively report on the patterns and trends of births and deaths. A particular focus by the authors will be on the disparities that continue to exist for Aboriginal compared with non-Aboriginal children who die before reaching their 11th birthday. 

“The report emphasises that linking population data from different data collections provides an important opportunity to gather information describing Indigenous identification from multiple sources and, in the process, affords a validation process,” Professor Freemantle says.  

The authors believe the new study shows how, by linking population data and uncovering more accurate information, health outcomes can be improved and scarce health resources more effectively allocated. 

“By applying this now well-proven methodology beyond the life of the current project and continuing the trend line annually, the births and mortality dataset can provide a sustainable resource by which to identify areas of greatest risk,” Associate Professor Freemantle says. 

“Essentially, all maternal and child populations of Victoria, but specifically the Aboriginal populations, will be the beneficiaries of this research.

“The current underestimation of Aboriginal births in Victoria, which we establish as being between 87 per cent (a conservative estimate) and 120 per cent overall, is highest in the metropolitan areas where we see underestimation of up to a massive 269 per cent being reported. 

“Policies, interventions and strategies aimed at closing the gap on Aboriginal child disadvantage are currently based on these significantly flawed statistics. 

“We believe that good quality data describing births and deaths of Aboriginal and Torres Strait Islander infants, children and young people are needed to accurately determine the rate and cause of death, and that the consistent input of the Aboriginal community and relevant experts in all phases of the project will enable and strengthen links with those who can influence government and policy-makers to effect positive change.”  

www.onemda.unimelb.edu.au