National Health Performance Authority Healthy Communities: Child and maternal health in 20092012 National Health Performance Authority National Health Performance Authority GPO Box 9848 Sydney, NSW 2001 Australia Telephone: +61 2 9186 9210 www.nhpa.gov.au National Health Performance Authority 2014 The National Health Performance Authority licenses use of this report under Creative Commons Attribution-Non Commercial- No Derivatives Licence 3.0, Australia and the terms of this notice. You are permitted to make fair use of the report consistent with the terms of the licence. You must not make use of the report in a misleading or deceptive manner or in a manner that is inconsistent with the context of the report. Permissions beyond the scope of the licence may be available at nhpaadmin@nhpa.gov.au Disclaimer This report is produced for health research, health care and health advocacy purposes. This report is not intended to provide guidance on particular health care choices. You should contact your medical advisors on particular health care choices. ISSN: 2201-8212 Print ISBN: 978-1-74186-152-5 Online ISBN: 978-1-74186-153-2 Suggested citation: National Health Performance Authority 2014, Healthy Communities: Child and maternal health in 20092012. Further copies of this document can be downloaded from www.myhealthycommunities.gov.au Published July 2014. Please note that there is the potential for minor revisions of this report. Please check www.myhealthycommunities.gov.au for any amendments. i National Health Performance Authority www.myhealthycommunities.gov.au Healthy Communities: Child and maternal health in 20092012 Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iii Key fndings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iii Next steps . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vi Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 About this report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Why information on maternal and child health matters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 About the data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Fair comparisons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Key fndings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Infant and young child mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Low birthweight and smoking during pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Antenatal visits in the frst trimester . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 Health status and outcomes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Infant and young child mortality rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 Infant mortality rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Low-birthweight babies, all women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 Low-birthweight babies, Aboriginal and Torres Strait Islander women . . . . . . . . . . . . . . . . . . . . 24 Prevention . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 Smoking during pregnancy, all women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 Smoking during pregnancy, Aboriginal and Torres Strait Islander women . . . . . . . . . . . . . . . . 30 Use of health services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 Antenatal visits in the frst trimester, all women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34 Antenatal visits in the frst trimester, Aboriginal and Torres Strait Islander women . . . . . . . . . . 36 Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40 Acknowledgements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 About the Authority . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42 Additional document Healthy Communities: Child and maternal health in 20092012, Technical Supplement Table of contents ii National Health Performance Authority www.myhealthycommunities.gov.au Healthy Communities: Child and maternal health in 20092012 iii National Health Performance Authority www.myhealthycommunities.gov.au Healthy Communities: Child and maternal health in 20092012 Summary The numbers of infants and children who die prematurely has fallen rapidly in recent years on a population basis. Nevertheless, Australia has infant mortality rates three times higher than the best-performing countries. 1 Even within Australia, there is a marked difference in infant and young child death rates between the areas where the rates are lowest, and areas where they are highest. Identifying these differences may help to inform improvements in access to or delivery of services that could in time lead to reductions in avoidable deaths among infants and young children. This is the frst report from the National Health Performance Authority (the Authority) that presents data at the local level for infant and young child mortality, low birthweight, smoking during pregnancy and access to antenatal care. There is a strong relationship between antenatal care that commences within the frst 13 weeks (frst trimester) of pregnancy and positive child health outcomes. 2 Accordingly, in 2011 the Council of Australian Governments (COAG) identifed the number of women with at least one antenatal visit in the frst trimester as an important indicator of access to care in communities. COAG also agreed that infant and young child mortality rates, the proportion of babies born with low birthweight and prevalence of smoking are important population health outcome measures that provide context for the interpretation of local health system performance. For example, low-birthweight babies are at greater risk of poor health outcomes including death and disability, particularly in the frst year of life, and have an increased risk in adulthood of diabetes type 2, high blood pressure and cardiovascular disease. 3 Measuring access to antenatal care and the health outcomes of children at the local level, including premature death, low birthweight and smoking during pregnancy, allows us to begin to identify the communities where programs such as antenatal services are needed or have achieved success. Other factors such as the quality of antenatal care provided and broader social determinants of health also impact on infant and child heath outcomes. This report shows variation across local areas that is not seen when reporting at national or state and territory level. Data in the report cover all children and mothers and, where the data are available, Aboriginal and Torres Strait Islander mothers and their babies. Data are presented for the period from January 2009 to December 2012, for 61 local areas across Australia called Medicare Local catchments. For measures regarding Aboriginal and Torres Strait Islander mothers and their babies, data are presented for the period from January 2007 to December 2011. Key fndings Infant and young child mortality rate In 20102012, the national rate of infant and young child mortality was 4.4 deaths per 1,000 live births (1,344 deaths). Across local areas, the infant and young child mortality rate was more than three times higher in the catchment with the highest rate compared to the catchment with the lowest rate. iv National Health Performance Authority www.myhealthycommunities.gov.au Healthy Communities: Child and maternal health in 20092012 The infant and young child mortality rate ranged as follows: Highest: Northern Territory 9.2 deaths per 1,000 live births Lowest: Bayside (Vic) 2.6 deaths per 1,000 live births (Figure 3, page 7 and pages 18 to 19). To allow fairer comparisons, the Authority compared local areas across Australia that have similar characteristics such as remoteness, socioeconomic status and distance to hospitals. These catchments are grouped into one of seven peer groups (page vi). The report shows there are differences in infant and young child mortality rates across catchments in peer groups that have similar geographic characteristics. Across the metropolitan catchments, the highest infant and young child mortality rate was more than double in the local area with the highest rate (6.1 deaths per 1,000 live births in Greater Metro South Brisbane) compared to the local area with the lowest rate (2.6 deaths per 1,000 live births in Bayside (Vic)). There were also differences across similar local areas within the same peer group, even after accounting for geographic and socioeconomic characteristics. Across lower-income metropolitan communities (Metro 2 peer group), the infant and young child mortality rate was more than double in Greater Metro South Brisbane (6.1 deaths per 1,000 live births) compared to South Western Melbourne (2.9 deaths per 1,000 live births) Across middle-income regional communities (Regional 2 peer group), the infant and young child mortality rate was 86% higher in Country South SA (6.5 deaths per 1,000 live births) compared to Goulburn Valley (Vic) (3.5 deaths per 1,000 live births) (Table 1, page 6). While this report shows higher rates in many regional and rural areas compared to metropolitan areas, and in lower-income compared to higher-income areas, there are some areas that do not follow this trend. These areas demonstrate what is possible to achieve for other similar areas. For example, Nepean-Blue Mountains (NSW), Barwon (Vic) and Goulburn Valley (Vic) are middle- to lower-income regional areas that have infant and young child mortality rates similar to or better than many higher-income metropolitan communities (Figure 4, page 12). Low-birthweight babies The national percentage of all liveborn singleton babies that were of low birthweight was 4.8% for babies born to all women in 20092011 and 11.0% for babies born to Aboriginal and Torres Strait Islander women in 20072011. Across local areas, the percentage of all live births that were of low birthweight was more than double in the catchment with the highest percentage compared to the catchment with the lowest percentage. The percentage of low-birthweight babies ranged as follows: Highest: Northern Territory 7.7% Lowest: Sydney North Shore & Beaches 3.3% (Figure 4, page 12 and pages 22 to 23). v National Health Performance Authority www.myhealthycommunities.gov.au Healthy Communities: Child and maternal health in 20092012 Differences were found across similar local areas even after accounting for geographic and socioeconomic characteristics. Across middle-income metropolitan communities in the Metro 2 peer group, the percentage of low-birthweight babies was 41% higher in South Western Melbourne (5.2%) compared to Fremantle (WA) (3.7%). The report also found that among Aboriginal and Torres Strait Islander mothers there was a greater proportion of low-birthweight babies compared with other mothers in Australia. Across local areas, the percentage of low- birthweight babies to Aboriginal and Torres Strait Islander women ranged from 17.5% in Gippsland (Vic) to 6.7% in Frankston-Mornington Peninsula (Vic) (Figure 5, page 13 and pages 24 to 25). Smoking during pregnancy The national percentage of women who smoked during pregnancy was 13.9% for all women for 20092011 and 51.7% for Aboriginal and Torres Strait Islander women for 20072011. Across local areas, the percentage of women who smoked during pregnancy was 18 times higher in the catchment with the highest percentage compared to the catchment with the lowest percentage. The percentage of women who smoked during pregnancy ranged as follows: Highest: Far West NSW 33.1% Lowest: Sydney North Shore & Beaches 1.8% (Figure 4, page 12 and pages 28 to 29). There were differences found across similar local areas even after accounting for geographic and socioeconomic characteristics. Across high-income metropolitan communities (Metro 1 peer group), the percentage of women who smoked during pregnancy was more than fve times higher in Australian Capital Territory (10.2%) compared to Sydney North Shore & Beaches (1.8%). The percentage of Aboriginal and Torres Strait Islander women who smoked during pregnancy ranged from 66.4% in Goulburn Valley (Vic) to 29.4% in Macedon Ranges & North Western Melbourne (Figure 5, page 13 and pages 30 to 31). Antenatal visits in the frst trimester In 20102011, the national percentage of women who had at least one antenatal visit in the frst trimester of pregnancy was 67.2% for all women and 50.3% for Aboriginal and Torres Strait Islander women. Across local areas, the percentage of women who had at least one antenatal visit in the frst trimester was more than double in the catchment with the highest percentage compared to the catchment with the lowest percentage. The percentage of women who had at least one antenatal visit in the frst trimester ranged as follows: Highest: Western Sydney 87.7% Lowest: Grampians (Vic) 36.6% (Figure 4, page 12 and pages 34 to 35). Differences were found across similar local areas even after accounting for geographic and socioeconomic characteristics. vi National Health Performance Authority www.myhealthycommunities.gov.au Healthy Communities: Child and maternal health in 20092012 Across higher-income regional communities (Regional 1 peer group), the percentage of women who had at least one antenatal visit in the frst trimester of pregnancy was double in Nepean-Blue Mountains (NSW) (85.5%) compared to Frankston-Mornington Peninsula (Vic) (41.7%). While this report shows higher rates in many regional and rural areas compared to metropolitan areas, and in lower-income compared to higher-income areas, there are some that do not follow this trend. These areas demonstrate what is possible to achieve for other similar areas. For example, Western Sydney is a lower-income metropolitan area that has a lower rate of smoking during pregnancy than most higher-income metropolitan communities, and has the highest rate of antenatal visits in the frst trimester than all other metropolitan communities for all women, and the second-highest rate for Aboriginal and Torres Strait Islander women. The percentage of Aboriginal and Torres Strait Islander women who had at least one antenatal visit in the frst trimester ranged from 80.5% in Nepean- Blue Mountains (NSW) to 21.8% in Grampians (Vic). State and territory differences in defnitions and methods used for data collection affect the comparability of data relating to smoking during pregnancy, low-birthweight babies and antenatal visits in the frst trimester across state and territory jurisdictions and lower levels of geography within these jurisdictions. Next steps This is the frst report from the Authority that presents data at the local level for infant and child mortality rates, low birthweight, smoking About the peer groups To enable fairer comparisons, the Authority allocated each Medicare Local catchment to one of seven peer groups, based on socioeconomic status, remoteness and distance to hospitals. Metro 1: High urban density, higher socioeconomic status Metro 2: Medium urban density, medium socioeconomic status Metro 3: Low urban density, lower socioeconomic status Regional 1: Outer urban areas, middle socioeconomic status Regional 2: Mostly non-metro urban and regional areas, middle socioeconomic status Rural 1: Distant from metro cities, with diverse socioeconomic status Rural 2: Mostly large remote areas, middle or lower socioeconomic status. To fnd more information about peer groups, see Healthy Communities: Child and maternal health in 20092012, Technical Supplement at www.myhealthycommunities.gov.au during pregnancy and access to antenatal care across Australia. Future reports will allow trends to be monitored across local communities and may explore other factors that contribute to poorer health outcomes for infants and young children. 1 National Health Performance Authority www.myhealthycommunities.gov.au Healthy Communities: Child and maternal health in 20092012 Introduction About this report The National Health Performance Authority (the Authority) bases its performance reports on indicators agreed by the Council of Australian Governments (COAG). This report focuses on the following indicators: Infant and young child mortality rate Proportion of babies with low birthweight Prevalence of smoking Number of women with at least one antenatal visit in the frst trimester. The report provides information broken down by 61 Medicare Local catchments. The national network of Medicare Local organisations was established between 2011 and 2012 to improve the responsiveness, coordination and integration of local health services. These organisations are due to be replaced in 2015 with Primary Health Networks. Data are presented for the period from January 2009 to December 2012. For some measures regarding Aboriginal and Torres Strait Islander mothers and their babies, data are presented for the period from January 2007 to December 2011. Presentation of the fndings in this report aims to help clinicians, health managers, administrators and the public see how rates of infant and child mortality, low birthweight, maternal smoking and antenatal care differ across local areas. They are also intended to provide Medicare Locals, Primary Health Networks and Local Health Networks with information they need to plan and deliver community and hospital care. Why information on maternal and child health matters Infant and child mortality is a broad measure of the overall health of a population. In Australia, infant mortality rates have declined by 33% from 2005 to 2012, from 4.9 deaths to 3.3 deaths per 1,000 live births. 4 Australia is currently ranked 14 of 30 OECD countries for which infant mortality rates were reported for 2012. Australia had an infant mortality rate (3.3 deaths per 1,000 live births) three times higher than that of the best-performing country, Iceland (1.1 deaths per 1,000 live births), and twice that of Slovenia (1.6 deaths per 1,000 live births). 1 Figure 1: Infant and young child deaths measured in this report Birth 28 days 1 year At least 20 weeks or 400 grams 0 to 27 days 28 days to <1 year Perinatal deaths Infant deaths (0 to <1 year) Fetal deaths Neonatal deaths 5 years 1 year to <5 years Infant and young child deaths (0 to <5 years) Post-neonatal deaths Measured in this report Young child deaths 2 National Health Performance Authority www.myhealthycommunities.gov.au Healthy Communities: Child and maternal health in 20092012 Infant and young child mortality rates are reported as the number of deaths among children aged less than 5 years per 1,000 live births during the three calendar years from 1 January 2010 to 31 December 2012. The number of infant and young child deaths are reported as the average number of deaths per year during the same time period. The majority of these deaths (84%) occur in infancy (before 1 year of age). In this report, infant mortality rates are reported as the number of deaths of liveborn infants aged less than 1 year per 1,000 live births during the three calendar years from 1 January 2010 to 31 December 2012. In 20102012, 70% of infant and young child deaths occurred before 28 days of life (neonatal death) (Figure 1, page 1). Three years of data were combined to create stable estimates for reporting mortality rates at the local area level. In 2011, there were 297,126 women who gave birth to 299,588 liveborn and 2,220 stillborn babies in Australia. Of these women, 11,729 were identifed on the National Perinatal Data Collection (NPDC) as being Aboriginal and Torres Strait Islander women who gave birth to 11,737 liveborn and 158 stillborn babies. 5
The leading causes of infant and young child mortality in Australia are shown below in Figure 2. Low-birthweight babies are defned in this report as liveborn singleton babies who weigh less than 2,500 grams at birth. A babys birthweight is a key indicator of health status and may refect the health of a mother during her pregnancy, including her smoking status and the quality of antenatal care received. 3 In this report, the percentage of babies who were of low birthweight is the number of liveborn singleton babies who weighed less than 2,500 grams at birth, divided by the total number of live singleton babies born. Figure 2: Most common causes and percentage of infant and young child deaths by category, in Australia, 20102012 Source: National Health Performance Authority analysis of Australian Bureau of Statistics Causes of Death Collection 20102012. Infant and young child deaths 0 to <1 year 1 to <5 years Infant Young child T o p
5
c a u s e s
o f
i n f a n t
a n d
y o u n g
c h i l d
d e a t h s 1 2 3 4 5 Fetus and newborn affected by maternal factors and by complications of pregnancy, labour and delivery 26.6% Accidental drowning and submersion 10.5% Ill-defned and unknown causes of mortality (including SIDS) 11.1% Pedestrian injured in transport accident 6.7% Congenital malformations of the circulatory system 6.7% Ill-defned and unknown causes of mortality 5.7% Disorders related to length of gestation and fetal growth (including low birthweight) 6.5% Malignant neoplasms of eye, brain and other parts of central nervous system 4.4% Congenital malformations of the nervous system 4.7% Car occupant injured in transport accident 4.3% 3 National Health Performance Authority www.myhealthycommunities.gov.au Healthy Communities: Child and maternal health in 20092012 Smoking during pregnancy is the most common preventable risk factor for complications in pregnancy and is associated with poorer outcomes for babies such as low birthweight and perinatal death 5 , including sudden infant death syndrome (SIDS). In this report, the percentage of women who smoked during pregnancy is the number of women who self-reported having smoked at any time during pregnancy, divided by the total number of women who gave birth. Antenatal visits within the frst trimester of pregnancy are important for monitoring the health of mothers and babies and identifying pregnancy complications early so that appropriate treatment can be provided. Antenatal care within the frst trimester is within the frst 13 weeks of pregnancy and involves assessment, appropriate advice and treatment during pregnancy either in hospital, in primary health care or specialist practices, or in the home. An antenatal visit in the frst trimester represents an opportunity for appropriate care to be provided early on in pregnancy. During an antenatal visit, a GP, midwife or other health professional provides care to monitor the health of the mother and fetus. This care may include taking a medical history, assessing the womans specifc health needs, screening tests, providing advice on pregnancy and delivery, and referral to a medical specialist if necessary. 5,6 Australian clinical guidelines recommend that the frst antenatal visit is arranged at the frst contact with a woman during pregnancy. This visit requires a long appointment and should occur within the frst 10 weeks. Guidelines recommend for a womans frst pregnancy without complications, a schedule of 10 visits and seven visits for subsequent uncomplicated pregnancies. 6 In this report, the percentage of women who had at least one antenatal visit within the frst trimester is the number of women who self-reported or who had a medical record that showed an antenatal visit occurred within the frst trimester, divided by the total number of women who gave birth. About the data Infant and young child mortality rates were calculated using data from the Australian Bureau of Statistics (ABS) Death Registrations Collection and the ABS Birth Registrations Collection for the calendar years 2010, 2011 and 2012. ABS births and deaths data contain administrative information supplied by the births, deaths and marriages registries in each state and territory. Deaths are attributed to the catchment in which a baby usually resided, irrespective of where they died. Live births are attributed to the catchment in which the mother usually resided, irrespective of where the birth occurred. Information on low birthweight, smoking during pregnancy and antenatal visits are from the Australian Institute of Health and Welfares (AIHW) National Perinatal Data Collection (NPDC). The NPDC is a national population-based cross- sectional data collection of pregnancy and childbirth. Information is collected from the mother and the hospital, as well as records taken by a midwife or other health professional at the time of birth. The data are based on births reported to the perinatal data collection in each state and territory and are compiled and reported on annually by the AIHWs National Perinatal Epidemiology and Statistics Unit. 4 National Health Performance Authority www.myhealthycommunities.gov.au Healthy Communities: Child and maternal health in 20092012 For the measures presented in this report, the NPDC data are attributed to the local area where the mother usually resided, rather than the place where the birth occurred and exclude Australian non-residents, residents of external territories and women who could not be allocated to a Medicare Local catchment because their Statistical Local Area of usual residence was not stated or was not valid. Results for smoking during pregnancy exclude women whose smoking status during pregnancy was not stated. Results for antenatal visits in the frst trimester exclude women whose gestation at the frst antenatal visit was not stated. State and territory differences in defnitions and methods used for collection of data related to smoking during pregnancy and antenatal visits in the frst trimester affect the comparability of these data across state and territory jurisdictions and lower levels of geography within these jurisdictions. In particular, as data on smoking during pregnancy are not available for women who gave birth in Victoria in 2007 or 2008, the percentage of Aboriginal and Torres Strait Islander women who gave birth and smoked during pregnancy during the fve calendar years from 1 January 2007 to 31 December 2011 does not include Aboriginal and Torres Strait Islander women who usually resided and gave birth in Victoria in 2007 or 2008. In WA and ACT, frst antenatal visits that occur outside of the hospital may not be included. Results for each measure in this report are presented on maps from pages 17 to 37 and on www.myhealthycommunities. gov.au Fair comparisons To enable fairer comparisons, the Authority has allocated each Medicare Local catchment to one of seven peer groups, based on socioeconomic status, remoteness, and distance to hospitals: three in metropolitan areas, two in regional areas, and two in rural areas (page vi). For further information see Healthy Communities: Child and maternal health in 20092012, Technical Supplement at www.myhealthycommunities. gov.au The data presented on Aboriginal and Torres Strait Islander mothers and their babies are infuenced by the quality and completeness of Aboriginal and Torres Strait Islander identifcation, which may vary across local areas. 5 National Health Performance Authority www.myhealthycommunities.gov.au Healthy Communities: Child and maternal health in 20092012 Infant and young child mortality in this report refers to the death of a liveborn child before the age of 5 years. The majority of these deaths (84%) occur in infancy (before 1 year of age). In 20102012, the national rate of infant and young child mortality was 4.4 deaths per 1,000 live births (1,344 deaths). Variation across local areas Across local areas, the infant and young child mortality rate was more than three times higher in the catchment with the highest rate compared to the catchment with the lowest rate. The infant and young child mortality rate ranged as follows: Highest: Northern Territory 9.2 deaths per 1,000 live births Lowest: Bayside (Vic) 2.6 deaths per 1,000 live births (Figure 3, page 7 and pages 18 to 19). The percentage of infant deaths compared with young child deaths also varied across local areas. Of the 59 local areas reported, infant deaths accounted for the vast majority (90% or more) of all infant and young child deaths in fve Medicare Local catchments Central Coast NSW, Eastern Sydney, Macedon Ranges & North Western Melbourne, Inner East Melbourne and Northern Sydney. In contrast, infant deaths accounted for less than 75% of all infant and young child deaths in South West WA, Great South Coast (Vic), Frankston- Mornington Peninsula (Vic) and Country South SA. Variation across peer groups There were differences found in infant and young child mortality rates across local areas with similar geographic characteristics. Across metropolitan areas, the infant and young child mortality rate was more than double in the lower-income urban catchment of Greater Metro South Brisbane (6.1 deaths per 1,000 live births, Metro 2) compared to the wealthier inner-city catchment of Bayside (Vic) (2.6 deaths per 1,000 live births, Metro 1) Across regional areas, the infant and young child mortality rate was almost double in the lower-income catchment of Country South SA (6.5 deaths per 1,000 live births, Regional 2) compared to the wealthier catchment of Nepean-Blue Mountains (NSW) (3.3 deaths per 1,000 live births, Regional 1) Across rural areas, the infant and young child mortality rate was almost double in the Rural 2 catchment of Northern Territory (9.2 deaths per 1,000 live births) compared to 4.9 deaths per 1,000 live births in Country North SA (Rural 1) and Goldfelds-Midwest (WA) (Rural 2). Variation within peer groups There were differences across similar local areas even after accounting for broad geographic and socioeconomic circumstances. For example: Within the Metro 2 peer group, the infant and young child mortality rate was more than double in Greater Metro South Brisbane (6.1 deaths per 1,000 live births) compared to South Western Melbourne (2.9 deaths per 1,000 live births). Within the Regional 2 peer group, the infant and young child mortality rate was 86% higher in Country South SA (6.5 deaths per 1,000 live births) compared to Goulburn Valley (Vic) (3.5 deaths per 1,000 live births) (Table 1, page 6). Key fndings: Infant and young child mortality 6 National Health Performance Authority www.myhealthycommunities.gov.au Healthy Communities: Child and maternal health in 20092012 While this report shows higher rates of infant and young child deaths in regional and rural compared to metropolitan areas and in lower-income compared to higher-income areas, there are some areas that do not follow this trend. These areas demonstrate what can be achieved for other similar areas. Peer group Highest rate Lowest rate Difference Metro 1 4.2 2.6 62% (1.6 times higher) Metro 2 6.1 2.9 110% (2.1 times higher) Metro 3 5.0 3.3 52% (1.5 times higher) Regional 1 5.8 3.3 76% (1.8 times higher) Regional 2 6.5 3.5 86% (1.9 times higher) Rural 1 7.3 4.9 49% (1.5 times higher) Rural 2 9.2 4.9 88% (1.9 times higher) Table 1: Highest and lowest infant and young child mortality rates across Medicare Local catchments, by peer group, 20102012 For example, Nepean-Blue Mountains (NSW), Barwon (Vic) and Goulburn Valley (Vic) are middle- to lower-income regional areas that have infant and child mortality rates similar to or better than many higher-income metropolitan communities. Aboriginal and Torres Strait Islander infant and young child mortality Infant and young child mortality rates for Aboriginal and Torres Strait Islander children have declined over the past decade with 42% of the decline in infant mortality rates due to a decrease in sudden infant deaths syndrome (SIDS) and 25% due to a fall in deaths from certain conditions originating in the perinatal period. 7 External causes (injury and poisoning) account for just over half of all deaths of Aboriginal and Torres Strait Islander infant and young children. The recent Australian Government report on Closing the Gap (2014) showed that changes in the Aboriginal and Torres Strait Islander infant and young child mortality rate are currently within range to meet the target of halving the gap in mortality rates by 2018. 8 However, between 2006 and 2010 Aboriginal and Torres Strait Islander infant and young child mortality rates were still double the non-Indigenous rate, as were infant mortality rates (8 deaths per 1,000 live births compared with 4 deaths per 1,000 live births). Aboriginal and Torres Strait Islander infant mortality rates also varied across states and territories, from 6 deaths per 1,000 live births in SA, to 13 deaths per 1,000 live births in the NT.* 9
* Reliable data on child mortality for Aboriginal and Torres Strait Islander people are available for NSW, Qld, WA, SA and the NT. 7 National Health Performance Authority www.myhealthycommunities.gov.au Healthy Communities: Child and maternal health in 20092012 Infant (< 1 year) mortality rate Infant and young child (< 5 years) mortality rate Figure 3: Infant and young child mortality rates, by Medicare Local catchment, 20102012 Medicare Local catchments Infant and young child deaths per 1,000 live births * The number of deaths may vary across Medicare Local catchments with similar rates due to differences in the number of live births. NP Not available for publication. Notes: Deaths are attributed to the Medicare Local catchment in which the infant or young child usually resided, irrespective of where they died. Births are attributed to the Medicare Local catchment in which the mother usually resided, irrespective of where the birth occurred. Sources: National Health Performance Authority analysis of Australian Bureau of Statistics Death Registrations Collection 20102012 and Australian Bureau of Statistics Birth Registrations Collection 20102012. NATIONAL RESULT 3.7 4.4 1,344 Infant mortality rate Average annual no. deaths children < 5 years* Metro 1 Bayside (Vic) Sydney North Shore & Beaches Eastern Sydney Northern Sydney Inner East Melbourne Inner West Sydney Australian Capital Territory Inner NW Melbourne 2.9 2.3 2.3 2.7 2.8 3.0 3.2 3.2 3.7 3.3 2.6 2.8 3.0 3.1 3.3 3.6 3.8 4.2 164 19 18 15 13 21 33 20 24 Metro 2 South Western Melbourne Perth North Metro South Eastern Sydney Perth Central & East Metro Central Adelaide & Hills Fremantle (WA) Bentley-Armadale (WA) Eastern Melbourne Sthn Adelaide-Fleurieu-Kangaroo Is. Metro North Brisbane Gold Coast (Qld) Greater Metro South Brisbane 3.6 2.4 2.4 2.7 2.6 2.9 2.6 3.0 3.3 3.2 4.1 4.4 5.5 4.1 2.9 3.0 3.0 3.2 3.4 3.4 3.6 3.7 3.9 4.7 5.0 6.1 333 13 22 20 18 19 10 21 19 18 56 34 83 Metro 3 Northern Melbourne Northern Adelaide Macedon Ranges & NW Melb West Moreton-Oxley (Qld) Western Sydney South Eastern Melbourne South Western Sydney 3.6 2.7 2.9 3.6 3.7 3.8 4.0 4.4 4.3 3.3 3.4 3.9 4.3 4.4 4.8 5.0 272 31 20 29 25 63 37 67 Regional 1 Nepean-Blue Mountains (NSW) Barwon (Vic) Central Coast NSW Perth South Coastal Illawarra-Shoalhaven (NSW) Frankston-Mornington Peninsula (Vic) Hunter (NSW) Sunshine Coast (Qld) 3.6 2.6 2.8 3.7 3.5 3.5 3.2 4.0 4.8 4.3 3.3 3.6 3.9 3.9 4.3 4.7 4.8 5.8 158 16 12 15 13 20 16 42 24 Regional 2 Goulburn Valley (Vic) Southern NSW Gippsland (Vic) Hume (Vic/NSW) Great South Coast (Vic) Grampians (Vic) Tasmania South West WA North Coast NSW Loddon-Mallee-Murray (Vic/NSW) Darling Downs-SW Qld Murrumbidgee (NSW) Western NSW New England (NSW) Wide Bay (Qld) Country South SA 4.1 2.8 3.4 3.5 3.7 2.9 3.3 4.1 3.1 4.3 4.3 4.3 4.9 4.5 5.3 5.0 4.6 5.0 3.5 4.0 4.0 4.1 4.3 4.4 4.7 4.9 5.0 5.1 5.3 5.7 5.7 6.1 6.2 6.5 241 7 9 12 10 5 11 30 19 28 13 23 14 20 15 15 10 Rural 1 Country North SA Townsville-Mackay (Qld) Far West NSW Lower Murray (Vic/NSW) Central Qld 4.6 3.8 4.0 NP NP 6.1 5.6 4.9 5.0 5.3 5.7 7.3 75 12 31 3 5 24 Rural 2 Goldfelds-Midwest (WA) Kimberley-Pilbara (WA) Central & NW Qld Far North Qld Northern Territory 6.5 3.7 5.7 6.9 7.0 7.6 7.9 4.9 6.7 8.1 8.5 9.2 101 10 11 7 36 37 0 1 2 3 4 5 6 7 8 9 10 8 National Health Performance Authority www.myhealthycommunities.gov.au Healthy Communities: Child and maternal health in 20092012 Low birthweight, all women Nationally, the percentage of liveborn babies* of low birthweight was 4.8% for babies born to all women in 20092011 and 11.0% for babies born to Aboriginal and Torres Strait Islander women in 20072011. Variation across local areas Across local areas, the percentage of all live births that were of low birthweight was more than double in the catchment with the highest percentage compared to the catchment with the lowest percentage. The percentage of all live births that were of low birthweight ranged as follows: Highest: Northern Territory 7.7% Lowest: Sydney North Shore & Beaches 3.3% (Figure 4, page 12 and pages 22 to 23). Variation across peer groups There were differences in the percentage of babies born of low birthweight across local areas with similar geographic characteristics. Across metropolitan areas, the percentage of all liveborn babies of low birthweight was 73% higher in the lower-income urban catchment of Northern Adelaide (5.7%, Metro 3) compared to the wealthy inner-city catchment of Sydney North Shore & Beaches (3.3%, Metro 1) Across regional and rural areas, the percentage of all liveborn babies of low birthweight was higher in most lower-income catchments (Regional 2 and Rural 2) compared to higher- income catchments (Regional 1 and Rural 1). Key fndings: Low birthweight and smoking during pregnancy Variation within peer groups There were differences across similar catchments even after accounting for geographic and socioeconomic circumstances. Within the Metro 2 peer group, the percentage of all live births that were of low birthweight was 41% higher in South Western Melbourne (5.2%) compared to Fremantle (WA) (3.7%) Within the Regional 2 peer group, the percentage of all live births that were of low birthweight was 27% higher in Country South SA, New England (NSW) and Tasmania (5.6%) compared to South West WA (4.4%) (Table 2, page 9). Smoking during pregnancy, all women Nationally, the percentage of women who smoked during pregnancy was 13.9% for all women for 20092011 and 51.7% for Aboriginal and Torres Strait Islander women for 20072011. Variation across local areas Across local areas, the percentage of women who smoked during pregnancy was 18 times higher in the catchment with the highest compared to the catchment with the lowest percentage. The percentage of women who smoked during pregnancy ranged as follows: Highest: Far West NSW 33.1% Lowest: Sydney North Shore & Beaches 1.8% (Figure 4, page 12 and pages 28 to 29). * Multiple births are excluded for the results for low birthweight in this report. 9 National Health Performance Authority www.myhealthycommunities.gov.au Healthy Communities: Child and maternal health in 20092012 Variation across peer groups There were differences in the percentage of women who smoked during pregnancy across local areas with similar geographic characteristics. Across metropolitan areas, the percentage of women who smoked during pregnancy was 12 times higher in the lower-income urban catchment of Northern Adelaide (22.4%, Metro 3) compared to the wealthier inner-city catchment of Sydney North Shore & Beaches (1.8%, Metro 1) Across regional areas, the percentage of women who smoked during pregnancy was higher in most lower-income catchments compared to higher-income catchments. For example, the percentage of women who smoked during pregnancy was almost double at 26.5% in Wide Bay (Qld) (Regional 2) compared to 14.0% in Barwon (Vic) and Illawarra-Shoalhaven (NSW) (Regional 1). However across rural areas this trend of lower rates of smoking during pregnancy in higher- income areas compared to lower-income areas was not apparent. Variation within peer groups There were differences across similar catchments even after accounting for geographic and socioeconomic circumstances. Within the Metro 1 peer group, the percentage of women who smoked during pregnancy was more than fve times higher in Australian Capital Territory (10.2%) compared to Sydney North Shore & Beaches (1.8%) Within the Metro 2 peer group, the percentage of women who smoked during pregnancy was three times higher in Southern Adelaide- Fleurieu-Kangaroo Island (SA) (14.5%) compared to South Eastern Sydney (4.7%) (Table 3). Table 2: Highest and lowest percentage of low-birthweight babies of all women across Medicare Local catchments, by peer group, 20092011 Table 3: Highest and lowest percentage of smoking during pregnancy among all women across Medicare Local catchments, by peer group, 20092011 Peer group Highest percentage Lowest percentage Difference Metro 1 4.4% 3.3% 33% (1.3 times higher) Metro 2 5.2% 3.7% 41% (1.4 times higher) Metro 3 5.7% 4.7% 21% (1.2 times higher) Regional 1 4.9% 4.3% 14% (1.1 times higher) Regional 2 5.6% 4.4% 27% (1.3 times higher) Rural 1 7.5% 5.0% 50% (1.5 times higher) Rural 2 7.7% 5.8% 33% (1.3 times higher) Peer group Highest percentage Lowest percentage Difference Metro 1 10.2% 1.8% 467% (5.7 times higher) Metro 2 14.5% 4.7% 209% (3.1 times higher) Metro 3 22.4% 8.0% 180% (2.8 times higher) Regional 1 18.8% 14.0% 34% (1.3 times higher) Regional 2 26.5% 15.5% 71% (1.7 times higher) Rural 1 33.1% 19.5% 70% (1.7 times higher) Rural 2 27.6% 21.2% 30% (1.3 times higher) 10 National Health Performance Authority www.myhealthycommunities.gov.au Healthy Communities: Child and maternal health in 20092012 * The results do not include data for Aboriginal and Torres Strait Islander women who usually resided in Victoria and gave birth in Victoria in 2007 and 2008. Low birthweight, Aboriginal and Torres Strait Islander women Variation across local areas Across local areas, the percentage of live births to Aboriginal and Torres Strait Islander women that were of low birthweight was 2.6 times higher in the catchment with the highest compared to the catchment with the lowest percentage. The percentage of live births to Aboriginal and Torres Strait Islander women that were of low birthweight ranged from: Highest: Gippsland (Vic) 17.5% Lowest: Frankston-Mornington Peninsula (Vic) 6.7% (Figure 5, page 13 and pages 24 to 25). Variation across peer groups Across the three metropolitan peer groups, there was no apparent trend of lower rates of low-birthweight babies in higher-income areas compared to lower-income areas. Similarly, no trend was seen across regional areas or across rural areas. Variation within peer groups There were differences across similar catchments after accounting for geographic and socioeconomic circumstances. Within the Metro 2 peer group, the percentage of all live births that were babies of low birthweight born to Aboriginal and Torres Strait Islander mothers was twice as high in Bentley-Armadale (WA) (14.3%) compared to Metro North Brisbane (7.1%) Within the Regional 2 peer group, the percentage of all live births that were babies of low birthweight born to Aboriginal and Torres Strait Islander mothers was more than twice as high in Gippsland (Vic) (17.5%) compared to Wide Bay (Qld) (7.6%) (Table 4). Smoking during pregnancy, Aboriginal and Torres Strait Islander women Variation across local areas Across local areas, the percentage of Aboriginal and Torres Strait Islander women who smoked during pregnancy* was more than double in the catchment with the highest compared to the catchment with the lowest percentage. The percentage of Aboriginal and Torres Strait Islander women who smoked during pregnancy ranged as follows: Highest: Goulburn Valley (Vic) 66.4% Lowest: Macedon Ranges & North Western Melbourne 29.4% (Figure 5, page 13 and pages 30 to 31). Variation across peer groups There were differences in the percentage of Aboriginal and Torres Strait Islander women who smoked during pregnancy across regional peer groups with higher rates of smoking during pregnancy in almost all lower-income areas compared to middle-income areas. Across metropolitan areas and across rural areas, this trend of lower rates of low-birthweight babies in higher-income areas compared to lower-income areas was not apparent. 11 National Health Performance Authority www.myhealthycommunities.gov.au Healthy Communities: Child and maternal health in 20092012 Table 5: Highest and lowest percentage of smoking during pregnancy among Aboriginal and Torres Strait Islander women across Medicare Local catchments, by peer group, 20072011* Table 4: Highest and lowest percentage of low-birthweight babies of Aboriginal and Torres Strait Islander women across Medicare Local catchments, by peer group, 20072011 Variation within peer groups There were differences across similar catchments even after accounting for geographic and socioeconomic circumstances. Within the Metro 3 peer group, the percentage of Aboriginal and Torres Strait Islander women who smoked during pregnancy was more than double in Northern Adelaide (62.0%) compared to Macedon Ranges & North Western Melbourne (29.4%) Within the Regional 2 peer group, the percentage of Aboriginal and Torres Strait Islander women who smoked during pregnancy was almost double in Goulburn Valley (Vic) (66.4%) compared to Grampians (Vic) (34.7%) (Table 5). * The results do not include data for Aboriginal and Torres Strait Islander women who usually resided in Victoria and gave birth in Victoria in 2007 and 2008. Peer group Highest percentage Lowest percentage Difference Metro 1 13.5% 8.0% 69% (1.7 times higher) Metro 2 14.3% 7.1% 101% (2.0 times higher) Metro 3 13.5% 7.0% 93% (1.9 times higher) Regional 1 13.0% 6.7% 94% (1.9 times higher) Regional 2 17.5% 7.6% 130% (2.3 times higher) Rural 1 13.6% 9.1% 49% (1.5 times higher) Rural 2 13.3% 10.3% 29% (1.3 times higher) Peer group Highest percentage Lowest percentage Difference Metro 1 53.7% 35.1% 53% (1.5 times higher) Metro 2 56.7% 34.4% 65% (1.6 times higher) Metro 3 62.0% 29.4% 111% (2.1 times higher) Regional 1 48.9% 42.0% 16% (1.2 times higher) Regional 2 66.4% 34.7% 91% (1.9 times higher) Rural 1 62.2% 51.5% 21% (1.2 times higher) Rural 2 55.6% 46.7% 19% (1.2 times higher) 12 National Health Performance Authority www.myhealthycommunities.gov.au Healthy Communities: Child and maternal health in 20092012 * Women who usually resided in the Australian Capital Territory and gave birth in New South Wales were not counted in the results for the Australian Capital Territory Medicare Local catchment for antenatal visits in the frst trimester, smoking during pregnancy and low birthweight. # Interpret with caution. In WA and ACT, frst antenatal visits that occur outside of the hospital may not be included. Notes: Jurisdictional differences in defnitions and methods used for data collection affect the comparability of these data across jurisdictions and lower levels of geography within jurisdictions. For data limitations and exclusions, see this reports Technical Supplement. Sources: Customised data report prepared for the NHPA from the AIHW National Perinatal Data Collection 20092011 (birthweight, smoking during pregnancy) and 20102011 (antenatal visits) and NHPA analysis of ABS Death Registrations Collection 20102012 and ABS Birth Registrations Collection 20102012. Figure 4: Percentage of all women who had at least one antenatal visit in the frst trimester, by measures of child and maternal health, by Medicare Local catchment, 20092012 Medicare Local catchments Infant & young child mortality rate per 1,000 Antenatal visit in frst trimester Smoking during pregnancy Low birth- weight Western Sydney ................................... Nepean-Blue Mountains (NSW) ............ Sydney North Shore & Beaches ............ Northern Sydney .................................. Central Adelaide & Hills ......................... Central Coast NSW .............................. Western NSW ....................................... Northern Adelaide ................................. Eastern Sydney .................................... New England (NSW) ............................. Murrumbidgee (NSW) ........................... North Coast NSW ................................. Hunter (NSW) ....................................... Metro North Brisbane ........................... Illawarra-Shoalhaven (NSW) .................. Country North SA ................................. Country South SA ................................. West Moreton-Oxley (Qld) ..................... Inner East Melbourne ............................ Bayside (Vic) ......................................... Sthn Adelaide-Fleurieu-Kangaroo Is. ..... Far West NSW ...................................... Perth South Coastal ............................. Northern Territory .................................. Inner West Sydney ................................ Eastern Melbourne ............................... Great South Coast (Vic) ........................ Southern NSW ..................................... Lower Murray (Vic/NSW)....................... Sunshine Coast (Qld) ............................ South West WA .................................... South Eastern Sydney .......................... Tasmania .............................................. Inner NW Melbourne ............................. Townsville-Mackay (Qld) ........................ Barwon (Vic) ......................................... Northern Melbourne ............................. Darling Downs-SW Qld ......................... Gippsland (Vic) ..................................... Hume (Vic/NSW)................................... Central Qld ........................................... Bentley-Armadale (WA) ......................... South Western Melbourne .................... Gold Coast (Qld) ................................... Greater Metro South Brisbane .............. Goldfelds-Midwest (WA) ....................... Loddon-Mallee-Murray (Vic/NSW) ......... Central & NW Qld ................................. South Western Sydney ......................... South Eastern Melbourne ..................... Perth North Metro ................................. Far North Qld ........................................ Fremantle (WA) ..................................... Perth Central & East Metro ................... Macedon Ranges & NW Melb ............... Kimberley-Pilbara (WA) ......................... Australian Capital Territory* ................... Frankston-Mornington Peninsula (Vic) ... Goulburn Valley (Vic) ............................. Wide Bay (Qld)...................................... Grampians (Vic) .................................... 87.7% 85.5% 85.5% 85.1% 84.7% 83.0% 82.7% 82.3% 81.2% 81.2% 79.9% 79.7% 77.1% 75.6% 75.4% 75.2% 74.9% 74.2% 72.7% 72.7% 72.5% 72.1% 72.0% # 71.2% 70.5% 69.3% 68.5% 68.5% 67.9% 67.8% 67.3% # 67.1% 67.1% 64.1% 63.9% 63.7% 63.1% 62.3% 61.2% 59.5% 58.8% 58.5% # 58.3% 57.8% 56.3% 55.9% # 55.5% 55.2% 55.0% 54.0% 53.9% # 53.5% 50.4% # 50.1% # 49.8% 45.2% # 45.2% # 41.7% 41.3% 40.9% 36.6% 8.0% 14.8% 1.8% 2.2% 10.8% 15.8% 23.2% 22.4% 2.5% 22.7% 18.2% 18.2% 16.9% 13.0% 14.0% 26.7% 25.6% 19.6% 3.9% 5.5% 14.5% 33.1% 18.8% 27.0% 6.3% 11.3% 19.1% 19.2% 22.3% 15.6% 17.1% 4.7% 22.2% 6.8% 19.5% 14.0% 9.5% 23.9% 21.2% 19.2% 22.1% 12.8% 11.1% 12.6% 13.7% 21.2% 20.9% 27.6% 14.4% 15.4% 8.5% 27.3% 7.4% 9.6% 10.7% 25.4% 10.2% 18.5% 24.4% 26.5% 15.5% 4.8% 4.4% 3.3% 3.6% 4.8% 4.9% 4.9% 5.7% 3.5% 5.6% 4.7% 4.8% 4.7% 4.6% 4.3% 5.6% 5.6% 4.9% 4.3% 4.0% 4.7% 7.5% 4.3% 7.7% 4.2% 4.7% 5.0% 5.2% 5.8% 4.9% 4.4% 4.0% 5.6% 4.4% 5.2% 4.4% 4.9% 4.6% 5.5% 5.0% 5.0% 5.1% 5.2% 4.2% 4.7% 5.8% 5.2% 7.6% 4.7% 5.1% 4.7% 6.2% 3.7% 4.6% 4.9% 6.5% 4.3% 4.3% 5.4% 5.3% 5.2% 4.4 3.3 2.8 3.1 3.4 3.9 5.7 3.4 3.0 6.1 5.7 5.0 4.8 4.7 4.3 4.9 6.5 4.3 3.3 2.6 3.9 5.3 3.9 9.2 3.6 3.7 4.3 4.0 5.7 5.8 4.9 3.0 4.7 4.2 5.0 3.6 3.3 5.3 4.0 4.1 7.3 3.6 2.9 5.0 6.1 4.9 5.1 8.1 5.0 4.8 3.0 8.5 3.4 3.2 3.9 6.7 3.8 4.7 3.5 6.2 4.4 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 13 National Health Performance Authority www.myhealthycommunities.gov.au Healthy Communities: Child and maternal health in 20092012 * Women who usually resided in the Australian Capital Territory and gave birth in New South Wales were not counted in the results for the Australian Capital Territory Medicare Local catchment for antenatal visits in the frst trimester, smoking during pregnancy and low birthweight. # Interpret with caution. In WA and ACT, frst antenatal visits that occur outside of the hospital may not be included. Data on smoking during pregnancy were not available for Aboriginal and Torres Strait Islander women who usually resided in Victoria and gave birth in Victoria in 2007 and 2008. Notes: Jurisdictional differences in defnitions and methods used for data collection affect the comparability of these data across jurisdictions and lower levels of geography within jurisdictions. For data limitations and exclusions, see this reports Technical Supplement. Source: Customised data report prepared for the NHPA from the AIHW National Perinatal Data Collection 20072011 (birthweight, smoking during pregnancy) and 20102011 (antenatal visits). Medicare Local catchments Antenatal visit in frst trimester Smoking during pregnancy Low birth- weight Nepean-Blue Mountains (NSW) ............ Western Sydney ................................... Central Coast NSW .............................. North Coast NSW ................................. Illawarra-Shoalhaven (NSW) .................. Murrumbidgee (NSW) ........................... Western NSW ....................................... New England (NSW) ............................. Perth South Coastal ............................. Tasmania .............................................. Hunter (NSW) ....................................... West Moreton-Oxley (Qld) ..................... Far West NSW ...................................... Southern NSW ..................................... Country South SA ................................. Northern Adelaide ................................. Hume (Vic/NSW)................................... Lower Murray (Vic/NSW)....................... South Western Sydney ......................... Country North SA ................................. Sunshine Coast (Qld) ............................ Central Adelaide & Hills ......................... Inner West Sydney ................................ Australian Capital Territory* ................... Northern Territory .................................. Sthn Adelaide-Fleurieu-Kangaroo Is. ..... Gippsland (Vic) ..................................... Darling Downs-SW Qld ......................... Metro North Brisbane ........................... Northern Melbourne ............................. South West WA .................................... Townsville-Mackay (Qld) ........................ Far North Qld ........................................ Loddon-Mallee-Murray (Vic/NSW) ......... Central Qld ........................................... Kimberley-Pilbara (WA) ......................... Central & NW Qld ................................. Gold Coast (Qld) ................................... Macedon Ranges & NW Melb ............... Goulburn Valley (Vic) ............................. Goldfelds-Midwest (WA) ....................... Wide Bay (Qld)...................................... Greater Metro South Brisbane .............. Grampians (Vic) .................................... Bentley-Armadale (WA) ......................... Perth North Metro ................................. Perth Central & East Metro ................... Barwon (Vic) ......................................... Bayside (Vic) ......................................... Eastern Melbourne ............................... Eastern Sydney .................................... Frankston-Mornington Peninsula (Vic) ... Fremantle (WA) ..................................... Great South Coast (Vic) ........................ Inner East Melbourne ............................ Inner NW Melbourne ............................. Northern Sydney .................................. South Eastern Melbourne ..................... South Eastern Sydney .......................... South Western Melbourne .................... Sydney North Shore & Beaches ............ 80.5% 74.7% 73.5% 70.0% 69.9% 68.1% 67.9% 66.6% 65.3% # 64.5% 64.2% 60.8% 60.8% 60.6% 57.1% 57.1% 57.1% 56.8% 55.3% 55.0% 52.9% 51.9% 50.9% 50.8% # 49.8% 48.8% 48.1% 46.8% 45.5% 44.8% 44.4% # 42.5% 41.6% 41.2% 38.7% 38.7% # 38.5% 38.1% 37.9% 36.2% 32.8% # 28.6% 27.6% 21.8% 21.6% # 19.9% # 19.0% # NP NP NP NP NP NP NP NP NP NP NP NP NP NP 46.4% 49.4% 42.0% 52.5% 46.9% 52.1% 53.1% 55.1% 48.3% 52.7% 48.9% 53.9% 60.8% 55.6% 64.6% 62.0% 51.8% # 56.6% # 47.0% 62.2% 42.8% 55.3% 49.0% 53.7% 52.2% 56.7% 52.1% # 60.4% 47.1% 35.7% # 51.8% 51.5% 55.6% 54.4% # 52.4% 52.9% 53.1% 35.0% 29.4% # 66.4% # 46.7% 50.4% 43.5% 34.7% # 52.5% 44.3% 51.4% NP NP NP 35.1% NP 47.6% NP NP NP NP 43.4% # 34.4% NP NP 10.3% 11.6% 9.9% 10.6% 7.8% 7.8% 8.9% 11.5% 10.8% 8.3% 10.3% 8.0% 12.4% 14.7% 10.7% 13.5% 10.9% 13.6% 9.7% 13.0% 8.1% 10.6% 13.1% 11.6% 13.0% 8.9% 17.5% 9.3% 7.1% 10.0% 14.0% 10.9% 10.3% 12.1% 9.1% 13.3% 12.3% 8.3% 7.0% 9.7% 12.5% 7.6% 9.1% 11.9% 14.3% 11.9% 12.9% 13.0% NP NP 8.0% 6.7% 13.0% 16.4% NP 13.5% NP 7.2% 7.2% NP NP 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% Figure 5: Percentage of Aboriginal and Torres Strait Islander women who had at least one antenatal visit in the frst trimester, by measures of child and maternal health, by Medicare Local catchment, 20072011 14 National Health Performance Authority www.myhealthycommunities.gov.au Healthy Communities: Child and maternal health in 20092012 Key fndings: Antenatal visits in the frst trimester All women In 20102011, the national percentage of women who had at least one antenatal visit in the frst trimester of pregnancy was 67.2% for all women and 50.3% for Aboriginal and Torres Strait Islander women. Variation across local areas Across local areas, the percentage of women who had at least one antenatal visit in the frst trimester in 20102011 was more than double in the catchment with the highest percentage compared to the catchment with the lowest percentage. The percentage of women who had at least one antenatal visit in the frst trimester ranged as follows: Highest: Western Sydney 87.7% Lowest: Grampians (Vic) 36.6% (Figure 4, page 12 and pages 34 to 35). Variation across peer groups There were differences in the percentage of women who had at least one antenatal visit in the frst trimester across local areas with similar geographic characteristics. Across rural areas, the percentage of women who had at least one antenatal visit in the frst trimester was 41% higher in the Rural 1 catchment of Country North SA (75.2%) compared to the Rural 2 catchment of Far North Queensland (53.5%). However, across metropolitan areas and across regional areas this trend of higher rates of women who had at least one antenatal visit in the frst trimester in higher-income areas compared to lower-income areas was not apparent, with some local areas demonstrating what can be achieved for other similar areas. For example: Across metropolitan areas, the percentage of women who had at least one antenatal visit in the frst trimester was 37% higher in the lower- income urban catchment of Western Sydney (87.7%, Metro 3) compared to wealthier inner- city catchment of Inner North West Melbourne (64.1%, Metro 1) Across regional areas, the percentage of women who had at least one antenatal visit in the frst trimester was almost double in the lower-income catchment of Western NSW (82.7%) compared to the wealthier catchment of Frankston-Mornington-Peninsula (Vic) (41.7%). Variation within peer groups There were differences across similar catchments even after accounting for geographic and socioeconomic circumstances. Within the Metro 1 peer group, the percentage of women who had at least one antenatal visit in the frst trimester was 33% higher in Sydney North Shore & Beaches (85.5%) compared to Inner North West Melbourne (64.1%) Within the Regional 1 peer group, the percentage of women who had at least one antenatal visit in the frst trimester was double in Nepean-Blue Mountains (NSW) (85.5%) compared to Frankston-Mornington-Peninsula (Vic) (41.7%) (Table 6, page 15). 15 National Health Performance Authority www.myhealthycommunities.gov.au Healthy Communities: Child and maternal health in 20092012 Table 6: Highest and lowest percentage of all women who had at least one antenatal visit in the frst trimester across Medicare Local catchments, by peer group, 20102011 Aboriginal and Torres Strait Islander women Variation across local areas Across local areas, the percentage of Aboriginal and Torres Strait Islander women who had at least one antenatal visit in the frst trimester in 20102011 was almost four times higher in the catchment with the highest compared to the catchment with the lowest percentage. The percentage of Aboriginal and Torres Strait Islander women who had at least one antenatal visit in the frst trimester ranged as follows: Highest: Nepean-Blue Mountains (NSW) 80.5% Lowest: Grampians (Vic) 21.8% (Figure 5, page 13 and pages 36 to 37). Variation across peer groups There were differences in the percentage of Aboriginal and Torres Strait Islander women who had at least one antenatal visit in the frst trimester across local areas with similar geographic characteristics. Across regional areas, the percentage of Aboriginal and Torres Strait Islander women who had at least one antenatal visit in the frst trimester was almost four times higher in the wealthier catchment of Nepean- Blue Mountains (NSW) (80.5%, Regional 1) compared to the lower-income catchment of Grampians (Vic) (21.8%, Regional 2) Across rural areas, the percentage of Aboriginal and Torres Strait Islander women who had at least one antenatal visit in the frst trimester tended to be higher in the Rural 1 peer group compared to the Rural 2 peer group. The percentage was 58% higher in Far West NSW (60.8%, Rural 1) compared to Central & North West Queensland (38.5%, Rural 2). However, across metropolitan areas this trend of higher rates of Aboriginal and Torres Strait Islander women who had at least one antenatal visit in the frst trimester in higher-income areas compared to lower-income areas was not apparent, with some local areas demonstrating what can be achieved for other similar areas. Peer group Highest percentage Lowest percentage Difference Metro 1 85.5% 64.1% 33% (1.3 times higher) Metro 2 84.7% 56.3% 50% (1.5 times higher) Metro 3 87.7% 49.8% 76% (1.8 times higher) Regional 1 85.5% 41.7% 105% (2.1 times higher) Regional 2 82.7% 36.6% 126% (2.3 times higher) Rural 1 75.2% 58.8% 28% (1.3 times higher) Rural 2 71.2% 53.5% 33% (1.3 times higher) Note: Results for Medicare Local catchments that are to be interpreted with caution are not included. 16 National Health Performance Authority www.myhealthycommunities.gov.au Healthy Communities: Child and maternal health in 20092012 For example, across metropolitan areas, the percentage of Aboriginal and Torres Strait Islander women who had at least one antenatal visit in the frst trimester was almost three times higher in the lower-income urban catchment of Western Sydney (74.7%, Metro 3) compared to Greater Metro South Brisbane (27.6%, Metro 2). Variation within peer groups There were differences across similar catchments even after accounting for geographic and socioeconomic circumstances. Within the Metro 2 peer group, the percentage of Aboriginal and Torres Strait Islander women who had at least one antenatal visit in the frst trimester was almost double in Central Adelaide & Hills (51.9%) compared to Greater Metro South Brisbane (27.6%) Table 7: Highest and lowest percentage of Aboriginal and Torres Strait Islander women who had at least one antenatal visit in the frst trimester across Medicare Local catchments, by peer group, 20102011 Within the Regional 2 peer group, the percentage of Aboriginal and Torres Strait Islander women who had at least one antenatal visit in the frst trimester was more than three times higher in North Coast NSW (70.0%) compared to Grampians (Vic) (21.8%) (Table 7). Peer group Highest percentage Lowest percentage Difference Metro 1* - - - Metro 2 51.9% 27.6% 88% (1.9 times higher) Metro 3 74.7% 37.9% 97% (2.0 times higher) Regional 1 80.5% 52.9% 52% (1.5 times higher) Regional 2 70.0% 21.8% 221% (3.2 times higher) Rural 1 60.8% 38.7% 57% (1.6 times higher) Rural 2 49.8% 38.5% 29% (1.3 times higher) * Data were only available for two Medicare Local catchments in this peer group. Note: Results for Medicare Local catchments that are to be interpreted with caution are not included. 17 Health status and outcomes Child and maternal health in 20092012 National Health Performance Authority www.myhealthycommunities.gov.au Healthy Communities: Child and maternal health in 20092012 18 111 113 114 115 116 117 118 211 212 213 214 215 216 217 306 307 308 309 310 311 404 405 506 507 508 601 701 501 502 503 504 505 506 401 402 403 404 405 201 202 203 204 205 206 207 208 209 210 211 214 215 216 217 117 801 CANBERRA ROCKINGHAM MELBOURNE GEELONG PERTH i. vi. ii. iii. iv. v. ADELAIDE Results for Medicare Local catchments were ranked from highest to lowest and then split into fve equal-sized groups. 1
The range within each of the fve groups was as follows: L o w e s t g r o u p H i g h e s t g r o u p Medicare Local catchment boundary Numbers on map are Medicare Local reference codes 211 ii. Adelaide and surrounding areas i. Perth and surrounding areas iii. Melbourne and surrounding areas iv. Canberra and surrounding areas 1. Each Medicare Local has been assigned to a quintile group. 2. For more information on peer groups and the calculation of peer group results refer to this reports Technical Supplement. Notes: Deaths are attributed to the Medicare Local catchment in which the infant or young child usually resided, irrespective of where they died. Births are attributed to the Medicare Local catchment in which the mother usually resided, irrespective of where the birth occurred. Sources: National Health Performance Authority analysis of Australian Bureau of Statistics Death Registrations Collection 20102012 and Australian Bureau of Statistics Birth Registrations Collection 20102012. Data can be downloaded from www.myhealthycommunities.gov.au Years of data: 20102012 Infant and young child mortality rate During 20102012, the infant and young child mortality rate varied across Medicare Local catchments and across peer groups, ranging from 2.6 deaths per 1,000 live births in Bayside (Vic) to 9.2 deaths per 1,000 live births in the Northern Territory. Number of deaths among infants and young children aged less than 5 years per 1,000 live births, 20102012 5.4 9.2 4.8 5.3 4.0 4.7 3.4 3.9 2.6 3.3 National Health Performance Authority www.myhealthycommunities.gov.au National overviews Healthy Communities: Child and maternal health in 20092012 19 Health status and outcomes 0 2 4 6 8 10 Metro 1 3.3 Bayside .................................. 202 Sydney Nth Shore & Beaches . 108 Eastern Sydney....................... 101 Northern Sydney ..................... 107 Inner East Melbourne .............. 206 Inner West Sydney .................. 102 Australian Capital Territory ....... 801 Inner NW Melbourne ............... 201 2.6 2.8 3.0 3.1 3.3 3.6 3.8 4.2 0 2 4 6 8 10 Metro 2 4.1 South Western Melbourne ...... 203 Perth North Metro ................... 502 South Eastern Sydney ............ 103 Perth Central & East Metro ...... 501 Central Adelaide & Hills ........... 402 Fremantle ............................... 503 Bentley-Armadale ................... 504 Eastern Melbourne .................. 207 Sthn Adelaide-Fleurieu-Kang. Is. 403 Metro North Brisbane .............. 301 Gold Coast ............................. 303 Greater Metro South Brisbane . 302 2.9 3.0 3.0 3.2 3.4 3.4 3.6 3.7 3.9 4.7 5.0 6.1 0 2 4 6 8 10 Metro 3 4.3 Northern Melbourne ................ 205 Northern Adelaide ................... 401 Macedon Ranges & NW Melb . 204 West Moreton-Oxley ............... 305 Western Sydney...................... 105 South Eastern Melbourne........ 208 South Western Sydney ........... 104 3.3 3.4 3.9 4.3 4.4 4.8 5.0 0 2 4 6 8 10 Regional 1 4.3 Nepean-Blue Mountains .......... 106 Barwon ................................... 210 Central Coast NSW ................. 109 Perth South Coastal ................ 505 Illawarra-Shoalhaven ............... 110 Frankston-Mornington Peninsula 209 Hunter .................................... 111 Sunshine Coast ...................... 304 3.3 3.6 3.9 3.9 4.3 4.7 4.8 5.8 0 2 4 6 8 10 Regional 2 5.0 Goulburn Valley ....................... 215 Southern NSW ........................ 117 Gippsland ............................... 217 Hume ..................................... 216 Great South Coast .................. 212 Grampians .............................. 211 Tasmania ................................ 601 South West WA ...................... 506 North Coast NSW ................... 113 Loddon-Mallee-Murray ............ 214 Darling Downs-SW Qld ........... 306 Murrumbidgee ........................ 116 Western NSW ......................... 115 New England .......................... 114 Wide Bay ................................ 307 Country South SA ................... 404 3.5 4.0 4.0 4.1 4.3 4.4 4.7 4.9 5.0 5.1 5.3 5.7 5.7 6.1 6.2 6.5 0 2 4 6 8 10 Rural 1 5.6 Country North SA ................... 405 Townsville-Mackay .................. 310 Far West NSW ........................ 118 Lower Murray ......................... 213 Central Qld ............................. 308 4.9 5.0 5.3 5.7 7.3 0 2 4 6 8 10 Rural 2 7.9 Goldfelds-Midwest ................. 507 Kimberley-Pilbara .................... 508 Central & NW Qld ................... 309 Far North Qld .......................... 311 Northern Territory .................... 701 4.9 6.7 8.1 8.5 9.2 102 103 104 105 106 107 108 109 110 111 101 113 301 302 303 304 305 306 307 SYDNEY BRISBANE NEWCASTLE SUNSHINE COAST GOLD COAST WOLLONGONG Fair comparisons To compare Medicare Locals more fairly, each Medicare Local catchment has been grouped into one of seven peer groups 2 , based on remoteness and socioeconomic status. This allows: Medicare Local catchments to be compared within the same metropolitan, regional or rural peer group, and Medicare Local catchments to be compared with the average for their peer group. It also allows variation to be seen across peer groups that may be associated with remoteness and socioeconomic status. v. Sydney and surrounding areas vi. Brisbane and surrounding areas Peer groups Map Ref. More information can be found at www.myhealthycommunities.gov.au and in this reports Technical Supplement. National Health Performance Authority www.myhealthycommunities.gov.au Healthy Communities: Child and maternal health in 20092012 20 111 113 114 115 116 117 118 211 212 213 214 215 216 217 306 307 308 309 310 311 404 405 506 507 508 601 701 501 502 503 504 505 506 401 402 403 404 405 201 202 203 204 205 206 207 208 209 210 211 214 215 216 217 117 801 CANBERRA ROCKINGHAM MELBOURNE GEELONG PERTH i. vi. ii. iii. iv. v. ADELAIDE Results for Medicare Local catchments were ranked from highest to lowest and then split into fve equal-sized groups. 1
The range within each of the fve groups was as follows: L o w e s t g r o u p H i g h e s t g r o u p Medicare Local catchment boundary Numbers on map are Medicare Local reference codes 507 ii. Adelaide and surrounding areas i. Perth and surrounding areas iii. Melbourne and surrounding areas iv. Canberra and surrounding areas 1. Each Medicare Local has been assigned to a quintile group. 2. For more information on peer groups and the calculation of peer group results refer to this reports Technical Supplement. Notes: Deaths are attributed to the Medicare Local catchment in which the infant usually resided, irrespective of where they died. Births are attributed to the Medicare Local catchment in which the mother usually resided, irrespective of where the birth occurred. Sources: National Health Performance Authority analysis of Australian Bureau of Statistics Death Registrations Collection 20102012 and Australian Bureau of Statistics Birth Registrations Collection 20102012. Data can be downloaded from www.myhealthycommunities.gov.au Years of data: 20102012 Infant mortality rate During 20102012, the infant mortality rate varied across Medicare Local catchments and across peer groups, ranging from 2.3 deaths per 1,000 live births in Sydney North Shore & Beaches and Bayside (Vic) to 7.6 deaths per 1,000 live births in the Northern Territory. Number of deaths among infants aged less than 1 year per 1,000 live births, 20102012 4.6 7.6 3.8 4.5 3.3 3.7 2.9 3.2 2.3 2.8 Not available for publication National Health Performance Authority www.myhealthycommunities.gov.au National overviews Healthy Communities: Child and maternal health in 20092012 21 Health status and outcomes 0 2 4 6 8 10 Metro 1 2.9 Bayside .................................. 202 Sydney Nth Shore & Beaches . 108 Eastern Sydney....................... 101 Northern Sydney ..................... 107 Inner East Melbourne .............. 206 Inner West Sydney .................. 102 Australian Capital Territory ....... 801 Inner NW Melbourne ............... 201 2.3 2.3 2.7 2.8 3.0 3.2 3.2 3.7 0 2 4 6 8 10 Metro 2 3.6 Perth North Metro ................... 502 South Western Melbourne ...... 203 Perth Central & East Metro ...... 501 Fremantle ............................... 503 South Eastern Sydney ............ 103 Central Adelaide & Hills ........... 402 Bentley-Armadale ................... 504 Sthn Adelaide-Fleurieu-Kang. Is. 403 Eastern Melbourne .................. 207 Metro North Brisbane .............. 301 Gold Coast ............................. 303 Greater Metro South Brisbane . 302 2.4 2.4 2.6 2.6 2.7 2.9 3.0 3.2 3.3 4.1 4.4 5.5 0 2 4 6 8 10 Metro 3 3.6 Northern Melbourne ................ 205 Northern Adelaide ................... 401 Macedon Ranges & NW Melb . 204 West Moreton-Oxley ............... 305 Western Sydney...................... 105 South Eastern Melbourne........ 208 South Western Sydney ........... 104 2.7 2.9 3.6 3.7 3.8 4.0 4.4 0 2 4 6 8 10 Regional 1 3.6 Nepean-Blue Mountains .......... 106 Barwon ................................... 210 Frankston-Mornington Peninsula 209 Perth South Coastal ................ 505 Illawarra-Shoalhaven ............... 110 Central Coast NSW ................. 109 Hunter .................................... 111 Sunshine Coast ...................... 304 2.6 2.8 3.2 3.5 3.5 3.7 4.0 4.8 0 2 4 6 8 10 Regional 2 4.1 Goulburn Valley ....................... 215 Great South Coast .................. 212 South West WA ...................... 506 Grampians .............................. 211 Southern NSW ........................ 117 Gippsland ............................... 217 Hume ..................................... 216 Tasmania ................................ 601 Loddon-Mallee-Murray ............ 214 North Coast NSW ................... 113 Darling Downs-SW Qld ........... 306 Western NSW ......................... 115 Country South SA ................... 404 Murrumbidgee ........................ 116 Wide Bay ................................ 307 New England .......................... 114 2.8 2.9 3.1 3.3 3.4 3.5 3.7 4.1 4.3 4.3 4.3 4.5 4.6 4.9 5.0 5.3 0 2 4 6 8 10 Rural 1 4.6 Country North SA ................... 405 Townsville-Mackay .................. 310 Central Qld ............................. 308 Far West NSW ........................ 118 Lower Murray ......................... 213 3.8 4.0 6.1 NP NP 0 2 4 6 8 10 Rural 2 6.5 Goldfelds-Midwest ................. 507 Kimberley-Pilbara .................... 508 Central & NW Qld ................... 309 Far North Qld .......................... 311 Northern Territory .................... 701 3.7 5.7 6.9 7.0 7.6 102 103 104 105 106 107 108 109 110 111 101 113 301 302 303 304 305 306 307 SYDNEY BRISBANE NEWCASTLE SUNSHINE COAST GOLD COAST WOLLONGONG Fair comparisons To compare Medicare Locals more fairly, each Medicare Local catchment has been grouped into one of seven peer groups 2 , based on remoteness and socioeconomic status. This allows: Medicare Local catchments to be compared within the same metropolitan, regional or rural peer group, and Medicare Local catchments to be compared with the average for their peer group. It also allows variation to be seen across peer groups that may be associated with remoteness and socioeconomic status. v. Sydney and surrounding areas vi. Brisbane and surrounding areas Peer groups Map Ref. NP Not available for publication. More information can be found at www.myhealthycommunities.gov.au and in this reports Technical Supplement. National Health Performance Authority www.myhealthycommunities.gov.au Healthy Communities: Child and maternal health in 20092012 22 111 113 114 115 116 117 118 211 212 213 214 215 216 217 306 307 308 309 310 311 404 405 506 507 508 601 701 501 502 503 504 505 506 401 402 403 404 405 201 202 203 204 205 206 207 208 209 210 211 214 215 216 217 117 801 CANBERRA ROCKINGHAM MELBOURNE GEELONG PERTH ADELAIDE i. vi. ii. iii. iv. v. Results for Medicare Local catchments were ranked from highest to lowest and then split into fve equal-sized groups. 1
The range within each of the fve groups was as follows: L o w e s t g r o u p H i g h e s t g r o u p Medicare Local catchment boundary Numbers on map are Medicare Local reference codes 402 ii. Adelaide and surrounding areas i. Perth and surrounding areas iii. Melbourne and surrounding areas iv. Canberra and surrounding areas Years of data: 20092011 Low-birthweight babies, all women During 20092011, the percentage of liveborn babies of low birthweight varied across Medicare Local catchments and across peer groups, ranging from 3.3% in Sydney North Shore & Beaches to 7.7% in Northern Territory. Percentage of live births that were of low birthweight, all women, 20092011 1. Each Medicare Local has been assigned to a quintile group. 2. For more information on peer groups and the calculation of peer group results refer to this reports Technical Supplement. Notes: Multiple births and stillbirths are excluded. Births are attributed to the Medicare Local catchment in which the mother usually resided, irrespective of where the birth occurred. Data exclude births to Australian non-residents, residents of external territories and women who could not be allocated to a Medicare Local catchment because their Statistical Local Area of usual residence was not stated or was not valid. Source: Customised data report prepared for the National Health Performance Authority from the Australian Institute of Health and Welfare National Perinatal Data Collection 20092011. Data can be downloaded from www.myhealthycommunities.gov.au 5.6 7.7% 5.0 5.5% 4.8 4.9% 4.4 4.7% 3.3 4.3% National Health Performance Authority www.myhealthycommunities.gov.au National overviews Healthy Communities: Child and maternal health in 20092012 23 Health status and outcomes 0% 2% 4% 6% 8% 10% Metro 1 4.0% Inner NW Melbourne ............... 201 Inner East Melbourne .............. 206 Australian Capital Territory* ..... 801 Inner West Sydney .................. 102 Bayside .................................. 202 Northern Sydney ..................... 107 Eastern Sydney....................... 101 Sydney Nth Shore & Beaches . 108 4.4% 4.3% 4.3% 4.2% 4.0% 3.6% 3.5% 3.3% 0% 2% 4% 6% 8% 10% Metro 2 4.6% South Western Melbourne ...... 203 Bentley-Armadale ................... 504 Central Adelaide & Hills ........... 402 Sthn Adelaide-Fleurieu-Kang. Is. 403 Eastern Melbourne .................. 207 Greater Metro South Brisbane . 302 Perth North Metro ................... 502 Perth Central & East Metro ...... 501 Metro North Brisbane .............. 301 Gold Coast ............................. 303 South Eastern Sydney ............ 103 Fremantle ............................... 503 5.2% 5.1% 4.8% 4.7% 4.7% 4.7% 4.7% 4.6% 4.6% 4.2% 4.0% 3.7% 0% 2% 4% 6% 8% 10% Metro 3 4.9% Northern Adelaide ................... 401 South Eastern Melbourne........ 208 West Moreton-Oxley ............... 305 Macedon Ranges & NW Melb . 204 Northern Melbourne ................ 205 Western Sydney...................... 105 South Western Sydney ........... 104 5.7% 5.1% 4.9% 4.9% 4.9% 4.8% 4.7% 0% 2% 4% 6% 8% 10% Regional 1 4.6% Central Coast NSW ................. 109 Sunshine Coast ...................... 304 Hunter .................................... 111 Barwon ................................... 210 Nepean-Blue Mountains .......... 106 Frankston-Mornington Peninsula 209 Perth South Coastal ................ 505 Illawarra-Shoalhaven ............... 110 4.9% 4.9% 4.7% 4.4% 4.4% 4.3% 4.3% 4.3% 0% 2% 4% 6% 8% 10% Regional 2 5.1% Country South SA ................... 404 New England .......................... 114 Tasmania ................................ 601 Gippsland ............................... 217 Goulburn Valley ....................... 215 Wide Bay ................................ 307 Loddon-Mallee-Murray ............ 214 Southern NSW ........................ 117 Grampians .............................. 211 Hume ..................................... 216 Great South Coast .................. 212 Western NSW ......................... 115 North Coast NSW ................... 113 Murrumbidgee ........................ 116 Darling Downs-SW Qld ........... 306 South West WA ...................... 506 5.6% 5.6% 5.6% 5.5% 5.4% 5.3% 5.2% 5.2% 5.2% 5.0% 5.0% 4.9% 4.8% 4.7% 4.6% 4.4% 0% 2% 4% 6% 8% 10% Rural 1 5.4% Far West NSW ........................ 118 Lower Murray ......................... 213 Country North SA ................... 405 Townsville-Mackay .................. 310 Central Qld ............................. 308 7.5% 5.8% 5.6% 5.2% 5.0% 0% 2% 4% 6% 8% 10% Rural 2 6.8% Northern Territory .................... 701 Central & NW Qld ................... 309 Kimberley-Pilbara .................... 508 Far North Qld .......................... 311 Goldfelds-Midwest ................. 507 7.7% 7.6% 6.5% 6.2% 5.8% 102 103 104 105 106 107 108 109 110 111 101 113 301 302 303 304 305 306 307 SYDNEY BRISBANE NEWCASTLE SUNSHINE COAST GOLD COAST WOLLONGONG Fair comparisons To compare Medicare Locals more fairly, each Medicare Local catchment has been grouped into one of seven peer groups 2 , based on remoteness and socioeconomic status. This allows: Medicare Local catchments to be compared within the same metropolitan, regional or rural peer group, and Medicare Local catchments to be compared with the average for their peer group. It also allows variation to be seen across peer groups that may be associated with remoteness and socioeconomic status. v. Sydney and surrounding areas vi. Brisbane and surrounding areas Peer groups Map Ref. * In 20092011, there were 202 liveborn babies of women who usually resided in the Australian Capital Territory and gave birth in New South Wales who were not counted in the result for the Australian Capital Territory Medicare Local catchment. More information can be found at www.myhealthycommunities.gov.au and in this reports Technical Supplement. National Health Performance Authority www.myhealthycommunities.gov.au Healthy Communities: Child and maternal health in 20092012 24 111 113 114 115 116 117 118 211 212 213 214 215 216 217 306 307 308 309 310 311 404 405 506 507 508 601 701 501 502 503 504 505 506 401 402 403 404 405 201 202 203 204 205 206 207 208 209 210 211 214 215 216 217 117 801 CANBERRA ROCKINGHAM MELBOURNE GEELONG PERTH i. vi. ii. iii. iv. v. ADELAIDE Results for Medicare Local catchments were ranked from highest to lowest and then split into fve equal-sized groups. 1
The range within each of the fve groups was as follows: L o w e s t g r o u p H i g h e s t g r o u p Medicare Local catchment boundary Numbers on map are Medicare Local reference codes 402 ii. Adelaide and surrounding areas i. Perth and surrounding areas iii. Melbourne and surrounding areas iv. Canberra and surrounding areas Years of data: 20072011 Low-birthweight babies, Aboriginal and Torres Strait Islander women During 20072011, the percentage of liveborn babies of low birthweight born to Aboriginal and Torres Strait Islander women varied across Medicare Local catchments and across peer groups, ranging from 6.7% in Frankston-Mornington Peninsula (Vic) to 17.5% in Gippsland (Vic). Percentage of live births that were of low birthweight, Aboriginal and Torres Strait Islander women, 20072011 1. Each Medicare Local has been assigned to a quintile group. 2. For more information on peer groups and the calculation of peer group results refer to this reports Technical Supplement. Notes: Multiple births and stillbirths are excluded. Births are attributed to the Medicare Local catchment in which the mother usually resided, irrespective of where the birth occurred. Data exclude births to Australian non-residents, residents of external territories and women who could not be allocated to a Medicare Local catchment because their Statistical Local Area of usual residence was not stated or was not valid. Source: Customised data report prepared for the National Health Performance Authority from the Australian Institute of Health and Welfare National Perinatal Data Collection 20072011. Data can be downloaded from www.myhealthycommunities.gov.au 13.1 17.5% 11.7 13.0% 10.1 11.6% 8.2 10.0% 6.7 8.1% Not available for publication National Health Performance Authority www.myhealthycommunities.gov.au National overviews Healthy Communities: Child and maternal health in 20092012 25 Health status and outcomes 0% 4% 8% 12% 16% 20% Metro 1 10.3% Inner NW Melbourne ............... 201 Inner West Sydney .................. 102 Australian Capital Territory* ..... 801 Eastern Sydney....................... 101 Northern Sydney ..................... 107 Sydney Nth Shore & Beaches . 108 Bayside .................................. 202 Inner East Melbourne .............. 206 13.5% 13.1% 11.6% 8.0% NP NP NP NP 0% 4% 8% 12% 16% 20% Metro 2 10.2% Bentley-Armadale ................... 504 Fremantle ............................... 503 Perth Central & East Metro ...... 501 Perth North Metro ................... 502 Central Adelaide & Hills ........... 402 Greater Metro South Brisbane . 302 Sthn Adelaide-Fleurieu-Kang. Is. 403 Gold Coast ............................. 303 South Eastern Sydney ............ 103 Metro North Brisbane .............. 301 South Western Melbourne ...... 203 Eastern Melbourne .................. 207 14.3% 13.0% 12.9% 11.9% 10.6% 9.1% 8.9% 8.3% 7.2% 7.1% NP NP 0% 4% 8% 12% 16% 20% Metro 3 10.3% Northern Adelaide ................... 401 Western Sydney...................... 105 Northern Melbourne ................ 205 South Western Sydney ........... 104 West Moreton-Oxley ............... 305 South Eastern Melbourne........ 208 Macedon Ranges & NW Melb . 204 13.5% 11.6% 10.0% 9.7% 8.0% 7.2% 7.0% 0% 4% 8% 12% 16% 20% Regional 1 9.7% Barwon ................................... 210 Perth South Coastal ................ 505 Nepean-Blue Mountains .......... 106 Hunter .................................... 111 Central Coast NSW ................. 109 Sunshine Coast ...................... 304 Illawarra-Shoalhaven ............... 110 Frankston-Mornington Peninsula 209 13.0% 10.8% 10.3% 10.3% 9.9% 8.1% 7.8% 6.7% 0% 4% 8% 12% 16% 20% Regional 2 10.5% Gippsland ............................... 217 Great South Coast .................. 212 Southern NSW ........................ 117 South West WA ...................... 506 Loddon-Mallee-Murray ............ 214 Grampians .............................. 211 New England .......................... 114 Hume ..................................... 216 Country South SA ................... 404 North Coast NSW ................... 113 Goulburn Valley ....................... 215 Darling Downs-SW Qld ........... 306 Western NSW ......................... 115 Tasmania ................................ 601 Murrumbidgee ........................ 116 Wide Bay ................................ 307 17.5% 16.4% 14.7% 14.0% 12.1% 11.9% 11.5% 10.9% 10.7% 10.6% 9.7% 9.3% 8.9% 8.3% 7.8% 7.6% 0% 4% 8% 12% 16% 20% Rural 1 11.4% Lower Murray ......................... 213 Country North SA ................... 405 Far West NSW ........................ 118 Townsville-Mackay .................. 310 Central Qld ............................. 308 13.6% 13.0% 12.4% 10.9% 9.1% 0% 4% 8% 12% 16% 20% Rural 2 12.2% Kimberley-Pilbara .................... 508 Northern Territory .................... 701 Goldfelds-Midwest ................. 507 Central & NW Qld ................... 309 Far North Qld .......................... 311 13.3% 13.0% 12.5% 12.3% 10.3% 102 103 104 105 106 107 108 109 110 111 101 113 301 302 303 304 305 306 307 SYDNEY BRISBANE NEWCASTLE SUNSHINE COAST GOLD COAST WOLLONGONG Fair comparisons To compare Medicare Locals more fairly, each Medicare Local catchment has been grouped into one of seven peer groups 2 , based on remoteness and socioeconomic status. This allows: Medicare Local catchments to be compared within the same metropolitan, regional or rural peer group, and Medicare Local catchments to be compared with the average for their peer group. It also allows variation to be seen across peer groups that may be associated with remoteness and socioeconomic status. v. Sydney and surrounding areas vi. Brisbane and surrounding areas Peer groups Map Ref. * In 20072011, there were eight liveborn babies of Aboriginal and Torres Strait Islander women who usually resided in the Australian Capital Territory and gave birth in New South Wales who were not counted in the result for the Australian Capital Territory Medicare Local catchment. NP Not available for publication. More information can be found at www.myhealthycommunities.gov.au and in this reports Technical Supplement. 27 Prevention Child and maternal health in 20092012 National Health Performance Authority www.myhealthycommunities.gov.au Healthy Communities: Child and maternal health in 20092012 28 111 113 114 115 116 117 118 211 212 213 214 215 216 217 306 307 308 309 310 311 404 405 506 507 508 601 701 501 502 503 504 505 506 401 402 403 404 405 201 202 203 204 205 206 207 208 209 210 211 214 215 216 217 117 801 CANBERRA ROCKINGHAM MELBOURNE GEELONG PERTH i. vi. ii. iii. iv. v. ADELAIDE Results for Medicare Local catchments were ranked from highest to lowest and then split into fve equal-sized groups. 1
The range within each of the fve groups was as follows: L o w e s t g r o u p H i g h e s t g r o u p Medicare Local catchment boundary Numbers on map are Medicare Local reference codes 506 ii. Adelaide and surrounding areas i. Perth and surrounding areas iii. Melbourne and surrounding areas iv. Canberra and surrounding areas 1. Each Medicare Local has been assigned to a quintile group. 2. For more information on peer groups and the calculation of peer group results refer to this reports Technical Supplement. Notes: Data exclude women whose smoking status was not stated, Australian non-residents, residents of external territories and women who could not be allocated to a Medicare Local catchment because their Statistical Local Area of usual residence was not stated or was not valid. Source: Customised data report prepared for the National Health Performance Authority from the Australian Institute of Health and Welfare National Perinatal Data Collection 20092011. Data can be downloaded from www.myhealthycommunities.gov.au Years of data: 20092011 Smoking during pregnancy, all women During 20092011, the percentage of women who gave birth and smoked during pregnancy varied across Medicare Local catchments and across peer groups, ranging from 1.8% in Sydney North Shore & Beaches to 33.1% in Far West NSW. Percentage of women who gave birth and smoked during pregnancy, 20092011 22.5 33.1% 18.9 22.4% 14.1 18.8% 9.6 14.0% 1.8 9.5% National Health Performance Authority www.myhealthycommunities.gov.au National overviews Healthy Communities: Child and maternal health in 20092012 29 Prevention 0% 5% 10% 15% 20% 25% 30% 35% Metro 1 5.0% Australian Capital Territory* ..... 801 Inner NW Melbourne ............... 201 Inner West Sydney .................. 102 Bayside .................................. 202 Inner East Melbourne .............. 206 Eastern Sydney....................... 101 Northern Sydney ..................... 107 Sydney Nth Shore & Beaches . 108 10.2% 6.8% 6.3% 5.5% 3.9% 2.5% 2.2% 1.8% 0% 5% 10% 15% 20% 25% 30% 35% Metro 2 11.3% Sthn Adelaide-Fleurieu-Kang. Is. 403 Greater Metro South Brisbane . 302 Metro North Brisbane .............. 301 Bentley-Armadale ................... 504 Gold Coast ............................. 303 Eastern Melbourne .................. 207 South Western Melbourne ...... 203 Central Adelaide & Hills ........... 402 Perth Central & East Metro ...... 501 Perth North Metro ................... 502 Fremantle ............................... 503 South Eastern Sydney ............ 103 14.5% 13.7% 13.0% 12.8% 12.6% 11.3% 11.1% 10.8% 9.6% 8.5% 7.4% 4.7% 0% 5% 10% 15% 20% 25% 30% 35% Metro 3 13.2% Northern Adelaide ................... 401 West Moreton-Oxley ............... 305 South Eastern Melbourne........ 208 South Western Sydney ........... 104 Macedon Ranges & NW Melb . 204 Northern Melbourne ................ 205 Western Sydney...................... 105 22.4% 19.6% 15.4% 14.4% 10.7% 9.5% 8.0% 0% 5% 10% 15% 20% 25% 30% 35% Regional 1 16.1% Perth South Coastal ................ 505 Frankston-Mornington Peninsula 209 Hunter .................................... 111 Central Coast NSW ................. 109 Sunshine Coast ...................... 304 Nepean-Blue Mountains .......... 106 Barwon ................................... 210 Illawarra-Shoalhaven ............... 110 18.8% 18.5% 16.9% 15.8% 15.6% 14.8% 14.0% 14.0% 0% 5% 10% 15% 20% 25% 30% 35% Regional 2 21.0% Wide Bay ................................ 307 Country South SA ................... 404 Goulburn Valley ....................... 215 Darling Downs-SW Qld ........... 306 Western NSW ......................... 115 New England .......................... 114 Tasmania ................................ 601 Gippsland ............................... 217 Loddon-Mallee-Murray ............ 214 Hume ..................................... 216 Southern NSW ........................ 117 Great South Coast .................. 212 North Coast NSW ................... 113 Murrumbidgee ........................ 116 South West WA ...................... 506 Grampians .............................. 211 26.5% 25.6% 24.4% 23.9% 23.2% 22.7% 22.2% 21.2% 20.9% 19.2% 19.2% 19.1% 18.2% 18.2% 17.1% 15.5% 0% 5% 10% 15% 20% 25% 30% 35% Rural 1 22.2% Far West NSW ........................ 118 Country North SA ................... 405 Lower Murray ......................... 213 Central Qld ............................. 308 Townsville-Mackay .................. 310 33.1% 26.7% 22.3% 22.1% 19.5% 0% 5% 10% 15% 20% 25% 30% 35% Rural 2 26.0% Central & NW Qld ................... 309 Far North Qld .......................... 311 Northern Territory .................... 701 Kimberley-Pilbara .................... 508 Goldfelds-Midwest ................. 507 27.6% 27.3% 27.0% 25.4% 21.2% 102 103 104 105 106 107 108 109 110 111 101 113 301 302 303 304 305 306 307 SYDNEY BRISBANE NEWCASTLE SUNSHINE COAST GOLD COAST WOLLONGONG Fair comparisons To compare Medicare Locals more fairly, each Medicare Local catchment has been grouped into one of seven peer groups 2 , based on remoteness and socioeconomic status. This allows: Medicare Local catchments to be compared within the same metropolitan, regional or rural peer group, and Medicare Local catchments to be compared with the average for their peer group. It also allows variation to be seen across peer groups that may be associated with remoteness and socioeconomic status. v. Sydney and surrounding areas vi. Brisbane and surrounding areas Peer groups Map Ref. * In 20092011, there were 205 women who usually resided in the Australian Capital Territory and gave birth in New South Wales who were not counted in the result for the Australian Capital Territory Medicare Local catchment. More information can be found at www.myhealthycommunities.gov.au and in this reports Technical Supplement. National Health Performance Authority www.myhealthycommunities.gov.au Healthy Communities: Child and maternal health in 20092012 30 111 113 114 115 116 117 118 211 212 213 214 215 216 217 306 307 308 309 310 311 404 405 506 507 508 601 701 501 502 503 504 505 506 401 402 403 404 405 201 202 203 204 205 206 207 208 209 210 211 214 215 216 217 117 801 CANBERRA ROCKINGHAM MELBOURNE GEELONG PERTH i. vi. ii. iii. iv. v. ADELAIDE Results for Medicare Local catchments were ranked from highest to lowest and then split into fve equal-sized groups. 1
The range within each of the fve groups was as follows: L o w e s t g r o u p H i g h e s t g r o u p Medicare Local catchment boundary Numbers on map are Medicare Local reference codes 506 ii. Adelaide and surrounding areas i. Perth and surrounding areas iii. Melbourne and surrounding areas iv. Canberra and surrounding areas Years of data: 20072011 Smoking during pregnancy, Aboriginal and Torres Strait Islander women During 20072011, the percentage of Aboriginal and Torres Strait Islander women who gave birth and smoked during pregnancy varied across Medicare Local catchments and across peer groups, ranging from 29.4% in Macedon Ranges & North Western Melbourne to 66.4% in Goulburn Valley (Vic). Percentage of Aboriginal and Torres Strait Islander women who gave birth and smoked during pregnancy, 20072011 1. Each Medicare Local has been assigned to a quintile group. 2. For more information on peer groups and the calculation of peer group results refer to this reports Technical Supplement. Notes: Data exclude women whose smoking status was not stated, Australian non-residents, residents of external territories and women who could not be allocated to a Medicare Local catchment because their Statistical Local Area of usual residence was not stated or was not valid. Source: Customised data report prepared for the National Health Performance Authority from the Australian Institute of Health and Welfare National Perinatal Data Collection 20072011. More information can be found at www.myhealthycommunities.gov.au and in this reports Technical Supplement. Data can be downloaded from www.myhealthycommunities.gov.au 55.4 66.4% 52.5 55.3% 49.1 52.4% 43.6 49.0% 29.4 43.5% Not available for publication National Health Performance Authority www.myhealthycommunities.gov.au National overviews Healthy Communities: Child and maternal health in 20092012 31 Prevention 0% 10% 20% 30% 40% 50% 60% 70% Metro 1 40.3% Australian Capital Territory* ..... 801 Inner West Sydney .................. 102 Eastern Sydney....................... 101 Northern Sydney ..................... 107 Sydney Nth Shore & Beaches . 108 Inner NW Melbourne ............... 201 Bayside .................................. 202 Inner East Melbourne .............. 206 53.7% 49.0% 35.1% NP NP NP NP NP 0% 10% 20% 30% 40% 50% 60% 70% Metro 2 47.3% Sthn Adelaide-Fleurieu-Kang. Is. 403 Central Adelaide & Hills ........... 402 Bentley-Armadale ................... 504 Perth Central & East Metro ...... 501 Fremantle ............................... 503 Metro North Brisbane .............. 301 Perth North Metro ................... 502 Greater Metro South Brisbane . 302 Gold Coast ............................. 303 South Eastern Sydney ............ 103 South Western Melbourne ...... 203 Eastern Melbourne .................. 207 56.7% 55.3% 52.5% 51.4% 47.6% 47.1% 44.3% 43.5% 35.0% 34.4% NP NP 0% 10% 20% 30% 40% 50% 60% 70% Metro 3 50.5% Northern Adelaide ................... 401 West Moreton-Oxley ............... 305 Western Sydney...................... 105 South Western Sydney ........... 104 South Eastern Melbourne # ...... 208 Northern Melbourne # ............... 205 Macedon Ranges & NW Melb # 204 62.0% 53.9% 49.4% 47.0% 43.4% 35.7% 29.4% 0% 10% 20% 30% 40% 50% 60% 70% Regional 1 46.3% Hunter .................................... 111 Perth South Coastal ................ 505 Illawarra-Shoalhaven ............... 110 Nepean-Blue Mountains .......... 106 Sunshine Coast ...................... 304 Central Coast NSW ................. 109 Frankston-Mornington Peninsula 209 Barwon ................................... 210 48.9% 48.3% 46.9% 46.4% 42.8% 42.0% NP NP 0% 10% 20% 30% 40% 50% 60% 70% Regional 2 54.4% Goulburn Valley # ...................... 215 Country South SA ................... 404 Darling Downs-SW Qld ........... 306 Southern NSW ........................ 117 New England .......................... 114 Loddon-Mallee-Murray # ........... 214 Western NSW ......................... 115 Tasmania ................................ 601 North Coast NSW ................... 113 Murrumbidgee ........................ 116 Gippsland # .............................. 217 Hume # .................................... 216 South West WA ...................... 506 Wide Bay ................................ 307 Grampians # ............................. 211 Great South Coast .................. 212 66.4% 64.6% 60.4% 55.6% 55.1% 54.4% 53.1% 52.7% 52.5% 52.1% 52.1% 51.8% 51.8% 50.4% 34.7% NP 0% 10% 20% 30% 40% 50% 60% 70% Rural 1 55.2% Country North SA ................... 405 Far West NSW ........................ 118 Lower Murray # ........................ 213 Central Qld ............................. 308 Townsville-Mackay .................. 310 62.2% 60.8% 56.6% 52.4% 51.5% 0% 10% 20% 30% 40% 50% 60% 70% Rural 2 52.9% Far North Qld .......................... 311 Central & NW Qld ................... 309 Kimberley-Pilbara .................... 508 Northern Territory .................... 701 Goldfelds-Midwest ................. 507 55.6% 53.1% 52.9% 52.2% 46.7% 102 103 104 105 106 107 108 109 110 111 101 113 301 302 303 304 305 306 307 SYDNEY BRISBANE NEWCASTLE SUNSHINE COAST GOLD COAST WOLLONGONG Fair comparisons To compare Medicare Locals more fairly, each Medicare Local catchment has been grouped into one of seven peer groups 2 , based on remoteness and socioeconomic status. This allows: Medicare Local catchments to be compared within the same metropolitan, regional or rural peer group, and Medicare Local catchments to be compared with the average for their peer group. It also allows variation to be seen across peer groups that may be associated with remoteness and socioeconomic status. v. Sydney and surrounding areas vi. Brisbane and surrounding areas Peer groups Map Ref. * In 20072011, there were eight Aboriginal and Torres Strait Islander women who usually resided in the Australian Capital Territory and gave birth in New South Wales who were not counted in the result for the Australian Capital Territory Medicare Local catchment. # Interpret with caution. Data on smoking during pregnancy are not available for women who gave birth in Victoria in 2007 or 2008. Therefore, the data presented do not include Aboriginal and Torres Strait Islander women who usually resided in Victoria and gave birth in Victoria in 2007 or 2008. NP Not available for publication. 33 Use of health services Child and maternal health in 20092012 National Health Performance Authority www.myhealthycommunities.gov.au Healthy Communities: Child and maternal health in 20092012 34 111 113 114 115 116 117 118 211 212 213 214 215 216 217 306 307 308 309 310 311 404 405 506 507 508 601 701 501 502 503 504 505 506 401 402 403 404 405 201 202 203 204 205 206 207 208 209 210 211 214 215 216 217 117 801 CANBERRA ROCKINGHAM MELBOURNE GEELONG PERTH ADELAIDE i. vi. ii. iii. iv. v. Results for Medicare Local catchments were ranked from highest to lowest and then split into fve equal-sized groups. 1
The range within each of the fve groups was as follows: L o w e s t g r o u p H i g h e s t g r o u p Medicare Local catchment boundary Numbers on map are Medicare Local reference codes 506 ii. Adelaide and surrounding areas i. Perth and surrounding areas iii. Melbourne and surrounding areas iv. Canberra and surrounding areas 1. Each Medicare Local has been assigned to a quintile group. 2. For more information on peer groups and the calculation of peer group results refer to this reports Technical Supplement. Notes: Jurisdictional differences in defnitions and methods used for data collection affect the comparability of these data across jurisdictions and lower levels of geography within jurisdictions. Data exclude women whose gestation at frst antenatal visit was not stated, Australian non-residents, residents of external territories and women who could not be allocated to a Medicare Local catchment because their Statistical Local Area of usual residence was not stated or was not valid. Source: Customised data report prepared for the National Health Performance Authority from the Australian Institute of Health and Welfare National Perinatal Data Collection 20102011. Data can be downloaded from www.myhealthycommunities.gov.au Years of data: 20102011 Antenatal visits in the frst trimester, all women During 20102011, the percentage of women who gave birth and had at least one antenatal visit in the frst trimester varied across Medicare Local catchments and across peer groups, ranging from 87.7% in Western Sydney to 36.6% in Grampians (Vic). Percentage of women who gave birth and had at least one antenatal visit in the frst trimester, 20102011 77.2 87.7% 70.6 77.1% 62.4 70.5% 54.1 62.3% 36.6 54.0% National Health Performance Authority www.myhealthycommunities.gov.au National overviews Healthy Communities: Child and maternal health in 20092012 35 Use of health services 0% 20% 40% 60% 80% 100% Metro 1 72.2% Sydney Nth Shore & Beaches . 108 Northern Sydney ..................... 107 Eastern Sydney....................... 101 Inner East Melbourne .............. 206 Bayside .................................. 202 Inner West Sydney .................. 102 Inner NW Melbourne ............... 201 Australian Capital Territory* # .... 801 85.5% 85.1% 81.2% 72.7% 72.7% 70.5% 64.1% 45.2% 0% 20% 40% 60% 80% 100% Metro 2 63.5% Central Adelaide & Hills ........... 402 Metro North Brisbane .............. 301 Sthn Adelaide-Fleurieu-Kang. Is. 403 Eastern Melbourne .................. 207 South Eastern Sydney ............ 103 Bentley-Armadale # .................. 504 South Western Melbourne ...... 203 Gold Coast ............................. 303 Greater Metro South Brisbane . 302 Perth North Metro # .................. 502 Fremantle # .............................. 503 Perth Central & East Metro # ..... 501 84.7% 75.6% 72.5% 69.3% 67.1% 58.5% 58.3% 57.8% 56.3% 53.9% 50.4% 50.1% 0% 20% 40% 60% 80% 100% Metro 3 67.2% Western Sydney...................... 105 Northern Adelaide ................... 401 West Moreton-Oxley ............... 305 Northern Melbourne ................ 205 South Western Sydney ........... 104 South Eastern Melbourne........ 208 Macedon Ranges & NW Melb . 204 87.7% 82.3% 74.2% 63.1% 55.0% 54.0% 49.8% 0% 20% 40% 60% 80% 100% Regional 1 72.5% Nepean-Blue Mountains .......... 106 Central Coast NSW ................. 109 Hunter .................................... 111 Illawarra-Shoalhaven ............... 110 Perth South Coastal # ............... 505 Sunshine Coast ...................... 304 Barwon ................................... 210 Frankston-Mornington Peninsula . 209 85.5% 83.0% 77.1% 75.4% 72.0% 67.8% 63.7% 41.7% 0% 20% 40% 60% 80% 100% Regional 2 65.9% Western NSW ......................... 115 New England .......................... 114 Murrumbidgee ........................ 116 North Coast NSW ................... 113 Country South SA ................... 404 Great South Coast .................. 212 Southern NSW ........................ 117 South West WA # ..................... 506 Tasmania ................................ 601 Darling Downs-SW Qld ........... 306 Gippsland ............................... 217 Hume ..................................... 216 Loddon-Mallee-Murray ............ 214 Goulburn Valley ....................... 215 Wide Bay ................................ 307 Grampians .............................. 211 82.7% 81.2% 79.9% 79.7% 74.9% 68.5% 68.5% 67.3% 67.1% 62.3% 61.2% 59.5% 55.5% 41.3% 40.9% 36.6% 0% 20% 40% 60% 80% 100% Rural 1 65.2% Country North SA ................... 405 Far West NSW ........................ 118 Lower Murray ......................... 213 Townsville-Mackay .................. 310 Central Qld ............................. 308 75.2% 72.1% 67.9% 63.9% 58.8% 0% 20% 40% 60% 80% 100% Rural 2 59.3% Northern Territory .................... 701 Goldfelds-Midwest # ................ 507 Central & NW Qld ................... 309 Far North Qld .......................... 311 Kimberley-Pilbara # ................... 508 71.2% 55.9% 55.2% 53.5% 45.2% 102 103 104 105 106 107 108 109 110 111 101 113 301 302 303 304 305 306 307 SYDNEY BRISBANE NEWCASTLE SUNSHINE COAST GOLD COAST WOLLONGONG Fair comparisons To compare Medicare Locals more fairly, each Medicare Local catchment has been grouped into one of seven peer groups 2 , based on remoteness and socioeconomic status. This allows: Medicare Local catchments to be compared within the same metropolitan, regional or rural peer group, and Medicare Local catchments to be compared with the average for their peer group. It also allows variation to be seen across peer groups that may be associated with remoteness and socioeconomic status. v. Sydney and surrounding areas vi. Brisbane and surrounding areas Peer groups Map Ref. * In 20102011, there were 142 women who usually resided in the Australian Capital Territory and gave birth in New South Wales who were not counted in the result for the Australian Capital Territory Medicare Local catchment. # Interpret with caution. In WA and ACT, frst antenatal visits that occur outside of the hospital may not be included. More information can be found at www.myhealthycommunities.gov.au and in this reports Technical Supplement. National Health Performance Authority www.myhealthycommunities.gov.au Healthy Communities: Child and maternal health in 20092012 36 111 113 114 115 116 117 118 211 212 213 214 215 216 217 306 307 308 309 310 311 404 405 506 507 508 601 701 501 502 503 504 505 506 401 402 403 404 405 201 202 203 204 205 206 207 208 209 210 211 214 215 216 217 117 801 CANBERRA ROCKINGHAM MELBOURNE GEELONG PERTH i. vi. ii. iii. iv. v. ADELAIDE Results for Medicare Local catchments were ranked from highest to lowest and then split into fve equal-sized groups. 1
The range within each of the fve groups was as follows: L o w e s t g r o u p H i g h e s t g r o u p Medicare Local catchment boundary Numbers on map are Medicare Local reference codes 405 ii. Adelaide and surrounding areas i. Perth and surrounding areas iii. Melbourne and surrounding areas iv. Canberra and surrounding areas Years of data: 20102011 Antenatal visits in the frst trimester, Aboriginal and Torres Strait Islander women During 20102011, the percentage of Aboriginal and Torres Strait Islander women who gave birth and had at least one antenatal visit in the frst trimester varied across Medicare Local catchments and across peer groups, ranging from 80.5% in Nepean-Blue Mountains (NSW) to 21.8% in Grampians (Vic). Percentage of Aboriginal and Torres Strait Islander women who gave birth and had at least one antenatal visit in the frst trimester, 20102011 1. Each Medicare Local has been assigned to a quintile group. 2. For more information on peer groups and the calculation of peer group results refer to this reports Technical Supplement. Notes: Jurisdictional differences in defnitions and methods used for data collection affect the comparability of these data across jurisdictions and lower levels of geography within jurisdictions. Data exclude women whose gestation at frst antenatal visit was not stated, Australian non-residents, residents of external territories and women who could not be allocated to a Medicare Local catchment because their Statistical Local Area of usual residence was not stated or was not valid. Source: Customised data report prepared for the National Health Performance Authority from the Australian Institute of Health and Welfare National Perinatal Data Collection 20102011. Data can be downloaded from www.myhealthycommunities.gov.au 64.6 80.5% 55.1 64.5% 45.6 55.0% 38.0 45.5% 19.0 37.9% Not available for publication National Health Performance Authority www.myhealthycommunities.gov.au National overviews Healthy Communities: Child and maternal health in 20092012 37 Use of health services 0% 20% 40% 60% 80% 100% Metro 1 56.3% Inner West Sydney .................. 102 Australian Capital Territory* # .... 801 Eastern Sydney....................... 101 Northern Sydney ..................... 107 Sydney Nth Shore & Beaches . 108 Inner NW Melbourne ............... 201 Bayside .................................. 202 Inner East Melbourne .............. 206 50.9% 50.8% NP NP NP NP NP NP 0% 20% 40% 60% 80% 100% Metro 2 32.2% Central Adelaide & Hills ........... 402 Sthn Adelaide-Fleurieu-Kang. Is. 403 Metro North Brisbane .............. 301 Gold Coast ............................. 303 Greater Metro South Brisbane . 302 Bentley-Armadale # .................. 504 Perth North Metro # .................. 502 Perth Central & East Metro # ..... 501 South Eastern Sydney ............ 103 South Western Melbourne ...... 203 Eastern Melbourne .................. 207 Fremantle ............................... 503 51.9% 48.8% 45.5% 38.1% 27.6% 21.6% 19.9% 19.0% NP NP NP NP 0% 20% 40% 60% 80% 100% Metro 3 58.1% Western Sydney...................... 105 West Moreton-Oxley ............... 305 Northern Adelaide ................... 401 South Western Sydney ........... 104 Northern Melbourne ................ 205 Macedon Ranges & NW Melb . 204 South Eastern Melbourne........ 208 74.7% 60.8% 57.1% 55.3% 44.8% 37.9% NP 0% 20% 40% 60% 80% 100% Regional 1 65.9% Nepean-Blue Mountains .......... 106 Central Coast NSW ................. 109 Illawarra-Shoalhaven ............... 110 Perth South Coastal # ............... 505 Hunter .................................... 111 Sunshine Coast ...................... 304 Frankston-Mornington Peninsula 209 Barwon ................................... 210 80.5% 73.5% 69.9% 65.3% 64.2% 52.9% NP NP 0% 20% 40% 60% 80% 100% Regional 2 58.1% North Coast NSW ................... 113 Murrumbidgee ........................ 116 Western NSW ......................... 115 New England .......................... 114 Tasmania ................................ 601 Southern NSW ........................ 117 Country South SA ................... 404 Hume ..................................... 216 Gippsland ............................... 217 Darling Downs-SW Qld ........... 306 South West WA # ..................... 506 Loddon-Mallee-Murray ............ 214 Goulburn Valley ....................... 215 Wide Bay ................................ 307 Grampians .............................. 211 Great South Coast .................. 212 70.0% 68.1% 67.9% 66.6% 64.5% 60.6% 57.1% 57.1% 48.1% 46.8% 44.4% 41.2% 36.2% 28.6% 21.8% NP 0% 20% 40% 60% 80% 100% Rural 1 47.2% Far West NSW ........................ 118 Lower Murray ......................... 213 Country North SA ................... 405 Townsville-Mackay .................. 310 Central Qld ............................. 308 60.8% 56.8% 55.0% 42.5% 38.7% 0% 20% 40% 60% 80% 100% Rural 2 44.0% Northern Territory .................... 701 Far North Qld .......................... 311 Kimberley-Pilbara # ................... 508 Central & NW Qld ................... 309 Goldfelds-Midwest # ................ 507 49.8% 41.6% 38.7% 38.5% 32.8% 102 103 104 105 106 107 108 109 110 111 101 113 301 302 303 304 305 306 307 SYDNEY BRISBANE NEWCASTLE SUNSHINE COAST GOLD COAST WOLLONGONG Fair comparisons To compare Medicare Locals more fairly, each Medicare Local catchment has been grouped into one of seven peer groups 2 , based on remoteness and socioeconomic status. This allows: Medicare Local catchments to be compared within the same metropolitan, regional or rural peer group, and Medicare Local catchments to be compared with the average for their peer group. It also allows variation to be seen across peer groups that may be associated with remoteness and socioeconomic status. v. Sydney and surrounding areas vi. Brisbane and surrounding areas Peer groups Map Ref. * In 20102011, there were seven Aboriginal and Torres Strait Islander women who usually resided in the Australian Capital Territory and gave birth in New South Wales who were not counted in the result for the Australian Capital Territory Medicare Local catchment. # Interpret with caution. In WA and ACT, frst antenatal visits that occur outside of the hospital may not be included. NP Not available for publication. More information can be found at www.myhealthycommunities.gov.au and in this reports Technical Supplement. 38 National Health Performance Authority www.myhealthycommunities.gov.au Healthy Communities: Child and maternal health in 20092012 Glossary Antenatal Pertaining to, or occurring in, the period covering conception up to the time of birth. Also known as prenatal. Antenatal visit An appointment with a health care professional for pregnancy-related care and advice after a pregnancy has been confrmed. An antenatal visit can be recorded by a variety of health professionals, such as a general practitioner, midwife or a doctor who specialises in pregnancy and birth (obstetrician). Visits at different stages of pregnancy can involve specifc tests and health checks to assess and improve maternal and fetal wellbeing throughout pregnancy and prior to labour. Also referred to as antenatal care. Birth For the purposes of this report a birth is counted when a fetus of at least 20 weeks gestation or weighing 400 grams or more is born. The fetus can be liveborn or stillborn. Birthweight The frst weight of a baby measured after birth (usually rounded to the nearest 5 grams and recorded within 1 hour of birth). Death The defnition in this report excludes all deaths prior to birth. For the purposes of the ABS Death Registration collection, a death refers to any death which occurs in or on the way to Australia and is registered with a state or territory Registry of Births, Deaths and Marriages. Gestation The process or period of carrying a baby in the womb from conception to delivery. Infant A child who is aged less than 1 year. Live birth A live birth is the birth of a child who, after delivery, breathes or shows any other evidence of life such as a heartbeat. Low birthweight Weight of a baby at birth that is less than 2,500 grams. Medicare Local Medicare Locals plan and fund health services in communities across Australia. They help to ensure patients can access the care they need, particularly when a variety of health workers are involved in providing treatments. Medicare Local catchment A Medicare Local catchment is a population that lives in a specifc geographical area covered by a particular Medicare Local. See Medicare Local. 39 National Health Performance Authority www.myhealthycommunities.gov.au Healthy Communities: Child and maternal health in 20092012 Mortality rate For the purposes of this report, the number of deaths in a specifed period per 1,000 live births in the same period. Multiple birth A pregnancy with multiple fetuses that remain in the womb until 20 weeks gestation and are subsequently delivered. NP Not available for publication This applies when data are not able to be published for reasons related to reliability, validity and/or confdentiality. Methods used to determine whether a statistic is published are included in each reports technical supplement or technical note. Peer group For some reports the Performance Authority groups Medicare Locals into peer groups based on factors such as remoteness, socioeconomic status and distance to hospitals. This allows Medicare Locals to be compared to other Medicare Locals with similar characteristics, and to the average for their peer group. See Healthy Communities: Australians experiences with primary health care in 201011, Technical Supplement for more information. Perinatal Pertaining to, or occurring in, the period shortly before or after birth (usually up to 28 days after). Quintile Five equal parts of a distribution. For example, if 100 patients were ranked according to the number of times they visit a doctor, the top quintile will refer to the 20 patients with the most visits, and the bottom quintile to the 20 patients with the fewest visits. Singleton birth A pregnancy with a single fetus that remains in the womb until 20 weeks gestation and is subsequently delivered. Trimester A period of about 3 months. Pregnancy is divided into three trimesters: frst trimester (conception to 13 weeks), second trimester (13 to 26 weeks), third trimester (26 to 40 weeks). Young child For the purposes of this report a young child is aged between 1 year and less than 5 years. 40 National Health Performance Authority www.myhealthycommunities.gov.au Healthy Communities: Child and maternal health in 20092012 References 1. Organisation for Economic Co-operation Development (OECD) Indicators [Internet]. OECDiLibrary. 2014 Jun [cited 2014 Jul 10]. Available from: http://www.oecd-ilibrary.org/social-issues-migration- health/infant-mortality_20758480-table9 2. World Health Organization (WHO). Chapter 1.6. Provision of effective antenatal care in standards for maternal and neonatal care [Internet]. Geneva. [cited 2014 Jun 26]. Available from: http://www. who.int/reproductivehealth/publications/maternal_perinatal_health/effective_antenatal_care.pdf 3. Australian Institute of Health and Welfare. Headline Indicators for childrens health, development and wellbeing 2011 [Internet]. Cat. no. PHE 144. Canberra: AIHW. 2011 [cited 2014 Jun 26]. Available from: http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=10737419586 4. Australian Bureau of Statistics. Deaths, Australia, 2012 [Internet]. 2013 Nov 11 [cited 2014 May 26]; ABS cat. no. 3302.0. Available from: http://www.abs.gov.au/AUSSTATS/abs@.nsf/ Lookup/3302.0Explanatory%20Notes12012?OpenDocument 5. Li Z, Zeki R, Hilder L & Sullivan EA. Australias mothers and babies 2011. National Perinatal Epidemiology and Statistics Unit. Perinatal statistics series no. 28. Cat. no. PER 59. Canberra: AIHW; 2013. 6. Australian Health Ministers Advisory Council 2012, Clinical Practice Guidelines: Antenatal Care Module 1 [Internet]. Canberra: Australian Government Department of Health and Ageing. Updated 2014 Jan [cited 2014 Jun 26]. Available from: http://www.health.gov.au/antenatal 7. Australian Institute of Health and Welfare. Timing impact assessment of COAG Closing the Gap targets: Child mortality. Cat. no. IHW 124. Canberra: AIHW; 2014. 8. Australian Government. Closing the Gap Prime Ministers Report 2014 [Internet]. 2014 [cited 2014 Jul 9]. Available from: http://www.dpmc.gov.au/publications/docs/closing_the_gap_2014.pdf 9. Australian Health Ministers Advisory Council. Aboriginal and Torres Strait Islander Health Performance Framework 2012 Report. Canberra: AHMAC; 2012. 41 National Health Performance Authority www.myhealthycommunities.gov.au Healthy Communities: Child and maternal health in 20092012 Acknowledgements This report has benefted from advice from a number of individuals and organisations with interest and expertise in child and maternal health. The National Health Performance Authority established a report advisory committee to provide advice around various aspects of this work. The group did not have a direct role in writing the report. The committee was comprised of: Dr Jason Agostino - Data Clinician, National Aboriginal Community Controlled Health Organisation (NACCHO) Ms Sue Cornes - Executive Director, Health Statistics Branch, Health Commissioining Queensland, Department of Health, Queensland Government Ms Jan Donovan - Consumer representative nominated to bring a consumer perspective by the Consumers Health Forum of Australia Associate Professor Lynn Kemp - Director, Centre for Health Equity Training Research & Evaluation (CHETRE), part of the University of New South Wales (UNSW) Centre for Primary Health Care & Equity Professor Elizabeth Sullivan - Associate Dean (Research), Professor Public Health, Faculty of Health, University of Technology Sydney. The Authority also received advice from Dr Fadwa Al-Yaman and Mr Conan Liu from the Australian Institute of Health and Welfares Indigenous and Childrens group. This report relies on data provided by the Australian Bureau of Statistics (ABS) and the Australian Institute of Health and Welfare (AIHW). These data were used to calculate the performance measures in this report. The Authority does a number of checks to ensure data quality, and also relies on the data quality work of the ABS and AIHW. Thanks are extended to all those who contributed. 42 National Health Performance Authority www.myhealthycommunities.gov.au Healthy Communities: Child and maternal health in 20092012 About the Authority The National Health Performance Authority has been set up as an independent agency under the National Health Reform Act 2011. It commenced full operations in 2012. Under the terms of the Act, the Authority monitors and reports on the performance of Local Hospital Networks, public and private hospitals, primary health care organisations and other bodies that provide health care services. The Authoritys reports give all Australians access to timely and impartial information that allows them to compare fairly their local health care organisations against other similar organisations and against national standards. The reports let people see, often for the frst time, how their local health care organisations measure up against comparable organisations across Australia. The Authoritys activities are also guided by a document known as the Performance and Accountability Framework agreed by the Council of Australian Governments. The framework contains a set of indicators that form the basis for the Authoritys performance reports. The Authoritys role will include reporting on the performance of health care organisations against these indicators in order to identify both high-performing Local Hospital Networks, Medicare Locals and hospitals (so effective practices can be shared), and Local Hospital Networks and Medicare Local catchments that perform poorly (so that steps can be taken to address problems). The Authority releases reports on a quarterly basis, and also publishes performance data on the MyHospitals website (www.myhospitals. gov.au), the MyHealthyCommunities website (www.myhealthycommunities.gov.au) and on www.nhpa.gov.au The Authority consists of a Chairman, a Deputy Chairman and fve other members, appointed for up to fve years. Members of the Authority are: Ms Patricia Faulkner AO (Chairman) Mr John Walsh AM (Deputy Chairman) Dr David Filby PSM Professor Michael Reid Professor Bryant Stokes AM RFD (on leave) Professor Paul Torzillo AM Professor Claire Jackson. The conclusions in this report are those of the Authority. No offcial endorsement from any Minister, department of health or health care organisation is intended or should be inferred. National Health Performance Authority MDP 158, GPO Box 9848 Sydney, NSW 2001, Australia Telephone: +61 2 9186 9210 www.nhpa.gov.au