Early mortality from external causes in Aboriginal mothers: a retrospective cohort study IJPDS (2017) Issue 1, Vol 1:004, Proceedings of the IPDLN Conference (August 2016)

Abstract

ABSTRACT

Background
Maternal loss can have a deep-rooted impact on families. Whilst a disproportionate number of Aboriginal women die from potentially preventable causes, no research has investigated mortality in Aboriginal mothers. We aimed to examine the elevated mortality risk in Aboriginal mothers with a focus on external cause.

Methods
We linked data from four state administrative datasets to identify all women who had a child from 1983-2010 in Western Australia and ascertained their Aboriginality, socio-demographic details, and dates and causes of death of all mothers who had died prior to 2011. For Aboriginal mothers and compared to other mothers, we calculated the hazard ratios (HRs) for death by any external cause and each of the sub-categories of accident, suicide and homicide and the corresponding age of their youngest child.

Results and discussion
Compared to non-Aboriginal mothers and after adjustment, Aboriginal mothers were more likely to die from external cause [HR=4.61(95% CI: 3.7, 5.7)], accident [HR=4.74(95% CI: 3.2, 7.0)], suicide [HR=2.48(95% CI: 1.5, 4.0)] or homicide [HR=11.72(95% CI: 6.5, 21.0)]. For mothers experiencing death, the median age of the youngest child was 4.8 years. Aboriginal mothers are much more likely to die from external causes than non-Aboriginal mothers with the scale of difference ranging from 2.5 times for suicide, to more than eleven times for homicide. Comparisons with the extant literature suggest that the magnitude of ethnic disparities in mortality from external causes is greater among mothers than the female population overall, identifying Aboriginal mothers as a particularly at-risk group in both relative and absolute terms.

Conclusion
During the study period, Aboriginal mothers were more likely to die than other mothers and they usually left young children. Our increased adjusted HRs were only partly explained by socio-demographic circumstances. Further research is required to fully examine the risk factors associated with these potentially preventable deaths and to enable the development of informed health promotion to increase the life chances of Aboriginal mothers and their children.