Early mortality from external causes in Aboriginal mothers: a retrospective cohort study
Aboriginal mothers in Western Australia are 17.5 times more likely to die from homicide than other mothers in the state; 6.4 times more likely to die from accidents; and 3.4 times more likely to die from suicide. Whilst a disproportionate number of Aboriginal women die from potentially preventable causes, no research has investigated mortality in Aboriginal mothers. This study by Jenny Fairthorne, Roz Walker, Nick de Klerk and Carrington Shepherd examined the elevated mortality risk in Aboriginal mothers with a focus on external causes.
Researchers analysed data from the West Australian midwife notification system, death registry, hospital morbidity data system and mental health information system. During the study period it was found that Aboriginal mothers were much more likely to die than other mothers and they usually left more and younger children. These increased rates were only partly explained by socio-demographic circumstances. About half of these elevated risks were explained by poorer socio-economic circumstances and residential location.
- Aboriginal mothers are 6.5 times more likely to die form preventable causes than non-Aboriginal mothers
- Risk factors include poverty and socio-economic disadvantage, rural living, abuse, lack of purpose and role models and dislocation from family and community
- Children can face long-term problems after losing their mother at a young age
The researchers also found the median age of death by any external cause for Aboriginal mothers was 33 compared to 36.5 for deceased non-Aboriginal mothers, and they usually left behind more and younger children. The median age of the youngest child at the time of their mother’s death from any external cause was 4.8 years. The study highlights that this is a period when children are particularly vulnerable, and where the circumstances leading to and arising from a maternal loss can have profoundly negative consequences for social and emotional wellbeing.
The main external cause of death was accidents, with about 40 per cent of Aboriginal mothers dying in transport accidents. Aboriginal mothers tend to live in more remote areas where the roads are of poorer standard and speed limits are higher, but also, and this is also connected to areas of poverty and socio-economic disadvantage, they tend to have access to cars that aren't as safe.
The research of Professor Rhonda Marriott shows the importance of culturally competent and safe support services for Aboriginal women throughout their lives. This includes a culturally safe birthing experience, culturally safe and secure child health experience, and schooling that values a child’s cultural identity and strengthens their cultural identity.
According to the research, promoting healthy mental wellbeing, preventing and managing substance abuse, reducing domestic violence and the stresses associated with the persistent marginalisation of Aboriginal people in Australian society were central to reducing risk.
The study authors indicated that further research is required to 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.
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