Australia Yearbook - 2001

370 Year Book Australia 2001
Child mortality in the 20th
century
Mortality as a measure of health
One major way in which epidemiologists measure
health is actually to measure death. “This
preoccupation is not so morbid as it sounds. In
modern times the news has been almost entirely
good. Western countries have doubled their life
expectancies from around 40 years in the
mid-nineteenth century to almost 80 years at the
end of the twentieth. If we were to enter one of
those competitions to nominate the greatest
advance of the latter part of the millennium, it
would be difficult to overlook the pushing back
of the frontiers of death and the guarantee that
most people will live to old age” (Caldwell 1999).
The data on mortality below have been compiled
by the Australian Institute of Health and Welfare
(AIHW) Mortality Monitoring System from official
death registrations.
The under five mortality fell from 2,604 per
100,000 in males and from 2,214 in females in
1907 to 137 and 111 respectively in 1998 (graph
C6.1). More than 50% of the fall had occurred by
1930 and most (more than 80%) by 1960. The
rates at the end of the century are very low. The
most important contribution to under 5 mortality
was death in infancy (see below). The death rates
in 1–4 year old children were much lower
throughout the last 100 years, although the
pattern of their fall was similar to infant death
rates. Once a child survived beyond its first
year, even in early 1900s, its chances of
survival were good. Now they are excellent.
In children aged 5–14 and 15–19 years the
rates were initially much lower than in
younger children and have fallen steadily. For
5–14 year old males the rate was 187 in 1907
and 17 in 1998; for females 172 falling to 12.
In 15–19 year old males, the rate was 267 in
1907 and 75 in 1998; for females 237 and
37 respectively.
Infant mortality
Infant mortality, defined as deaths in children
from birth to the first year of age per 1,000
live births, has been viewed traditionally as
an important social indicator, reflecting
general population health and wellbeing. It is
of great interest to those assessing the social
development of communities as groups with
more advanced development in terms of
social circumstances, educational level and
income tend to have lower rates of infant
mortality than those with less development.
Infant mortality is strongly related to fertility
rates and to life expectancy at birth. Falls in
infant and childhood deaths have been
shown to be followed by declines in fertility
(Caldwell 1999). Infant mortality, influenced
by preventive health measures, which
include social improvements, is used as a
measure of such services for a population.
C6.1 DEATH DUE TO ALL CAUSES, By Age of Child
0to4
5to14
15 to 19
rate(a)
2500
2000
1500
1000
500
0
1907 1917 1927 1937 1947 1957 1967 1977 1987 1997
(a) Rate per 100,000 population.
Source: AIHW Mortality Monitoring System.