Copyright and reuse:The Warwick Research Archive Portal (WRAP) makes this work of researchers of the University of Warwick available open access under the following conditions. Copyright © and all moral rights to the version of the paper presented here belong to the individual author(s) and/or other copyright owners. To the extent reasonable and practicable the material made available in WRAP has been checked for eligibility before being made available.Copies of full items can be used for personal research or study, educational, or not-forprofit purposes without prior permission or charge. Provided that the authors, title and full bibliographic details are credited, a hyperlink and/or URL is given for the original metadata page and the content is not changed in any way. AbstractThrough a structured narrative review of the literature, we have identified a wide range of factors influencing child and adolescent mortality in high income countries. These can be conceptualised within the four domains of intrinsic factors, the physical environment, the social environment, and service delivery factors. The most prominent factors in the literature are socio-economic gradients, although the mechanisms through which these gradients exert their effects are complex, affecting all four domains, and often poorly understood. While some factors are relatively fixed, including the child's gender, age, ethnicity and inherent genetic make-up, some parental characteristics, and some wider 3 environmental conditions, others may be amenable to interventions that could lessen risks and help to prevent future child deaths. A number of examples of systemic health service factors that may impact child survival are given, along with interventions such as modifications to the physical or social environmental that may impact more distal factors.
The proposed set of ICD-10 codes encompasses the codes used in different countries for most SUDI cases. Use of these codes will allow for better international comparisons and tracking of trends over time.
Objective-To review Indigenous infant mortality, stillbirth, birth weight, and preterm birth outcomes in Australia, Canada, New Zealand and the United States.Methods-Systematic searches of published literature and a review and assessment of existing perinatal surveillance systems were undertaken. Where possible, within country comparisons of Indigenous to non-Indigenous birth outcomes are included.Results-Indigenous/non-Indigenous infant mortality rate ratios range from 1.6 to 4.0. Stillbirth rates, where data are available, are also uniformly higher for Indigenous people. In all four countries, the disparities in Indigenous/non-Indigenous infant mortality rate ratios are most marked in the post-neonatal period. With few exceptions, the rates of leading causes of infant mortality are higher among Indigenous infants than non-Indigenous infants within all four countries. In most cases, rates of small for gestational age and preterm birth were also elevated for Indigenous compared to non-Indigenous infants.Conclusions-There are significant disparities in Indigenous/non-Indigenous birth outcomes in Australia, Canada, New Zealand and the United States. These Indigenous/non-Indigenous birth outcome disparities fit the criteria for health inequities, as they are not only unnecessary and avoidable, but also unfair and unjust. KeywordsIndigenous; birth outcomes; infant mortality; stillbirth; birth weight; and preterm birth; Canada; Australia; New Zealand; United StatesThis is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http:// creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.
Inaccuracies in the identification of Indigenous status and the collection of and access to vital statistics data impede the strategic implementation of evidence-based public health initiatives to reduce avoidable deaths. The impact of colonization and subsequent government initiatives has been commonly observed among the Indigenous peoples of Australia, Canada, New Zealand, and the United States. The quality of Indigenous data that informs mortality statistics are similarly connected to these distal processes, which began with colonization. We discuss the methodological and technical challenges in measuring mortality for Indigenous populations within a historical and political context, and identify strategies for the accurate ascertainment and inclusion of Indigenous people in mortality statistics.
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