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Analysis of Health Statistics for Status Indians in British Columbia 1991 - 1998

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Overview of Infant Mortality Statistics

Infant mortality is a widely used measure of health status. Infant deaths are deaths of babies under the age of one. This section presents the number of infant deaths and mortality rates in the early neonatal, neonatal and post-neonatal periods at the provincial level (Table 6), as well as noting major findings for Status Indians in the South Mainland, Vancouver Island, North West and North East areas (Tables 6a, 6b, 6c, 6d). Causes of infant deaths are presented in Tables 7, 7a, 7b, 7c, 7d. The section ends with an overview of the pattern of infant mortality by age of mother and birth weight (Table 8). Due to the small number of annual infant deaths, tables show aggregate statistics for the 1991-1998 period.

Definitions

Infant mortality is defined as the death of a child under one year of age. Early neonatal mortality refers to an infant death where the age at death was less than 7 days. Neonatal mortality, which includes the early neonatal period, refers to an age at death less than 28 days old. Post neonatal mortality refers to an age at death between 28 and 364 days after birth.

Infant Mortality

From 1991 to 1998, one out of every seven infant deaths (age under one year old) in the province was a Status Indian baby. In total, 274 of the 1,978 infant deaths in B.C. in the eight years were Status Indian infants. At the provincial level, the Status Indian infant mortality rate was 11.3 infant deaths per 1,000 Status Indian live births, more than double the rate of 5.0 for other BC residents. However, these aggregate statistics disguise the progress made in infant mortality over the period.
There has been a significant decrease in infant mortality in the Status Indian population in the last four years. The number of Status Indian infant deaths dropped each year from 45 in 1995 to 14 in 1998, and the Status Indian infant mortality rate showed a similar dramatic decline from 14.7 to 4.6 infant deaths per 1,000 Status Indian live births. Infant mortality also declined somewhat in the rest of the provincial population, where the rate decreased from 5.3 to 4.0.

[Click here to download a Microsoft Excel Spreadsheet of the above table]
The Vancouver Island area Status Indian population had the highest infant mortality rate of the four areas, 17.7 for the eight year period. This was double the lowest regional Status Indian infant mortality rate of 8.9 in the North West area. All areas showed a decreasing trend in infant mortality over the last four years.

Infant Mortality By Age At Death

In the eight year period, there were 96 Status Indian infant deaths in the neonatal period, 78 of which were in the early neonatal period. The Status Indian neonatal mortality rate (4.0 deaths per 1,000 live births in the Status Indian population) and the early neonatal mortality rate (3.2 ), were only slightly higher than the rates for all other B.C. residents (3.5 and 3.0 respectively).
The major difference between the pattern of infant deaths in the Status Indian and other residents of B.C. was in the post neonatal period. In the eight year period, two thirds of Status Indian infant deaths (178 of the 274 infant deaths) were between 28 and 364 days after birth, for a rate of 7.4 deaths in the post neonatal period per 1,000 live births. Among all other B.C. residents, less than one third of infant deaths were in the post neonatal period (529 out of 1,704 infant deaths), and the post neonatal mortality rate was only 1.6.
Post neonatal mortality was highest in the Vancouver Island area Status Indian population where the rate was 12.0 deaths in the neonatal period per 1,000 live births in the area. This rate was more than six and a half times the rate for other residents of the Vancouver Island area, and approximately double the rate for Status Indian populations in the four areas.

Causes of Infant Deaths

Sudden Infant Death Syndrome (SIDS) was the leading cause of infant mortality in the Status Indian population between 1991 and 1998, accounting for 40% of all Status Indian infant deaths. Over the eight year period, 108 of the 328 SIDS deaths in the province were Status Indian children. The infant mortality rate for SIDS in the Status Indian population was 44.7 deaths per 10,000 live births, almost seven times the rate of 6.5 for all other B.C. residents Since the majority of SIDS deaths occur between 28 and 364 days after birth, SIDS is the major cause of post neonatal mortality. The incidence of SIDS was highest among Vancouver Island area Status Indians which had 75.3 infant death from SIDS per 10,000 live births. The North East area had the lowest SIDS rate of 26.9.
Perinatal complications were responsible for three quarters of infant deaths in the first week of life (early neonatal period), and one quarter of all Status Indian deaths under the age of one in the eight year period. The Status Indian infant mortality rate from perinatal complications was 27.7 deaths per 10,000 live births, slightly higher than all other B.C. residents rate of 22.2. Status Indians had similar mortality rates from perinatal complications as other residents in the South Mainland and the North West areas, and slightly higher rates than the rates for other residents in the Vancouver Island and the North East areas.
Congenital anomalies were responsible for one in nine Status Indian infant deaths (30 deaths) in 1991-1998. The Status Indian infant mortality rate for congenital anomalies, 12.4 deaths per 10,000 live births, was below the rate of 14.7 for all other B.C. residents The Status Indian populations in all areas except the Vancouver Island area had infant mortality rates from congenital anomalies which were equal to or lower than those for other residents in the area.

Infant Mortality and Age of Mother

In the 1991-1998 period, there were 197 infant deaths where the mother was under 20 years of age, and more than a third (69 deaths) were Status Indians. Of all maternal age groups, teenage mothers had the highest infant mortality rates in both populations. The Status Indian infant mortality rate for teenage mothers was 14.7 infant deaths per 1,000 live births of Status Indian babies, compared to 8.8 for all other B.C. residents In general, Status Indian mothers tend to be younger than other B.C. mothers, therefore it is not surprising about eight out of every ten Status Indian infant deaths were to mothers under 30 years of age, compared to five out of ten infant deaths among all other B.C. residents population.

Infant Mortality and Birth Weight

Generally, low birth weight is less of a factor in infant deaths among the province's Status Indian population. Of the 274 Status Indian infant deaths in 1991-1998, two in five (109 deaths) were had birth weights below 2,500 grams. Of the 1,704 infant deaths of other residents of B.C., almost three in five (973 deaths) had low birth weights.

Infant Mortality Tables


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