Cumulative mortality in children aged 1 to 6 years born in Western Australia from 1980-89

Purpose-To investigate cumulative mortality for children aged 1-6 years bor n in Western Australia from 1980 to 1989. Study design-Births and deaths were ascertained from a linked total populat ion database supplemented by information from postmortem records. Deaths we re classified according to the underlying cause, and mortality rates, inclu ding factor specific rates, were calculated. Trends were investigated and c omparisons were made using relative risks with 95% confidence intervals. Results-Cumulative mortality was 2.2/1000 infant survivors, with a signific ant decrease during the years studied. Mortality was almost four times high er for Indigenous children, with no decrease. Accidents comprised 45.6% of all deaths, birth defects 17.3%, cancer and leukaemias 12.5%, and infection s 11.0%. Low birth weight, preterm birth, and young maternal age significan tly increased the risk of death in both Indigenous and non-Indigenous child ren; single marital status was also a significant risk factor for non-Indig enous children. Conclusion-High quality data and appropriate classification systems are ess ential to enable effective monitoring of childhood deaths and the planning of preventive programmes. Further decreases in mortality rates might be dep endent on ensuring that resources are directed towards improving social and economic conditions for Indigenous and other disadvantaged families.