The infant mortality rate is used internationally as one of the key indicators of community health. It is defined as the number of infant deaths (deaths of children less than one year of age) for every 1000 live births. Among Indigenous Australians there was an exceedingly high rate of infant mortality of around 100 infant deaths per 1000 live births—recorded as recently as the mid-1960s. In subsequent years, there was a steady and precipitous decline to around 26 per 1000 by 1981, with much of this due to improvements in post-neonatal mortality. While further improvement in infant survival also occurred during the 1980s and 1990s, this has been less impressive, with Indigenous infant mortality rates remaining consistently around two and a half times the Australian average. Consequently, about seven per cent of Indigenous male deaths and eight per cent of Indigenous female deaths occur to people less than one year old. This compares with only one per cent of all deaths among all other infants (Cunningham & Paradies 2000). The latest available data from the ABS indicate an infant mortality rate among Indigenous infants of 14.1 per 1000 live births compared with 5.7 per 1000 live births among all infants (ABS 2000a: 75).

For Indigenous Australians, the initial drop in infant death rates coincided with improvements in community infrastructure and the development, in the 1970s, of intensive Indigenous health programs and services. However, this medical intervention is not the only factor leading to declines in infant mortality. While access and equity issues remain important in terms of the delivery of health care services to Indigenous Australians, further significant improvements in infant survival are also reliant on a decrease in the proportion of low birthweights which, in turn, is heavily correlated with nutritional issues, smoking rates, and the socio-economic status of mothers. In 1995–96, the proportion of low birthweight babies (less than 2500 grams) born to Indigenous mothers was almost twice that of babies born to non-Indigenous mothers (12.4 per cent compared with 6.2 per cent). Such low birthweight babies are less likely to survive, and those who do survive are more likely to have worse health early in life, and perhaps even in adulthood.