Trends in infant/child mortality and life expectancy in Indigenous populations in Yunnan Province, China

OBJECTIVE: The 2000 Census in China registered 55 groups of Indigenous population, including 104.49 million people, making up 8.1% of China's total population. Yunnan Province, located in Southwest China, is the only province where all 55 Indigenous nationalities are represented (14.15 million), making up 33.4% of Yunnan's total population. This study aimed to examine trends in infant and child mortality and life expectancy at birth of the 22 largest Indigenous nationalities and compared these trends with those of the majority Han Chinese in Yunnan and China as a whole. METHODS: Data sources of mortality and socioeconomic status came from the population censuses of China (1953, 1964, 1982, 1990, and 2000) and Yunnan (1990-2000) and from the Provincial Health Department (1990, 1995, 1996 and 2000). Weighted linear regression analysis was used to examine the associations between infant/child mortality and life expectancy at birth, socioeconomic indicators and the use of preventive health services. RESULTS: In 2000, the infant mortality rate was 26.90 for China and 53.64 for Han Chinese in Yunnan per 1,000 live birth versus 77.75 for the 22 largest minority nationalities in Yunnan, despite improvements in health status indicators since 1990. The inequalities in life expectancy at birth between China as a whole and some minority nationalities remained striking in 2000 (57.18 versus 71.40). Literacy, prenatal examination, hospital deliveries, economic development were important predictors of these health indicators. IMPLICATIONS: Efforts to continue to improve these intermediate proximate determinants and to target the most disadvantaged Indigenous groups are likely to further reduce health disparities between the Chinese and Indigenous populations.