An extensive study of infant mortality in Manitoba has shown that the death rate for aboriginal babies is more than twice the Canadian average and doesn't improve no matter how close their mothers live to sophisticated health-care facilities.

Although infant mortality among non-aboriginals declined with proximity to cities, the rate remained stubbornly high for First Nations women, says a new report published in the Journal of Rural Health.

"First Nations infants do not seem to have similarly benefited from the better health-care facilities in urban centres," the report says.

"We speculate that access to and effective use of the better health-care facilities available in urban areas may be inadequate for First Nations women and children."

The conclusions come as Prime Minister Stephen Harper seeks to make maternal health one of the main agenda items at the upcoming G20 summit in Toronto.

150,000 Manitoba births examined

The report examined a massive sample size of more than 150,000 births in Manitoba between 1991 and 2000, the latest years for which full records are available, said lead researcher Zhong-Cheng Luo of the University of Montreal.

Manitoba is one of two provinces that keep records that allow researchers to compare aboriginal and non-aboriginal births.

Luo's team looked at 25,000 aboriginal births and 125,000 non-aboriginal births, and divided the large groupings into four smaller groups according to how far they were from the province's three main urban areas. Those groups went from complete rural isolation to living in a city.

'We need to improve the access to quality prenatal care for First Nations.'—Zhong-Cheng Luo

The researchers found that in completely isolated communities, the rate of infant mortality was almost 11 per 1,000 live births for aboriginals and a little more than seven for non-aboriginals.

The closer the non-aboriginal moms got to cities, the lower the rate at which their babies died. In urban areas, that rate fell to 4.6 per 1,000.

But the rate for aboriginal women stayed stubbornly high — almost 10 per 1,000, even in cities.

That shouldn't be happening, Luo said. Not only do cities have more sophisticated health-care facilities, they're also associated with higher incomes, which should also translate into healthier babies.

Same trend in other provinces likely

"The health-care facility is there, but probably there is some barrier to accessing better care in these facilities in urban centres for First Nations people," said Luo.

Those barriers could include language or culture, he said.

Luo's report said the problem will grow as more aboriginal people migrate into urban areas.

"The results clearly suggest a strong need to improve First Nations' maternal and infant health care in meeting the challenges of urban migration," the report says.

Luo previously studied Inuit infant mortality and found the mortality rate for Inuit infants was 16.5 per 1,000 live births — a rate not seen in southern Canada since 1971 and several times the Canadian average of 4.6 deaths.

Although his data is almost a decade old, Luo said it remains the best available and is unlikely to be countered by any trends. He also said that although there are no statistics to back it up, he suspects the numbers are similar in other provinces.

Some U.S. studies have shown bigger gaps between aboriginal and non-aboriginal infant mortality in cities than rural areas. A British Columbia study reached a similar conclusion.

"The general conclusion is the same," said Luo. "We need to improve the access to quality prenatal care for First Nations."