The number of Aboriginal teenage mothers in NSW has dropped and the frequency of immunisation in Aboriginal children has surpassed their non-indigenous counterparts, according to a report from the state's chief health officer.

But instances of Aboriginal women smoking during pregnancy in NSW remain a concern for Dr Kerry Chant.

The smoking rate has fallen by one-third since 1996 but 41 per cent of expectant mothers were still lighting up in 2016, which is six times higher than non-Aboriginal mums.

In delivering her 2018 report on Thursday, Aboriginal Kids - A Healthy Start To Life, Dr Chant said it was possible even more indigenous mums-to-be were smoking given Aboriginal people are often under-reported when data is collected.

"We know it's such an important driver for premature delivery of a baby and small for gestational age," she said.

"We may need to take a very much community-based approach to supporting the woman to give up during pregnancy or potentially give up prior to conception."

The report analysed data concerning the health of Aboriginal children in NSW pre-birth and up to the age of five.

In 2016, 13 per cent of Aboriginal mothers were teenagers, though this has dropped from 23 per cent in 1994.

The Aboriginal infant mortality rate decreased, almost halving over a decade from 7.2 per cent per 1000 live births to 4.6 per cent in 2016.

The report also found 97 per cent of five-year-old Aboriginal children were fully immunised compared to 94 per cent of non-Aboriginal children.

Co-author Stephen Blunden, acting chief executive officer of the Aboriginal Health and Medical Research Council of NSW, said community partnerships are imperative if the report is to be used "as a tool" to gauge Aboriginal youth health improvements.

"We need all of government to work together for housing, health, education, and so forth, so our younger generation can live healthier lives," he said.

Dr Chant wants more Aboriginal nurses, doctors and dentists employed in the health sector because it contributes to the "cultural safety" of Aboriginal people by highlighting role models and job opportunities.

"Unless we actually address some of the social determinants of health - access to education, employment - we are not going to see the generational changes we need to in reducing any health inequalities," she said.