Poverty to blame for England’s “sustained and unprecedented” rise in infant mortality

THE years of austerity have taken a grim toll on children in England’s most deprived areas, suggests new research linking poverty to an “unprecedented and sustained” rise in infant mortality.

Over the last four years, England’s infant mortality rate has risen, but it was unclear what impact increasing levels of child poverty were having. To find out why more children were dying, researchers from the Universities of Newcastle, Leeds and Liverpool set out to analyse the trends buried in the data.

“Over the last decade infant mortality rates and child poverty rates have increased in places such as the North East of England,” said Professor Clare Bambra, professor of public health at Newcastle University. “Child poverty reduced in our region in the 2000s but since austerity it has increased again with horrendous implications for child health and well-being.”

Rising infant mortality is unusual in high income countries, the researchers point out, and international data shows that infant mortality has continued to decline in most rich countries in recent years. So, clearly something has gone awry in England’s case.

To find out what, the research team carried out an analysis of trends in infant mortality in English local authorities over a 17-year period, covering 2000-2017. They soon found a ‘smoking gun’.

“This study provides evidence that the unprecedented rise in infant mortality disproportionately affected the poorest areas of the country, leaving the more affluent areas unaffected,” said Professor David Taylor-Robinson, from Liverpool University, lead author on the research.

“Our analysis also linked the recent increase in infant mortality in England with rising child poverty, suggesting that about a third of the increase in infant mortality from 2014-17 may be attributed to rising child poverty.”

The researchers grouped 324 local authorities into five categories based on their level of income deprivation. Quintile 1 was the most affluent and Quintile 5, the most deprived. A statistical model was then used to quantify the association between regional changes in child poverty and infant mortality during the same period.

Once they’d crunched the data, they found that the “sustained and unprecedented” rise in infant mortality in England from 2014-2017 was not experienced evenly across the population.

In the most deprived local authorities, the previously declining trend in infant mortality reversed and mortality rose, leading to an additional 24 infant deaths per 100,000 live births per year, relative to the previous trend.

However, there was no significant change from the pre-existing trend in the most affluent local authorities. As a result, inequalities in infant mortality increased, with the gap between the most and the least deprived local authority areas widening by 52 deaths per 100,000 births.

Overall from 2014-2017, there were a total of 572 excess infant deaths compared to what would have been expected based on historical trends. The researchers estimate that each 1% increase in child poverty was significantly associated with an extra 5.8 infant deaths per 100,000 live births.

The findings suggest that about a third of the increases in infant mortality between 2014 and 2017 may be attributed to rising child poverty, equivalent to an extra 172 infant deaths.

“These findings are really concerning given that child poverty is rising. It is time for the Government to reverse this trend establishing a welfare system that protects children from poverty,” Taylor-Robinson added.

“We know that child poverty has a myriad of adverse impacts on other aspects of child health that will have repercussions for decades to come. In the context of increasing health inequalities in England, policies that reduce poverty and social inequalities are likely to reduce the occurrence of infant mortality and that of many other adverse child health outcomes.”

NH

Read the full research: Assessing the impact of rising child poverty on the unprecedented rise in infant mortality in England 2000-17: time trend analysis. BMJ Open.

 

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