Ethnic variations in mortality in pre-school children in Denmark, 1973–2004

Abstract

The objective of the study was to describe ethnic differences in under-five-years mortality in Denmark according to maternal country of origin. We conducted a large registry-linkage study of all singleton live-born children from mothers born in Denmark and from the ten largest migrant groups (n=1.841.450). Study outcomes were death before the age of five years from all causes combined and the most frequent death causes. Results showed that children of mothers of Turkish, Pakistani, Somali and Iraqi origin had an elevated risk of dying before the age of five compared to offspring of mothers born in Denmark, with hazards ratios (HR) and 95 % confidence intervals (CI) of 1.48 (1.31-1.67), 1.97 (1.68-2.32), 1.70 (1.29-2.25), and 1.92 (1.41-2.62), respectively. Ethnic differences were also observed in the underlying causes of death. Children of mothers born in Former Yugoslavia, Lebanon, Norway, Sweden, Iran, and Afghanistan did not differ in under-five-years mortality from ethnic Danish children. Adjustments for household income did not attenuate the risk estimates. In conclusion, we found excess child mortality in some migrant groups, but not in all. The differences could not be explained by socioeconomic status.

A Register‐Based Study of Diseases With an Autosomal Recessive Origin in Small Children in Denmark According to Maternal Country of Origin

“…The highest risk was found in the group of ‘severe and profound intellectual disability’. The results of this report support the hypothesis that consanguinity may play a role in the disparities of health in Danish‐born children of women with different countries of origin …”

“…Considerable disparities in perinatal, infant, and under 5‐year mortality (U5‐mortality) have been observed between children born in Denmark in the period from 1973 to 2004 by mothers who migrated to Denmark from Afghanistan, Iraq, Pakistan, Somalia, and Turkey when compared with the majority of the population. The increased mortality was apparently not explained by differences in indicators of parental socio‐economic position . Higher childhood mortality rates among some ethnic minorities are well described in many Western countries, but the underlying causes behind these disparities are not fully established .…”

“…They also reported no association between deprivation and congenital anomalies but an association between low maternal educational level and congenital anomalies, across all ethnic groups. In a Danish investigation, the excess mortality among children of Afghani, Iraqi, Pakistani, Somali, and Turkish women was especially due to congenital anomalies and ‘other causes of death’ (not including perinatal causes, external causes, and sudden death) …”

Breastfeeding Practices in Relation to Country of Origin Among Women Living in Denmark: A Population-Based Study

“…However, in this study country of origin was not taken into account. It has been shown that reproductive and child health are diverging among the different migrant groups in Denmark [19, 20], and to understand the mechanisms behind the potential increased vulnerability of the migrant groups, it is important not to treat migrants as one entity. Therefore, in order to guide future preventive strategies, we find it justified that a better understanding of patterns in breastfeeding prevalence and the mechanisms behind will be obtained using a country of origin approach.…”

Preterm Birth and Birthweight‐for‐Gestational Age among Immigrant Women in Denmark 1978–2007: A Nationwide Registry Study

“…Two recent Danish studies have found ethnic disparities within perinatal, infant and early child mortality 1,2 . Both studies looked at differences among the largest immigrant groups and found that some immigrant women experience similarly, some even better, although a large majority worse pregnancy outcomes when compared with Danish‐born women.…”