Infant mortality in the European Union: A time trend analysis of the 1994–2015 period

Onambele, Luc; San-Martin-Rodríguez, Leticia; Niu, Hao; Álvarez‐Álvarez, Ismael; Arnedo-Pena, Alberto; Guillén-Grima, Francisco; Aguinaga-Ontoso, Inés

doi:10.1016/j.anpede.2019.03.002

Cited by 12 publications

(15 citation statements)

References 35 publications

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“…The overall downward trend in IMR in Scotland between 2000 and 2018 is comparable with observed trends across the European Union (EU) between 1994 and 2015. In contrast to England, whilst Scotland did not experience an increase in IMR in recent years, the potential plateauing of trends observed in descriptive analysis from 2015 onwards does mirror findings from the UK overall and in Ireland [19].…”

Section: Explanation Of Findings and Comparison With Previous Literaturementioning

confidence: 64%

Trends in infant mortality and stillbirth rates in Scotland by socio-economic position, 2000–2018: a longitudinal ecological study

et al. 2021

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Background As Scotland strives to become a country where children flourish in their early years, it is faced with the challenge of socio-economic health inequalities, which are at risk of widening amidst austerity policies. The aim of this study was to explore trends in infant mortality rates (IMR) and stillbirth rates by socio-economic position (SEP) in Scotland, between 2000 and 2018, inclusive. Methods Data for live births, infant deaths, and stillbirths between 2000 and 2018 were obtained from National Records of Scotland. Annual IMR and stillbirth rates were calculated and visualised for all of Scotland and when stratified by SEP. Negative binomial regression models were used to estimate the association between SEP and infant mortality and stillbirth events, and to assess for break points in trends over time. The slope (SII) and relative (RII) index of inequality compared absolute and relative socio-economic inequalities in IMR and stillbirth rates before and after 2010. Results IMR fell from 5.7 to 3.2 deaths per 1000 live births between 2000 and 2018, with no change in trend identified. Stillbirth rates were relatively static between 2000 and 2008 but experienced accelerated reduction from 2009 onwards. When stratified by SEP, inequalities in IMR and stillbirth rates persisted throughout the study and were greatest amongst the sub-group of post-neonates. Although comparison of the SII and RII in IMR and stillbirths before and after 2010 suggested that inequalities remained stable, descriptive trends in mortality rates displayed a 3-year rise in the most deprived quintiles from 2016 onwards. Conclusion Whilst Scotland has experienced downward trends in IMR and stillbirth rates between 2000 and 2018, the persistence of socio-economic inequalities and suggestion that mortality rates amongst the most deprived groups may be worsening warrants further action to improve maternal health and strengthen support for families with young children.

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Section: Explanation Of Findings and Comparison With Previous Literaturementioning

confidence: 64%

Trends in infant mortality and stillbirth rates in Scotland by socio-economic position, 2000–2018: a longitudinal ecological study

et al. 2021

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“…To allow us to look for disparities across Europe we split the countries into four regions; Northern (Denmark, Finland, Ireland, Norway, and Sweden, UK), Eastern (Bulgaria, Croatia, Czech Republic, Estonia, Hungry, Latvia, Lithuania, Poland, Romania, Slovakia, Slovenia, and Ukraine), Southern (Greece, Italy, Portugal, Spain, Cyprus, and Malta), and Western (Austria, Belgium, France, Germany, Luxemburg, Netherlands, and Switzerland) based on the geographic location within Europe and as used by other studies (Bosetti et al, 2010; Onambele et al, 2019).…”

Section: Methodsmentioning

confidence: 99%

“…However, deaths in childhood, particularly among children with congenital anomalies, do occur and it is therefore important to monitor changes in mortality in children as well as infants. Recent studies (Göpfert, Sethi, Rakovac, & Mitis, 2015; Lyons & Brophy, 2005; Onambele et al, 2019) have shown that all‐cause infant mortality has significantly decreased in Europe, with an annual percentage change of −3.8%; from 8.3 to 3.6 per 1,000 live births from 1994 to 2015 (Onambele et al, 2019). However, in Europe there is limited recent research in mortality of children post infancy.…”

Section: Introductionmentioning

confidence: 99%

European trends in mortality in children with congenital anomalies: 2000–2015

Pitt

Morris

2021

Birth Defects Research

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Objective To investigate if the survival of children with congenital anomalies has improved from 2000 to 2015 and whether there is heterogeneity in the improvements across Europe. Design Population‐based study of routine collected data from the WHO database on mortality and causes. Setting Data on 31 European countries from 2000 to 2015. Main outcome measures All‐cause and congenital anomaly mortality rates for infants and children up to age 9 in countries and regions of Europe. Results The relative odds of all‐cause mortality in 2015 compared with 2000 was 0.54 (95% CI: 0.50–0.59) for under 1, 0.48 (95% CI: 0.44–0.53) for ages 1–4, and 0.53 (95% CI: 0.49–0.56) for ages 5–9 with the relative odds of mortality from congenital anomalies being 0.49 (95% CI: 0.44–0.55), 0.51 (95% CI: 0.44–0.60), and 0.65 (95% CI: 0.53–0.80), respectively. The proportion of deaths from congenital anomalies remained relatively constant over time (26, 16, and 9% for under 1, ages 1–4, and ages 5–9, respectively) and was similar in all regions of Europe. For mortality from all causes and from congenital anomalies heterogeneity between countries and regions of Europe was high, with the countries in Eastern Europe having higher rates, but also experiencing greater relative reductions in mortality from 2000 to 2015. Conclusion There was a large geo‐spatial disparity in all cause and congenital anomaly mortality for infants and children up to 9. However, all regions saw a significant decrease in all cause and congenital anomaly mortality rates, with the proportions of deaths from congenital anomalies remaining constant over this time.

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“…Besides, children in Catalonia suffer the most from poverty, more than other age groups [ 11 , 12 ]. In spite of this high poverty rate, macro health indicators such as life expectancy at birth and infant mortality have improved since 1994, maintaining a similar downward trend as is seen in other European countries [ 13 , 14 ]. By contrast, poor health outcomes related to social determinants and lifestyle are indicators that have worsened in Catalonia and other similar contexts; these indicators include low birth weight rate, being overweight, higher consumption of sugary beverages, and physical activity engagement, among others [ 14 – 18 ].…”

Section: Introductionmentioning

confidence: 89%

Socioeconomic inequalities in 29 childhood diseases: evidence from a 1,500,000 children population retrospective study

2021

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Background Socioeconomic position (SEP) powerfully affects health status in the childhood population. However, the knowledge of which diseases are more affected by SEP and whose outcomes could be improved by having a more equitable society remains uncertain on a population basis. Methods We measured socioeconomic and gender inequalities in the pre-COVID-19 era for 29 diseases in the entire childhood population in Catalonia to identify which diseases are most impacted by inequalities. This population-based study included 1,449,816 children under 15 years old from 2014 to 2017 (48.52% girls) and each of their registered diagnoses within the Catalonia National Health System. We calculated frequency measures by SEP and their sex ratios for each disease. We estimated four regression-based inequality measures: slope index of inequality, relative index of inequality (RII), absolute population-attributable fraction, and population-attributable fraction. Results Twenty-five of the 29 diseases examined showed SEP inequalities. The diseases with the greatest inequalities in both sexes were tuberculosis, obesity, adjustment and anxiety disorders, essential hypertension, poisoning, short gestation, low birth weight, foetal growth retardation and intrauterine hypoxia and birth asphyxia and trauma (RII ≥ 2.0); only food allergy showed the opposite pattern (RII < 1.0). Overall, 80,188 (7.80%) of the disease events in boys and 74,921 (8.88%) in girls would be avoided if all children had the same disease rate as those in the medium-high SEP group, with tuberculosis, intrauterine hypoxia and birth asphyxia and trauma, obesity, and short gestation, low birth weight, foetal growth retardation being those that could be reduced the most in relative terms, and dermatitis, injuries, acute bronquitis, and being overweight those that could be reduced the most in absolute terms. Girls present higher RII than boys for respiratory allergy, asthma, dermatitis, being overweight, and obesity (p < 0.05). In contrast, boys showed higher RII compared to girls only in congenital anomalies (p < 0.05). Conclusions Socioeconomic and gender inequalities are widely present in childhood health. This indicates that SEP plays a common role in their development although it varies in magnitude according to each disease. It is also a phenomenon that comprises all SEP groups in society. Action needs to be taken to ensure a fairer start in life in terms of health.

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Infant mortality in the European Union: A time trend analysis of the 1994–2015 period

Cited by 12 publications

References 35 publications

Trends in infant mortality and stillbirth rates in Scotland by socio-economic position, 2000–2018: a longitudinal ecological study

Trends in infant mortality and stillbirth rates in Scotland by socio-economic position, 2000–2018: a longitudinal ecological study

European trends in mortality in children with congenital anomalies: 2000–2015

Socioeconomic inequalities in 29 childhood diseases: evidence from a 1,500,000 children population retrospective study

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