A three-part paper on child mortality, published in the latest issue of medical journal The Lancet, investigated child deaths in four high-income countries: England, the USA, Australia and New Zealand.
A group of researchers from all four countries found that 20 per cent of child deaths occurring in England between 2010 and 2011 were a result of preventable factors such as accidents, suicide, abuse or neglect.
Child mortality rates were higher in the Midlands and north England and lower in the south and east of England and Wales, the report added.
At an international level, a higher proportion of deaths in older children aged between 15 and 19 were due to external causes such as homicides in the USA, Australia and New Zealand compared with England and Wales.
The paper also highlights a ‘persistent socioeconomic gradient’ for child deaths, with children from deprived backgrounds ‘significantly more likely’ to die prematurely than their wealthier peers.
The five high-income countries with the worst child death rates (USA, New Zealand, Portugal, Canada, and the UK) were also those with the widest inequalities in income, the paper said.
The authors of the report suggested that lives were lost as a result of failures in health services, drawing on figures from the World Health Organisation which estimated that 1,500 more children die every year in the UK than in Sweden, Europe’s best-performing country for child mortality, due to poor health service provision.
In the final paper of the three-part report, the authors called for better training of healthcare staff to improve recognition of serious illnesses and knowledge of best practice guidelines to reduce avoidable child deaths.
Leader author and associate professor of child health at the University of Warwick Dr Peter Sidebotham said, ‘What these variations in mortality tell us is that more could be done to prevent child deaths across all age groups.
‘Although some contributing factors are relatively fixed, including a child’s age, sex, and genetics, many environmental, social, and health service factors are amenable to interventions that could lessen risks and help prevent future deaths.’
He called on governments to do more to reduce preventable child mortality rates. ‘It needs to be recognised that many child deaths could be prevented through a combination of changes in long-term political commitment, welfare services to tackle child poverty, and health-care services. Politicians should recognise that child survival is as much linked to socioeconomic policies that reduce inequality as it is to a country’s overall gross domestic product and systems of health-care delivery.
Dr Hilary Cass, president of the Royal College of Paediatrics and Child Health, said the report represented a ‘serious wake-up call’ for both healthcare professionals and policy makers.
‘As healthcare professionals, first and foremost we have to take responsibility for making improvements that relate directly to the healthcare system. So that means ensuring all frontline health professionals involved in the acute assessment of children and young people are confident and competent to recognise a sick child and know what to do about it. And we must put children and young people at the heart of service delivery by developing flexible multi-disciplinary models.’
Dr Cass called for a focus on reducing the gap between rich and poor and more support for disadvantaged families to help improve the UK’s record on child mortality.
‘Only with collective action and some bold policies will we be able to make inroads into tackling the UK’s poor child mortality rate. As more data and information emerges, it’s becoming all the more clear that acting quickly is vital if we’re to save children’s lives.’
- The report can be found here
