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'Unprecedented' rise in infant mortality in England linked to poverty

Welfare cuts in the last decade have taken their toll on certain communities, new research has found.

AN “UNPRECEDENTED” RISE in infant mortality in England is linked to poverty, according to new research.

An additional 570 infant deaths, compared to what would have been expected based on historical trends, were recorded in the country from 2014-2017. 

About one-third of those deaths, which related to children under the age of one, were linked to rising poverty.

Rising infant mortality is unusual in high income countries, and international statistics show that infant mortality has continued to decline in most rich countries in recent years.

The results of a new study by researchers from the University of Liverpool, University of Leeds and Newcastle University, which analysed data from 2000-2017, have now been released. 

In their report, published in BMJ Open, the researchers note that infant mortality rates often act as an indicator of the changing overall health of societies, as well as an early warning system for future adverse trends.

The researchers grouped 324 local authorities into five categories (quintiles) based on their level of income deprivation, with Quintile 1 being 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.

The researchers found that “a 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.

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.

An additional 572 deaths

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 one-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.

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

“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.

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 said 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,” he added. 

Welfare cuts 

The report notes the impact of “sustained reductions” in welfare benefits in England in the last decade. It states:

Since 2010, there have been sustained reductions in the welfare benefits available to families with children, including the abolition of child benefit and child tax credit for the third child or more; reductions in the value of tax credits and below-inflation up-rating of most working-age benefits; housing benefit reforms including the under occupancy charge (most commonly referred to as ‘bedroom tax’) and introduction of universal credit; and household caps on total benefit receipt (regardless of how many children are in the household).

“These welfare changes have disproportionately affected the most deprived local authorities and regions and have led to a rise in child poverty.”

Dr Paul Norman of the University of Leeds, who also worked on the research, noted that the findings show “an unprecedented rise in the deaths of children under one year of age”.

He said the researchers’ next step is “to examine the gestational age and the number of weeks at which infants die, to learn more about when key interventions may be needed or when they are being missed”.

“This will inform the urgent action needed by national and local governments, and help drive the health and social care policies needed to reduce infant mortality rates,” Norman said. 

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    Mute briewee
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    Nov 18th 2011, 9:00 AM

    a doctor has to prescribe a these so they should be talking to doctors who over prescribe them. my doctor will not give one unless he feels its warrants it and with children he rather lets it run its course where possible. it is not the patients fault they feel sick and go to the doctors just to make sure it is ok, at the end of the check up the doctor decides what to prescribe not the patient

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    Mute InTrapWeTrust
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    Nov 18th 2011, 9:13 AM

    Fair point re doctors, but I know myself, a lot of people self diagnose and use anti-biotics they purchased abroad or got from friends which is obviously wrong and can really cause long term harm.

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    Mute Tom Mc Carthy
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    Nov 18th 2011, 9:30 AM

    ironically most don’t realise that if your illness is viral and you take antibiotics you actually lower your immunity further. I presume there is bad news on way from HSE, they have never taken this issue seriously but suddenly they need to look like they’re doing something?

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    Mute Sean Armstrong
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    Nov 18th 2011, 9:35 AM

    Nah it’s more of a global WHO thing. And the immunity thing… Not sure what you’re getting at there, maybe suppressing gut flora? Pretty unlikely on the antibiotics used by GPs for the amount of time that they are taken.

    More of an issue is people taking the full course of antibiotics. Take them all you silly people, we don’t say take for 5 days when 2 will do, it’s to ensure full eradication of the bug.

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    Mute Paula Nolan
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    Nov 18th 2011, 11:22 AM

    If I had read this 25 years ago, I might have been impressed at the HSE tackling the issue, and dictating best practice. I might have been impressed with a public information campaign. I’d have been impressed at a public information campaign being second in importance to a campaign to stop GPs giving antibiotics to people like they were lollipops. A quarter of a century later, I am far from impressed. Way too little, way too late. The waste of time and the waste of money involved by GPs prescribing unnecessary antibiotics pales into insignificance in the face of the incalculable loss of life, and loss of quality of life. For seven years they train, with the major help of our taxes, and then behave like sheer idiots in this regard. Over the decades, every time I hear a work colleague chime, “I’ve a bit of a cold so I’m going to the doc for some antibiotics” I get so angry. I know they’ll be sick again in two week’s time, because the antibiotics will mess with their immune system – their resistance to the person next to them on the bus coughing will be minimal to nought. We will never know how many people have died due to hospital acquired infection due to antibiotics being resistant to bacteria, due to antibiotic overuse and abuse. I know someone who chose not to have a surgery to reduce his chance of a cancer recurrence, because he’d witnessed so many people battling bacterial infections post surgery. On balance, he felt the risk of a recurrence was the lesser risk. I have to wonder ‘why now?’ with this unspeakably overdue statement from the HSE. Why not a quarter of a century ago? Is there a lucrative pharma deal languishing in the filing cabinet of a penthouse office suite? Or recently shredded? Are we getting Messages From Merkel that we have to act upon? Is there a good solid reason why insanity in this regard has prevailed for so long? Did someone in the HSE just take their reality check medication? Answers please.

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    Mute Saoilí
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    Nov 18th 2011, 9:55 AM

    The HSE has diagnosed the illness; people are taking too many antibiotics. But it has prescribed the wrong treatment: http://saoili.blogspot.com/2011/11/open-letter-to-dr-fidelma-fitzpatrick.html

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    Mute Paula Nolan
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    Nov 18th 2011, 10:07 AM

    Good letter. Personally I never go to a GP with a cold or flu unless I need a sick cert for work. I let it run its course. If it feels like it’s getting into other territories: strep throat, lung infection – then I’d go to GP.

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    Mute Sean
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    Nov 18th 2011, 11:04 AM

    Good article on this. People in this country do love their anti-biotics a bit too much…

    http://www.reuters.com/article/2011/11/17/antibiotic-superbugs-europe-idUSL5E7MH2A420111117

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    Mute Saffron Marriott
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    Nov 18th 2011, 1:52 PM

    I was in the UK over 20 years ago and I read a public information poster about doctors being incentivised not to prescribe unnecessary antibiotics. Why has it taken the HSE so long. Having spent the last 10 years working in childcare it depressed me to see how many children and staff are given antibiotics for viral illnesses. I can only think that doctors are doing this to justify the fees they charge. After all, if someone pays 45 euros for a doctors visit they don’t want to come away empty handed.

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    Mute Dark Stormnm
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    Nov 19th 2011, 10:58 PM

    I can only blame the gobshite Irish public for bacterial resistance to antibiotics and their overuse. I heard one lady proclaim that her doctor was a “rip-off” because he had diagnosed her throat infection as being viral, and had not prescribed antibiotics. She felt she had wasted 50 euro because she left his surgery without a prescription. Her attitude is not uncommon, and is commonly seen across Ireland with patients plaguing GP’s to prescribe antibiotics or harassing pharmacies for a “repeat” of some antibiotic they were prescribed many moons ago. All so “the kitchen sink can be thrown at the problem” and to “hit ” the infection, even if that infection is viral and they have been informed of this.

    But then again the Irish are complete gobshites in many ways from the IMF being here to voting FF in three times, to building housing estates without sewerage connected in the middle of nowhere, the contempt with which law and order is held, to the likes of Jackie Healy Rae being in the Dail or drunken Cowen singing off the back of lorries in Clara, etc.

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    Mute Oskar Fritsche
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    Nov 18th 2011, 12:21 PM

    So When are the HSE being disbanded the sooner the better.

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