England is one of the few places, other than warzones, where babies' risk of dying is rising. An analysis of these deaths' locations has shown it is a direct effect of poverty, which has been responsible for an extra 500 deaths before the age of one in recent years. The findings are a warning to the whole world that we can't take improving infant health for granted.
In any debate about whether the world is getting better or worse, the fall in infant mortality is exhibit A for optimists. Once, almost half of children died before they were five, today that is 4 percent globally and falling fast. So it is shocking to discover a rise in infant mortality in the place the child health revolution began.
The rate of infant deaths in the UK is still 100 times lower than it was before vaccinations, clean water, and antibiotics, but four successive annual rises can't be considered a blip. The University of Liverpool's Professor David Taylor-Robinson sought the causes and found it is all about poverty.
It's certainly not news that the poor have shorter life expectancies than the middle and upper classes. However, when Taylor-Robinson and colleagues broke down infant deaths by local council authority they found the rise is entirely in poorer areas, widening the income-based health gap.
Between 2014 and 2017 an extra 572 babies died in the UK beyond the numbers predicted by the previous trend, almost all in the poorest 20 percent of councils.
In BMJ Open Taylor-Robinson points to many government decisions that could have contributed to this situation, including: “The abolition of child benefit and child tax credit for the third child or more… and household caps on total benefit receipt (regardless of how many children are in the household).” Remarkably, the paper notes, a Public Health England review of rising death rates didn't even consider poverty as a potential cause.
At 30 percent, English child poverty is three times that of Scandinavia or Austria.
"These findings are really concerning given that child poverty is rising. It is time for the government to reverse this trend by establishing a welfare system that protects children from poverty,” Taylor-Robinson said in a statement.
Although increasing poverty over this period (despite it being one of economic growth) is a simple explanation, Taylor-Robinson shows this only explains a third of the extra deaths. Another 400 were concentrated in the poorest 20 percent of councils, but couldn't be related to changing economic circumstances. Instead, for reasons that are not yet clear, pre-existing income inequality appears to be producing a greater loss of life.
The authors hope in future to identify the timing and immediate causes of the extra deaths to help target solutions.