Prematurity, congenital abnormalities and infections are all taking toll on young children in UK, according to researchers from Nottingham.
The death rate among pre-school children in the UK is almost double that of Sweden, their study found. The findings, published online in Archives of Disease in Childhood, prompted the researchers to call for a stronger focus on prevention in the UK.
“The differences in mortality rates for a wide variety of clinical conditions… raise important questions about the organisation and delivery of services for young children in the UK”
The Nottingham University researchers compared causes of death among children under the age of five in the UK and Sweden, using data spanning 2006-08.
The child death rate is considered by UNICEF to be a barometer of children’s health within any given country, say the researchers, but it is higher in the UK than in many other European countries.
The researchers chose Sweden as the comparator country as it has one of the lowest child death rates in Europe, has comparable levels of economic and social development and has healthcare free at the point of access.
During the study period, the total number of live births was 2,295,964 in the UK and 315,884 in Sweden. But the death rate among this age group was significantly higher in the UK – amounting to 614 per 100,000 of the pre-school population, compared with 328 per 100,000 in Sweden.
The primary causes of death in the UK were problems associated with premature birth, congenital abnormalities, and infections, the respective rates of which per 100,000 of the pre-school population were 138.5, 112.1, and 63.9.
The equivalent figures for the same three conditions in Sweden were 10.1 – representing a 13-fold difference – 88.6 and 34.8.
The three main causes of death for the under-fives in Sweden were inborn abnormalities, complications of pregnancy and labour, and infections. But both newborns and young children were significantly more likely to die of treatable infections, such as pneumonia, meningitis, and septicaemia in the UK than they were in Sweden.
“The high mortality rate from prematurity in the UK is not a reflection on the quality of neonatal intensive care,” said the researchers. “It is, however, a reflection on the adverse social determinants of health in the UK that result in a large number of preterm births.”
They added: “The differences in mortality rates for a wide variety of clinical conditions, including respiratory disorders in both young children and neonates, cardiovascular, gastrointestinal, and neurological disorders raise important questions about the organisation and delivery of services for young children in the UK.”
They suggested that money would be better spent looking into why children do not get prompt care with existing treatments rather than evaluating new medicines.