Reducing infant mortality A summary of the evidence · 2017. 3. 30. · Email:...

Reducing infant mortalityA summary of the evidence

Dr Marilena Korkodilos Deputy Director, Specialist Public Health Services, PHE (London)Email: marilena.korkodilos@phe.gov.uk, Twitter: @DrMarilena18th January 2016

2 Source: Stillbirth and Neonatal Death Charity (2009) Saving Babies’ Lives Report 2009

‘It’s hard to put into words. It isreally devastating. I wish my babywas here to hold, feed and lookafter. Instead I have empty arms

and a box of ashes’

3 Source: ONS

0.0

2.0

4.0

6.0

8.0

10.0

12.0R

ate

per 1

,000

live

birth

s

Infant mortality Neonatal mortality Postneonatal mortality

Infant mortality in England and Wales

Source: World Bank

0

5

10

15

20

25

1960196319661969197219751978198119841987199019931996199920022005200820112014

Rat

e pe

r 1,0

00 liv

e bi

rths

United Kingdom Finland

196021.9

20141.9

91.3%

196022.9

20143.5

84.7%

Infant Mortality Rate per 1,000 live births

14 years

International comparisons

20003.5

Havering2.0 per 1,000 live births

Stoke on Trent7.9 per 1,000 live births

4xThe IMR in Stoke on Trent was 4x higher

than in Havering

Sourcehttps://fingertips.phe.or g.uk /

Health inequalities in infant mortalityInfant mortality rates (IMRs)

in England (2013-15)

Health inequalities in infant mortality

*Data for City and HackneySource: https://fingertips.phe.org.uk /Picture credits: Dr Marilena Korkodilos

Infant mortality rates (IMRs) in London (2013-15)

Inequalities in infant mortality by socio-economic group*

Data source: Office for National Statistics

* National Statistics Socio-Economic Classification (NS SEC), based on father’s occupation. Based on births inside marriage or outside marriage registered jointly by both parents, i.e. excludes sole registered births. Figures for earlier years are based on an approximation to NS SEC categories (‘NS SEC 90’).

5.95.7

5.45.2

5.04.8

4.54.3

4.2

6.7

6.46.2

6.05.9

5.6

5.3

4.74.5

3.5

4.0

4.5

5.0

5.5

6.0

6.5

7.0

1994-96 1995-97 1996-98 1997-99 1998-00 1999-01 2000-02 2001-03 2002-04 2003-05 2004-06 2005-07 2006-08 2007-09 2008-10 2009-11

NS SEC 2001NS SEC 90

‘Routine and manual’socio-economic group*

All socio-economic groups* (excluding sole registered births)

Infant deaths per 1,000 live births, England & Wales

0

Relative gap(difference in rate between ‘Routine and manual’ and ‘All’, as percentage of ‘All’ rate)

15%

12%14%

16%18%

16%

16%

10%

x%

§Infant mortality rates have fallen across socio-economic groups

§The relative gap between the routine and manual group and all socio-economic groups widened between 1996-98 and 2002-04, but has narrowed since then

§The infant mortality rate in the routine and manual group was 9% higher than for all groups in 2009-11, compared with 18% higher in 2002-04.

9%

Note: Figures for 2008-10 and 2009-11 are provisional

Causes of infant mortality (2014)

Source: ONSPicture credits: Dr Marilena Korkodilos

Risk factors for infant mortality (2014)

Source: ONS *Data for 2013Picture credits: Dr Marilena Korkodilos

What needs to be done to reduce infant mortality?

Reference: PHE (2015) Reducing infant mortality in London: An evidence based resourcePicture credits: Dr Marilena Korkodilos

Timing of actions to prevent infant mortality

Reference: DH (2007) Review of the health inequalities PSA targetPicture credits: Dr Marilena Korkodilos

Child poverty

Reference: PHE (2015) Reducing infant mortality in London: An evidence based resourcePicture credits: Dr Marilena Korkodilos

10 factors for a local strategy to reduce teenage pregnancy

SRE: Sex and relationships

education

Teenage pregnancy

Reference: PHE (2015) Reducing infant mortality in London: An evidence based resourcePicture credits: Dr Marilena Korkodilos

2003 2014

50.1 per 1,000

21.5per 1,000

From 2003-14 teenage pregnancy in girls aged 15-17 years has decreased by 57% in London

Access to antenatal care

Reference: PHE (2015) Reducing infant mortality in London: An evidence based resourcePicture credits: Dr Marilena Korkodilos

Smoking in pregnancy

Reference: PHE (2015) Reducing infant mortality in London: An evidence based resourcePicture credits: Dr Marilena Korkodilos

Maternal obesity

Reference: PHE (2015) Reducing infant mortality in London: An evidence based resourcePicture credits: Dr Marilena Korkodilos

Breastfeeding

Reference: PHE (2015) Reducing infant mortality in London: An evidence based resourcePicture credits: Dr Marilena Korkodilos

*No dataSource: https://fingertips.phe.org.uk /Picture credits: Dr Marilena Korkodilos

Breastfeeding rates in London

Ensuring that infants sleep in the

supine position -‘back to sleep’

Reducing parental smoking

Ensuring that infants sleep in the same room

as their parents

Ensuring that infants sleep in a separate

cot

Keeping the baby’s head

uncovered by placing the baby in the ‘feet to foot’

position

What works to reduce Sudden Unexpected Deaths in Infancy (SUDI)

Changing knowledge and behaviour through clear communication about the risk factors for SUDI

Encouraging and

supporting mothers to breastfeed their baby

Smoking 5x

higher risk

Low birth weight 5x

higher riskDeprivation

3.5xhigher risk

Mothers aged under 20 2.5x

higher risk

Bed sharing 2.7x

higher risk

About every 15 days in London a baby dies from a SUDI, risk factors include:

Sudden Unexpected Death in Infancy (SUDI)

Reference: PHE (2015) Reducing infant mortality in London: An evidence based resource, Picture credits: Dr Marilena Korkodilos

Reference: PHE (2015) Reducing infant mortality in London: An evidence based resource, Source: https://fingertips.phe.org.uk/ , Picture credits: Dr Marilena Korkodilos

Vaccination