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Reducing infant mortalityA summary of the evidence
Dr Marilena Korkodilos Deputy Director, Specialist Public Health Services, PHE (London)Email: [email protected], 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
