New figures show that there were 3 743 deaths in children in the year ending March 2023 – up from 3 452 the previous year, with experts citing poverty as a major factor.
Estimates for England suggest that deaths were highest for children of Black or Black British ethnicity, as well as youngsters living in poor and disadvantaged areas.
The figures come from the National Child Mortality Database (NCMD, 2023), a collaboration of universities, as well as health and bereavement organisations, and show the steepest rise in child mortality was for under-5-year-olds. Research is continuing to try to establish the reason for this phenomenon.
The NCMD includes data from reviews of all children who die at any time after birth and before their 18th birthday and was set up in 2019.
For 2023, it estimated that:
- The child death rate went up from 29.3 to 31.8 per 100 000 children
- The death rates in the poorest areas were more than twice as high as in the richest
- For children of Black or Black British ethnicity, the death rate stood at 56.6 per 100 000
- For children of Asian or Asian British ethnicity, the figure was 50.8
- It was much less for children of White ethnicity, at 25.5
While death rates continued to rise for children of Black and Black British ethnicities, the death rate for children of White ethnicity was similar to the previous year. For infants (under 1 year of age) the report shows:
- The death rate increased from 3.6 per 1 000 live births in 2022 to 3.8 In 2023
- The death rate for the poorest went up from 5.4 per 1 000 infant population in 2022 to 5.9 In 2023
- This was more than twice that of infants in least deprived neighbourhoods
- The infant death rate was highest for infants of Black or Black British ethnicity (8.7 per 1 000 live births), approximately three times the rate of infants of White ethnicity
- The death rate for infants of Asian or Asian British ethnicity was 6.2 per 1 000 live births
The data also suggested that while infant death rates for youngsters of Black and Asian ethnicity increased in comparison to the previous year, the death rates for infants of White ethnicity stayed steady.
The director of the NCMD and professor of neonatal medicine at the University of Bristol, Prof Karen Luyt, told the BBC that infant mortality was a standard by which countries judge the state of their healthcare (Mundasad, 2023). In most high-income countries the figures were improving – but not in England.
She said there were many different factors behind England's figures, but increasing deprivation since the pandemic was one of the main reasons. ‘Most infant deaths are due to prematurity and we know people who live in social deprivation are at higher risks of premature births,’ she said.
‘There is also evidence that women from ethnic minorities do not always feel as welcome in the health service, and capacity and resources in healthcare services are also constrained.’
The Royal College of Paediatrics and Child Health (RCPCH) described the figures as ‘devastating’. The organisation's president, Dr Camilla Kingdon, said: ‘Every death of a child or young person is a unique tragedy, so the latest NCMD figures make for a devastating read. The data now shows that infants and children living in deprived areas are more than twice as likely to die than those in less deprived areas.
‘The data now shows that infants and children living in deprived areas are more than twice as likely to die than those in less deprived areas.’
‘This is a harrowing but avoidable statistic. Behind this awful data published today, is a whole raft of deteriorating child health outcomes and the clear driver is rising child poverty in the UK.
‘Poverty, health inequalities and the associated loss of life is not inevitable. Poverty is a political choice, and our government has had ample opportunity to tackle it. If our government wants to get serious about health, then it must also get serious about poverty and inequality.
‘Infant mortality is a globally recognised sign of how well a country is looking after the health of its citizens. What do today's figures then tell us? Figures such as these in a nation as rich as ours are unforgivable.
‘Reducing child poverty must finally become a national priority. We need to see a clear strategy, with measurable targets across national and local levels, and a strong emphasis on preventative health measures. This has to be a wake-up call for us all and I urge our political leaders to action.’
Dr Jackie Bradley, a GP working in the West Midlands, agreed with the RCPCH analysis of the figures. She said: ‘In recent years, GPs have seen a rise in illnesses among children, and in families generally, that are typically associated with disadvantage and poverty, so it is not surprising that health organisations are linking these factors to deaths.
‘Reducing child poverty must finally become a national priority. We need to see a clear strategy, with measurable targets across national and local levels, and a strong emphasis on preventative health measures …’
‘A poor diet and living conditions, such as cold and damp houses, all contribute to increased sickness and children – who are still developing physically – can suffer more than adults.
‘Unless there is the political will to lift people out of the spiral of poverty in which many now find themselves, then I'm afraid we can't expect to see any improvement in these figures in the foreseeable future.’
According to the government there are 1.7 million fewer people living in absolute poverty than in 2010, including 400 000 children, and a record support package worth £3 300 per household on average was being provided to families.
‘From October 2022, local maternity and neonatal systems began to publish equity and equality action plans to tackle disparities experienced by women and babies from ethnic minorities and those living in the most deprived areas,’ a spokesman told the BBC (Mundasad, 2023).
The National Child Mortality Database (NCMD) programme is commissioned by the Healthcare Quality Improvement Partnership (HQIP) as part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP). The programme was established and is delivered by the University of Bristol, in collaboration with the University of Oxford's National Perinatal Epidemiology Unit (NPEU), UCLPartners and the software company QES.
It also includes representation from bereaved families through the NCMD charity partners: Child Bereavement UK, The Lullaby Trust and Sands.