scholarly journals Assessing the impact of rising child poverty on the unprecedented rise in infant mortality in England, 2000–2017: time trend analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e029424 ◽  
Author(s):  
David Taylor-Robinson ◽  
Eric T C Lai ◽  
Sophie Wickham ◽  
Tanith Rose ◽  
Paul Norman ◽  
...  
Keyword(s):  
Infant Mortality ◽  
Fixed Effects ◽  
Child Poverty ◽  
Infant Mortality Rate ◽  
Historical Trends ◽  
Local Authorities ◽  
Infant Deaths ◽  
Live Births ◽  
Fixed Effects Regression ◽  
The Impact

ObjectiveTo determine whether there were inequalities in the sustained rise in infant mortality in England in recent years and the contribution of rising child poverty to these trends.DesignThis is an analysis of trends in infant mortality in local authorities grouped into five categories (quintiles) based on their level of income deprivation. Fixed-effects regression models were used to quantify the association between regional changes in child poverty and regional changes in infant mortality.Setting324 English local authorities in 9 English government office regions.ParticipantsLive-born children under 1 year of age.Main outcome measureInfant mortality rate, defined as the number of deaths in children under 1 year of age per 100 000 live births in the same year.ResultsThe sustained and unprecedented rise in infant mortality in England from 2014 to 2017 was not experienced evenly across the population. In the most deprived local authorities, the previously declining trend in infant mortality reversed and mortality rose, leading to an additional 24 infant deaths per 100 000 live births per year (95% CI 6 to 42), relative to the previous trend. There was no significant change from the pre-existing trend in the most affluent local authorities. As a result, inequalities in infant mortality increased, with the gap between the most and the least deprived local authority areas widening by 52 deaths per 100 000 births (95% CI 36 to 68). Overall from 2014 to 2017, there were a total of 572 excess infant deaths (95% CI 200 to 944) compared with what would have been expected based on historical trends. We estimated that each 1% increase in child poverty was significantly associated with an extra 5.8 infant deaths per 100 000 live births (95% CI 2.4 to 9.2). The findings suggest that about a third of the increases in infant mortality between 2014 and 2017 can be attributed to rising child poverty (172 deaths, 95% CI 74 to 266).ConclusionThis study provides evidence that the unprecedented rise in infant mortality disproportionately affected the poorest areas of the country, leaving the more affluent areas unaffected. Our analysis also linked the recent increase in infant mortality in England with rising child poverty, suggesting that about a third of the increase in infant mortality from 2014 to 2017 may be attributed to rising child poverty.

scholarly journals Smoke-free legislation and neonatal and infant mortality in Brazil: longitudinal quasi-experimental study

2019 ◽  
pp. tobaccocontrol-2019-054923 ◽  
Author(s):  
Thomas Hone ◽  
Andre Salem Szklo ◽  
Filippos T Filippidis ◽  
Anthony A Laverty ◽  
Isabela Sattamini ◽  
...  
Keyword(s):  
Experimental Study ◽  
Mortality Rate ◽  
Infant Mortality ◽  
Neonatal Mortality ◽  
Fixed Effects ◽  
Infant Health ◽  
Infant Mortality Rate ◽  
Infant Deaths ◽  
Quasi Experimental ◽  
Fixed Effects Regression

ObjectiveTo examine the associations of partial and comprehensive smoke-free legislation with neonatal and infant mortality in Brazil using a quasi-experimental study design.DesignMonthly longitudinal (panel) ecological study from January 2000 to December 2016.SettingAll Brazilian municipalities (n=5565).ParticipantsInfant populations.InterventionSmoke-free legislation in effect in each municipality and month. Legislation was encoded as basic (allowing smoking areas), partial (segregated smoking rooms) or comprehensive (no smoking in public buildings). Associations were quantified by immediate step and longer term slope/trend changes in outcomes.Statistical analysesMunicipal-level linear fixed-effects regression models.Main outcomes measuresInfant and neonatal mortality.ResultsImplementation of partial smoke-free legislation was associated with a −3.3 % (95% CI −6.2% to −0.4%) step reduction in the municipal infant mortality rate, but no step change in neonatal mortality. Comprehensive smoke-free legislation implementation was associated with −5.2 % (95% CI −8.3% to −2.1%) and −3.4 % (95% CI −6.7% to −0.1%) step reductions in infant and neonatal mortality, respectively, and a −0.36 (95% CI −0.66 to−0.06) annual decline in the infant mortality rate. We estimated that had all smoke-free legislation introduced since 2004 been comprehensive, an additional 10 091 infant deaths (95% CI 1196 to 21 761) could have been averted.ConclusionsStrengthening smoke-free legislation in Brazil is associated with improvements in infant health outcomes—particularly under comprehensive legislation. Governments should accelerate implementation of comprehensive smoke-free legislation to protect infant health and achieve the United Nation’s Sustainable Development Goal three.

Infant Mortality Among Singletons and Twins in Japan During 1999–2008 on the Basis of Risk Factors

2013 ◽  
Vol 16 (2) ◽  
pp. 639-644 ◽  
Author(s):  
Yoko Imaizumi ◽  
Kazuo Hayakawa
Keyword(s):  
Infant Mortality ◽  
Maternal Age ◽  
Survival Rates ◽  
Mortality Rates ◽  
Vital Statistics ◽  
Infant Mortality Rate ◽  
Age Group ◽  
Neonatal Deaths ◽  
Infant Deaths ◽  
Live Births

The infant mortality rate (IMR) among single and twin births from 1999 to 2008 was analyzed using Japanese Vital Statistics. The IMR was 5.3-fold higher in twins than in singletons in 1999 and decreased to 3.9-fold in 2008. The reduced risk of infant mortality in twins relative to singletons may be related, partially, to survival rates, which improved after fetoscopic laser photocoagulation for twin — twin transfusion syndrome. The proportion of neonatal deaths among total infant deaths was 54% for singletons and 74% for twins. Thus, intensive care of single and twin births may be very important during the first month of life to reduce the IMR. The IMR decreased as gestational age (GA) rose in singletons, whereas the IMR in twins decreased as GA rose until 37 weeks and increased thereafter. The IMR was significantly higher in twins than in singletons from the shortest GA (<24 weeks) to 28 weeks as well as ≥38 weeks, whereas the IMR was significantly higher in singletons than in twins from 30 to 36 weeks. As for maternal age, the early neonatal and neonatal mortality rates as well as the IMR in singletons were significantly higher in the youngest maternal age group than in the oldest one, whereas the opposite result was obtained in twins. The lowest IMR in singletons was 1.1 per 1,000 live births for ≥38 weeks of gestation and heaviest birth weight (≥2,000 g), while the lowest IMR in twins was 1.8 at 37 weeks and ≥2,000 g.

scholarly journals Impact of federal transfers upon US infant mortality rates: a secondary analysis using a fixed effects regression approach

BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e021533
Author(s):  
Michael McLaughlin ◽  
Mark R Rank
Keyword(s):  
Mortality Rate ◽  
Infant Mortality ◽  
Fixed Effects ◽  
State Level ◽  
Well Being ◽  
Mortality Rates ◽  
Postneonatal Mortality ◽  
Per Capita ◽  
Fixed Effects Regression ◽  
The Impact

ObjectivesIn order to improve health outcomes, the federal government allocates hundreds of billions of annual dollars to individual states in order to further the well-being of its citizens. This study examines the impact of such federal intergovernmental transfers on reducing state-level infant mortality rates.SettingAnnual data are collected from all 50 US states between 2004 and 2013.ParticipantsEntire US population under the age of 1 year between 2004 and 2013.Primary and secondary outcome measuresState-level infant mortality rate, neonatal mortality rate and postneonatal mortality rate.ResultsUsing a fixed effects regression model to control for unmeasurable differences between states, the impact of federal transfers on state-level infant mortality rates is estimated. After controlling for differences across states, increases in per capita federal transfers are significantly associated with lower infant, neonatal and postneonatal mortality rates. Holding all other variables constant, a $200 increase in the amount of federal transfers per capita would save one child’s life for every 10 000 live births.ConclusionsConsiderable debate exists regarding the role of federal transfers in improving the well-being of children and families. These findings indicate that increases in federal transfers are strongly associated with reductions in infant mortality rates. Such benefits should be carefully considered when state officials are deciding whether to accept or reject federal funds.

Regional Contribution of Previable Infant Deaths to Infant Mortality Rates in the United States

2019 ◽  
Author(s):  
MacKenzie Lee ◽  
Eric S. Hall ◽  
Meredith Taylor ◽  
Emily A. DeFranco
Keyword(s):  
United States ◽  
Infant Mortality ◽  
Infant Death ◽  
The United States ◽  
Mortality Rates ◽  
Population Based ◽  
Infant Mortality Rate ◽  
Infant Deaths ◽  
Live Births ◽  
Healthy People 2020

Objective Lack of standardization of infant mortality rate (IMR) calculation between regions in the United States makes comparisons potentially biased. This study aimed to quantify differences in the contribution of early previable live births (<20 weeks) to U.S. regional IMR. Study Design Population-based cohort study of all U.S. live births and infant deaths recorded between 2007 and 2014 using Centers for Disease Control and Prevention's (CDC's) WONDER database linked birth/infant death records (births from 17–47 weeks). Proportion of infant deaths attributable to births <20 vs. 20 to 47 weeks, and difference (ΔIMR) between reported and modified (births ≥20 weeks) IMRs were compared across four U.S. census regions (North, South, Midwest, and West). Results Percentages of infant deaths attributable to birth <20 weeks were 6.3, 6.3, 5.3, and 4.1% of total deaths for Northeast, Midwest, South, and West, respectively, p < 0.001. Contribution of < 20-week deaths to each region's IMR was 0.34, 0.42, 0.37, and 0.2 per 1,000 live births. Modified IMR yielded less regional variation with IMRs of 5.1, 6.2, 6.6, and 4.9 per 1,000 live births. Conclusion Live births at <20 weeks contribute significantly to IMR as all result in infant death. Standardization of gestational age cut-off results in more consistent IMRs among U.S. regions and would result in U.S. IMR rates exceeding the healthy people 2020 goal of 6.0 per 1,000 live births.

scholarly journals ANALYSIS OF CHARACTERISTICS OF INFANT DEATH RATE (2015-2019) IN UPTD PUSKESMAS JAPARA KUNINGAN DISTRICT, 2020

2021 ◽  
Vol 1 (1) ◽  
pp. 12-22
Author(s):  
Yona Septina ◽  
Luthfiah Zakiyah ◽  
Heri Hermansyah ◽  
Siti Nunung Nurjannah
Keyword(s):  
Mortality Rate ◽  
Infant Mortality ◽  
Maternal Age ◽  
Sampling Technique ◽  
Infant Mortality Rate ◽  
P Value ◽  
Test Technique ◽  
Infant Deaths ◽  
Live Births ◽  
Birth Attendants

Infant mortality is a death incident that occurs in newborns up to <1 year of age. Infant mortality is measured as the infant mortality rate, which is the number of deaths for children under 1 year of age per 1000 births. According to WHO, the infant mortality rate in Indonesia reaches 27/1000 live births. Based on the health profile of West Java, the number of infant deaths in 2017 reached 3.4 / 1000 live births. In the UPTD Puskesmas Japara there are 34 cases of infant mortality. Infant mortality is caused by several factors, including maternal age, education, birth attendants, and parity. The research objective was to determine the analysis of the characteristics of the incidence of infant mortality in 2015-2019 at the UPTD Puskesmas Japara, Kuningan Regency. The research method used was quantitative with a retrospective design, taken from secondary data 2015-2019, the population in the study was all infant deaths in the UPTD Puskesmas Japara, amounting to 34 people. Selection of a sample of 34 people using the total sampling technique. The statistical test technique uses the Chi Square test. The results showed that there was a relationship between parity (p-value = 0.006) and there was no relationship between maternal age (p-value = 0.129), education (p-value = 0.156), birth attendants (p-value = 0.781) and death. babies in 2015-2019 at UPTD Puskesmas Japara, Kuningan Regency. It can be concluded that the incidence of infant mortality occurs in some mothers with no risk age, some mothers with primary education, some mothers with multiparity parity. Suggestions for health centers are expected to increase the priority of health programs in an effort to reduce the incidence of infant mortality.

scholarly journals How many infants may have died in low-income and middle-income countries in 2020 due to the economic contraction accompanying the COVID-19 pandemic? Mortality projections based on forecasted declines in economic growth

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e050551
Author(s):  
Gil Shapira ◽  
Damien de Walque ◽  
Jed Friedman
Keyword(s):  
Infant Mortality ◽  
Health Services ◽  
Low Income ◽  
Infant Mortality Rate ◽  
Demographic And Health Surveys ◽  
Income Shocks ◽  
Middle Income ◽  
Infant Deaths ◽  
Middle Income Countries ◽  
The Impact

ObjectivesWhile COVID-19 has a relatively small direct impact on infant mortality, the pandemic is expected to indirectly increase mortality of this vulnerable group in low-income and middle-income countries through its effects on the economy and health system performance. Previous studies projected indirect mortality by modelling how hypothesised disruptions in health services will affect health outcomes. We provide alternative projections, relying on modelling the relationship between aggregate income shocks and mortality.DesignWe construct a sample of 5.2 million births by pooling retrospective birth histories reported by women in Demographic and Health Surveys conducted in 83 low-income and middle-income countries between 1985 and 2018. We employ regression models with country-specific fixed-effects and flexible time trends to estimate the impact of gross domestic product per capita on infant mortality rate. We then use growth projections by the International Monetary Fund to predict the effect of the economic downturn in 2020 on infant mortality.ResultsWe estimate 267 208 (95% CI 112 000 to 422 415) excess infant deaths in 128 countries, corresponding to a 6.8% (95% CI 2.8% to 10.7%) increase in the total number of infant deaths expected in 2020.ConclusionsThe findings underscore the vulnerability of infants to the negative income shocks such as those imposed by the COVID-19 pandemic. While efforts towards prevention and treatment of COVID-19 remain paramount, the global community should also strengthen social safety nets and assure continuity of essential health services.

scholarly journals The impact of New Labour’s English health inequalities strategy on geographical inequalities in infant mortality: a time-trend analysis

2019 ◽  
Vol 73 (6) ◽  
pp. 564-568 ◽  
Author(s):  
Tomos Robinson ◽  
Heather Brown ◽  
Paul D Norman ◽  
Lorna K Fraser ◽  
Ben Barr ◽  
...  
Keyword(s):  
Infant Mortality ◽  
Health Inequalities ◽  
Evidence Base ◽  
Early Years ◽  
Infant Mortality Rate ◽  
Segmented Regression ◽  
Local Authorities ◽  
Geographical Inequalities ◽  
Segmented Regression Analysis ◽  
The Impact

BackgroundThe English health inequalities strategy (1999–2010) aimed to reduce health inequalities between the most deprived local authorities and the rest of England. The multifaceted strategy included increased investment in healthcare, the early years, education and neighbourhood renewal. The objective of this study was to investigate whether the strategy was associated with a reduction in geographical inequalities in the infant mortality rate (IMR).MethodsWe used segmented regression analysis to measure inequalities in the IMR between the most deprived local authorities and the rest of England before, during and after the health inequalities strategy period.ResultsBefore the strategy was implemented (1983–1998), absolute inequalities in the IMR increased between the most deprived local authorities and the rest of England at a rate of 0.034 annually (95% CI 0.001 to 0.067). Once the strategy had been implemented (1999–2010), absolute inequalities decreased at a rate of −0.116 annually (95% CI −0.178 to −0.053). After the strategy period ended (2011–2017), absolute inequalities increased at a rate of 0.042 annually (95% CI −0.042 to 0.125). Relative inequalities also marginally decreased during the strategy period.ConclusionThe English health inequalities strategy period was associated with a decline in geographical inequalities in the IMR. This research adds to the evidence base suggesting that the English health inequalities strategy was at least partially effective in reducing health inequalities, and that current austerity policies may undermine these gains.

scholarly journals Narrowing inequalities in infant mortality in Southern Brazil

2002 ◽  
Vol 36 (4) ◽  
pp. 478-483 ◽  
Author(s):  
Marcelo Zubaran Goldani ◽  
Rosange Benatti ◽  
Antônio Augusto Moura da Silva ◽  
Heloisa Bettiol ◽  
Joel Cristiano Westphal Correa ◽  
...  
Keyword(s):  
Infant Mortality ◽  
Maternal Education ◽  
Geographic Area ◽  
Infant Mortality Rate ◽  
Chi Square ◽  
Infant Deaths ◽  
Live Births ◽  
Maternal Schooling ◽  
Chi Square Test ◽  
Maternal Educational Level

OBJECTIVE: To determine the trends of infant mortality from 1995 to 1999 according to a geographic area-based measure of maternal education in Porto Alegre, Brazil. METHODS: A registry-based study was carried out and a municipal database created in 1994 was used. All live births (n=119,170) and infant deaths (n=1,934) were considered. Five different geographic areas were defined according to quintiles of the percentage of low maternal educational level (<6 years of schooling): high, medium high, medium, medium low, and low. The chi-square test for trend was used to compare rates between years. Incidence rate ratio was calculated using Poisson regression to identify excess infant mortality in poorer areas compared to higher schooling areas. RESULTS: The infant mortality rate (IMR) decreased steadily from 18.38 deaths per 1,000 live births in 1995 to 12.21 in 1999 (chi-square for trend p<0.001). Both neonatal and post-neonatal mortality rates decreased although the drop seemed to be steeper for the post-neonatal component. The higher decline was seen in poorer areas. CONCLUSION: Inequalities in IMR seem to have decreased due to a steeper reduction in both neonatal and post-neonatal components of infant mortality in lower maternal schooling area.

Trends in and determinants of neonatal and infant mortality in Nigeria based on Demographic and Health Survey data

2020 ◽  
pp. 1-11
Author(s):  
Kamalesh Kumar Patel ◽  
Jang Bahadur Prasad ◽  
Rajeshwari A. Biradar
Keyword(s):  
Infant Mortality ◽  
Health Survey ◽  
Mortality Rates ◽  
Demographic And Health Survey ◽  
Infant Mortality Rate ◽  
North West ◽  
Infant Deaths ◽  
Live Births ◽  
The North ◽  
West Region

Abstract This study aimed to assess the changes in neonatal and infant mortality rates in Nigeria over the period 1990 to 2018 using Nigerian Demographic and Health Survey (NDHS) data, and assess their socio-demographic determinants using data from the most recent survey conducted in 2018. The infant mortality rate was 87 per 1000 live births in 1990, and this increased to 100 per 1000 live births in 2003 – an increase of around 15% over 13 years. Neonatal and infant mortality rates started to decline steadily thereafter and continued to do so until 2013. After 2013, neonatal morality rose slightly by the year 2018. Information for 27,465 infants under 1 year of age from the NDHS-2018 was analysed using bivariate and multivariate analysis and the Cox proportional hazard technique. In 2018, infant deaths decreased as wealth increased, and the incidence of infant deaths was greater among those of Islam religion than among those of other religions. A negative association was found between infant deaths and the size of a child at birth. Infant mortality was higher in rural than in urban areas, and was higher among male than female children. Both neonatal and infant death rates varied by region and were found to be highest in the North West region and lowest in the South region. An increasing trend was observed in neonatal mortality in the 5-year period from 2013 to 2018. Policy interventions should be focused on the poor classes, women with a birth interval of less than 2 years and those living in the North West region of the country.

Measuring Effectiveness Of Economic Growth On Reducing Infant Mortality Rate In Tamilnadu

2019 ◽  
Vol 118 (4) ◽  
pp. 129-141
Author(s):  
Mr. Y. EBENEZER
Keyword(s):  
Economic Growth ◽  
Mortality Rate ◽  
Infant Mortality ◽  
Negative Relationship ◽  
Infant Mortality Rate ◽  
Domestic Product ◽  
Per Capita ◽  
The Impact ◽  
Adf Test ◽  
Bound Test

                   This paper deals with economic growth and infant mortality rate in Tamilnadu. The objects of this paper are to test the relationship between Per capita Net State Domestic Product and infant mortality rate and also to measure the impact of Per capita Net State Domestic Product on infant mortality rate in Tamil Nadu. This analysis has employed the ADF test and ARDL approach. The result of the study shows that IMR got reduced and Per capita Net State Domestic Product increased during the study period. This analysis also revealed that there is a negative relationship between IMR and the economic growth of Tamilnadu. In addition, ARDL bound test result has concluded that per capita Net State Domestic Product of Tamilnadu has long run association with IMR.

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