To Explain Rising Mortality Rates By The Change In Population

We’ve another report insisting that austerity is murdering us all in our beds. This not necessarily being quite the truth. For the claim actually is that rising inequality is killing our kidz. Which is a difficult thing to prove:

The report from the Office for National Statistics (ONS), covering 2017, said that “the infant mortality rate increased to 3.9 deaths per 1,000 live births compared with 3.8 in 2016”. In 2014, it was 3.6 deaths per 1,000. The situation had been improving steadily until 2014, when it went into reverse. This should not be happening, especially in one of the largest economies in the world. Alarmingly, when declines such as this have occurred elsewhere, for example in the Soviet Union in the 1980s, it has been an early marker of severe problems in society. But while these figures are sufficiently concerning in their own right, they are national averages and the situation is even worse in some places. In the most deprived areas of England, babies were almost twice as likely to die within the first year of life (5.2 deaths per 1,000 live births) than those in the least deprived areas (2.7 deaths per 1,000 live births). Equally concerning, the UK now lags well behind many other European countries, with 24 nations achieving better rates out of the 42 with available data for 2017.

Entirely fair to insist this is a problem. At which point we want to know what is the cause.

Prof Russell Viner, president of the Royal College of Paediatrics and Child Health, said: “To address the UK’s dismal infant mortality rates, it is paramount that the government take immediate steps to tackle social inequality and improve maternal and early years care.” This is not the first time urgent action has been called for.

It’s unlikely to be that social inequality. Quite why the kid two houses over having a third pair of trainers when you’ve only got two causes death to babies is a little difficult to prove. Further, we’ve this:

This is evidence of rising inequality, is it?

That is, we’ve not had a rise in inequality in recent years.

So, what might it be?

Life expectancy, mortality rates and infant mortality are the most important statistics a nation can produce about its health – and the UK’s are not only stalling, but worsening, falling behind international trends. These developments must surely be a concern for an incoming prime minister, but what can be done? The first priority must be to determine why they are happening. We can exclude some obvious explanations. While flu may explain some of the increasing deaths at older ages, it cannot explain them all, and it certainly cannot play a major role in the increasing deaths at younger ages. Nor have any data errors or mass population changes been reported.

Well, actually, we have had a mass population change. Probably the largest population change in the history of these islands in fact. Over such a short period of time anyway. And one of those major changes has been a substantial immigration of a group – Pakistani – that often embraces first cousin marriage. Something that roughly – among that population of course – doubles the chances of severe natal disability.

Now, I don’t insist that this is enough to move those national numbers. But I’d want to see someone proving that it isn’t before I accept that it isn’t. Note that just noting percentage of population isn’t enough. The much higher fertility rate also needs to be taken into account.

The inequality point stands either way. As we’ve not had rising inequality this past decade – recessions always collapse it – that can’t be the cause now, can it?

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Rhoda Klapp
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Rhoda Klapp

Are there any publicly available stats which would confirm or refute the problem to which you allude? (I’m sure you are right).

Rhoda Klapp
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Rhoda Klapp

And..the rate in the West Midlands is 6.0. Congenital problems account for 10% of infant mortality overall. The rate in Wales is 3.0. Is there less inequality in Wales?

Rhoda Klapp
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Rhoda Klapp

OK, found the details I was looking for. ONS website. Deaths per 100,000 births

Bangla 3.3
Indian 3.3
Pakistani 4.9
African 4.5
Caribbean 4.7
White British 2.3
White other 2.3

The worst three groups made up 58000 out of 695000 births. These numbers for neonatal deaths, infant deaths have similar rates.

Matt
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Matt

Done a little additional munging on the 2015 birth year and 2016 birth year infant mortality statistics (which are the most recent available, here: https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/datasets/infantmortalitybirthcohorttablesinenglandandwales)

If you take the statistics for total number of births (vs live births), we don’t have an increase in infant mortality. It looks like what’s happened is that a number of weak babies that would have been stillborn in 2015 survived long enough to make it into the infant mortality stats in 2016.