Child deaths have fallen to very low rates in all industrialised countries, but many deaths in children and adolescents are still potentially preventable, and much more could be done to cut future deaths, according to a new three-part series on child deaths in high-income countries, published in The Lancet.
The series highlights the substantial number of preventable deaths. For example, 20 per cent of child deaths reviewed in England between 2010 and 2011 (800 of 4,601) were from preventable causes.
It also reveals that death rates vary widely between and within high income countries and between different age groups. For example, in England and Wales death rates tend to be higher in the Midlands and north England and lower in the south and east.
At an international level, a higher proportion of deaths in older children in the USA, Australia, and New Zealand are due to external causes such as homicides, accidents and suicides compared with England and Wales.
Professor Peter Fleming, from the School of Social and Community Medicine at the University of Bristol, was one of the authors.
He said: “This international investigation has identified contributory factors - often unexpected - to childhood deaths that may be preventable. Many of these factors are linked to potentially modifiable aspects of deprivation and are amenable to targeted interventions.”
Dr Peter Sidebotham, series leader and Associate Professor of Child Health at the University of Warwick, said: “What these variations in mortality tell us is that more could be done to prevent child deaths across all age groups.
“Although some contributing factors are relatively fixed, including a child’s age, sex, and genetics, many environmental, social, and health service factors are amenable to interventions that could lessen risks and help prevent future deaths.”
The series highlights a ‘persistent socioeconomic gradient’ for child deaths, with children from deprived backgrounds significantly more likely to die than their wealthier peers. Indeed, the five high-income countries with the worst child death rates - USA, New Zealand, Portugal, Canada, and the UK - are also those with the widest inequalities in income.
Worryingly, the series indicates that health services do not always deliver optimal care for children and lives are lost as a result. For example, WHO estimates that 1,500 more children die every year in the UK than Sweden due to poor health service provision.
The authors call for better training of healthcare staff to improve recognition of serious illnesses and knowledge of best practice guidelines to reduce avoidable child deaths.